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Coe, A.-B. & Rönnblom, M. (2019). Collective caring: creating safety through interactions between young activist groups and young adults in Sweden. Journal of Youth Studies, 22(6), 839-855
Open this publication in new window or tab >>Collective caring: creating safety through interactions between young activist groups and young adults in Sweden
2019 (English)In: Journal of Youth Studies, ISSN 1367-6261, E-ISSN 1469-9680, Vol. 22, no 6, p. 839-855Article in journal (Refereed) Published
Abstract [en]

Existing research explores safety among young adults as a complex phenomenon in diverse social spaces. Nonetheless, it largely approaches perceptions of unsafety and safety strategies as discrete individual action. In this paper, we show how safety is created through the social interactions between young activist groups and their main target or audience, young adults. Our study aimed to explore how young adults created meanings and actions of safety within their activism. Grounded Theory method was use to collect and analyze qualitative interviews with young adults often social change groups located in two medium-size cities inSweden. To interpret our findings, we drew upon interactionist concepts of shared definitions and joint action [Blumer, Herbert.1966. “Sociological Implications of the thought of George Herbert Mead.” American Journal of Sociology 71 (5): 535–544]. Shared definitions challenged narrow notions of unsafety by identifying uniform categories and harmful stereotypes as the source of the problem, and thereby locating constraints upon the capacity ofdifferent groups of young adults to define situations as (un)safe. Joint action combined an immediate response of moving to where young adults were with an enduring response of being there for young adults. Combined, these constituted an overarching social process of collective caring, which we linked to Isabel Lorey’s [2015. State of Insecurity. London: Verso] concept of practices of caring.

Place, publisher, year, edition, pages
Taylor & Francis, 2019
Keywords
Activism, gender, interactionism, safety, social processes, youth
National Category
Sociology
Research subject
Sociology
Identifiers
urn:nbn:se:umu:diva-153409 (URN)10.1080/13676261.2018.1546384 (DOI)000473444400007 ()
Projects
Fear and Safety in Policy and Practice: Overcoming Paradoxes in Local Planning
Funder
Marianne and Marcus Wallenberg Foundation, 2012.0211
Available from: 2018-11-19 Created: 2018-11-19 Last updated: 2019-08-05Bibliographically approved
Coe, A.-B. & Sandberg, L. (2019). Gender beliefs as a dimension of tactical choice: the 'Take Back the Night' march in Sweden. Social Movement Studies, 18(5), 622-638
Open this publication in new window or tab >>Gender beliefs as a dimension of tactical choice: the 'Take Back the Night' march in Sweden
2019 (English)In: Social Movement Studies, ISSN 1474-2837, E-ISSN 1474-2829, Vol. 18, no 5, p. 622-638Article in journal (Refereed) Published
Abstract [en]

Two main explanations of tactical choice among social movements are repertoires of contention and characteristics of collective actors. Feminist theorizing suggests another dimension of tactical choice: the role of gender beliefs. This paper examines the relationship between these three explanations by drawing on a qualitative study that explored how activist groups in Sweden selected the 'Take Back the Night' (TBTN) march as a tactic. Begun in the 1970s, the TBTN march has been performed around the world, usually on central city streets at nighttime, to protest gender violence in spaces presumed to be gender neutral and safe for women. Our findings resulted in three themes that captured how activist groups selected it as a tactic: a routine performance in publicly visible urban settings, alignment with preferred forms of feminist organizing, and refusal of normalized fear and violence in the seemingly safe city. Each theme corresponded to one of the three explanations and shed light on a different dimension of tactical choice. We propose three heuristic tools for identifying these dimensions: making claims, enacting claims and reclaiming spaces. The different dimensions relate to distinct conceptions of power: centralized authority, movement agency and gender power relations respectively.

