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Johansson, K., Norström, F., Ivarsson, A., Richter Sundberg, L., Själander, A., Therrien, A., . . . Myléus, A. (2025). Early career progression in young adults with coeliac disease: a register‐based retrospective cohort study. Acta Paediatrica
Open this publication in new window or tab >>Early career progression in young adults with coeliac disease: a register‐based retrospective cohort study
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2025 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227Article in journal (Refereed) Epub ahead of print
Abstract [en]

Aim: To investigate early career progression and national insurance use in young adults with paediatric coeliac disease.

Methods: We performed a register study of a population born in Sweden between 1976 and 1992. Coeliac disease was diagnosed before 15 years of age. The comparison population was matched 4:1 by sex, region of residence at birth and birth year/month. We analysed education, employment, income, job position and national insurance use (sickness benefits, parental leave benefits and social welfare provision) at 25 and 30 years of age.

Results: We identified 1812 individuals with coeliac disease (6888 comparison population) at 25 years of age and 263 individuals (984 comparison population) at 30 years of age. No statistically significant differences were seen in education, employment, income, job position, use of parental leave benefits or social welfare provision. More individuals with coeliac disease used sickness benefits at age 25 years (OR 1.34 [95% CI 1.12–1.59]).

Conclusion: In this register study, we showed that coeliac disease diagnosed in childhood does not cause disadvantages on career progression on a population level. However, findings suggest that coeliac disease increases the risk for sickness benefit use.

Place, publisher, year, edition, pages
John Wiley & Sons, 2025
Keywords
career, children, coeliac disease, gluten-free diet, national insurance use
National Category
Gastroenterology and Hepatology
Identifiers
urn:nbn:se:umu:diva-237021 (URN)10.1111/apa.70073 (DOI)001455667300001 ()40150956 (PubMedID)2-s2.0-105001636639 (Scopus ID)
Funder
Region Västerbotten
Note

Funding: The Center for Clinical Research Region Dalarna, Anna Cederberg foundation, Faculty of Medicine Umeå University, National Research Schoolin General Practice, Region Västerbotten and the Swedish Celiac Disease Association supported with funding of the project. Research reported in this publication was supported by the National Institute of Diabetes And Digestive And Kidney Diseases of the National Institutes of Health under Award NumberK23DK119584. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes ofHealth. This study was supported by the ISSCD M-in-M programme. The ISSCD M-in-M programme has been made possible by an unrestricted grant fromTakeda Pharmaceuticals. The Umeå SIMSAM Lab data infrastructure used in this study was developed with support from the Swedish Research Council, the Riksbanken Jubileumsfond and by strategic funds from Umeå University. The work was done independent of the funding source.

Available from: 2025-03-30 Created: 2025-03-30 Last updated: 2025-04-28
Norström, F., Bölenius, K., Sahlen, K.-G., Zingmark, M. & Pettersson-Strömbäck, A. (2025). In-home work environment for home care workers in Northern Sweden before and during the Covid-19 pandemic. BMC Health Services Research, 25(1), Article ID 137.
Open this publication in new window or tab >>In-home work environment for home care workers in Northern Sweden before and during the Covid-19 pandemic
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2025 (English)In: BMC Health Services Research, E-ISSN 1472-6963, Vol. 25, no 1, article id 137Article in journal (Refereed) Published
Abstract [en]

Background: The in‑home work environment is the main work environment for home care workers, but it has only been sparsely studied. Our aim was to investigate the in‑home work environment for home care workers by exploring challenges that arise regardless of a pandemic and by investigating Covid‑19–specific challenges.

Methods: Two cross‑sectional studies were conducted, one before (2017) and one during the pandemic (2021/2022) in three Swedish regions (Jämtland/Härjedalen, Västerbotten and Västernorrland), in which 1,154 (58%) out of 2,000 and 629 (33%) of 1,900 invited home care workers participated, respectively. Participants responded to a question‑naire asking about 10 problems associated with the in‑home work environment as well as Covid‑19–related chal‑lenges. Comparisons were conducted between regions and between study years using univariable analyses.

