المؤلفون: Karakul A; Tarsus University, Faculty of Health Sciences, Department of Nursing, Turkey. Electronic address: atiyekarakul@gmail.com., Düzkaya DS; Tarsus University, Faculty of Health Sciences, Department of Nursing, Turkey., Bozkul G; Tarsus University, Faculty of Health Sciences, Department of Nursing, Turkey., Çapanoğlu M; Mersin Allergy and Children Clinic, Turkey.

المصدر: Journal of pediatric nursing [J Pediatr Nurs] 2024 May-Jun; Vol. 76, pp. e149-e158. Date of Electronic Publication: 2024 Mar 11.

نوع المنشور: Journal Article; Randomized Controlled Trial

بيانات الدورية: Publisher: W.B. Saunders Country of Publication: United States NLM ID: 8607529 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-8449 (Electronic) Linking ISSN: 08825963 NLM ISO Abbreviation: J Pediatr Nurs Subsets: MEDLINE

مواضيع طبية MeSH: Asthma*/drug therapy , Asthma*/therapy , Quality of Life* , Video Games* , Patient Education as Topic*/methods, Humans ; Child ; Male ; Female ; Turkey ; Mobile Applications

مستخلص: Purpose: This study aimed to examine the effect of mobile game training designed for children with asthma on inhaler use skills, asthma symptoms and treatment needs, and quality of life.
Design and Methods: This randomized controlled study was conducted between April and October 2023 at "Pediatric Asthma and Allergy Clinic" in Turkey. The sample of the study consists of a total of 74 children diagnosed with asthma, including the Mobile game (n: 37) and the Control group (n: 37). In the study, a mobile game was developed for children with asthma between the ages of 8-12. In collecting research data; Child and Parent Information Form, Inhaler Use Skill Evaluation Form, Asthma Symptom and Treatment Need Scoring (Asthma Symptom Score [ASS], Rhinitis Symptom Score [RSS] and Total Symptom Score [TSS]), DISABKIDS Asthma Scale were used.
Results: There was no significant difference between the groups in terms of the demographic status of the children (p > 0.05). It was determined that the average inhaler use skill score and DISABKIDS asthma scale Child/Parent score average of the children in the mobile game group were higher than the control group (p < 0.05). When the children's final follow-up ASS, RSS and TSS total scores were examined; It was determined that there was a statistically significant difference between the children in the mobile game and control groups (p < 0.05).
Conclusions: As a result of this study, it was determined that mobile game training designed for children is an effective method in increasing children's ability to use inhaler medications, reducing asthma symptoms and treatment needs, and improving quality of life.
Practice Implication: Nurses can improve children's quality of life by using mobile game training programs that attract children's attention.
Competing Interests: Declaration of competing interest The authors declare that they have no conflict of interests.
(Copyright © 2024. Published by Elsevier Inc.)

المؤلفون: Sudarshan M; Section of Thoracic Surgery, Department of Thoracic and Cardiovascular Surgery, Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio., Bribriesco AC; Section of Thoracic Surgery, Department of Thoracic and Cardiovascular Surgery, Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio. Electronic address: bribria@ccf.org.

المصدر: Seminars in thoracic and cardiovascular surgery [Semin Thorac Cardiovasc Surg] 2022 Spring; Vol. 34 (1), pp. 373-374. Date of Electronic Publication: 2021 May 15.

نوع المنشور: Editorial; Comment

بيانات الدورية: Publisher: W.B. Saunders Country of Publication: United States NLM ID: 8917640 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-9488 (Electronic) Linking ISSN: 10430679 NLM ISO Abbreviation: Semin Thorac Cardiovasc Surg Subsets: MEDLINE

مواضيع طبية MeSH: Patient Education as Topic*, Humans ; Treatment Outcome

المؤلفون: Watson E, Kumar R, Tabio L, Shpigel D

المصدر: Archives of physical medicine and rehabilitation [Arch Phys Med Rehabil] 2021 Dec; Vol. 102 (12), pp. 2491-2493. Date of Electronic Publication: 2021 Sep 10.

