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Eurenius, E. (2019). Cultural parenting programmes could play an important role in helping immigrants adapt to their host countries. Acta Paediatrica, 108(8), 1491-1491
Open this publication in new window or tab >>Cultural parenting programmes could play an important role in helping immigrants adapt to their host countries
2019 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 108, no 8, p. 1491-1491Article in journal, Editorial material (Other academic) Published
Place, publisher, year, edition, pages
John Wiley & Sons, 2019
National Category
Pediatrics
Identifiers
urn:nbn:se:umu:diva-161808 (URN)10.1111/apa.14853 (DOI)000474935600020 ()31099086 (PubMedID)
Available from: 2019-08-14 Created: 2019-08-14 Last updated: 2019-08-14Bibliographically approved
Wilson, I. M., Eurenius, E., Lindkvist, M., Edin, K. & Edvardsson, K. (2019). Is there an association between pregnant women's experience of violence and their partner's drinking?: A Swedish population-based study. Midwifery, 69, 84-91
Open this publication in new window or tab >>Is there an association between pregnant women's experience of violence and their partner's drinking?: A Swedish population-based study
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2019 (English)In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 69, p. 84-91Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: Pregnancy is a time of heightened vulnerability for women, especially for experiencing violence in their close and intimate relationships. Alcohol misuse by a male intimate partner is a known contributor to increased risk and severity of intimate partner violence generally, however less is known about the relationship between partner drinking patterns and women's experience of violence in their relationship, and particularly in early pregnancy. This study aimed to explore these associations in a large, population-based sample of Swedish expectant parents.

DESIGN, SETTING AND PARTICIPANTS: Data for this cross-sectional study were drawn from 11 461 couples (22 922 participants) enrolled in Salut, a child health promotion programme in Västerbotten County Council, Sweden. Data were collected at women's antenatal care visits during the first trimester of pregnancy.

MEASUREMENTS: Questionnaires included male partners' self-reported drinking patterns using AUDIT (Alcohol Use Disorders Identification Test) and pregnant women's reports of violence. Descriptive and logistic regression analyses were undertaken to examine prevalence of reported violence and association with partner drinking patterns.

FINDINGS: There was a strong association between male partner alcohol misuse and the odds of pregnant women experiencing violence in general, experiencing violence since becoming pregnant, and fear for their own safety at the time of enrolment in ANC. The odds of having experienced being controlled or physically hurt in a relationship, or having ever experienced sexual violence, were higher with more serious alcohol misuse by the male partner. Most striking was that women whose partners reported hazardous drinking or alcohol dependence had nearly nine times higher odds of experiencing being physically hurt by a partner since becoming pregnant, compared to women whose partners reported non-harmful alcohol use (OR 8.50, CI 2.39-30.17, p = 0.001). Fearing for current safety was also strongly linked to more severe alcohol use by their current male partner (OR 7.65, CI 1.02-57.24, p = 0.048).

KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: This study contributes population-level evidence that the risk for women of experiencing violence in general or in early pregnancy is exacerbated when a male partner drinks in harmful ways. Health professionals and those supporting pregnant women should pay attention to the role of risk factors such as partner alcohol use. Ensuring the health of pregnant women and safety in their relationships is important for maternal, foetal and infant health and family functioning.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Alcohol drinking, Cross-sectional study, Intimate partner violence, Pregnancy, Risk factors, Sweden
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-153435 (URN)10.1016/j.midw.2018.10.019 (DOI)000454129800011 ()30415105 (PubMedID)2-s2.0-85056169104 (Scopus ID)
Available from: 2018-11-21 Created: 2018-11-21 Last updated: 2019-10-16Bibliographically approved
Eurenius, E., Richter Sundberg, L., Vaezghasemi, M., Silfverdal, S.-A., Ivarsson, A. & Lindkvist, M. (2019). Social-emotional problems among three-year-olds differ based on the child's gender and custody arrangement. Acta Paediatrica, 108(6), 1087-1095
Open this publication in new window or tab >>Social-emotional problems among three-year-olds differ based on the child's gender and custody arrangement
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2019 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 108, no 6, p. 1087-1095Article in journal (Refereed) Published
Abstract [en]

AIM: The aim of this study was to investigate mental health with respect to social-emotional problems among three-year-olds in relation to their gender, custody arrangements and place of residence.

METHODS: A cross-sectional population-based design was used, encompassing 7,179 three-year-olds in northern Sweden during the period 2014-2017 from the regional Salut Register. Descriptive and comparative analyses were performed based on parents' responses on the Ages and Stages Questionnaires: Social-Emotional (ASQ:SE), supplemented with items on gender, custody arrangement and place of residence.

