Similarity Report ID: oid:14465:143170378
PAPER NAME
AUTHOR
Team 12.docx
-
WORD COUNT
CHARACTER COUNT
3192 Words
18941 Characters
PAGE COUNT
FILE SIZE
10 Pages
41.1KB
SUBMISSION DATE
REPORT DATE
Apr 14, 2023 4:26 PM GMT+3
Apr 14, 2023 4:27 PM GMT+3
47% Overall Similarity
The combined total of all matches, including overlapping sources, for each database.
34% Internet database
32% Publications database
Crossref database
Crossref Posted Content database
41% Submitted Works database
Summary
12
1
HEALTH PSYCHOLOGY Year one - Semester two
CV Team PROJECT TWO – literature Review 1500 words template
CARDIAC REHABILITATION
1. Complete the form below (all fields must be filled).
2. The document name should be of the team number.doc (e.g., team 25.doc).
Please also change the header to your team number
3. All text must be formatted as Arial, 12-point, black color and have single line
spacing. Italic, bold and underline styles are optional.
4. Total word count 1500 words (excludes headings and questions, references,
student information, instructions, search strategy, etc.).
5. Please refer to the detailed CV Project 2 guidelines for full details and
instructions
Project Title: Literature review for cardiac rehabilitation
Team number:
Team 12
Date of final submission:
Team
details
Student ID
number:
Team role
Number
of
meetings
attended
0-6
who
uploaded
To
Kaizen
X
Student 1
21200695
Coach
6
X
Student 2
21200178
Director
6
Student 3
21200617
Connector
6
Student 4
22200354
Actualizer
6
Student 5
21200146
Finalizer
6
Student 6
21204160
Diplomat
6
Student 7
21202341
Judge appraiser
6
1
12
Literature Review Cardiac rehabilitation
Importance and Efficacy of Remote Cardiac Rehabilitation:
A Literature Review
Ayah Alia, Kawthar Maqwara, Lulwa Alselahya, Nawaf Albassama, Qaswar
Sudania, Saif Aly Kabania, Zayed Behzada
a
2
MED Year 1, School of Medicine, Royal College of Surgeons Ireland - Medical
University of Bahrain
51
1. Introduction
1.1.
Cardiac Rehabilitation
CR (cardiac rehabilitation) utilizes specific exercises supervised by health care
professionals, such as cycling, swimming, running, and walking, which benefit the
patient’s blood lipid levels and blood pressure. The goal is to help them return to an active
lifestyle post coronary artery disease, myocardial infarction, and atherosclerosis.1
CR comprises three phases: Clinical, out-patient, and post-CR.2 The clinical phase
focuses on post-intervention therapy and assessing the patient’s ability to tolerate
rehabilitation. Out-patient CR focuses on developing a patient-centered therapy plan and
starting physical rehabilitation to prevent recurrent events. Post-CR involves aerobic
training and independence, where the patient can maintain a healthy, active lifestyle at
home with intervention as necessary.3
CR has clear positive effects as it reduces heart disease mortality.4,5 It was also
beneficial in preventing future heart problems in those with a risk factor that is a
precursor to cardiovascular disease.6
1.2.
Inequity in Access to Cardiac Rehabilitation
6
There are several barriers that prevent heart failure patients from accessing cardiac
rehabilitation.
These include a lack of awareness about the availability of rehab programs
47
and transportation issues for those who live in rural or remote areas. In addition, there
are cost concerns due to insurance coverage limitations, time constraints for patients who
work full-time, and physical limitations such as mobility issues.7
Additionally, social barriers such as profiling based on race, gender, and culture
may also be factors that limit access to cardiac rehabilitation
services.8 Addressing these
50
barriers is important because research has45 shown that participation in cardiac
rehabilitation can improve outcomes such as quality of life, functional capacity, and
mortality rates among people
with heart failure. Nonetheless, a randomized program
57
concluded no correlation between CR and all-cause mortality.7 Howbeit,54a gender bias
of mostly males led to a reduction in accuracy. It is important to note that there is a lack
of data on the effects of CR on patient populations from populations due to attrition bias.