نوع المنشور: Journal Article; Research Support, Non-U.S. Gov't

بيانات الدورية: Publisher: W.B. Saunders Country of Publication: United States NLM ID: 2985158R Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-821X (Electronic) Linking ISSN: 00039993 NLM ISO Abbreviation: Arch Phys Med Rehabil Subsets: MEDLINE

مواضيع طبية MeSH: Patient Education as Topic*, Brain Injuries, Traumatic/*complications , Brain Injuries, Traumatic/*therapy , Sleep Wake Disorders/*etiology , Sleep Wake Disorders/*therapy, Humans

المؤلفون: Koch-Weser S; Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston., Porteny T; Department of Occupational Therapy, Tufts University, Medford, Massachusetts., Rifkin DE; Division of Nephrology, Veterans Affairs Healthcare System and University of California, San Diego, San Diego, California., Isakova T; Center for Translational Metabolism and Health, Institute for Public Health and Medicine, Chicago, Illinois., Gordon EJ; Department of Surgery, Division of Transplantation, Center for Health Services and Outcomes Research, and Center for Bioethics and Medical Humanities, Chicago, Illinois., Rossi A; Piedmont Transplant Institute, Atlanta, Georgia., Baumblatt GL; Northwestern University Feinberg School of Medicine; Articulations Consulting, Chicago, Illinois., St Clair Russell J; National Kidney Foundation, New York, NY., Damron KC; Dialysis Clinics Inc, Spartanburg, South Carolina., Wofford S; Dialysis Clinics Inc, Spartanburg, South Carolina., Agarwal A; William B. Schwartz Division of Nephrology, Tufts Medical Center, Boston., Weiner DE; William B. Schwartz Division of Nephrology, Tufts Medical Center, Boston., Ladin K; Department of Occupational Therapy, Tufts University, Medford, Massachusetts; Department of Community Health and Research on Ethics, Aging, and Community Health (REACH Lab), Tufts University, Medford, Massachusetts. Electronic address: keren.ladin@tufts.edu.

المصدر: American journal of kidney diseases : the official journal of the National Kidney Foundation [Am J Kidney Dis] 2021 Nov; Vol. 78 (5), pp. 690-699. Date of Electronic Publication: 2021 Apr 22.

نوع المنشور: Journal Article; Research Support, Non-U.S. Gov't

بيانات الدورية: Publisher: W.B. Saunders Country of Publication: United States NLM ID: 8110075 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1523-6838 (Electronic) Linking ISSN: 02726386 NLM ISO Abbreviation: Am J Kidney Dis Subsets: MEDLINE

مواضيع طبية MeSH: Patient Education as Topic* , Renal Insufficiency, Chronic*/diagnosis , Renal Insufficiency, Chronic*/therapy, Decision Making ; Humans ; Nephrologists ; Patient Participation ; Qualitative Research ; Renal Dialysis

مستخلص: Rationale & Objective: Education programs are needed for people with advanced chronic kidney disease to understand kidney failure treatment options and participate in shared decision-making (SDM). Little is known about the content and accessibility of current education programs or whether they support SDM.
Study Design: Stakeholder-engaged, mixed-methods design incorporating qualitative observations and interviews, and a quantitative content analysis of slide presentations.
Setting & Participants: Four sites located in Boston, Chicago, Portland (Maine), and San Diego.
Analytical Approach: Thematic analysis based on the Ottawa Framework (observations and interviews) and descriptive statistical analysis (slide presentations).
Results: Data were collected from observations of 9 education sessions, 5 semistructured interviews with educators, and 133 educational slide presentations. Sites offered group classes or one-on-one sessions. Development, quality, and accuracy of educational materials varied widely. Educators emphasized dialysis (often in-center hemodialysis), with little mention of conservative management. Educators reported patients were often referred too late to education sessions and that some patients become overwhelmed if they learn of the implications of kidney failure in a group setting. Commonly, sessions were general and did not provide opportunities for tailored information most supportive of SDM. Few nephrologists were involved in education sessions or aware of the educational content. Content gaps included prognosis, decision support, mental health and cognition, advance care planning, cost, and diet. Slide presentations used did not consistently reflect best practices related to health literacy.
Limitations: Findings may not be broadly generalizable.
Conclusions: Education sessions focused on kidney failure treatment options do not consistently follow best practices related to health literacy or for supporting SDM. To facilitate SDM, the establishment of expectations for kidney failure treatment options should be clearly defined and integrated into the clinical workflow. Addressing content gaps, health literacy, and communication with nephrologists is necessary to improve patient education in the setting of advanced chronic kidney disease.
(Copyright © 2021 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.)