Results: Daily problems with the in‑home work environment were common before the pandemic, and they increased statistically significantly during the pandemic for, among other things, non‑ergonomic beds (29% vs. 37%), impractical bathrooms (40% vs. 50%), indoor smoking (24% vs. 31%), and pets (19% vs. 25%). There were major con‑cerns about the risk of getting infected with Covid‑19 for both staff (42%) and the home care recipients (50%). There were statistically significant differences between regions, e.g. many problems were more common in the Västerbotten region than in the other two regions during the pandemic, while challenges with protective equipment was most common in the Västernorrland region.

Conclusions: In‑home work environment problems are common for home care workers and worsen in a more strained situation. Efforts are needed to strengthen the work environment for home care workers.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2025
Keywords
Staff, Equipment, Work conditions, Cross‑sectional study
National Category
Public Health, Global Health and Social Medicine
Research subject
Occupational and Environmental Medicine; Epidemiology; Geriatrics
Identifiers
urn:nbn:se:umu:diva-234581 (URN)10.1186/s12913-024-12161-y (DOI)001406133600004 ()39856654 (PubMedID)2-s2.0-85217000627 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2015-00647AFA Insurance, 200340
Available from: 2025-01-24 Created: 2025-01-24 Last updated: 2025-03-03Bibliographically approved
Sondell, A., Widar, L., Stigmar, K., Norström, F., Fjellman-Wiklund, A. & Eskilsson, T. (2025). Managers’ experiences of the Workplace Dialogue: a digital support for detecting and acting on work-related ill-health. International Journal of Workplace Health Management
Open this publication in new window or tab >>Managers’ experiences of the Workplace Dialogue: a digital support for detecting and acting on work-related ill-health
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2025 (English)In: International Journal of Workplace Health Management, ISSN 1753-8351, E-ISSN 1753-836XArticle in journal (Refereed) Epub ahead of print
Abstract [en]

Purpose: The Workplace Dialogue is a digitalized method directed at managers. The purpose of this study was to explore managers’ experiences of using the digital Workplace Dialogue in cases of employee ill-health.

Design/methodology/approach: The Workplace Dialogue provides an easy and accessible method for managers, including text, short films, client examples and concrete guides that provides support in how managers can act in the event of ill-health, for example, by creating dialogue and adjustments at work. A total of five public and private organizations participated in a cohort study, implementing and using the Workplace Dialogue for one year. We interviewed 22 managers to explore their experiences of using the Workplace Dialogue. The interviews were analyzed using Qualitative Content Analysis.

Findings: The experiences of using the Workplace Dialogue are presented in one overall theme: Supports and strengthens managers’ leadership and ability to handle and act on work-related health, and four sub-themes: Requires organizational legitimacy, Facilitates management of work-related health, Strengthens manager–employee collaboration and Contributes to leadership development. The Workplace Dialogue was described as a method that contributed to better work-related health by emphasizing the early identification of problems. Manager–employee collaboration was improved, and responsibilities were made clearer. Using the method enabled personal development among managers. Some prerequisites were pointed out, such as a need for time and support from the organization.

Originality/value: The Workplace Dialogue can support managers in addressing and acting on cases of employee ill-health.

Place, publisher, year, edition, pages
Emerald Group Publishing Limited, 2025
Keywords
s Leadership, Qualitative research, Occupational health, Workplace intervention, Work rehabilitation
National Category
Work Sciences
Research subject
Occupational and Environmental Medicine
Identifiers
urn:nbn:se:umu:diva-237005 (URN)10.1108/ijwhm-03-2024-0049 (DOI)001445812900001 ()2-s2.0-105000273690 (Scopus ID)
Funder
AFA Insurance
Available from: 2025-03-28 Created: 2025-03-28 Last updated: 2025-04-07
Kallerhult Hermansson, S., Hilli, Y., Solbakken, R., Norström, F. & Bölenius, K. (2025). The need for organisational structure and leadership support: a qualitative study on nurse mentors' perspectives on the prerequisites for effective mentoring. Journal of Advanced Nursing
Open this publication in new window or tab >>The need for organisational structure and leadership support: a qualitative study on nurse mentors' perspectives on the prerequisites for effective mentoring
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2025 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648Article, review/survey (Refereed) Epub ahead of print
Abstract [en]

Background: Research consistently underscores the importance of mentoring and a supportive work environment for nurse retention and well-being. Previous research on nurse mentoring has primarily focused on mentees' perspectives. Research is scarce on the prerequisites for mentoring from the perspective of mentors—experienced registered nurses who guide and support their new colleagues, mentees.

