coursework-banner

IOM Future of Nursing Report and Nursing NRS-440V

IOM Future of Nursing Report and Nursing NRS-440V

Grand Canyon University IOM Future of Nursing Report and Nursing NRS-440V-Step-By-Step Guide

 

This guide will demonstrate how to complete the IOM Future of Nursing Report and Nursing NRS-440V assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.

 

How to Research and Prepare for IOM Future of Nursing Report and Nursing NRS-440V                                   

 

Whether one passes or fails an academic assignment such as the Grand Canyon University   IOM Future of Nursing Report and Nursing NRS-440V depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.

 

After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.

 

How to Write the Introduction for IOM Future of Nursing Report and Nursing NRS-440V                                   

 

The introduction for the Grand Canyon University   IOM Future of Nursing Report and Nursing NRS-440V is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.

 

How to Write the Body for IOM Future of Nursing Report and Nursing NRS-440V                                   

 

After the introduction, move into the main part of the IOM Future of Nursing Report and Nursing NRS-440V assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.

 

Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.

 

How to Write the Conclusion for IOM Future of Nursing Report and Nursing NRS-440V                                   

 

After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.

 

How to Format the References List for IOM Future of Nursing Report and Nursing NRS-440V                                   

 

The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.

Stuck? Let Us Help You

 

Completing assignments can sometimes be overwhelming, especially with the multitude of academic and personal responsibilities you may have. If you find yourself stuck or unsure at any point in the process, don’t hesitate to reach out for professional assistance. Our assignment writing services are designed to help you achieve your academic goals with ease. 

 

Our team of experienced writers is well-versed in academic writing and familiar with the specific requirements of the IOM Future of Nursing Report and Nursing NRS-440V assignment. We can provide you with personalized support, ensuring your assignment is well-researched, properly formatted, and thoroughly edited. Get a feel of the quality we guarantee – ORDER NOW. 

 

IOM Future of Nursing Report and Nursing NRS-440V

Introduction

Many healthcare systems are on the verge of improving the quality of care by incorporating different approaches critical in the treatment and general care processes. In the United States of America, most of the stakeholders believe that it is necessary to expand the role of healthcare providers, including pharmacists, primary physicians, and nurses. Therefore, Robert Wood’s committee formulated an initiative for future nursing at the Institute of Medicine (IOM). The team developed a vision that would transform the entire healthcare system to address the above issues. In the IOM Report, Wood’s committee envisages a future where the primary care and the prevention system are the key drivers of the healthcare processes. Also, they anticipate coordination and interprofessional collaborations as the norms within the healthcare systems. All of the above approaches ought to provide reward values through affordable healthcare services.

Collaboration among healthcare professionals is essential in creating synergy to provide efficient, safe, and high-quality patient care. The synergy model suggests that the outcomes of productive collaboration between two or more teams or professionals are expected to be greater than the sum of their isolated effects (Wei et al., 2020). The quality and effectiveness of team members’ relationships and com- munication affect patient care quality and professionals’ job satisfaction. Currently, preventable medical errors are estimated to claim about 400,000 lives each year and become the third leading cause of death in the United States (Wei et al., 2020). As we can witness the statistics visibly show the need to improve healthcare performance and promote patient care and safety.Interprofessional collaboration improves the patients care and output. It reduces the risk of fatalities as well as enhances the quality of care provided to the patients. Hence interprofessional collaboration is important in the case of serious cases. For example in the case of patient suffering from chronic disease as well as depression. Hence the health care professionals such as psychologist and cardiologist need to come together to work on this patient. The patient requires counselling as well as proper disease management. Hence the patient can easily recover with the illness. It also increases the treatment efficiency.

