New perspectives for motivating better decisions in older adults

JoNell Strough, Wändi Bruine de Bruin, Ellen Peters, JoNell Strough, Wändi Bruine de Bruin, Ellen Peters

Abstract

Decision-making competence in later adulthood is affected by declines in cognitive skills, and age-related changes in affect and experience can sometimes compensate. However, recent findings suggest that age-related changes in motivation also affect the extent to which adults draw from experience, affect, and deliberative skills when making decisions. To date, relatively little attention has been given to strategies for addressing age-related changes in motivation to promote better decisions in older adults. To address this limitation, we draw from diverse literatures to suggest promising intervention strategies for motivating older recipients' motivation to make better decisions. We start by reviewing the life-span developmental literature, which suggests that older adults' motivation to put effort into decisions depends on the perceived personal relevance of decisions as well as their self-efficacy (i.e., confidence in applying their ability and knowledge). Next, we discuss two approaches from the health intervention design literature, the mental models approach and the patient activation approach, which aim to improve motivation for decision making by improving personal relevance or by building self-efficacy or confidence to use new information and skills. Using examples from these literatures, we discuss how to construct interventions to motivate good decisions in later adulthood.

Keywords: aging; cognition; decision making; emotions; interventions; mental models; motivation; self efflicacy.

References

    1. Allen J. Y., Hilgeman M. M., Allen R. S. (2011). Prospective end-of-life treatment decisions and perceived vulnerability: future time left to live and memory self-efficacy. Aging Ment. Health 15, 122–131. 10.1080/13607863.2010.505229
    1. Anderson B. L., Obrecht N. A., Chapman G. B., Driscoll D. A., Schulkin J. (2011). Physicians’ communication of Down syndrome screening test results: the influence of physician numeracy. Genet. Med. 13, 744–749. 10.1097/GIM.0b013e31821a370f
    1. Arkes H. R., Blumer C. (1985). The psychology of sunk cost. Organ. Behav. Hum. Decis. Process. 35, 124–140. 10.1016/0749-5978(85)90049-4
    1. Bandura A. (1997). Self-efficacy: The Exercise of Control. New York, NY: Freeman.
    1. Barber S. J., Mather M. (2014). “Stereotype threat in older adults: when and why does it occur and who is most affected?” in Emotion, Social Cognition, and Problem Solving During Adulthood, eds Verhaeghen P., Hertzog C. (New York, NY: Oxford University Press; ), 302–319.
    1. Berry J. M. (1999). “Memory self-efficacy in its social cognitive context,” in Social Cognition and Aging, eds Hess T. M., Blanchard-Fields F. (San Diego, CA: Academic Press; ), 70–96.
    1. Bruine de Bruin W., Bostrom A. (2013). Assessing what to address in science communication. Proc. Natl. Acad. Sci. U.S.A. 110, 14062–14068. 10.1073/pnas.1212729110
    1. Bruine de Bruin W., Downs J. S., Fischhoff B. (2007a). “Adolescents’ thinking about the risks and benefits of sexual behavior,” in Thinking with Data, eds Lovett M. C., Shah P. (Mahwah, NJ: Erlbaum; ), 421–439.
    1. Bruine de Bruin W., Parker A. M., Fischhoff B. (2007b). Individual differences in adult decision-making competence. J. Pers. Soc. Psychol. 92, 938–956. 10.1037/0022-3514.92.5.938
    1. Bruine de Bruin W., McNair S. J., Taylor A. L., Summers B., Strough J. (2015). Thinking about numbers is not my idea of fun: need for cognition mediates age differences in numeracy performance. Med. Decis. Mak. 35, 22–26. 10.1177/0272989X14542485
    1. Bruine de Bruin W., Parker A. M., Fischhoff B. (2012). Explaining adult age differences in decision-making competence. J. Behav. Decis. Mak. 25, 352–360. 10.1002/bdm.712