Aim: To explore nurse mentors' perspectives on the prerequisites for mentoring, following their participation in a mentoring intervention.

Design: Qualitative study design with an inductive approach using focus group interviews as a data collection method.

Methods: A total of 19 experienced registered nurses, appointed as mentors, were interviewed in four focus groups and one individual interview, in May and June 2022, following the conclusion of the intervention period. Focus groups consisted of three to six participants. The transcribed interview data were analysed using qualitative content analysis.

Results: The main theme identified in the results was that mentors needed organisational structure and leaders' support to facilitate the mentoring process. Participants underscored the necessity of a comprehensive support system that spans the entire mentoring process, as described in three themes: creating foundations for mentoring; navigating mentoring challenges in everyday work routines; and post-mentoring reflection and learning.

Conclusions: This study underscores the importance of integrating mentoring into daily healthcare routines by addressing barriers and facilitators, such as organisational structure and support from first line leaders. Key results highlight the need for pre- and post-mentoring phases to create a sustainable, continuous learning process. Further research should focus on developing sustainable frameworks for implementing mentoring.

Implications for the Profession: Policies should explicitly support the dual role of experienced registered nurses as both caregivers and mentors, acknowledging the demands on their time and responsibilities. Policymakers should integrate mentoring frameworks into nursing roles. This could play a critical role in stabilising the work environment.

Place, publisher, year, edition, pages
John Wiley & Sons, 2025
Keywords
evaluation research, focus groups, mentors, nurse roles, professional development, qualitative approaches
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-237039 (URN)10.1111/jan.16948 (DOI)40159667 (PubMedID)2-s2.0-105001825008 (Scopus ID)
Funder
Region Västerbotten, 232100‐0222Umeå University, 202100-2874
Available from: 2025-04-01 Created: 2025-04-01 Last updated: 2025-04-29
Lindgren, M., Palmkvist, E., Norström, F., Cerqueiro Bybrant, M., Myléus, A., Samuelsson, U., . . . Carlsson, A. (2024). Cumulative incidence of type 1 diabetes in two cohorts of children with different national gluten recommendations in infancy. Acta Diabetologica, 61(1), 35-41
Open this publication in new window or tab >>Cumulative incidence of type 1 diabetes in two cohorts of children with different national gluten recommendations in infancy
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2024 (English)In: Acta Diabetologica, ISSN 0940-5429, E-ISSN 1432-5233, Vol. 61, no 1, p. 35-41Article in journal (Refereed) Published
Abstract [en]

Aims: Between 1985 and 1996, Sweden experienced an "epidemic" of celiac disease with a fourfold increase in incidence in young children. Timing and amount of gluten introduced during infancy have been thought to explain this "epidemic". We aimed to study whether the cumulative incidence of type 1 diabetes differs between children born during the "epidemic" compared to children born after.

Methods: This is a national register study in Sweden comparing the cumulative incidence of type 1 diabetes in two birth cohorts of 240 844 children 0-17 years old born 1992-1993, during the "epidemic", and 179 530 children born 1997-1998, after the "epidemic". Children diagnosed with type 1 diabetes were identified using three national registers.

Results: The cumulative incidence of type 1 diabetes by the age of 17 was statistically significantly higher in those born after the "epidemic" 0.77% than in those born during the "epidemic" 0.68% (p < 0.001).

Conclusion: The incidence of type 1 diabetes is higher in those born after the epidemic compared to those born during the epidemic, which does not support the hypothesis that gluten introduction increases the incidence of T1D. Changes in gluten introduction did not halt the increased incidence of type 1 diabetes in Sweden.