RESULTS: Parental-reported social-emotional problems were found in almost 10% of the children. Boys were reported to have more problems (12.3%) than girls (5.6%) (p<0.001). Parents were most concerned about children's eating habits and interactions at mealtimes. Parents not living together reported more problems among their children than those living together (p<0.001). When stratifying by custody arrangement, girls in rural areas living alternately with each parent had more problems compared to those in urban areas (p<0.008).

CONCLUSION: Gender and custody arrangements appear to be important factors for social-emotional problems among three-year-olds. Thus, such conditions should receive attention during preschool age, preferably by a systematic preventive strategy within Child Health Care.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
ages and stages questionnaires, cross-sectional study, emotional and behavioural problems, mental health, preschool child
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-154007 (URN)10.1111/apa.14668 (DOI)000467867900018 ()30496622 (PubMedID)2-s2.0-85058852765 (Scopus ID)
Available from: 2018-12-11 Created: 2018-12-11 Last updated: 2019-06-19Bibliographically approved
Ivarsson, A., Eurenius, E., Lindkvist, M. & Richter Sundberg, L. (2019). Socioemotionell förmåga hos treåringar: Resultat från en befolkningsbaserad studie i Västerbottens län. Brookes Publishing Company
Open this publication in new window or tab >>Socioemotionell förmåga hos treåringar: Resultat från en befolkningsbaserad studie i Västerbottens län
2019 (Swedish)Report (Other academic)
Abstract [sv]

Det övergripande målet för svensk barnhälsovård är att främja barns hälsa, trygghet och utveckling samt ge stöd i föräldraskapet. Barn i Sverige är i hög grad fysiskt friska i internationell jämförelse, men det finns indikationer på att den psykiska ohälsan har ökat hos barn och ungdomar under de senaste decennierna. Kunskapen om förekomst av, och bakomliggande faktorer, till psykisk ohälsa hos förskolebarn är dock otillräcklig. Syftet med denna studie är därför att undersöka treåringars socioemotionella förmåga med avseende på könsskillnader och boende i stad eller på landsbygd i Västerbottens län.

Förskolebarns psykiska hälsa undersöks systematiskt

I denna studie har instrumentet Ages and Stages Questionnaires: Social-Emotional (ASQ:SE) använts för att undersöka föräldrars rapporterade socioemotionella förmåga hos treåringar. ASQ:SE 36-månadersversion delas rutinmässigt ut till föräldrar inför treårsbesöket på barnavårdscentraler i Västerbottens län sedan 2013. ASQ:SE är ursprungligen utvecklat i USA och mäter barns socioemotionella förmåga inom sju domäner: självreglering, följsamhet, kommunikation, adaptiv förmåga, autonomi, affekt och social interaktion. Socioemotionell förmåga i treårsåldern är exempelvis förmåga till samspel med vuxna och jämnåriga samt förmåga att med stöd av förälder reglera egna känslor. Betydande avvikelser i den socioemotionella förmågan vid denna ålder kan tyda på att barnet har en sårbarhet som kan leda till fortsatta och ibland mer allvarliga socioemotionella problem.

Generellt god psykisk hälsa men fler problem bland pojkar

Svaren från majoriteten av föräldrarna indikerar god socioemotionell förmåga hos barnen, dock hade nästan en av tio treåringar föräldrarapporterade socioemotionella problem, med ASQ:SE-poäng över gränsvärdet 59. Problemen var dubbelt så vanliga bland pojkar (12 procent) som bland flickor (6 procent) (p <0,001). Det fanns inga signifikanta skillnader i socioemotionell förmåga mellan barn bosatta i städer i jämförelse med barn bosatta på landsbygden. Skillnaderna mellan könen var dock kvarstående oberoende av geografisk hemvist. Domänerna autonomi och följsamhet innehöll de frågor för vilka flest föräldrar rapporterade svårigheter, detta gällde för både pojkar och flickor.