2
12
Attrition bias is the process by which the number of participants decreases for multiple
reasons: unwanted side effects, dissatisfaction with treatments, or death from other
causes. This bias further decreases the generalisability, validity, and reliability of the
results.9
1.2.1. Racial Inequity
18
Even though
rates of hypertension prevalence are highest in African Americans.10–
18
12
They are less likely to be appropriately treated for most of the conditions predisposed
to the development of PAD, including cigarette smoking, diabetes, hypertension, and
hyperlipidemia. Lack of referral and financial resources are among the main barriers to
CR participation globally.13 However, most patients who need this rehabilitation are inpatients who are referred to the3 program by their attending doctor, thus minimizing the
number of walk-in CR patients. Studies indicate that 3CR referral and participation rates
are lower among patients from ethnic minorities. When socioeconomic status and
education access are controlled, ethnic
minorities often receive lower-quality health care
39
than white patients. It is unclear how the quality of health care was measured and it is
difficult to know if ethnicity played a part in the wellbeing of the patients throughout the
trials.14
1.2.2. Gender
Women tend to have a lower referral and enrollment rate than men.15,16 They also
have a higher dropout rate due to social and logistical factors (e.g., family responsibilities
and dependence).16 One study conducted in 2017 with 44 men and 21 women aged 50
to 76 argues that women older than 65 are more prone to disabilities post-cardiac
surgery.15,17 This once again launches a gender bias towards this study, and the sample
size is too small compared to a study with 1,297,204 bypass surgeries, including 317,716
done in females. The latter study established, with and without prejudice, that female
bypass patients had an increased risk of mortality between 28 to 41%. This plays a role
in females not getting the opportunity to participate in cardiac rehabilitation programs.18
1.2.3. Age
Due to the elderly community being more prone to suffer through a heart attack,
stroke, and CAD, there is a lack of evidence attributed to selection bias on the
effectiveness of CR in different age groups.19 Additionally,
younger patients who do
39
experience cardiovascular diseases inevitably have a higher mortality rate making it
difficult to determine the relationship between age and CR due to a phenomenon called
survivorship bias.6
1.3.
Comorbidities
3
12
Although comorbidities such as obesity are believed to affect the outcome of cardiac
rehabilitation, a study conducted in 2021 suggests no significant negative correlation
between
heart health and measurable results. This includes chronotropic competence
53
after cardiac rehabilitation between obese and non-obese patients.20
1.4.
Telehealth and Telerehabilitation
Telehealth or mHealth21 is a system
of providing healthcare remotely through
60
22,23
wireless technology.
This
includes
video
conferencing,
remote monitoring, and
29
29
mobile apps. It allows patients to receive medical care from their homes, reducing the
need for in-person visits and improving access to healthcare, especially for those who
live in remote areas or have mobility issues. Telehealth has been increasingly used
recently and has become especially relevant during the COVID-19 pandemic.24
Telerehabilitation is a type of telehealth that specifically focuses on providing
rehabilitation services remotely through technology.25 It can include video conferencing
sessions with a physical therapist or other healthcare providers, remote monitoring of
exercises and progress, and using mobile apps to guide patients through their
rehabilitation programs.26
49
Telerehabilitation has been shown to be effective for various conditions such as
stroke, spinal cord injury, and musculoskeletal disorders. Like telehealth in general, it
can improve access to care for those with difficulty traveling or accessing traditional inperson rehab services due to socio-economic barriers. However, there is not enough
data to come to a conclusion on the efficacy of telerehabilitation and there were no details
regarding the sample size and exclusion criteria.27
1.5.
Availability and Timing of CR Programs
59
The British Heart Foundation recommends cardiac rehabilitation to commence
within four weeks (28 days) of interventions.1 These interventions include PCI, and postMI-PCI; however, for coronary bypass surgery (CABG), the recommended
commencement period is adjusted for recovery and is therefore
increased to 42 days. A
23
paper from 2015 conducted a data analysis on the NHS National Audit of Cardiac
Rehabilitation (NACR) database. The study noted a strong
correlation and concluded that
44
for each day delayed in the commencement of CR; the patients were 1% less likely to
improve 23in fitness-related measures. In reference to early rehabilitation, patients
achieved healthy physical activity levels, and normal fitness-related QoL increased by
31% and 36%, respectively. On the contrary, late rehabilitation patients improved their
23
physical activity levels and QoL by 27% and 29%, respectively.28 More details should
have been provided on the limitations and biases.These include lack of control,
confounding variables and how the participants were selected.