Place, publisher, year, edition, pages
Routledge, 2019
Keywords
Gender beliefs, feminism, organizational forms, repertoires of contention, tactics
National Category
Sociology (excluding Social Work, Social Psychology and Social Anthropology)
Research subject
gender studies; Sociology
Identifiers
urn:nbn:se:umu:diva-158361 (URN)10.1080/14742837.2019.1599280 (DOI)000466109900001 ()
Funder
Marianne and Marcus Wallenberg Foundation, 2012.0211
Available from: 2019-04-26 Created: 2019-04-26 Last updated: 2019-10-10Bibliographically approved
Wiklund, E., Jonsson, E., Coe, A.-B. & Wiklund, M. (2019). 'Strong is the new skinny': navigating fitness hype among teenagers in northern Sweden. Sport, Education and Society, 24(5), 441-454
Open this publication in new window or tab >>'Strong is the new skinny': navigating fitness hype among teenagers in northern Sweden
2019 (English)In: Sport, Education and Society, ISSN 1357-3322, E-ISSN 1470-1243, Vol. 24, no 5, p. 441-454Article in journal (Refereed) Published
Abstract [en]

An increased interest in health, diet, and physical activity exist among young people, in this study termed 'fitness hype'. Viewing the body and health as commodities can be understood as part of a healthism discourse. In this study, we explored how Swedish high school students perceive and negotiate the trend regarding exercise, diet and body ideals.

Semi-structured interviews were conducted with ten high school students, aged 16 to 18 years, from various educational programs and with varying levels of physical activity. Using qualitative content analysis, we developd one overarching theme navigating life satisfaction in the face of an 'unhealthy fitness hype'. Four additional, interrelated categories showed how the young people negotiated this developing trend through: 1) the quest for social recognition and value, 2) social media sets the standards, 3) the paradox of strong and skinny as the new standard, and 4) the need for new safety nets.

Our results highlight the young people's perceptions of an excessive and influential focus on health and exercise in contemporary society. They described a fitness hype as exorbitant and unhealthy ideals of body and exercise, and understood this as problematic. Social media was seen as contributing to this hype as a powerful arena for 'the quest for social recognition and value'. While not all the young people felt negatively affected by the fitness hype, they perceived its influence on their lives. Further, body and fitness ideals were gendered. Teenage girls faced the paradox of shaping themselves as 'strong and skinny'. Social ties were recognized as an important safety net, particularly classmates, sports mates, and coaches. Knowledge of these problems from the perspective of young people is crucially needed among health professionals and educators. Further research should explore additional support strategies, and young people's experiences of fitness hype among additional youth groups.

Place, publisher, year, edition, pages
Abingdon: Routledge, 2019
Keywords
Body ideals, diet, exercise, healthism, gender, orthorexia nervosa, qualitative interviews, social media, Sweden, young people, ungdomar, tonåringar, kroppsideal, utseendeideal, träning, fysisk aktivitet, ortorexia nervosa, hälsoism, genus, medicinsk sociologi, kvalitativa intervjuer, kvalitativ innehållsanalys
National Category
Physiotherapy Sociology Gender Studies
Research subject
physiotherapy; gender studies; Sociology
Identifiers
urn:nbn:se:umu:diva-141946 (URN)10.1080/13573322.2017.1402758 (DOI)000466150700001 ()2-s2.0-85034224623 (Scopus ID)
Projects
Stress and Health in Youth (Umeå SHY)
Funder
Swedish Research Council, 344-2011-5478
Available from: 2017-11-16 Created: 2017-11-16 Last updated: 2019-05-21Bibliographically approved
Hultstrand Ahlin, C., Hörnsten, Å., Coe, A.-B., Lilja, M. & Hajdarevic, S. (2019). Wishing to be perceived as a capable and resourceful person: A qualitative study of melanoma patients’ experiences of the contact and interaction with healthcare professionals. Journal of Clinical Nursing, 28(7–8), 1223-1232
Open this publication in new window or tab >>Wishing to be perceived as a capable and resourceful person: A qualitative study of melanoma patients’ experiences of the contact and interaction with healthcare professionals
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2019 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 28, no 7–8, p. 1223-1232Article in journal (Refereed) Published
Abstract [en]

AIMS AND OBJECTIVES: To explore patients' experiences of contact and interaction with healthcare professionals (HCPs) during the diagnostic process of melanoma.