Slutsats

Studien har ökat förståelsen för socioemotionell förmåga hos treåringar i Sverige. Den förstärker vikten av att identifiera problem i tidig ålder och att beakta könsskillnader. Redan i förskoleåldern bör socioemotionell förmåga uppmärksammas, helst genom en systematisk strategi inom barnhälsovården

Place, publisher, year, edition, pages
Brookes Publishing Company, 2019. p. 36
Series
Rapport från Folkhälsomyndigheten
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-159192 (URN)
Available from: 2019-05-21 Created: 2019-05-21 Last updated: 2019-06-10Bibliographically approved
Lindqvist, M., Lindkvist, M., Eurenius, E., Persson, M. & Mogren, I. (2017). Change of lifestyle habits: motivation and ability reported by pregnant women in northern Sweden. Sexual & Reproductive HealthCare, 13, 83-90
Open this publication in new window or tab >>Change of lifestyle habits: motivation and ability reported by pregnant women in northern Sweden
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2017 (English)In: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 13, p. 83-90Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Pregnant women are generally more motivated to change their lifestyle habits compared with non-pregnant women. However, the ability to change these habits depends on the motivation to change. This study describes pregnant women's self-reported motivation and ability to change lifestyle habits and their relation to body mass index (BMI), self-rated health, educational level and country of origin.

METHODS: This cross-sectional study combined data from the Maternal Health Care Register in Västerbotten (MHCR-VB) and the Salut Programme Register (Salut-R). Data were collected from 3,868 pregnant residents in Västerbotten County (northern Sweden) between 2011 and 2012. Chi-square test, two independent samples t-test and univariate and multivariate logistic regression were performed.

RESULTS: Most of the pregnant women (61.3%) were satisfied with their self-reported lifestyle habits irrespective of BMI, self-rated health, educational level, and country of origin. Many reported that they wanted to increase their physical activity, improve their dietary habits, and reduce their weight. In general, they estimated their ability to change their lifestyle habits as equal to their motivation of change. Women who reported a large or very large motivation to change their lifestyle habits were characterized by higher BMI and higher educational level.

CONCLUSIONS: Most of the participating pregnant women were satisfied with their lifestyle habits, although they reported being further motivated to change some of them. Health care professionals encountering fertile and pregnant women may have a unique opportunity to support and promote lifestyle changes, taking into account women's motivation for change. Future research should focus on factors that motivate pregnant women to change their lifestyle, explore barriers for change of lifestyle and how support best may be provided to pregnant women. In addition, studies on lifestyle and motivation for lifestyle change from non-Nordic countries are called for.

Place, publisher, year, edition, pages
Clare: Elsevier, 2017
Keywords
Change, Cross-sectional study, Lifestyle habits, Motivation, Pregnancy
National Category
Public Health, Global Health, Social Medicine and Epidemiology Nursing
Identifiers
urn:nbn:se:umu:diva-140341 (URN)10.1016/j.srhc.2017.07.001 (DOI)000411305800012 ()28844363 (PubMedID)
Available from: 2017-10-05 Created: 2017-10-05 Last updated: 2019-05-20Bibliographically approved
Häggström, J., Sampaio, F., Eurenius, E., Pulkki-Brännström, A.-M., Ivarsson, A., Lindkvist, M. & Feldman, I. (2017). Is the Salut Programme an effective and cost-effective universal health promotion intervention for parents and their children?: a register-based retrospective observational study. BMJ Open, 7(9), Article ID e016732.
Open this publication in new window or tab >>Is the Salut Programme an effective and cost-effective universal health promotion intervention for parents and their children?: a register-based retrospective observational study
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2017 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 7, no 9, article id e016732Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: This study investigates the effectiveness and cost-effectiveness of the Salut Programme, a universal health promotion intervention, compared with care-as-usual, over the periods of pregnancy, delivery and the child's first 2 years of life.

METHOD: We adopted a register-based retrospective observational design using existing data sources with respect to both exposures and outcomes. Health outcomes and costs were compared between geographical areas that received care-as-usual (non-Salut area) and areas where the programme was implemented (Salut area). We included mothers and their children from both the Salut and non-Salut areas if: (1) the child was born 2002-2004 (premeasure period) or (2) the child was born 2006-2008 (postmeasure period). The effectiveness study adopted two strategies: (1) a matched difference-in-difference analysis using data from all participants and (2) a longitudinal analysis restricted to mothers who had given birth twice, that is, both in the premeasure and postmeasure periods. The economic evaluation was performed from a healthcare and a limited societal perspective. Outcomes were clustered during pregnancy, delivery and birth and the child's first 2 years.

RESULTS: Difference-in-difference analyses did not yield any significant effect on the outcomes. Longitudinal analyses resulted in significant positive improvement in Apgar scores, reflecting the newborn's physical condition, with more children having a normal Apgar score (1 min +3%, 5 min +1%). The cost of the programme was international dollar (INT$)308/child. From both costing perspectives, the programme yielded higher effects and lower costs than care-as-usual, being thus cost-saving (probability of around 50%).