1.6.
Target audience of CR
4
12
CR programmes are designated for cardiovascular patients. However, it is worth
noting that stroke patients and CAD patients share similar risk factors29,30 which is why it
could benefit them to join the cardiac rehabilitation program.31,32 However, it is
questionable whether or not they should be enrolled in the program as it produces many
ethical issues in relation to their inclusion.33 One of these issues would be occupying the
possibly available spaces for patients recovering from a heart attack. In addition, it is
important to note that stroke and cardiac patients may have different needs to treat their
specific concerns.31 Therefore, the best program for cardiac patients should include
aerobic exercises.34 This also applies to stroke patients as they are likely to suffer from
neurological deficits which can be most effectively treated with resistance exercises and
physiotherapy. It is important to note that both groups can benefit from the reduction in
risk factors, positive lifestyle changes and education but it may be unethical to combine
their treatment as it leads to inadequate care for both groups.29
2.





3.
Objectives
40
Highlight the current literature on the efficacy of hospital-based cardiac
rehabilitation.
40
Explore barriers to access and adherence to cardiac rehabilitation.
Ascertain the value of remote methods of cardiac rehabilitation in overcoming these
barriers.
Determine if CR can be expanded to include stroke patients.
Summarise and critique studies investigating alternate methods of cardiac
rehabilitation and their effectiveness.
Methodology
3.1 Search Strategy
The search was conducted across PubMed, MEDLINE, and PubMedCentral
databases. Two MeSH terms were used in the search: ”Cardiac Rehabilitation” and
”Telerehabilitation”. Additionally, other similar keywords were added to the query.
The query yielded 81 results. Their results were further narrowed by assessing them
through our inclusion criteria.
3.2 Inclusion Criteria
All studies included in this review were published between 2013-2023, measure
quantitative data and have full text available.
5
12
4.
Discussion
58
Currently, two forms of cardiac rehabilitation, center-based and home-based, are
provided to patients. During center-based rehabilitation, patients are supervised, making
it a safer option.35 However, it’s more costly as it runs over a longer course of time and
could be unsuitable for people living in rural areas.36 Home-based CR is only ideal when
the patients are compliant and disciplined enough to do everything independently. Center46
based cardiac rehabilitation had a higher drop-out rate than
home-based cardiac
55
rehabilitation. Still, both programs positively affected clinical outcomes and quality of
life.37 Home-based cardiac rehabilitation is more convenient but compromises on
improvements in chronotropic measures.38,39,27
In regard to overcoming barriers in minority groups, efforts should be made to
improve accessibility by offering home-based CR to patients struggling with constraints.
Patients should be made aware of CR programs post-discharge to prevent overwhelming
them with information. Furthermore, more equipment and staff should be allocated to CR
programs to increase uptake and decrease waiting times and improve outcomes from
timely interventions.
General solutions to the barriers faced by CR patients would be improving the
accessibility of the affiliated health care departments, making the programs more
individualized rather than doing it in groups, and raising awareness on the importance of
cardiac rehabilitation as an element of full recovery and treatment of certain heart
conditions.
5.
Conclusion
In conclusion, the importance of3 cardiac rehabilitation is usually undermined by
doctors and patients so it is necessary to assess the effectiveness of cardiac rehabilitation
in the methods available of following through with it and how accessible it is when needed.
It is also important to evaluate the different barriers that affect uptake, adherence, and
prognosis of the treatment and draw solutions to such barriers. CR could branch out to
other areas of detrimental diseases such as strokes which adds to the many motives of
uptaking of such programs.
Wordcount: 1603 not including methodology.