BACKGROUND: In Sweden, most patients with suspected skin lesions seek care at the primary level of services in the first instance. Previous research describes the diagnostic process as a complex journey with uncertainty. Nonetheless, the importance of contact and interaction between patient and HCPs during the diagnostic process is rarely explored.

DESIGN: This study adopted a qualitative design in which semi-structured interviews were conducted and the COREQ-checklist for qualitative studies employed (EQUATOR guidelines).

METHODS: A sample of 30 patients (15 women, 15 men) diagnosed with melanoma was included. Secondary analysis of interviews was carried out using qualitative content analysis.

RESULTS: One theme emerged: Wishing to be perceived as a capable and resourceful person that consisted of three categories: (a) The need of being valued, (b) The need of being informed and (c) The need of taking actions.

CONCLUSIONS: Our results suggest that patients wish to be valued as capable and resourceful persons as well as to be provided with honest and sufficient information about the diagnosis and subsequent procedures. By fulfilling these wishes, HCPs can involve patients in the diagnostic process and reduce patients' uncertainty. A need of supportive and accessible health care to manage the diagnostic process and to reduce patients' struggle for care was also identified.

RELEVANCE TO THE CLINICAL PRACTICE: Patients are satisfied when health care is organised in a patient-/person-centred manner, that is, in accordance with patients' needs, avoiding gatekeeping, and when HCPs interact respectfully in encounters. Accessible HCPs during the diagnostic process of melanoma are required to inform, support and navigate patients within the healthcare system and through their diagnostic journey.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
cancer, care needs, healthcare professional-patient relationship, patient-centred care, patients’ experience, qualitative study
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-155315 (URN)10.1111/jocn.14730 (DOI)000460767400018 ()30549354 (PubMedID)2-s2.0-85059608526 (Scopus ID)
Available from: 2019-01-11 Created: 2019-01-11 Last updated: 2019-10-16Bibliographically approved
Tetui, M., Zulu, J. M., Hurtig, A.-K., Ekirapa-Kiracho, E., Kiwanuka, S. N. & Coe, A.-B. (2018). Elements for harnessing participatory action research to strengthen health managers’ capacity: a critical interpretative synthesis. Health Research Policy and Systems, 16, Article ID 33.
Open this publication in new window or tab >>Elements for harnessing participatory action research to strengthen health managers’ capacity: a critical interpretative synthesis
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2018 (English)In: Health Research Policy and Systems, ISSN 1478-4505, E-ISSN 1478-4505, Vol. 16, article id 33Article, review/survey (Refereed) Published
Abstract [en]

Background: Health managers play a key role in ensuring that health services are responsive to the needs of the population. Participatory action research (PAR) is one of the approaches that have been used to strengthen managers’ capacity. However, collated knowledge on elements for harnessing PAR to strengthen managers’ capacity is missing. This paper bridges this gap by reviewing existing literature on the subject matter.

Methods: A critical interpretive synthesis method was used to interrogate eight selected articles. These articles reported the use of PAR to strengthen health managers’ capacity. The critical interpretive synthesis method’s approach to analysis guided the synthesis. Here, the authors interpretively made connections and linkages between different elements identified in the literature. Finally, the Atun et al. (Heal Pol Plann, 25:104–111, 2010) framework on integration was used to model the elements synthesised in the literature into five main domains.

Results: Five elements with intricate bi-directional interactions were identified in the literature reviewed. These included a shared purpose, skilled facilitation and psychological safety, activity integration into organisational procedures, organisational support, and external supportive monitoring. A shared purpose of the managers’ capacity strengthening initiative created commitment and motivation to learn. This purpose was built upon a set of facilitation skills that included promoting participation, self-efficacy and reflection, thereby creating a safe psychological space within which the managers interacted and learnt from each other and their actions. Additionally, an integrated intervention strengthened local capacity and harnessed organisational support for learning. Finally, supportive monitoring from external partners, such as researchers, ensured quality, building of local capacity and professional safety networks essential for continued learning.