CONCLUSIONS: Our findings suggest that the Salut Programme is an effective universal intervention to improve maternal and child health, and it may be good value for money; however, there is large uncertainty around the cost estimates.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2017
Keywords
Child Health, Cost-effectiveness, Health Promotion, Intervention Effectiveness, Maternal Health, Universal Intervention
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-139899 (URN)10.1136/bmjopen-2017-016732 (DOI)000412650700155 ()28939578 (PubMedID)
Available from: 2017-09-26 Created: 2017-09-26 Last updated: 2018-06-09Bibliographically approved
Westerlund, A., Garvare, R., Nyström, M. E., Eurenius, E., Lindkvist, M. & Ivarsson, A. (2017). Managing the initiation and early implementation of health promotion interventions: a study of a parental support programme in primary care. Scandinavian Journal of Caring Sciences, 31(1), 128-138
Open this publication in new window or tab >>Managing the initiation and early implementation of health promotion interventions: a study of a parental support programme in primary care
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2017 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 31, no 1, p. 128-138Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Mental health problems are increasing among children and adolescents worldwide, and parental support programmes have been suggested as one preventive intervention. However, the actual impact and low rates of adoption and sustainability of prevention programmes have proven to be a concern, and thus, further studies on their implementation are needed.

AIM: This study focused on the initial implementation of the International Child Development Programme (ICDP) in primary care. The aim was to investigate the involved actors' views on factors likely to affect implementation and the strategies used to manage them.

DESIGN: A case study design with a mixed-methods approach combining quantitative and qualitative data from questionnaires and interviews was used.

METHODS: Eighty-two professionals at different positions in the involved organisations participated. Directed content analysis was used for analyses, focusing on perceived levels of importance and the manifestation of implementation factors.

FINDINGS: Interviews and questionnaires provided descriptions of factors influencing the initial ICDP implementation. Uncertainty on how to manage important factors and vague change strategies was reported. Discrepancies in the perceived levels of importance versus manifestation were found regarding several factors, including hands-on support, time and resources, communication and information, a comprehensive plan of action, follow-ups, and external and internal collaborations. Manifested factors were a need for change, motivation and the ICDP's compatibility with existing norms, values and practices.

CONCLUSIONS: Implementing a parental support programme in a complex setting will benefit from being preceded by a thorough examination of the intervention and the target context and the development of clear implementation strategies based on the results of that examination. This study provides insights into how and by whom knowledge on implementation is applied during the launch of a health promotion programme, and these insights might help increase the rate of adoption and the use of such programmes and thereby increase their effectiveness.

Keywords
child health, health promotion, implementation, parental support programme, parent–child relationship, primary care
National Category
Public Health, Global Health, Social Medicine and Epidemiology Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:umu:diva-122412 (URN)10.1111/scs.12329 (DOI)000394988700014 ()27246248 (PubMedID)
Available from: 2016-06-17 Created: 2016-06-17 Last updated: 2018-06-07Bibliographically approved
Vaezghasemi, M., Sundberg, L., Ivarsson, A., Eurenius, E., Silfverdal, S. A. & Lindkvist, M. (2017). Psychometric analysis of Age and Stages Questionnaire: Social-Emotional (ASQ:SE) among 3-year-olds. Paper presented at 10th European Public Health Conference Sustaining resilient and healthy communities Stockholm, Sweden 1–4 November 2017. European Journal of Public Health, 27(Suppl_3), 173-174
Open this publication in new window or tab >>Psychometric analysis of Age and Stages Questionnaire: Social-Emotional (ASQ:SE) among 3-year-olds
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2017 (English)In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 27, no Suppl_3, p. 173-174Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Background: Mental health is an urgent public health challenge, and for some individuals the problem starts already in pre-school age. Increased knowledge is needed to guide evidence-based health-promoting interventions and early identification for adequate parental support. Valid and reliable instruments to measure children’s mental health are called for. Our aim is to analyze psychometric properties of the Ages and Stages Questionnaire: Social-Emotional (ASQ:SE) among 3-year-olds.

Methods: Within Child Health Care (CHC) in Västerbotten (Sweden) the 3-year-olds’ health check-up includes parent-rated socio-emotional health by scoring the ASQ:SE. This instrument has seven psychological domains (self-regulation, compliance, communication, adaptive functioning, autonomy, affect, and interaction); built up by 31 items, responded on a 3-point Likert scale with total scores 0-465. Item scores are combined into a total score with high values indicating social-emotional vulnerability. Most parents give informed consent for research and the study has ethical approval.