6
12
28
Not included in the word count
REFERENCES (VANCOUVER STYLE) (this section is not included in the
word count)
1. Cardiac rehabilitation:
your questions answered [Internet]. [cited 2023 Apr 14]. Available
43
from: https://www.bhf.org.uk/informationsupport/heart-mattersmagazine/wellbeing/cardiac-rehab
30
2. Tessler J, Bordoni B. Cardiac Rehabilitation. In: StatPearls [Internet]. Treasure Island
(FL): StatPearls Publishing; 2023 [cited 2023 Apr 11]. Available from:
http://www.ncbi.nlm.nih.gov/books/NBK537196/
48
3. MNG_D1_4. Rehabilitation
guideline of Myocardial Infarction.pdf [Internet]. [cited 2023
38
Apr 14]. Available from:
https://extranet.who.int/ncdccs/Data/MNG_D1_4.%20Rehabilitation%20guideline%20of
%20Myocardial%20Infarction.pdf
14
4. Powell R, McGregor G, Ennis S, Kimani PK, Underwood M. Is exercise-based cardiac
rehabilitation effective? A systematic review and meta-analysis to re-examine the
evidence. BMJ Open. 2018 Mar 14;8(3):e019656.
15
5. Long L, Mordi IR, Bridges C, Sagar VA, Davies EJ, Coats AJ, et al. Exercise-based
cardiac rehabilitation for adults with heart failure. Cochrane Database Syst Rev. 2019
Jan 29;1(1):CD003331.
25
6. Deley G, Culas C, Blonde MC, Mourey F, Vergès B. Physical and Psychological
Effectiveness of Cardiac Rehabilitation: Age Is Not a Limiting Factor! Can J Cardiol.
2019 Oct;35(10):1353–8.
11
7. Ruano-Ravina A, Pena-Gil C, Abu-Assi E, Raposeiras S, van ’t Hof A, Meindersma E, et
al. Participation and adherence to cardiac rehabilitation programs. A systematic review.
Int J Cardiol. 2016 Nov 15;223:436–43.
2
8. Mead H, Ramos C, Grantham SC. Drivers of Racial and Ethnic Disparities in Cardiac
Rehabilitation Use: Patient and Provider Perspectives. Med Care Res Rev. 2016
Jun;73(3):251–82.
27
9. Brueton V, Tierney J, Stenning S, Nazareth I, Meredith S, Harding S, et al. Strategies to
reduce36attrition in randomised trials. Trials. 2011 Dec;12(S1):A128.
10.
Gregory PC, LaVeist TA, Simpson C. Racial disparities in access to cardiac
rehabilitation.
Am J Phys Med Rehabil. 2006 Sep;85(9):705–10.
41
11.
Musemwa N, Gadegbeku CA. Hypertension in African Americans. Curr Cardiol
Rep. 2017
Dec;19(12):129.
33
12.
Lackland DT. Racial Differences in Hypertension: Implications for High Blood
Pressure
Management. Am J Med Sci. 2014 Aug;348(2):135–8.
31
13.
Vanzella LM, Oh P, Pakosh M, Ghisi GLM. Barriers to Cardiac Rehabilitation in
Ethnic Minority Groups: A Scoping Review. J Immigr Minor Health. 2021
Aug;23(4):824–39.
1
14.
Mathews L, Akhiwu O, Mukherjee M, Blumenthal RS, Matsushita K, Ndumele
CE. Disparities in the Use of Cardiac Rehabilitation in African Americans. Curr
Cardiovasc Risk Rep. 2022;16(5):31–41.
7
12
15.
16
Socha M, Wronecki K, Sobiech KA. Gender and age-dependent differences in
body composition changes in response to cardiac rehabilitation exercise training in
patients after coronary artery bypass grafting. Ann Agric Environ Med AAEM. 2017 Sep
21;24(3):517–21.
3
16.
Bittner V. Cardiac Rehabilitation for Women. Adv Exp Med Biol. 2018;1065:565–
77. 34
17.
Sawan MA, Calhoun AE, Fatade YA, Wenger NK. Cardiac rehabilitation in
women,
challenges and opportunities. Prog Cardiovasc Dis. 2022;70:111–8.