Conclusions: The five elements identified in this synthesis provide a basis upon which the use of PAR can be harnessed, not only to strengthen health managers’ capacity, but also to foster other health systems strengthening initiatives involving implementation research. In addition, the findings demonstrated the intricate and complex relations between the elements, which further affirms the need for a systems thinking approach to tackling health systems challenges.

Place, publisher, year, edition, pages
BioMed Central, 2018
Keywords
Participatory Action Research, factors, harnessing, health managers' capacity, systems thinking, implementation research
National Category
Health Care Service and Management, Health Policy and Services and Health Economy Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-146830 (URN)10.1186/s12961-018-0306-0 (DOI)29673346 (PubMedID)
Available from: 2018-04-19 Created: 2018-04-19 Last updated: 2018-06-09Bibliographically approved
Coe, A.-B. (2018). Practicing Gender and Race in Online Activism to Improve Safe Public Space in Sweden. Sociological inquiry, 88(3), 510-534
Open this publication in new window or tab >>Practicing Gender and Race in Online Activism to Improve Safe Public Space in Sweden
2018 (English)In: Sociological inquiry, ISSN 0038-0245, E-ISSN 1475-682X, Vol. 88, no 3, p. 510-534Article in journal (Refereed) Published
Abstract [en]

This article aims to locate the social practices of activist groups online and clarify how they collectively practice gender and race. It draws upon a qualitative study of two locale-oriented groups that sought to improve safe public space in their respective cities in Sweden. Using Grounded Theory method, I observed and analyzed each group’s public Facebook site from initiation until decline or maintenance. The findings captured five routine behaviors done by the groups in a tacit manner: responding to a concrete incident,creating meaningful participation, fostering substantive debate, formulating a long-term vision, and questioning social hierarchies. Working with theories of social,gendered, and racialized practices, I analyze these behaviors as practices available to the activist groups to do, yet open for social change through their performance. Although all five practices were detected among both groups, the two groups performed them differently and this had consequences for their maintenance as well as their ability to challenge gender and racial hierarchies. The analysis makes an important contribution tosocial movement scholarship by showing how tacit and routine behavior forms the backbone of any collective action and is a crucial site for the (re)construction of social hierarchies.

Keywords
Internet activism, gender hierarchies, immigration, racial hierarchies, rape, Sweden, youth gangs
National Category
Gender Studies
Research subject
Sociology; gender studies
Identifiers
urn:nbn:se:umu:diva-144766 (URN)10.1111/soin.12220 (DOI)000438665800006 ()2-s2.0-85049864762 (Scopus ID)
Projects
Rädsla och trygghet i ord och handling - att överkomma paradoxer i planering
Funder
Marianne and Marcus Wallenberg Foundation, 2012.0211
Note

This work was supported by the Marianne and Marcus Wallenberg Foundation under Grant 2012.0211 for the project “Fear and Safety in Policy and Practice: Overcoming Paradoxes in Local Planning” managed by the Umeå Center for Gender Studies

Available from: 2018-02-14 Created: 2018-02-14 Last updated: 2018-09-19Bibliographically approved
Tetui, M., Coe, A.-B., Hurtig, A.-K., Bennett, S., Kiwanuka, S. N., George, A. & Kiracho, E. E. (2017). A participatory action research approach to strengthening health managers' capacity at district level in Eastern Uganda. Health Research Policy and Systems, 15, Article ID 110.
Open this publication in new window or tab >>A participatory action research approach to strengthening health managers' capacity at district level in Eastern Uganda
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2017 (English)In: Health Research Policy and Systems, ISSN 1478-4505, E-ISSN 1478-4505, Vol. 15, article id 110Article in journal (Refereed) Published
Abstract [en]

Background: Many approaches to improving health managers' capacity in poor countries, particularly those pursued by external agencies, employ non-participatory approaches and often seek to circumvent (rather than strengthen) weak public management structures. This limits opportunities for strengthening local health managers' capacity, improving resource utilisation and enhancing service delivery. This study explored the contribution of a participatory action research approach to strengthening health managers' capacity in Eastern Uganda.