Place, publisher, year, edition, pages
Springer, 2024
Keywords
Celiac disease, Early childhood risk factors, Gluten, Infant feeding, Paediatric type 1 diabetes.
National Category
Endocrinology and Diabetes
Identifiers
urn:nbn:se:umu:diva-213517 (URN)10.1007/s00592-023-02168-y (DOI)001049930400001 ()37589890 (PubMedID)2-s2.0-85168120077 (Scopus ID)
Funder
Lund UniversitySwedish Association of Local Authorities and Regions, ALF 2018/2022
Available from: 2023-08-24 Created: 2023-08-24 Last updated: 2024-04-19Bibliographically approved
Meili, K. W., Mulhern, B., Ssegonja, R., Norström, F., Feldman, I., Månsdotter, A., . . . Lindholm, L. (2024). Eliciting a value set for the Swedish capability-adjusted life years instrument (CALY-SWE). Quality of Life Research, 33(1), 59-72
Open this publication in new window or tab >>Eliciting a value set for the Swedish capability-adjusted life years instrument (CALY-SWE)
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2024 (English)In: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 33, no 1, p. 59-72Article in journal (Refereed) Published
Abstract [en]

Purpose: Our aim was to elicit a value set for Capability-Adjusted Life Years Sweden (CALY-SWE); a capability-grounded quality of life instrument intended for use in economic evaluations of social interventions with broad consequences beyond health.

Methods: Building on methods commonly used in the quality-adjusted life years EQ-5D context, we collected time-trade off (TTO) and discrete choice experiment (DCE) data through an online survey from a general population sample of 1697 Swedish participants. We assessed data quality using a score based on the severity of inconsistencies. For generating the value set, we compared different model features, including hybrid modeling of DCE and TTO versus TTO data only, censoring of TTO answers, varying intercept, and accommodating for heteroskedasticity. We also assessed the models’ DCE logit fidelity to measure agreement with potentially less-biased DCE data. To anchor the best capability state to 1 on the 0 to 1 scale, we included a multiplicative scaling factor.

Results: We excluded 20% of the TTO answers of participants with the largest inconsistencies to improve data quality. A hybrid model with an anchor scale and censoring was chosen to generate the value set; models with heteroskedasticity considerations or individually varying intercepts did not offer substantial improvement. The lowest capability weight was 0.114. Health, social relations, and finance and housing attributes contributed the largest capability gains, followed by occupation, security, and political and civil rights.

Conclusion: We elicited a value set for CALY-SWE for use in economic evaluations of interventions with broad social consequences.

Place, publisher, year, edition, pages
Springer Nature, 2024
Keywords
Quality-adjusted life year, Time trade-off, Discrete choice experiment, Capability approach, Hybrid modeling, Economic evaluation
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:umu:diva-214379 (URN)10.1007/s11136-023-03507-w (DOI)001064459600002 ()37695477 (PubMedID)2-s2.0-85170367443 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2018-00143Forte, Swedish Research Council for Health, Working Life and Welfare, 2018-00143
Available from: 2023-09-13 Created: 2023-09-13 Last updated: 2024-04-29Bibliographically approved
Kallerhult Hermansson, S., Kasén, A., Hilli, Y., Norström, F., Vaag, J. R. & Bölenius, K. (2024). Exploring registered nurses’ perspectives as mentors for newly qualified nurses: a qualitative interview study. BMJ Open, 14(5), Article ID e082940.
Open this publication in new window or tab >>Exploring registered nurses’ perspectives as mentors for newly qualified nurses: a qualitative interview study
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2024 (English)In: BMJ Open, E-ISSN 2044-6055, Vol. 14, no 5, article id e082940Article in journal (Refereed) Published
Abstract [en]

Objective: Existing research has focused mostly on mentees’ experiences of mentoring rather than mentors’ experiences. Therefore, this study describes registered nurses’ experiences of being a mentor for newly qualified nurses.