المؤلفون: Casciato D; Fellow, University of Maryland Medical Center, Baltimore, MD. Electronic address: dominickcasciato@gmail.com., Bykowski A; Resident, OhioHealth Grant Medical Center, Columbus, OH., Joseph N; Resident, OhioHealth Grant Medical Center, Columbus, OH., Mendicino R; Residency Director, OhioHealth Grant Medical Center, Columbus, OH.

المصدر: The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons [J Foot Ankle Surg] 2023 Jul-Aug; Vol. 62 (4), pp. 727-730. Date of Electronic Publication: 2023 Mar 13.

نوع المنشور: Journal Article

بيانات الدورية: Publisher: W.B. Saunders Country of Publication: United States NLM ID: 9308427 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1542-2224 (Electronic) Linking ISSN: 10672516 NLM ISO Abbreviation: J Foot Ankle Surg Subsets: MEDLINE

مواضيع طبية MeSH: Health Literacy* , Diabetic Foot*, Humans ; Comprehension ; Patient Education as Topic ; Amputation, Surgical ; Internet

مستخلص: With countless sites detailing disease management, treatment, and prognosis, patients often turn to the internet for medical decision-making assistance. While such sites provide ample patient education material, little is known about the reading level, understandability, and actionability of information on these sites. In a limb preservation population, assessing what information patients are interpreting becomes vital to ensure care is not compromised. Internet searches of the terms "Charcot foot, diabetic foot ulcer, foot ulcer, critical limb ischemia, gangrene, osteomyelitis, lymphedema, DVT, pulmonary thrombosis, and amputation" were performed. The Flesch Kincaid readability score from the text from the first 10 links with patient education information were calculated. Understandability and actionability of each resource were then graded by 2 reviewers. Across the 100 accessed websites, 10% maintained patient education materials with at least one readability score at or below the recommended sixth grade reading level. Seventy-three percent of the materials revealed an understanding greater than the recommended 70%. Ninety-nine percent of materials maintained patient education materials with actionability less than 70%. The Spearman Rho correlation revealed a statistically significant relationship between understandability score and the order of each keyword's respective website search position (Rho = -0.01; p = .002). Overall, many online limb preservation patient education materials are written well above the recommended sixth grade reading level with varying understandability and actionability scores. Online resources, as well as physician offices, should examine their patient education materials to ensure they are of an appropriate reading level and provide actions to be taken in case of emergencies.
(Copyright © 2023 the American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.)

المؤلفون: Nickles D; Ramapo College of New Jersey, Nursing Programs, Mahwah, NJ, United States of America. Electronic address: dnickles@ramapo.edu., Dolansky M; Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, United States of America., Marek J; Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, United States of America., Burke K; Ramapo College of New Jersey, Mahwah, NJ, United States of America.

المصدر: Journal of professional nursing : official journal of the American Association of Colleges of Nursing [J Prof Nurs] 2020 Mar - Apr; Vol. 36 (2), pp. 70-76. Date of Electronic Publication: 2019 Aug 16.