42
18. 37 Gaudino M, Chadow D, Rahouma M, Soletti GJ, Sandner S, Perezgrovas-Olaria
R, et al. Operative Outcomes of Women
Undergoing Coronary Artery Bypass52Surgery in
56
the US, 2011 to 2020. JAMA Surg [Internet]. 2023 Mar 1 [cited 2023 Apr 11]; Available
from: https://jamanetwork.com/journals/jamasurgery/fullarticle/2802105
32
19.
Heart Health and Aging [Internet]. National Institute on Aging. [cited 2023 Apr
11]. Available
from: https://www.nia.nih.gov/health/heart-health-and-aging
6
20.
El Missiri A, Abdel Halim WA, Almaweri AS, Mohamed TR. Effect of a phase 2
cardiac rehabilitation program on obese and non-obese patients with stable coronary
artery 24disease. Egypt Heart J. 2021 Jan 7;73:4.
21.
Istepanian R, Jovanov E, Zhang YT. Introduction to the special section on MHealth: beyond seamless mobility and global wireless health-care connectivity. IEEE
Trans Inf Technol 35Biomed Publ IEEE Eng Med Biol Soc. 2004 Dec;8(4):405–14.
22.
Telehealth [Internet]. National Institute of Biomedical Imaging and
Bioengineering. [cited 2023 Apr 11]. Available from: https://www.nibib.nih.gov/scienceeducation/science-topics/telehealth
4
23.
Sari DM, Wijaya LCG. Cardiac rehabilitation via telerehabilitation in COVID-19
pandemic
situation. Egypt Heart J. 2021 Mar 29;73(1):31.
5
24.
Ramachandran HJ, Jiang Y, Tam WWS, Yeo TJ, Wang W. Effectiveness of
home-based cardiac telerehabilitation as an alternative to Phase 2 cardiac rehabilitation
of coronary heart disease: a systematic review and meta-analysis. Eur J Prev Cardiol.
2021 Jul
13;zwab106.
17
25.
Peretti A, Amenta F, Tayebati SK, Nittari G, Mahdi SS. Telerehabilitation: Review
of the State-of-the-Art and Areas of Application. JMIR Rehabil Assist Technol. 2017 Jul
21;4(2):e7.
10
26.
Nkonde-Price C, Reynolds K, Najem M, Yang SJ, Batiste C, Cotter T, et al.
Comparison of Home-Based vs Center-Based Cardiac Rehabilitation in Hospitalization,
Medication Adherence, and Risk Factor Control Among Patients With Cardiovascular
Disease.
JAMA Netw Open. 2022 Aug 1;5(8):e2228720.
19
27.
Clark RA, Conway A, Poulsen V, Keech W, Tirimacco R, Tideman P. Alternative
models of cardiac rehabilitation: A systematic review. Eur J Prev Cardiol. 2015 Jan
1;22(1):35–74.
26
28.
Fell J, Dale V, Doherty P. Does the timing of cardiac rehabilitation impact fitness
outcomes?
An observational analysis. Open Heart. 2016 Aug 1;3(1):e000369.
12
29.
Jeffares I, Merriman NA, Doyle F, Horgan F, Hickey A. Inclusion of stroke
patients in expanded cardiac rehabilitation services: a cross-national qualitative study
with cardiac and stroke rehabilitation professionals. Disabil Rehabil. 2022
Jul;44(14):3610–22.
8
12
30.
8
Candelaria D, Kirkness A, Farrell M, Roach K, Gooley L, Fletcher A, et al.
Remote-delivered cardiac rehabilitation during COVID-19: a prospective cohort
comparison of health-related quality of life outcomes and patient experiences. Eur J
Cardiovasc
Nurs. 2022 Feb 8;zvac006.
9
31.
Marzolini S. Integrating Individuals With Stroke Into Cardiac Rehabilitation
Following Traditional Stroke Rehabilitation: Promoting a Continuum of Care. Can J
Cardiol.
2018 Oct;34(10 Suppl 2):S240–6.
9
32.