Design: A qualitative interview study based on semistructured individual interviews. Interviews were analysed using qualitative content analysis.

Participants and setting: A purposive sample of experienced registered nurses (n=21) from healthcare units in northern Sweden and northern Norway. Inclusion criteria were to have been a mentor to at least one newly qualified nurse, hold permanent employment of 75%–100% as a registered nurse and to be able to communicate in Swedish or Norwegian.

Results: Our study’s findings suggest that being a mentor plays a crucial role in establishing safety in complex work environments. The main theme consists of three themes: feeling motivated in being a mentor; continuously developing the learning environment; and navigating obstacles and cultivating support.

Conclusion: Being a mentor is a complicated role for registered nurses. The mentoring role is beneficial—ie, positive and rewarding—if facilitated sufficiently in the context of a structured organisation. This study brings a more profound understanding of and provides new insights into registered nurses’ perspectives and needs regarding being a mentor and the study’s findings make an important contribution to the field of nursing regarding the facilitation of mentoring.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2024
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-225090 (URN)10.1136/bmjopen-2023-082940 (DOI)001300458500001 ()38803253 (PubMedID)2-s2.0-85194526587 (Scopus ID)
Funder
Umeå University
Available from: 2024-05-27 Created: 2024-05-27 Last updated: 2025-04-24Bibliographically approved
Hedlund, E., Tojjar, J., Lilja, L., Elding Larsson, H., Forsander, G., Ludvigsson, J., . . . Carlsson, A. (2024). Family history of diabetes and clinical characteristics in children at diagnosis of type 1 diabetes: a Swedish population-based study. Diabetes Care, 47(11), 2012-2016
Open this publication in new window or tab >>Family history of diabetes and clinical characteristics in children at diagnosis of type 1 diabetes: a Swedish population-based study
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2024 (English)In: Diabetes Care, ISSN 0149-5992, E-ISSN 1935-5548, Vol. 47, no 11, p. 2012-2016Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To compare the prevalence of parental diabetes between children with and without type 1 diabetes (T1D), and to compare clinical characteristics at diagnosis of T1D in children with, versus without, a family history of diabetes.

RESEARCH DESIGN AND METHODS: Parental diabetes among children with T1D was compared with a general population cohort. Clinical characteristics were compared by family history of diabetes in parents and grandparents of 3,603 children with T1D using relative risk (RR) and ANOVA.

RESULTS: Children with T1D more often had parents with type 2 diabetes (T2D) (RR 1.88; P < 0.001) than did children without diabetes. Children with T1D and a family history of T2D were more likely to be overweight or obese (P = 0.002).

CONCLUSIONS: A family history of T2D and being overweight may contribute to increased risk of T1D.

Place, publisher, year, edition, pages
American Diabetes Association, 2024
National Category
Endocrinology and Diabetes
Identifiers
urn:nbn:se:umu:diva-230187 (URN)10.2337/dc24-0534 (DOI)001345278000004 ()39302847 (PubMedID)2-s2.0-85207597199 (Scopus ID)
Funder
Samariten foundation for paediatric researchSwedish Child Diabetes Foundation
Available from: 2024-09-30 Created: 2024-09-30 Last updated: 2024-11-22Bibliographically approved
Kallerhult Hermansson, S., Norström, F., Hilli, Y., Rennemo Vaag, J. & Bölenius, K. (2024). Job satisfaction, professional competence, and self-efficacy: a multicenter cross-sectional study among registered nurses in Sweden and Norway. BMC Health Services Research, 24(1), Article ID 734.
Open this publication in new window or tab >>Job satisfaction, professional competence, and self-efficacy: a multicenter cross-sectional study among registered nurses in Sweden and Norway
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2024 (English)In: BMC Health Services Research, E-ISSN 1472-6963, Vol. 24, no 1, article id 734Article in journal (Refereed) Published
Abstract [en]

Background: Healthcare organizations worldwide face persistent challenges relating to turnover and intention to leave the nursing profession among registered nurses. Factors contributing to their retention and well-being at work include high job satisfaction, professional competence, and self-efficacy. Few multicenter studies have investigated these factors in relation to work experience in a Nordic context. Therefore, this study aimed to investigate job satisfaction, professional competence, and self-efficacy among registered nurses.