نوع المنشور: Journal Article

بيانات الدورية: Publisher: W.B. Saunders Country of Publication: United States NLM ID: 8511298 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-8481 (Electronic) Linking ISSN: 87557223 NLM ISO Abbreviation: J Prof Nurs Subsets: MEDLINE

مواضيع طبية MeSH: Health Knowledge, Attitudes, Practice* , Patient Education as Topic* , Patient Satisfaction* , Quality Improvement* , Students, Nursing*, Medication Adherence/*statistics & numerical data, Aged ; Drug-Related Side Effects and Adverse Reactions ; Female ; Humans ; Male ; Medicare ; United States

مستخلص: Background: Nurses provide education on medications to hospitalized patients and this intervention is measured by patient's satisfaction on the Hospital Consumer Assessment of Healthcare Providers and Systems Survey [HCAHPS] (Center for Medicare & Medicaid Services[CMS], 2008).
Purpose: Nursing students implement the teach-back method in a quality improvement project to improve patients' knowledge of medications and satisfaction on the HCAHPS survey. Specific aim 1: increase nursing students use of teach-back from the current state of 0% to 80% of their patient encounters; Specific aim 2: ensure that 80% of the patients approached can state the name, purpose and side effects of their current medications; Specific aim 3: have 80% of the patients satisfied with their medication teaching.
Methods: The Model for Improvement framework from the Institute for Healthcare Improvement was used (Ogrinc et al., 2012). Process and outcome measures and Plan-Do-Study-Act cycles were analyzed.
Results: Senior nursing students used teach back on 82.9%% of their patient encounters. Of the N = 55 patients who received the intervention, 58.2% could state the name and purpose, and 50.9% knew the side effects of their medications. HCAHPS survey responses did not achieve the benchmarks of 77.2% and 52.3% for "always" responses for medication education questions. However, patient satisfaction was measured at 96.4% with the One Minute Evaluation (Appendix A) by nursing students following the intervention.
Conclusion: Integrating QI into the clinical environment is a method to not only increase patient outcomes but also exposes students to the methods of QI. Although the intervention did not meet the benchmark for patient satisfaction in "Communication about Medicines" category as measured by HCAHPS survey results, the teach-back method was an effective evidence-based tool for improving patient knowledge of medications.
Competing Interests: Declaration of competing interest None.
(Copyright © 2019 Elsevier Inc. All rights reserved.)

المؤلفون: Hui RWH; Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong. Electronic address: huirex@connect.hku.hk.

المصدر: Paediatric respiratory reviews [Paediatr Respir Rev] 2020 Feb; Vol. 33, pp. 62-66. Date of Electronic Publication: 2019 Apr 11.

نوع المنشور: Journal Article; Review

بيانات الدورية: Publisher: W.B. Saunders Country of Publication: England NLM ID: 100898941 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1526-0550 (Electronic) Linking ISSN: 15260542 NLM ISO Abbreviation: Paediatr Respir Rev Subsets: MEDLINE

مواضيع طبية MeSH: Medication Adherence* , Patient Education as Topic*, Adrenal Cortex Hormones/*therapeutic use , Asthma/*drug therapy , Parents/*psychology , Phobic Disorders/*epidemiology, Administration, Inhalation ; Attitude to Health ; Bone Density ; Depression ; Fear/psychology ; Fractures, Bone ; Growth Disorders ; Humans ; Intelligence ; Mental Disorders ; Phobic Disorders/psychology ; Phobic Disorders/therapy ; Substance-Related Disorders ; Weight Gain

مستخلص: Asthma is the most prevalent chronic disease in children. Inhaled corticosteroids (ICS) is the first-line controller therapy for children with persistent asthma, however, suboptimal compliance to ICS therapy remains as a major obstacle in paediatric asthma management. Steroid-phobia, the fear of side-effects and subsequent aversion of ICS, has been widely reported in parents of asthmatic children. The reported prevalence of steroid-phobia varies widely from 19% to 67% in different populations. The concerns about ICS frequently raised by parents include growth suppression, weight gain, bone weakness, addiction and psychiatric disturbances. Outside of growth suppression, which is statistically significant yet mild in clinical studies, the other concerns are not evidence-based and are misconceptions. Conflicting results have been reported regarding the impact of steroid-phobia on ICS compliance. In contrast, steroid-phobia has consistent and negative effects on asthma control in children. While asthma educational programmes have demonstrable benefits in general paediatric populations, the generalisability of such programmes to steroid-phobic parents remains undetermined. There is a paucity of data on specific educational programmes to clear misconceptions and reduce steroid-phobia. Given the continually raising prevalence of paediatric asthma, high-quality studies are warranted to investigate the prevalence and impact of steroid-phobia, with an ultimate goal of developing effective strategies to tackle steroid-phobia and improve asthma care in children.
(Copyright © 2019 Elsevier Ltd. All rights reserved.)