    1. Bruine de Bruin W., Strough J., Parker A. M. (2014). Getting older isn’t all that bad: better decisions and coping when facing “sunk costs”. Psychol. Aging 29, 642–649. 10.1037/a0036308
    1. Cacioppo J. T., Petty R. E., Feinstein J. A., Jarvis W. G. (1996). Dispositional differences in cognitive motivation: the life and times of individuals varying in need for cognition. Psychol. Bull. 119, 197–253. 10.1037/0033-2909.119.2.197
    1. Carstensen L. L. (2006). The influence of a sense of time on human development. Science 312, 1913–1915. 10.1126/science.1127488
    1. Carstensen L. L., Mikels J. A. (2005). At the intersection of emotion and cognition: aging and the positivity effect. Curr. Dir. Psychol. Sci. 14, 117–121. 10.1111/j.0963-7214.2005.00348.x
    1. Carstensen L. L., Turan B., Scheibe S., Ram N., Ersner-Hershfield H., Samanez-Larkin G. R., et al. (2011). Emotional experience improves with age: evidence based on over 10 years of experience sampling. Psychol. Aging 26, 21–33. 10.1037/a0021285
    1. Charles S., Carstensen L. (2010). Social and emotional aging. Annu. Rev. Psychol. 61, 383–409. 10.1146/annurev.psych.093008.100448
    1. Couper M. P., Singer E. (2009). The role of numeracy in informed consent for surveys. J. Empir. Res. Hum. Res. Ethics 4, 17–26. 10.1525/jer.2009.4.4.17
    1. Covey M. K., McAuley E., Kapela M. C., Collins E. G., Alex C. G., Berbaum M. L., et al. (2012). Upper-body resistance training and self-efficacy enhancement in COPD. J. Pulm. Respir. Med. 20, 1–16. 10.4172/2161-105X.S9-001
    1. Crawford J. D., Stankov L. (1996). Age differences in the realism of confidence in judgments: a calibration study using tests of fluid and crystallized intelligence. Learn. Indiv. Differ. 8, 83–103. 10.1016/S1041-6080(96)90027-8
    1. Deen D., Lu W., Rothstein D., Santana L., Gold M. R. (2011). Asking questions: the effect of a brief intervention in community health centers on patient activation. Patient Educ. Couns. 84, 257–260. 10.1016/j.pec.2010.07.026
    1. Del Missier F., Mäntylä T., Hansson P., Bruine de Bruin W., Parker A. M., Nilsson L. (2013). The multifold relationship between memory and decision making: An individual-differences study. J. Exp. Psychol. Learn. Mem. Cogn. 39, 1344–1364. 10.1037/a0032379
    1. Del Missier F., Mäntylä T., Nilsson L. (2015). “Aging, memory, and decision making,” in Aging and Decision Making: Empirical and Applied Perspectives, eds Hess T., Strough J., Löckenhoff C. (San Diego, CA: Elsevier Academic Press; ), 127–149. 10.1016/B978-0-12-417148-0.00007-8
    1. Downs J. S., Bruine de Bruin W., Fischhoff B., Murray P. J. (in press). Behavioral decision research intervention reduces risky sexual behavior. Curr. HIV Res.
    1. Downs J. S., Murray P. J., Bruine de Bruin W., White J. P., Palmgren C., Fischhoff B. (2004). Interactive video behavioral intervention to reduce adolescent females’ STD risk: a randomized controlled trial. Soc. Sci. Med. 59, 1561–1572. 10.1016/j.socscimed.2004.01.032
    1. Eccles J. (2009). Who am I and what am I going to do with my life? Personal and collective identities as motivators of action. Educ. Psychol. 44, 78–89. 10.1080/00461520902832368
    1. Eccles. J., Wigfield A. (2002). Motivational beliefs, values, and goals. Annu. Rev. Psychol. 53, 109–132. 10.1146/annurev.psych.53.100901.135153
    1. Elliot A. J., Conroy D. E., Barron K. E., Murayama K. (2010). “Achievement motives and goals: a developmental analysis,” in The Handbook of Life-span Development, Vol. 2, Social and Emotional Development, eds Lamb M. E., Freund A. M., Lerner R. M. (Hoboken, NJ: John Wiley & Sons Inc; ), 474–510.
    1. Ennis G. E., Hess T. M., Smith B. T. (2013). The impact of age and motivation on cognitive effort: implications for cognitive engagement in older adulthood. Psychol. Aging 28, 495–504. 10.1037/a0031255