The debate about the United States’ healthcare reforms ranges far and wide. Some parties or individuals are most interested in issues of cost escalation and how to stop it. On the other hand, there are groups of decision-makers who are specifically interested in the issues of quality of healthcare provision. Additionally, some economists and healthcare providers mainly focus on medical access and patient safety issues. The above ideas and decisions exist in the free market, and when they are linked together, a comprehensive and better decision will emerge, a situation that will lead to an inclusive health care services. The quality of the healthcare system in the United States has raised a lot of questions over the decades. To improve the idea of quality, the Federal government alone cannot offer solutions to the improvement of the nature of the operation. The free market should be allowed to reshape the system with the aim of increasing the quality of services as well as the support from different stakeholders. IOM elaborates on the costs of healthcare systems and the best care processes that need to be undertaken for the provision of quality services.

IOM Report policies have an influence on the healthcare system as it elaborates on the need to expand the roles of nurses. From the report, the committee of experts recognizes the fact that there is a need for nurses to practice according to professional training.  IOM stipulates the need for nurse educators to prepare them better to deliver patient-centered, safe, equitable, and high-quality healthcare services. The report also states different ways of engaging with the physicians as well as other healthcare professionals to deliver effective and efficient healthcare services to the patients. Given that there are already policies are healthcare act that stipulates the best treatment and insurance costs in the healthcare settings, IOM presents further policies that are critical in healthcare management. IOM affirms that an expanded workforce can serve the increasing number of patients in healthcare settings. In other words, an increased workforce can serve the ever-rising number of patients that is attributed to the increase in insurance access. IOM Report also stipulates on the educational programs that ought to be attained by nurses. According to the report, nurses need to practice to the full extent of their training and education. They need to achieve higher education and medical training through the improved educational system that enhances seamless academic progression.

 

The Role of State-Based Action Coalitions

The state-based action coalitions conduct the work of the campaign at the local and state levels. These action groups consist of

IOM Future of Nursing Report and Nursing NRS-440V
IOM Future of Nursing Report and Nursing NRS-440V

advocates from the community, including the representatives from the businesses, health organizations, education, and nursing groups. The state-based action groups ensure that there are effective working conditions for healthcare workers. They often engage in such actions to ensure improvement in quality healthcare and effective patient outcomes. State-based action coalitions enhance the advancement of nursing practices through the stipulation of their rights and the provision of a better working environment; they advocate for quality education and the reduction in healthcare costs. These activities are in line with the provisions in the IOM report.

IOM’s main objectives are to advance the quality of healthcare processes through the implementation of the strategies that can best enable nurses and other healthcare professionals to operate effectively. The roles of state-based action coalitions are in line with the IOM objectives as both aimed at facilitating efficiency and quality in the treatment processes.  State-based action coalitions, just like the IOM stipulations, aimed at reducing healthcare costs and improving the general quality of healthcare and effective patient outcomes.

Click here to ORDER an A++ paper from our MASTERS and DOCTORATE WRITERS: IOM Future of Nursing Report and Nursing NRS-440V


Initiatives of the State-Action Coalitions

My state’s action coalitions are working on the quality improvement and reduction of costs in the healthcare systems. In my state, the state-action coalitions consist mainly of nurses, healthcare insurers, policymakers, and the public members who need improvements in the healthcare systems. Also, the action groups advocate for the effective educational processes for healthcare professionals, including nurses, physicians, and doctors. These initiatives are meant to advance nursing professionalism and increase competency in the nursing practice. The above initiatives also enhance the attainment of quality medical practices and educational programs that aim at improving the nursing profession and clinical practices in general.

Barriers to Advancement That Currently Exist in My State

Even though there are attempts to enhance advancement in healthcare settings, there are always barriers that may hinder these approaches to the initiatives that have been put forward by both the IOM and the state-action coalitions. Some of the state’s barriers include government policies, lack of strong collaboration from the governmental institutions, and the financial challenges. In most cases, the state-action coalitions face financial strains that that may hinder their operational processes. The state-action coalitions can overcome these barriers by establishing strong relationships and support from governmental organizations. Also, the financial barriers can be overcome through the mobilization of the resources and financial support from the well-wishers, including the firms and organizations with goodwill.