Methods: This was a qualitative study that used open-ended key informant interviews, combined with review of meeting minutes and observations to collect data. Both inductive and deductive thematic analysis was undertaken. The Competing Values Framework of organisational management functions guided the deductive process of analysis and the interpretation of the findings. The framework builds on four earlier models of management and regards them as complementary rather than conflicting, and identifies four managers' capacities (collaborate, create, compete and control) by categorising them along two axes, one contrasting flexibility versus control and the other internal versus external organisational focus.

Results: The findings indicate that the participatory action research approach enhanced health managers' capacity to collaborate with others, be creative, attain goals and review progress. The enablers included expanded interaction spaces, encouragement of flexibility, empowerment of local managers, and the promotion of reflection and accountability. Tension and conflict across different management functions was apparent; for example, while there was a need to collaborate, maintaining control over processes was also needed. These tensions meant that managers needed to learn to simultaneously draw upon and use different capacities as reflected by the Competing Values Framework in order to maximise their effectiveness.

Conclusions: Improved health manager capacity is essential if sustained improvements in health outcomes in low-income countries are to be attained. The expansion of interaction spaces, encouragement of flexibility, empowerment of local managers, and the promotion of reflection and accountability were the key means by which participatory action research strengthened health managers' capacity. The participatory approach to implementation therefore created opportunities to strengthen health managers' capacity.

Place, publisher, year, edition, pages
BioMed Central, 2017
Keywords
competing values framework, district health managers, health systems, participatory action research, Uganda
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-143689 (URN)10.1186/s12961-017-0273-x (DOI)000419507300007 ()29297346 (PubMedID)
Note

Supplement: 2

Available from: 2018-01-05 Created: 2018-01-05 Last updated: 2018-06-09Bibliographically approved
Goicolea, I., Coe, A.-B., San Sebastián, M. & Hurtig, A.-K. (2017). Developing and sustaining adolescent-friendly health services: a multiple case study from Ecuador and Peru. Global Public Health, 12(8), 1004-1017
Open this publication in new window or tab >>Developing and sustaining adolescent-friendly health services: a multiple case study from Ecuador and Peru
2017 (English)In: Global Public Health, ISSN 1744-1692, E-ISSN 1744-1706, Vol. 12, no 8, p. 1004-1017Article in journal (Refereed) Published
Abstract [en]

Adolescent-Friendly Health Services (AFHSs) are those that are accessible, acceptable, equitable, appropriate and effective for different youth sub-populations. This study investigated the process through which four clinics in two countries - Peru and Ecuador - introduced, developed and sustained AFHSs. A multiple case study design was chosen, and data from each clinic were collected through document review, observations and informant interviews. National level data were also collected. Data were analysed following thematic analysis. The findings showed that the process of introducing, developing and sustaining AFHSs was long term, and required a creative team effort and collaboration between donors, public institutions and health providers. The motivation and external support was crucial to initiating and sustaining the implementation of AFHSs. Health facilities' transformation into AFHSs was linked to the broader organisation of country health systems, and the evolution of national adolescent health policies. In Peru, the centralised approach to AFHSs introduction facilitated the dissemination of a comprehensive national model to health facilities, but dependency on national directives made it more difficult to systemise them when ideological and organisational changes occurred. In Ecuador, a less centralised approach to introducing AFHSs made for easier integration of the AFHSs model.

Place, publisher, year, edition, pages
Routledge, 2017
Keywords
Adolescent-friendly health services, case study, adolescence, sexual and reproductive health
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-119119 (URN)10.1080/17441692.2015.1123752 (DOI)000407645600005 ()26745032 (PubMedID)
Available from: 2016-04-12 Created: 2016-04-12 Last updated: 2018-06-07Bibliographically approved
Tetui, M., Coe, A.-B., Hurtig, A.-K., Ekirapa-Kiracho, E. & Kiwanuka, S. N. (2017). Experiences of using a participatory action research approach to strengthen district local capacity in Eastern Uganda. Global Health Action, 10, Article ID 1346038.
Open this publication in new window or tab >>Experiences of using a participatory action research approach to strengthen district local capacity in Eastern Uganda
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2017 (English)In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 10, article id 1346038Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: To achieve a sustained improvement in health outcomes, the way health interventions are designed and implemented is critical. A participatory action research approach is applauded for building local capacity such as health management. Thereby increasing the chances of sustaining health interventions.