    1. Finucane M. L., Gullion C. M. (2010). Developing a tool for measuring the decision-making competence of older adults. Psychol. Aging 25, 271–288. 10.1037/a0019106
    1. Frederickson B. L. (2001). The role of positive emotions in positive psychology: the broaden-and-build theory of positive emotions. Am. Psychol. 56, 218–226. 10.1037/0003-066X.56.3.218
    1. Frosch D. L., Rincon D., Ochoa S., Mangione C. M. (2010). Activating seniors to improve chronic disease care: results from a pilot intervention study. J. Am. Geriatr. Soc. 58, 1496–1503. 10.1111/j.1532-5415.2010.02980.x
    1. Fung H. H., Carstensen L. (2003). Sending memorable messages to the old: age differences in preferences and memory for advertisements. J. Pers. Soc. Psychol. 85, 163–178. 10.1037/0022-3514.85.1.163
    1. Fung H. H., Carstensen L. L., Lutz A. M. (1999). The influence of time on social preferences: implications for life-span development. Psychol. Aging 14, 595–604. 10.1037/0882-7974.14.4.595
    1. Gigerenzer G., Hoffrage U., Kleinbölting H. (1991). Probabilistic mental models: a Brunswikian theory of confidence. Psychol. Rev. 98, 506–528. 10.1037/0033-295X.98.4.506
    1. Gentner D. (2002). “Mental models, psychology of,” in International Encyclopedia of the Social and Behavioral Sciences, eds Smelser N. J., Bates P. B. (Amsterdam: Elsevier; ), 9683–9687.
    1. Greene J., Hibbard J. H. (2012). Why does patient activation matter? An examination of the relationships between patient activation and health-related outcomes. J. Gen. Intern. Med. 27, 520–526. 10.1007/s11606-011-1931-2
    1. Hansson P., Rönnlund M., Juslin P., Nilsson L. (2008). Adult age differences in the realism of confidence judgments: overconfidence, format dependence, and cognitive predictors. Psychol. Aging 23, 531–544. 10.1037/a0012782
    1. Hess T. M. (2005). Memory and Aging in Context. Psychol. Bull. 131, 383–406. 10.1037/0033-2909.131.3.383
    1. Hess T. M. (2014). Selective engagement of cognitive resources: Motivational influences on older adults’ cognitive functioning. Perspect. Psychol. Sci. 9, 388–407. 10.1177/1745691614527465
    1. Hess T. M., Germain C. M., Swaim E. L., Osowski N. L. (2009). Aging and selective engagement: The moderating impact of motivation on older adults’ resource utilization. J. Gerontol. B Psychol. Sci. Soc. Sci. 64B, 447–456. 10.1093/geronb/gbp020
    1. Hess T. M., Queen T. L. (2014). “Aging influences on judgment and decision processes: interactions between ability and experience,” in Emotion, Social Cognition, and Problem Solving During Adulthood, eds Verhaeghen P., Hertzog C. (New York, NY: Oxford University Press; ), 238–255.
    1. Hess T. M., Queen T. L., Ennis G. E. (2013). Age and self-relevance effects on information search during decision making. J. Gerontol. B Psychol. Sci. Soc. Sci. 68, 703–711. 10.1093/geronb/gbs108
    1. Hess T. M., Rosenberg D. C., Waters S. J. (2001). Motivation and representational processes in adulthood: the effects of social accountability and information relevance. Psychol. Aging 16, 629–642. 10.1037/0882-7974.16.4.629
    1. Hibbard J. H., Mahoney E. R. (2010). Toward a theory of patient and consumer activation. Patient Educ. Couns. 78, 377–381. 10.1016/j.pec.2009.12.015
    1. Hibbard J. H., Mahoney E., Stockard J., Tusler M. (2005). Development and testing of a short form of the Patient Activation Measure (PAM). Health Serv. Res. 40, 1918–1930. 10.1111/j.1475-6773.2005.00438.x
    1. Hibbard J. H., Stockard J., Mahoney E. R., Tusler M. (2004). Development of the Patient Activation Measure (PAM): conceptualizing and measuring activation in patient and consumers. Health Serv. Res. 39, 1005–1026. 10.1111/j.1475-6773.2004.00269.x
    1. Hummert M. (2011). “Age stereotypes and aging” in Handbook of the Psychology of Aging, 7th Edn, eds Schaie K., Willis S. L. (San Diego, CA: Elsevier Academic Press; ), 249–262.