Stone JE, Dukelow S, Stone JA. Stroke Rehabilitation and Cardiac
Rehabilitation:
Siblings or Strangers? CJC Open. 2020 May 23;2(4):189–91.
22
33.
Rannikko S, Stolt M, Suhonen R, Leino-Kilpi H. Ethical issues in the care of
patients
with stroke: A scoping review. J Clin Nurs. 2019;28(1–2):20–31.
1
34.
Toma J, Hammond B, Chan V, Peacocke A, Salehi B, Jhingan P, et al. Inclusion
of People Poststroke in Cardiac Rehabilitation Programs in Canada: A Missed
Opportunity
for Referral. CJC Open. 2020 Feb 10;2(4):195–206.
13
35.
Hwang R, Bruning J, Morris NR, Mandrusiak A, Russell T. Home-based
telerehabilitation is not inferior to a centre-based program in patients with chronic heart
failure:2 a randomised trial. J Physiother. 2017 Apr;63(2):101–7.
36.
Kraal JJ, Van den Akker-Van Marle ME, Abu-Hanna A, Stut W, Peek N, Kemps
HM. Clinical and cost-effectiveness of home-based cardiac rehabilitation compared to
conventional, centre-based cardiac rehabilitation: Results of the FIT@Home study. Eur
J Prev4Cardiol. 2017 Aug;24(12):1260–73.
37.
Dalal HM, Doherty P, McDonagh ST, Paul K, Taylor RS. Virtual and in-person
cardiac
rehabilitation. The BMJ. 2021 Jun 3;373:n1270.
20
38.
Anderson L, Sharp GA, Norton RJ, Dalal H, Dean SG, Jolly K, et al. Home‐based
versus centre‐based cardiac rehabilitation. Cochrane Database Syst Rev. 2017 Jun
30;2017(6):CD007130.
21
39.
Bashshur R, Doarn CR, Frenk JM, Kvedar JC, Woolliscroft JO. Telemedicine and
the COVID-19 Pandemic, Lessons for the Future. Telemed J E-Health Off J Am
Telemed Assoc. 2020 May;26(5):571–3.
9
12
7
REFER TO THE LIBRARY TUTORIAL FOR INSTRUCTIONS ON HOW TO
COMPLETE THIS TABLE
This section is not included in the word count
expand as required
Sources
Terms used,
Hits
How articles were finally
searched,
combinations
chosen
dates
3,689
PubMed,
"Cardiac
Depending on relevance of
March 25
Rehabilitation"[Mesh]
studies and facts such as
definitions
PubMed,
"Telerehabilitation"[Mesh] 936
Depending on relevance
March 25
towards patients and
outcomes
PubMed,
("Cardiac
40
Relevant to advantages and
March 27
Rehabilitation"[Mesh])
disadvantages of stroke
AND "Stroke"[Mesh]
patients in CR
Medline,
Cardiac rehabilitation
131
How up to date and what
April 2nd
effective
groups were chosen to
determine effectiveness
Medline,
Cardiac rehabilitation
398
Relevant to cardiac
April 2nd
types
rehabilitation phases and
categories
PubMed,
Telerehabilitation
233
Up to date
April 5th
PubMed,
Cardiac rehabilitation
113
Relevant and contains
April 10
target
evidence
PubMed,
Inequalities in Cardiac
8
Evidence based and relevant
April 10
rehabilitation
to patient
10
Similarity Report ID: oid:14465:143170378
47% Overall Similarity
Top sources found in the following databases:
34% Internet database
32% Publications database
Crossref database
Crossref Posted Content database
41% Submitted Works database
TOP SOURCES
The sources with the highest number of matches within the submission. Overlapping sources will not be
displayed.