Conclusion

Institute of Medicine (IOM) has the responsibility of improving the quality of healthcare and effective patient outcomes. They advocate for the quality education programs for healthcare professionals, improved healthcare processes, quality in patient care, and advanced nurse practices in healthcare settings. On the other hand, state-action coalitions operate in collaboration with the IOM guidelines. The functions of the two organizations are intertwined. They have almost similar objectives towards the improvement of healthcare processes. IOM recognized the fact that many aspects of the healthcare system ought to be changed, including the nursing profession, so as to ensure quality and efficiency in the healthcare processes. Therefore, IOM Report has an influence on the nursing practices, nursing education, and nursing workforce development. IOM also continues to advance the goals and objectives of the nursing profession.

Reference

Sullivan, T. (2017). Institute of Medicine report—The future of nursing: Leading change, advancing health. Policy and Medicine.

Bottom of Form

Assessment Description

Review the IOM report, “The Future of Nursing: Leading Change, Advancing Health,” and explore the “Campaign for Action: State Action Coalition” website. In a 1,000-1,250 word paper, discuss the influence the IOM report and state-based action coalitions have had on nursing practice, nursing education, and nursing workforce development, and how they continue to advance the goals for the nursing profession.

Include the following:

  1. Describe the work of the Robert Wood Foundation Committee Initiative that led to the IOM report, “Future of Nursing: Leading Change, Advancing Health.”
  2. Outline the four “Key Messages” that structure the IOM Report recommendations. Explain how these have transformed or influenced nursing practice, nursing education and training, nursing leadership, and nursing workforce development. Provide examples.
  3. Discuss the role of state-based action coalitions. Explain how these coalitions help advance the goals specified in the IOM report, “Future of Nursing: Leading Change, Advancing Health.”
  4. Research the initiatives on which your state’s action coalition is working. Summarize two initiatives spearheaded by your state’s action coalition. Discuss the ways these initiatives advance the nursing profession.
  5. Describe barriers to advancement that currently exist in your state and explain how nursing advocates in your state overcome these barriers.

You are required to cite a minimum of three sources to complete this assignment. Sources must be published within the last 5 years, appropriate for the assignment criteria, and relevant to nursing practice.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.

Thank you for your post! Definitely, all the reasons you have mentioned contribute tremendously to our current nursing shortage (Whitney, 2018). Unfortunately, it must be added the sad truth about the COVID-19 pandemic. As a hospital worker for many years, It was my first time seeing so many people leave their jobs to work remotely or completely change their profession. The fear, lack of equipment and lack of compensatory pay, among the risk of acquiring the virus and getting their family members sick, contributed to this huge nursing shortage during the pandemic. Nowadays, we are still suffering from this turnover, burnout, and overall disappointment within the profession, having less nurses than ever. Many studies have shown this, including not only hospitals, but also nursing homes, where staffing is already a bit more limited than acute care settings. This one study, “Shortages of staff in nursing homes during the COVID-19 pandemic: What are the driving factors?” (Xu, Intrator, and Bowblis, 2020), tried to understand factors that drove nursing staff to quit their jobs. They got to the conclusion that most of them were related to COVID conditions, and the care of COVID patients, as they require mostly RN care (Xu, Intrator, and Bowblis, 2020).