    1. Isaacowitz D. M., Choi Y. (2012). Looking, feeling, and doing: are there age differences in attention, mood, and behavioral responses to skin cancer information? Health Psychol. 31, 650–659. 10.1037/a0026666
    1. Isen A. (2008). “Some ways in which positive affect influences decision making and problem solving,” in Handbook of Emotions, Vol. 3, eds Lewis M., Haviland-Jones J. M., Barrett L. F. (New York, NY: Guilford Press; ), 548–573.
    1. Johnson M. M. S. (1990). Age differences in decision making: a process methodology for examining strategic information processing. J. Gerontol. B Psychol. Sci. Soc. Sci. 45, 75–78. 10.1093/geronj/45.2.P75
    1. Juslin P., Winman A., Olsson H. (2000). Naive empiricism and dogmatism in confidence research: a critical examination of the hard-easy effect. Psychol. Rev. 107, 384–396. 10.1037/0033-295X.107.2.384
    1. Keren G. (1991). Calibration and probability judgments: conceptual and methodological issues. Acta Psychol. 3, 217–273. 10.1016/0001-6918(91)90036-Y
    1. Kim S., Healey M. K., Goldstein D., Hasher L., Wiprzycka U. J. (2008). Age differences in choice satisfaction: a positivity effect in decision making. Psychol. Aging 23, 33–38. 10.1037/0882-7974.23.1.33
    1. Kinsella K., He W. (2008). An Aging World: 2008. International Population Reports, P95/09-1. Washington, DC: US Government Printing Office.
    1. Kovalchik S., Camerer C. F., Grether D. M., Plott C. R., Allman J. M. (2005). Aging and decision making: a comparison between neurologically healthy elderly and young individuals. J. Econ. Behav. Organ. 58, 79–94. 10.1016/j.jebo.2003.12.001
    1. Kullgren J. T., Harkins K. A., Bellamy S. L., Gonzales A., Tao Y., Zhu J., et al. (2014). A mixed-methods randomized controlled trial of financial incentives and peer networks to promote walking among older adults. Health Educ. Behav. 41, 43S–50S. 10.1177/1090198114540464
    1. Larson J. L., Covey M. K., Kapella M. C., Alex C. G., McAuley E. (2014). Self-efficacy enhancing intervention increases light physical activity in people with chronic obstructive pulmonary disease. Int. J. Chron. Obstruct. Pulmon. Dis. 9, 1081–1090. 10.2147/COPD.S66846
    1. Leventhal E. A., Leventhal H., Schaefer P., Easterling D. (1993). Conservation of energy, uncertainty reduction, and swift utilization of medical care among the elderly. J. Gerontol. B Psychol. Sci. Soc. Sci. 48, 78–86. 10.1093/geronj/48.2.P78
    1. Levy B. R., Zonderman A. B., Slade M. D., Ferrucci L. (2012). Memory shaped by age stereotypes over time. J. Gerontol. B Psychol. Sci. Soc. Sci. 67B, 432–436. 10.1093/geronb/gbr120
    1. Li Y., Gao J., Enkavi A. Z., Zaval L., Weber E. U., Johnson E. J. (2014). Sound credit scores and financial decisions despite cognitive aging. Proc. Natl. Acad. Sci. U.S.A. 112, 65–69. 10.1073/pnas.1413570112
    1. Löckenhoff C. E., Carstensen L. L. (2007). Aging, emotion, and health-related decision strategies: motivational manipulations can reduce age differences. Psychol. Aging 22, 134–146. 10.1037/0882-7974.22.1.134
    1. Lorig K., Green M., Ritter P. L., Jernigan V. B. B., Laurent D. D., et al. (2009). Online diabetes self-management program: a randomized study. Diabetes Care 33, 1275–1281. 10.2337/dc09-2153
    1. Mather M., Carstensen L. L. (2005). Aging and motivated cognition: the positivity effect in attention and memory. Trends Cogn. Sci. 9, 496–502. 10.1016/j.tics.2005.08.005
    1. Mather M., Knight M., McCaffrey M. (2005). The allure of the alignable: younger and older adults’ false memories of choice features. J. Exp. Psychol. Gen. 134, 38–51. 10.1037/0096-3445.134.1.38
    1. McAuley E., Courneya K. S., Rudolph D. L., Lox C. L. (1994). Enhancing exercise adherence in middle-aged males and females. Prev. Med. 23, 498–506. 10.1006/pmed.1994.1068