OBJECTIVE: This study explored stakeholder experiences of using PAR to implement an intervention meant to strengthen the local district capacity.

METHODS: This was a qualitative study featuring 18 informant interviews and a focus group discussion. Respondents included politicians, administrators, health managers and external researchers in three rural districts of eastern Uganda where PAR was used. Qualitative content analysis was used to explore stakeholders' experiences.

RESULTS: 'Being awakened' emerged as an overarching category capturing stakeholder experiences of using PAR. This was described in four interrelated and sequential categories, which included: stakeholder involvement, being invigorated, the risk of wide stakeholder engagement and balancing the risk of wide stakeholder engagement. In terms of involvement, the stakeholders felt engaged, a sense of ownership, felt valued and responsible during the implementation of the project. Being invigorated meant being awakened, inspired and supported. On the other hand, risks such as conflict, stress and uncertainty were reported, and finally these risks were balanced through tolerance, risk-awareness and collaboration.

CONCLUSIONS: The PAR approach was desirable because it created opportunities for building local capacity and enhancing continuity of interventions. Stakeholders were awakened by the approach, as it made them more responsive to systems challenges and possible local solutions. Nonetheless, the use of PAR should be considered in full knowledge of the undesirable and complex experiences, such as uncertainty, conflict and stress. This will enable adequate preparation and management of stakeholder expectations to maximize the benefits of the approach.

Place, publisher, year, edition, pages
Abingdon: Taylor & Francis, 2017
Keywords
Participatory action research, stakeholders experiences, local capacity, districts, implementation science
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-140440 (URN)10.1080/16549716.2017.1346038 (DOI)000423214500011 ()28856974 (PubMedID)
Note

Supplement 4: MANIFEST (Maternal and Neonatal Implementation for Equitable Systems Study)

Available from: 2017-10-11 Created: 2017-10-11 Last updated: 2018-06-09Bibliographically approved
Vives-Cases, C., Espinar-Ruiz, E., Castellanos-Torres, E. & Coe, A.-B. (2017). Multiple struggles in fighting violence against women: implications among Romani women leaders in Spain. Global Health Action, 10, Article ID 1317084.
Open this publication in new window or tab >>Multiple struggles in fighting violence against women: implications among Romani women leaders in Spain
2017 (English)In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 10, article id 1317084Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Violence against women (VAW) is a central issue in gender studies and one that has united feminist activists from around the world. But this does not mean that this struggle is singular: indeed, one can say that there are many, diverse and sometimes even contradictory struggles occurring throughout the world.

OBJECTIVES: To identify and analyze the different struggles faced by women from Roma organizations in Spain in relation to VAW and their work with affected women.

METHODS: Twelve semi-structured interviews were conducted among women actively involved in Roma associations in different Spanish cities, in 2015. An inductive thematic analysis was used to analyze the empirical materials.

RESULTS: Our analysis resulted in three themes that captured different struggles that women from Roma organizations have faced: 'between persistence and rupture of restrictive gender norms', 'invisibility and normalization of violence against women' and 'willingness and trust in daily work with women'. The activities related to VAW carried out by the interviewed women were more related to their personal initiatives and abilities than to strategies proposed by the organizations they work for.

CONCLUSIONS: The results show the need to support the initiatives of Romani women and their own struggles related to identity. This is what makes them true promoters of social change and, more specifically, change related to gender relations both within and outside of their communities.

Keywords
Intimate partner violence, Roma population, gender inequalities, intersectionality, qualitative study
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-135901 (URN)10.1080/16549716.2017.1317084 (DOI)000417200100004 ()28585896 (PubMedID)
Note

Special issue, supplement 2.

Available from: 2017-06-09 Created: 2017-06-09 Last updated: 2018-06-09Bibliographically approved
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