Whitney, S. (2018). Nursing Shortage. Trends in health care: A nursing perspective. Retrieved July 26, 2022, from https://lc.gcumedia.com/nrs440vn/trends-in-health-care-a-nursing-perspective/v1.1/#/chapter/1

Xu, H., Intrator, O., & Bowblis, J. R. (2020). Shortages of staff in nursing homes during the COVID-19 pandemic: What are the driving factors? Journal of the American Medical Directors Association21(10), 1371–1377. https://doi.org/10.1016/j.jamda.2020.08.002

Nurses are the healthcare professionals who tend to spend most of their time with patients, which makes them develop close relationship with them. As such, nurses play an essential role in enhancing patient care and health care system risk facing negative impacts without nurses’ contribution. The adoption of the IOM report on the future of nursing is a critical move towards empowering nurses to provide superior health care by improving the health care delivery system, improving the capacity of nurses to undertake scientific research, and equip nurses to take leadership positions. Eventually, these factors ensure enhancement in patient outcomes and also reduction in health care costs. Consequently, the purpose of this paper is to delve into the IOM Future of Nursing Report and Nursing by providing a description of the work of the Robert Wood Foundation Committee Initiative that led to this report, detail the key messages in the report, highlight the role of state -based action coalitions in advancing the report, provide some initiatives by state action coalition, barriers experienced by state action coalitions, and how to overcome the barriers.

Description of the Work of the Robert Wood Foundation Committee Initiative that Led to the IOM Report

The work of the Robert Wood Johnson Foundation (RWJF) committee initiative that led to IOM report was necessitated by widespread challenges that nurses encountered in their practice. The issues were attributed to the ever evolving and complex nature of health care system that nurses had problems in handling, thus, interfering with their practice. Therefore, it was imperative to reform nursing practice by addressing the challenges that nurses encountered and prepare nurses to actively participate in health care improvement and remain updated in the face of changing health care system and technological development.

Informed by these nursing challenges, the RWJF committee initiative opted to determine the nursing practice in various health care settings across the US. After conducting the assessment, the RWJF established that there was huge disparity in the nursing competencies and academic credentials. Moreover, the committee noted that there is need to create mechanisms that could motivate nurses to work to the full extent of their competency and deliver quality care in the future. To realize these objectives, the RWJF committee initiative reported that nurses need to be given superior training and education that are supported by the quality education system (National Academies of Sciences, Engineering, and Medicine, 2016). Overall, the work of the RWFJ committee initiative was to conduct the assessment and make recommendations on what could be done to change the future of nursing profession and the action that could be taken to be successful in changing the future of nursing practice.

The culmination of the RWJF work was the formulation of the IOM report dubbed, “The Future of Nursing: Leading Change, Advancing Health.” This report entailed detailed evidence-based plans on how to improve nursing practice and to better the future of nursing. Among the major proposals in the report included ensuring capacity building of nursing training institutions, ensuring nurse residency programs, striving for 80% of nurses with baccalaureate degrees’ qualification and having more nurses with doctorate degrees. The report also called for the creation of flexible nursing programs that are future oriented to facilitate continuous nursing education.

Key Messages in the IOM Report Recommendations

The IOM report recommendations on the future of nursing contained four key messages. The first message in the recommendations entails the idea that nurses need to practice to the full extent of their training and qualifications. In this message, the federal and state governments are tasked with the responsibility of ensuring that the rules relating to the nursing practice to the full extent of the training are regulated and updated to ensure that patients receive quality health care services delivery. The second message in the IOM report recommendations entails calling upon nurses to seek advanced education and training through enhanced education system that facilitates flawless academic advancement. The intent of this message is to have sophisticated structuring of nursing education to foster direct and seamless advancement to higher nursing education levels. Improving nursing education system is also essential in equipping the existing and future generation of nurses with competency to provide safe, quality, and patient-oriented care in different health care organizations (Arzouman, 2016).

The third message on the IOM report recommendations is that nurses ought to work as full partners with other health care professionals including physicians in an effort to restructure health care system in the country. Full partnership implies that nurses should be fully accountable and take active roles in the identification of the issues and factors that contribute to wastes in health care, tracking health care improvements, designing and implementing improvement measures, and taking actions to achieve desired goals. As such, it is imperative for nurses to acquire core competency in leadership at all levels of nursing profession to realize the objectives of this message. Nurses are also advised to actively engage in policy areas to help in influencing nursing profession by joining commissions, boards, and committees to advocate for the nurses.