1
2
3
4
5
6
7
8
Royal College of Surgeons in Ireland on 2023-04-13
Submitted works
ncbi.nlm.nih.gov
Internet
researchgate.net
Internet
globalcardiacrehab.com
Internet
static.cigna.com
Internet
wjgnet.com
Internet
Royal College of Surgeons in Ireland on 2023-04-13
Submitted works
University of Sydney on 2022-05-24
Submitted works
6%
3%
2%
1%
1%
1%
1%
1%
Sources overview
Similarity Report ID: oid:14465:143170378
9
10
11
12
13
14
15
16
17
18
19
20
e-bnr.org
1%
Internet
University of Northumbria at Newcastle on 2023-01-13
1%
Submitted works
dukespace.lib.duke.edu
1%
Internet
Royal College of Surgeons in Ireland on 2023-04-13
1%
Submitted works
jmir.org
1%
Internet
Middlesex University on 2022-09-04
<1%
Submitted works
Kartik Deshmukh, Arjun Khanna. "Implications of managing Chronic Ob...
Crossref
repository.uantwerpen.be
<1%
Internet
rehab.jmir.org
<1%
Internet
Eddie L. Hackler, Naomi M. Hamburg, Khendi T. White Solaru. "Racial a...
Crossref
clinfowiki.org
Internet
Queensland University of Technology on 2020-03-12
Submitted works
<1%
<1%
<1%
<1%
Sources overview
Similarity Report ID: oid:14465:143170378
21
22
23
24
25
26
27
28
29
30
31
32
Sarah M Kling, Matthew M Philp. "The effects of the COVID-19 pandem...
Crossref
lsmuni.lt
Internet
eprints.whiterose.ac.uk
Internet
bmccardiovascdisord.biomedcentral.com
Internet
dspace.uef.fi
Internet
Royal College of Surgeons in Ireland on 2023-04-12
Submitted works
University of Liverpool on 2023-04-10
Submitted works
Royal College of Surgeons in Ireland on 2023-04-13
Submitted works
Colorado Technical University on 2023-01-19
Submitted works
Eric Coffman on 2022-04-18
Submitted works
ses.library.usyd.edu.au
Internet
Royal College of Surgeons in Ireland on 2023-03-02
Submitted works
<1%
<1%
<1%
<1%
<1%
<1%
<1%
<1%
<1%
<1%
<1%
<1%
Sources overview
Similarity Report ID: oid:14465:143170378
33
34
35
36
37
38
39
40
41
42
43
44
en.wikipedia.org
Internet
srpskiarhiv.rs
Internet
University of Exeter on 2022-12-12
Submitted works
link.springer.com
Internet
nhi.no
Internet
University of Hertfordshire on 2021-01-03
Submitted works
Liberty University on 2023-03-10
Submitted works
University of Nottingham on 2018-09-07
Submitted works
researchsquare.com
Internet
University of Edinburgh on 2023-03-17
Submitted works
Royal College of Surgeons in Ireland on 2023-04-14
Submitted works
essay.utwente.nl
Internet
<1%
<1%
<1%
<1%
<1%
<1%
<1%
<1%
<1%
<1%
<1%
<1%
Sources overview
Similarity Report ID: oid:14465:143170378
45
46
47
48
49
50
51
52
53
54
55
56
University of Edinburgh on 2022-08-18
Submitted works
University of Lancaster on 2021-01-11
Submitted works
Montana State University, Billings on 2018-11-16
Submitted works
Singapore Institute of Technology on 2022-02-21
Submitted works
mhealth.jmir.org
Internet
South Bank University on 2022-10-07
Submitted works
University of Aberdeen on 2021-04-01
Submitted works
University of Brighton on 2023-04-03
Submitted works
University of Glamorgan on 2017-04-24
Submitted works
library.unisel.edu.my
Internet
research-repository.griffith.edu.au
Internet
cjess.ca
Internet
<1%
<1%
<1%
<1%
<1%
<1%
<1%
<1%
<1%
<1%
<1%
<1%
Sources overview
Similarity Report ID: oid:14465:143170378
57
58
59
60
Cardiff University on 2021-11-29
<1%
Submitted works
H. M Dalal, A. Zawada, K. Jolly, T. Moxham, R. S Taylor. "Home based v...
Crossref
Sebastian Hinde, Alexander Harrison, Laura Bojke, Patrick Doherty. "Qu...
Crossref
University of Salford on 2023-03-23
Submitted works
<1%
<1%
<1%
Sources overview