المؤلفون: Dowell J; Kent State University, United States of America. Electronic address: Jdowell1@kent.edu., Arcoleo K; Nationwide Children's Hospital, United States of America., Ruiz Z; Espranza, Inc., United States of America., Halula R; Akron Children's Hospital Pediatrics in Boardman, United States of America.

المصدر: Journal of pediatric nursing [J Pediatr Nurs] 2020 Jan - Feb; Vol. 50, pp. 81-88. Date of Electronic Publication: 2019 Nov 26.

نوع المنشور: Journal Article

بيانات الدورية: Publisher: W.B. Saunders Country of Publication: United States NLM ID: 8607529 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-8449 (Electronic) Linking ISSN: 08825963 NLM ISO Abbreviation: J Pediatr Nurs Subsets: MEDLINE

مواضيع طبية MeSH: Asthma* , Attitude to Health* , Communication* , Patient Education as Topic* , Professional-Patient Relations*, Child ; Comprehension ; Female ; Focus Groups ; Humans ; Male ; Pilot Projects ; Psychometrics

مستخلص: Purpose: Communication among healthcare providers, caregivers and children with asthma is challenging and sometimes may exclude the child. This may result in delay in recognizing and responding appropriately to asthma symptoms. The purpose was to test an instrument's subscale for content validity related to communication with the healthcare provider by examining age appropriateness, readability and clarity for children with asthma.
Design and Methods: This was a mixed method explanatory sequential design to examine age appropriateness, readability and clarity for a 15-item subscale of an instrument for children. The qualitative arm (focus groups) was used to enrich the questionnaire. The sample included children ages 8 to 12 with asthma (N = 25).
Results: The perspective of children with asthma provided enriched information to influence the development of instrument subscale on communication.
Conclusions: The subscale revealed internal consistency with Cronbach Alpha 0.85. One of the children reported that using the term "provider" was clearer as oppose to healthcare provider. Children participating in the study found readable and clear. A readability analysis revealed the items were readable at a 6th grade level.
Practice Implication: Although the instrument is designed for primary care providers (physicians, nurse practitioners, physician assistants), the information gained from this pilot increases understanding about including the child in a triadic discussion. Further research will lead to next step toward computing reliability of the full measure and a factor analysis.
(Copyright © 2019 Elsevier Inc. All rights reserved.)

المؤلفون: Weidler EM; Division of Pediatric Surgery, Phoenix Children's Hospital, 1919 E. Thomas Rd., Phoenix, AZ, United States., Baratz A; Androgen Insensitivity Syndrome-Differences of Sex Development Support Group, Duncan, OK, United States; Interact Advocates for Intersex Youth, Sudbury, MA, United States., Muscarella M; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, United States., Hernandez SJ; Division of Pediatric Surgery, Phoenix Children's Hospital, 1919 E. Thomas Rd., Phoenix, AZ, United States., van Leeuwen K; Division of Pediatric Surgery, Phoenix Children's Hospital, 1919 E. Thomas Rd., Phoenix, AZ, United States. Electronic address: kvan@phoenixchildrens.com.

المصدر: Seminars in pediatric surgery [Semin Pediatr Surg] 2019 Oct; Vol. 28 (5), pp. 150844. Date of Electronic Publication: 2019 Sep 19.