Finally, the message in the report calls for sophisticated management of data and information infrastructure to ensure effective workforce planning and policy development (Arzouman, 2016). The report proposed that the health care system needs to have universal methods of determining the number and type of nursing professionals, where they are employed, their tasks, responsibilities, and activities.  The data will play a significant role of recognizing critical areas that require improvement and used to make future nursing workforce needs and influence changes in the nursing profession.

Role of State-Based Action Coalitions

The health care system in the US is organized in a way that every state has its unique health care regulations, laws, and programs. State-based action coalitions were developed to facilitate more participation and possession of the IOM report by the nursing practitioners, public health organization, private health organizations, and state governments. The coalitions get directives from the RWJF and the Center to Champion Nursing in America (CCNA) to enable them deliver universal health care programs in all states. The RWJF and the CCNA partner with state-based coalitions to equip them with information and campaign resources, inter-state knowledge sharing, foster communication, and provide planning tools including technical support in utilization of the tools (Gimbel et al., 2017).

Initiatives by Pennsylvania State Coalitions

The initiatives by state coalitions in Pennsylvania include endeavor to define the responsibilities of nurses in health care delivery and to create ground for full nursing practice. The coalitions also consult widely with coalitions from other states to create a standard structure of nursing course for various nursing education levels in the respective state. However, the effort to attain these objectives is compromised by various barriers including disparity in educational qualification and competency levels among nurses drawn from distinct specialties. This barrier can be addressed by encouraging and helping nurses to acquire higher education and continuous training.

Conclusion

Based on the IOM report on future of nursing, it is clear that the intention of the report is the focus on the vital relationship between nursing practice actions and the diverse population health requirements. From the recommendations of this report, nurses should strive to advance their education and engage in more training to meet the diverse needs and cover many specialty areas in nursing practice, which is crucial in delivery of superior patient-oriented health care.  Ultimately, the success of the IOM report on future of nursing will ensure reduction of health care costs and improve health care delivery.

 

 

References

Arzouman, J. (2016). The future of nursing 5 years later–where are we now?. MedSurg Nursing, 25(1), 5-7. https://go.gale.com/ps/anonymous?id=GALE%7CA444912931&sid=googleScholar&v=2.1&it=r&linkaccess=abs&issn=10920811&p=AONE&sw=w

Gimbel, S., Kohler, P., Mitchell, P., & Emami, A. (2017). Creating academic structures to promote nursing’s role in global health policy. International Nursing Review, 64(1), 117-125. https://doi.org/10.1111/inr.12338

National Academies of Sciences, Engineering, and Medicine. (2016). Assessing progress on the Institute of Medicine report The Future of Nursing. National Academies Press.

The IOM future of nursing report and nursing underscored the crucial need for developing a leadership plan of action that harness nurses’ potential to spur change and advance health and health care by coming up with innovative educational opportunities and professional growth opportunities (Tierney et al., 2020). The purpose of the essay seeks to discuss the impact of the IOM report and state-based action coalitions on nursing practice, nursing education, and nursing workforce growth, and how they continue to advance the goals for the nursing profession.

The Obligation of the Robert Wood Foundation Committee Initiative

The Committee was responsible for producing a report having proposals for an action-oriented roadmap for nursing, including changes in public and institutional regulations at the national, state, and local levels. The report emphasized four main areas as far as advancing the nursing profession is concerned. The four segment recommendations include: nurses should practice to the full potential of their education and training; nurses should achieve higher levels of instruction and training through an enhanced education system that encourages seamless academic progression (Hassmiller & Reinhard, 2019). Further, the report proposed nurses should be full partners, with physicians and other health professionals, in redesigning health care in the United States. Moreover, they emphasized effective workforce planning and policy-making that called for better data collection and an improved information framework.

The influence of four key recommendations on nursing practice.