Methods: This multicenter cross-sectional study survey was part of a larger overarching Swedish-Norwegian project, and was conducted among registered nurses (n = 1137) in September 2021. The participants worked in a variety of health care units, e.g., hospital units, primary health care, and home care. Data was subjected to descriptive and comparative statistical analysis; chi-square test, one-way between-groups analysis of variance (ANOVA) and Kruskal-Wallis test.

Results: The findings show that job satisfaction is reported as lowest in registered nurses with medium-term work experience as compared to newly qualified and long-term work-experienced registered nurses. Professional competence and self-efficacy are reported as higher among registered nurses with long-term work experience as compared to those with medium-term work experience and newly qualified registered nurses. However, the participants reported their professional competence as highest in relation to the same factor – “Value-based nursing care” – regardless of their work experience.

Conclusions and implications: This study underscores the need for continuous support and professional development for registered nurses throughout their careers. Proactive support for newly qualified nurses may improve job satisfaction as they progress to being registered nurses with medium-term work experience. Tailored interventions to address the distinct needs of both newly qualified and medium-term work-experienced registered nurses are crucial for nurturing a sustainable nursing workforce.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2024
Keywords
Job satisfaction, Norway, Professional competence, Registered nurses, Self-efficacy, Sweden
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-226804 (URN)10.1186/s12913-024-11177-8 (DOI)001248065200006 ()38877558 (PubMedID)2-s2.0-85195915233 (Scopus ID)
Funder
Västerbotten County Council
Available from: 2024-06-20 Created: 2024-06-20 Last updated: 2025-04-24Bibliographically approved
Lindgren, M., Norström, F., Persson, M., Larsson, H. E., Forsander, G., Åkesson, K., . . . Carlsson, Á. (2024). Prevalence and predictive factors for celiac disease in children with type 1 diabetes - whom and when to screen?: A nationwide longitudinal cohort study of Swedish children. Diabetes Care, 47(4), 756-760
Open this publication in new window or tab >>Prevalence and predictive factors for celiac disease in children with type 1 diabetes - whom and when to screen?: A nationwide longitudinal cohort study of Swedish children
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2024 (English)In: Diabetes Care, ISSN 0149-5992, E-ISSN 1935-5548, Vol. 47, no 4, p. 756-760Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To examine the prevalence and predictive factors for celiac disease (CD) after a diagnosis of type 1 diabetes (T1D) in children and adolescents, to improve the current screening guidelines.

RESEARCH DESIGN AND METHODS: The association between sex, age at T1D diagnosis, HLA, and diabetes autoantibodies, and a diagnosis of CD was examined in 5,295 children with T1D from the Better Diabetes Diagnosis study in Sweden. RESULTS The prevalence of biopsy-proven CD was 9.8%, of which 58.2% already had a CD diagnosis before or at T1D onset. Almost all, 95.9%, were diagnosed with CD within 5 years after the T1D diagnosis. Younger age at the T1D diagnosis and being homozygote for DQ2 increased the risk of CD after T1D, but neither sex nor diabetes-related autoantibodies were associated with the risk.

CONCLUSIONS: Age at and time after diabetes diagnosis should be considered in screening guidelines for CD in children with T1D.

Place, publisher, year, edition, pages
American Diabetes Association, 2024
National Category
Endocrinology and Diabetes
Identifiers
urn:nbn:se:umu:diva-222973 (URN)10.2337/dc23-1671 (DOI)001335073100037 ()38363973 (PubMedID)2-s2.0-85188894512 (Scopus ID)
Funder
Swedish Child Diabetes Foundation
Available from: 2024-04-11 Created: 2024-04-11 Last updated: 2025-04-24Bibliographically approved
Projects
Is better public health worth the price? - A health economic evaluation of increased staffing in home care [2015-00647_Forte]; Umeå University
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-0457-2175

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