Results: During 2014-2016 we have ASQ:SE responses for 5434 children having had their 3-year health check-up (boys=2802, girls=2632), with total scores 0-215. Generally, boys scored higher (mean 31, SD 24; median 25) than girls (mean 25, SD 21; median 20), and 12% of boys, compared to 6% of girls, scored above the cut-off value (59). The internal consistency based on Cronbach’s alpha was 0.78. Confirmatory factor analysis was done and normative values were also reported for the ASQ:SE.

Conclusions: Our psychometric analyses of ASQ:SE among 3-year-olds indicates the relevance of an instrument for screening pre-school children’s social and emotional health. This is promising for future use of the instrument within ordinary CHC in Västerbotten and elsewhere.

Key messages:

  • The ASQ:SE instrument is a valuable asset within CHC to increase awareness about 3-year-olds social-emotional health.
  • The ASQ:SE instrument is a promising tool for low-cost screening of early social-emotional vulnerability.
Place, publisher, year, edition, pages
OXFORD UNIV PRESS, 2017
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-143146 (URN)10.1093/eurpub/ckx187.443 (DOI)000414389801209 ()
Conference
10th European Public Health Conference Sustaining resilient and healthy communities Stockholm, Sweden 1–4 November 2017
Available from: 2017-12-20 Created: 2017-12-20 Last updated: 2018-06-09Bibliographically approved
Feldman, I., Eurenius, E., Häggstrom, J., Sampaio, F., Lindkvist, M., Pulkki-Brannstrom, A.-M. & Ivarsson, A. (2016). Effectiveness and cost-effectiveness of the Salut Programme: a universal health promotion intervention for parents and children-protocol of a register-based retrospective observational study. BMJ Open, 6(8), Article ID e011202.
Open this publication in new window or tab >>Effectiveness and cost-effectiveness of the Salut Programme: a universal health promotion intervention for parents and children-protocol of a register-based retrospective observational study
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2016 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 6, no 8, article id e011202Article in journal (Refereed) Published
Abstract [en]

Introduction: There is inadequate evidence for the effectiveness and cost-effectiveness of health promotion interventions. The Salut Programme aims to reach all parents and children in the Vasterbotten County of Sweden with a combination of health promotion interventions initiated during pregnancy and continued over the childhood period. This study protocol describes an effectiveness study and an economic evaluation study, where the ongoing Salut Programme is compared to care-as-usual over the periods of pregnancy, delivery and the child's first 2 years of life. Methods: A register-based retrospective observational study design will be used with existing data sources with respect to exposures and outcomes. Outcomes of interest are clustered at 3 points: around the child's birth, 1 month after the child's birth and 2 years after the child's birth. We will simulate an experiment by retrospectively identifying and comparing children and their parents in the geographical areas where the Salut Programme was implemented since 2006 and onwards, and the areas where the Programme was not implemented before 2009. Outcomes will be analysed and compared for the premeasure period, and the postmeasure period for both groups. Our analysis combines difference-in-difference estimation with matching. A complementary analysis will be carried out on the longitudinal subsample of mothers who gave birth at least once during each of the time periods. The economic evaluation aims to capture the wider societal costs and benefits of the Salut Programme for the first 2 years of the children's lives. Incremental costs will be compared with incremental health gains and the results will be presented as a cost-consequence analysis. Ethics and dissemination: The Regional Ethical Review Board in Umea has given clearance for the Salut Programme research (2010-63-31M). No individual's identity will be revealed when presenting results. This study will provide information that can guide decision-makers to allocate resources optimally.

National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-126540 (URN)10.1136/bmjopen-2016-011202 (DOI)000382336700045 ()27491668 (PubMedID)
Available from: 2016-10-26 Created: 2016-10-10 Last updated: 2018-06-09Bibliographically approved
Feldman, I., Eurenius, E., Haggstrom, J., Sampaio, F., Lindkvist, M., Pulkki-Brännström, A.-M. & Ivarsson, A. (2016). Effectiveness of the Salut Program: a universal health promotion intervention for parents & children. In: : . OXFORD UNIV PRESS, 26
Open this publication in new window or tab >>Effectiveness of the Salut Program: a universal health promotion intervention for parents & children
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2016 (English)Conference paper, Oral presentation with published abstract (Refereed)
Place, publisher, year, edition, pages
OXFORD UNIV PRESS, 2016
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-134280 (URN)10.1093/eurpub/ckw171.037 (DOI)000398600402202 ()
Note

Supplement 1

Available from: 2017-05-12 Created: 2017-05-12 Last updated: 2018-06-09
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