    1. Mikels J. A., Löckenhoff C. E., Maglio S. J., Carstensen L. L., Goldstein M. K., Garber A. (2010). Following your heart or your head: focusing on emotions versus information differentially influences the decisions of younger and older adults. J. Exp. Psychol. Appl. 16, 87–95. 10.1037/a0018500
    1. Mikels J. A., Shuster M. M., Thai S. T. (2015). “Aging, emotion, and decision making,” in Aging and Decision Making: Empirical and Applied Perspectives, eds Hess T. M., Strough J., Löckenhoff C. (San Diego, CA: Elsevier Academic Press; ), 169–188.
    1. Miron-Shatz T., Hanoch Y., Doniger G. M., Omer Z. B., Ozanne E. M. (2014). Subjective but not objective numeracy influences willingness to pay for BRCA1/2 genetic testing. Judgm. Decis. Mak. 9, 152–158.
    1. Meyer B. F., Talbot A. P., Ranalli C. (2007). Why older adults make more immediate treatment decisions about cancer than younger adults. Psychol. Aging 22, 505–524. 10.1037/0882-7974.22.3.505
    1. Meyer D., Leventhal H., Gutmann M. (1985). Common-sense models of illness: The example of hypertension. Health Psychol. 4, 115–135.
    1. Morgan M. G., Fischhoff B., Bostrom A., Atman C. J. (2002). Risk Communication: a Mental Models Approach. Cambridge: Cambridge University Press.
    1. Nersessian N. J. (1992). Cognitive Models of Science, eds Giere R. N. (Minneapolis: Univ of Minnesota Press; ), 3–45.
    1. Noar S. M. (2005). A health educator’s guide to theories of health behavior. Int. Q. Community Health Educ. 24, 75–92. 10.2190/DALP-3F95-GCT3-M922
    1. Notthoff N., Carstensen L. L. (2014). Positive messaging promotes walking in older adults. Psychol. Aging 29, 329–341. 10.1037/a0036748
    1. Parker A. M., Bruine de Bruin W., Yoong J., Willis R. (2012). Inappropriate confidence and retirement planning: four studies with a national sample. J. Behav. Decis. Mak. 25, 382–389. 10.1002/bdm.745
    1. Parker A. M., Stone E. R. (2014). Identifying the effects of unjustified confidence versus overconfidence: Lessons learned from two analytic methods. J. Behav. Decis. Mak. 27, 134–145. 10.1002/bdm.1787
    1. Payne B. R., Jackson J. J., Hill P. L., Gao X., Roberts B. W., Stine-Morrow E. L. (2012). Memory self-efficacy predicts responsiveness to inductive reasoning training in older adults. J. Gerontol. B Psychol. Sci. Soc. Sci. 67B, 27–35. 10.1093/geronb/gbr073
    1. Peters E., Bjalkebring P. (2015). Multiple numeric competencies: when a number is not just a number. J. Pers. Soc. Psychol. 108, 802–822. 10.1037/pspp0000019
    1. Peters E., Bruine de Bruin W. (2012). “Aging and decision skills,” in Judgment and Decision Making as a Skill: Learning, Development, and Evolution, eds Dhami M. K., Schlottmann A., Waldmann M. (New York: Cambridge University Press; ), 113–139.
    1. Peters E., Hess T. M., Västfjäll D., Auman C. (2007). Adult age differences in dual information processes: implications for the role of affective and deliberative processes in older adults’ decision making. Perspect. Psychol. Sci. 2, 1–23. 10.1111/j.1745-6916.2007.00025.x
    1. Reed A. E., Chan L., Mikels J. A. (2014a). Meta-analysis of the age-related positivity effect: age differences in preferences for positive over negative information. Psychol. Aging 29, 1–15. 10.1037/a0035194
    1. Reed A. E., Sims T. L., English T., Carstensen L. (2014b). “The age-related positivity effect in decision making: implications for choice quality,” in Age Differences in Decision Making: Balancing Affect and Reason in Financial and Healthcare Settings. Symposium Conducted at the Annual Meeting of the Gerontological Society of America, eds Strough J., Löckenhoff C. E. (Chairs), (Gerontological Society of America: Washington; ).
    1. Reed A. E., Mikels J. A., Löckenhoff C. E. (2013). Preferences for choice across adulthood: age trajectories and potential mechanisms. Psychol. Aging 28, 625–632. 10.1037/a0031399