The recommendations emphasized that nurses use their education, training, and competencies and collaborate with other medical staff to avail higher quality care, decrease errors, and increase safety. The four key messages have underscored the need for the inclusion of evidence-based practice in nursing practice, which has provided nurses with scientific research and real-time, data-driven insight to make well-founded decisions (Tierney et al., 2020).

Through EBP, nurses are updated about new medical protocols for patient care. Additionally, the recommendations have encouraged and enhanced strong leadership that has transformed the health care system in the United States. In addition, nurse leaders have become designers, implementers, and evaluators, as well as playing the role of advocacy for reforms to the relevant systems. Furthermore, nursing research and practice have developed evidence-based improvements to care, leading to policy changes across the health care systems (Tierney et al., 2020). In sum, the recommendations have influenced and enhanced the population health needs assessment and management and collaboration of health professionals enabling the provision of patient-centered, coordinated, and community-based primary and specialty care services.

The role of state-based action coalitions.

State Action Coalitions work to advance the proposals of the IOM report. Additionally, the coalitions help increase the goals specified in the IOM report and are led by nurses and business partners; they aid spur change locally by working to transform health care through nursing and build healthier communities (Wakefield et al., 2021).

The Initiatives On Which New York State Action Coalition is Working

In sum, the initiatives spearheaded by the New York action coalition comprise improving health equity, building healthier New York communities, improving access to care in the states, and promoting nursing leadership. In addition, they work to increase diversity in nursing, transforming nursing education, collecting workforce data, and enhancing Interprofessional collaboration (Dorritie et al., 2020).

 

The barriers include a lack of understanding of the role of the coalition. Similarly, a lack of professional recognition, poor physician relations, and poor administrator relations pose limitations to the advancement of the work. Further, other challenges include the nursing shortage and the issue of aging of the nursing workforce, and a lag in nursing salaries;

Despite the barriers, nurse, through their membership with health organizations and associations, has continued to advocate for better health care access and education of their members and addressing salient healthcare policy decisions in an atmosphere of problem-solving and responsibility.

Conclusion

The IOM future of nursing report emphasized the need for developing a leadership plan of action that harness nurses’ potential to spur change and advance health and health care by coming up with innovative educational opportunities and professional growth development opportunities. The four segment proposals have enhanced access to healthcare and improved the nurse profession through the work of state-based action coalition. However, the recommendations have faced barriers. Despite the obstacles, nurses in New York have continued to address the critical healthcare policies through responsibility and training.

 

 

 

 

 

 

References

Dorritie, R., Fiore-Lopez, N., & Sonenberg, A. (2020). Leading for change: Nurses on boards. Nursing Management, 51(3), 14-20. https://doi.org/10.1097/01.NUMA.0000654844.72394.8f

Hassmiller, S. B., & Reinhard, S. (2019). The Robert Wood Johnson Foundation and AARP Story:: How Our Partnership Advanced the Future of Nursing. Nurse Leader, 17(5), 399-403. https://doi.org/10.1016/j.mnl.2019.07.005

Michael, R. D., Webster, C. A., Egan, C. A., Nilges, L., Brian, A., Johnson, R., & Carson, R. L. (2019). Facilitators and barriers to movement integration in elementary classrooms: a systematic review. Research Quarterly for Exercise and Sport, 90(2), 151-162. https://doi.org/10.1080/02701367.2019.1571675

Tierney, M., Finnell, D. S., Naegle, M., Mitchell, A. M., & Pace, E. M. (2020). The Future of Nursing: Accelerating gains made to address the continuum of substance use. Archives of Psychiatric Nursing, 34(5), 297-303. https://doi.org/10.1016/j.apnu.2020.07.010

Wakefield, M., Williams, D. R., & Le Menestrel, S. (2021). The future of nursing 2020-2030: Charting a path to achieve health equity. National Academy of Sciences. https://doi.org /10.17226/25982