نوع المنشور: Journal Article

بيانات الدورية: Publisher: W.B. Saunders Country of Publication: United States NLM ID: 9216162 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-9453 (Electronic) Linking ISSN: 10558586 NLM ISO Abbreviation: Semin Pediatr Surg Subsets: MEDLINE

مواضيع طبية MeSH: Checklist* , Decision Making, Shared* , Patient Education as Topic*, Androgen-Insensitivity Syndrome/*therapy, Humans ; Male

مستخلص: Reports exist regarding a gradual approach to the care of patients with differences of sexual development. Each patient and family have different values and styles of learning that have to be taken into account. The goals of care should include education about the condition, counseling of the patient and family, and a complete outlining of treatment options. Motivated by a call from the 2010 Health Reform Law for the use of shared decision-making tools and the emphasis placed on these issues by the DSD Consensus Statement, we sought to develop and implement such tools for the DSD population. ^1-3 Thus, we developed an organized checklist for providers to share with a patients and families affected by CAIS, beginning with the initial visit. The development of the document enlisted input from physicians, clinical coordinator, advocacy groups and affected individuals. It allows providers to explain the process of care and develop a plan for delivery of that care over multiple visits spanning six months or more. The checklist is divided into five sections: 1) An overview addressing how much information is desired and in what manner the patient prefers to obtain information; 2) A preferred words list so that the patient can choose nomenclature that is most comfortable; 3) A list of topics to review over the course of multiple visits; 4) A list of questions to be answered by the providers or other resources over time, and; 5) A list of concerns to be addressed before surgical intervention is considered. An organized approach to long-term delivery of compassionate care and accurate information can be facilitated for patients with CAIS by the use of a shared decision-making checklist. Documentation of the care delivery process can stimulate referral to peer support and promote fully informed consent for treatment decisions. The use of the checklist should encourage trust in the provider, as well as aid in identifying and addressing stressors for the patient and family. The checklist will be updated and revised as new treatments and advanced technology emerges.
(Copyright © 2019 Elsevier Inc. All rights reserved.)

المؤلفون: Basak T; University of Health Sciences, Gulhane Faculty of Nursing, Ankara, Turkey. Electronic address: tulay.basak@sbu.edu.tr., Demirtas A; University of Health Sciences, Gulhane Faculty of Nursing, Ankara, Turkey. Electronic address: ayla.demirtas@sbu.edu.tr., Iyigun E; University of Health Sciences, Gulhane Faculty of Nursing, Ankara, Turkey. Electronic address: emine.iyigun@sbu.edu.tr.

المصدر: Journal of professional nursing : official journal of the American Association of Colleges of Nursing [J Prof Nurs] 2019 Sep - Oct; Vol. 35 (5), pp. 417-424. Date of Electronic Publication: 2019 Feb 08.

نوع المنشور: Journal Article; Randomized Controlled Trial

بيانات الدورية: Publisher: W.B. Saunders Country of Publication: United States NLM ID: 8511298 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-8481 (Electronic) Linking ISSN: 87557223 NLM ISO Abbreviation: J Prof Nurs Subsets: MEDLINE

مواضيع طبية MeSH: Patient Education as Topic* , Patient Simulation* , Students, Nursing*, Clinical Competence/*standards, Adult ; Education, Nursing, Baccalaureate ; Female ; Humans ; Metered Dose Inhalers ; Young Adult

مستخلص: According to the literature, main problem in the education of nursing students in patient teaching about application of inhaler medication is ineffective and inadequate class and cannot be applied to the live patients. Also the literature shows that the main obstacle for teaching nursing students to provide inhaler instruction is inadequate in-class practice. In this study, comparison of the effectiveness between standard patients (SPs) usage and theoretical lecture on improving the patient teaching skills of nursing students for inhaler drug use for live patient is aimed. This study was conducted as a randomized controlled and single-blind trial. Total patient teaching skill score for control group was 26.73 ± 5.63 and 39.08 ± 5.49 for SP group which causes a statistically significant difference (p ≤ 0.01). The students' self-confidence mean score was 8.48 ± 0.88 for SPs group and 7.07 ± 1.33 in the control group for a statistically significant difference (p ≤ 0.01). The patient teaching skill scores of the students included in the group receiving simulation teaching with the SPs were found to be higher than the control group. The students included in SPs group were found to feel more confident while teaching a live patient on inhaler drug use.
(Copyright © 2019 Elsevier Inc. All rights reserved.)