    1. Reed A. E., Mikels J. A., Simon K. I. (2008). Older adults prefer less choice than young adults. Psychol. Aging 23, 671–675. 10.1037/a0012772
    1. Reyna V. F., Nelson W. L., Han P. K., Dieckmann N. F. (2009). How numeracy influences risk comprehension and medical decision making. Psychol. Bull. 135, 943–973. 10.1037/a0017327
    1. Rolison J. J., Wood S., Hanoch Y., Liu P. J. (2013). Subjective numeracy scale as a tool for assessing statistical numeracy in older adult populations. Gerontology 59, 283–288. 10.1159/000345797
    1. Shamaskin A. M., Mikels J. A., Reed A. E. (2010). Getting the message across: age differences in the positive and negative framing of health care messages. Psychol. Aging 25, 746–751. 10.1037/a0018431
    1. Smith S. G., Wolf M. S., von Wagner C. (2010). Socioeconomic status, statistical confidence, and patient-provider communication: an analysis of the Health Information National Trends Survey (HINTS 2007). J. Health Commun. 15(Suppl. 3), 169–185. 10.1080/10810730.2010.522690
    1. Strough J., Karns T., Schlosnagle L. (2011a). Decision making heuristics and biases across the life span. Ann. N. Y. Acad. Sci. 1235, 57–74. 10.1111/j.1749-6632.2011.06208.x
    1. Strough J., Schlosnagle L., DiDonato L. (2011b). Understanding decisions about sunk costs from older and younger adults’ perspectives. J. Gerontol. B Psychol. Sci. Soc. Sci. 66B, 681–686. 10.1093/geronb/gbr057
    1. Strough J., Mehta C. M., McFall J. P., Schuller K. L. (2008). Are older adults less subject to the sunk-cost fallacy than younger adults? Psychol. Sci. 19, 650–652. 10.1111/j.1467-9280.2008.02138.x
    1. Strough J., Parker A. M., Bruine de Bruin W. (2015). “Understanding life-span developmental changes in decision-making competence,” in Aging and Decision Making: Empirical and Applied Perspectives, eds Hess T., Strough J., Löckenhoff C. (San Diego, CA: Elsevier Academic Press; ), 235–257.
    1. Thomas A. K., Millar P. R. (2012). Reducing the framing effect in older and younger adults by encouraging analytic processing. J. Gerontol. B Psychol. Sci. Soc. Sci. 67B, 139–149. 10.1093/geronb/gbr076
    1. von Helversen B., Mata R. (2012). Losing a dime with a satisfied mind: positive affect predicts less search in sequential decision making. Psychol. Aging 27, 825–839. 10.1037/a0027845
    1. Vosniadou S. (2002). “Model-based reasoning in conceptual development.” in Model-based reasoning., eds Magnani L., Nersessian N. J. (New York: Springer; ), 353–368.
    1. Vosniadou S., Brewer W. F. (1992). Mental models of the earth: a study of conceptual change in childhood. Cogn. Psychol. 24, 535–585. 10.1016/0010-0285(92)90018-W
    1. West R. L., Hastings E. C. (2011). Self-regulation and recall: growth curve modeling of intervention outcomes for older adults. Psychol. Aging 26, 803–812. 10.1037/a0023784
    1. Wilson T. D., Schooler J. W. (1991). Thinking too much: introspection can reduce the quality of preferences and decisions. J. Pers. Soc. Psychol. 60, 181–192. 10.1037/0022-3514.60.2.181
    1. Woodward N. J., Wallston B. S. (1987). Age and health care beliefs: self-efficacy as a mediator of low desire for control. Psychol. Aging 2, 3–8. 10.1037/0882-7974.2.1.3
    1. Worthy D. A., Otto A. R., Doll B. B., Byrne K. A., Maddox W. T. (2015). Older adults are highly responsive to recent events during decision-making. Decisions 2, 27–38. 10.1037/dec0000018
    1. Zaval L., Li Y., Johnson E., Weber E. (2015). “Complementary contributions of fluid and crystallized intelligence to decision making across the life span,” in Aging and Decision Making: Empirical and Applied Perspectives, eds Hess T., Strough J., Löckenhoff C. (San Diego, CA: Elsevier Academic Press; ), 149–168.

Source: PubMed

Sponsor e collaboratori

Condizioni mediche

Interventi farmacologici

3
Sottoscrivi