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Köteles, F. & Nordin, S. (2024). Do somatic symptom distress and attribution predict symptoms associated with environmental factors?. Journal of Psychosomatic Research, 179, Article ID 111637.
Open this publication in new window or tab >>Do somatic symptom distress and attribution predict symptoms associated with environmental factors?
2024 (English)In: Journal of Psychosomatic Research, ISSN 0022-3999, E-ISSN 1879-1360, Vol. 179, article id 111637Article in journal (Refereed) Published
Abstract [en]

Objective: Not much is known on the development of symptoms associated with environmental factors (SAEF), also known as (idiopathic) environmental intolerances. Findings from qualitative studies suggest that appearance of symptoms might be the first step, followed by the acquisition of a specific attribution. The current study investigated cross-sectional and longitudinal (three years) associations between attribution and symptoms with respect to symptoms associated with chemical substances, certain indoor environments (buildings), sounds, and electromagnetic fields (EMFs).

Methods: We used data from the first two waves of the population-based Västerbotten Environmental Health Study (n = 2336). Participants completed the Patient Health Questionnaire Somatic Symptom Scale (PHQ-15), the Environmental Symptom-Attribution Scale, and answered single questions on the four aforementioned SAEFs.

Results: Using binary logistic regression analyses, all four SAEFs showed significant cross-sectional associations with somatic symptom distress and the respective attribution. In the longitudinal analysis, development of SAEF-Sound and SAEF-Chemicals were predicted by both somatic symptom distress and attribution. SAEF-EMFs was predicted only by attribution, whereas neither somatic symptom distress nor attribution forecasted SAEF-Buildings.

Conclusion: Overall, these findings suggest that attribution (i.e., a specific expectation) plays a substantial role in the development and maintenance of many SAEFs.

Place, publisher, year, edition, pages
Elsevier, 2024
Keywords
Chemical sensitivity, Electrohypersensitivity, Sick building syndrome
National Category
Psychiatry
Identifiers
urn:nbn:se:umu:diva-222231 (URN)10.1016/j.jpsychores.2024.111637 (DOI)2-s2.0-85186328451 (Scopus ID)
Funder
Afa Sjukförsäkringsaktiebolag, 190082
Available from: 2024-03-15 Created: 2024-03-15 Last updated: 2024-03-15Bibliographically approved
Andersson, E. M., Liv, P., Nordin, S., Näslund, U. & Lindvall, K. (2024). Does a multi-component intervention including pictorial risk communication about subclinical atherosclerosis improve perceptions of cardiovascular disease risk without deteriorating efficacy beliefs?. Social Science and Medicine, 341, Article ID 116530.
Open this publication in new window or tab >>Does a multi-component intervention including pictorial risk communication about subclinical atherosclerosis improve perceptions of cardiovascular disease risk without deteriorating efficacy beliefs?
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2024 (English)In: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 341, article id 116530Article in journal (Refereed) Epub ahead of print
Abstract [en]

Background: Pictorial communication about subclinical atherosclerosis can improve cardiovascular disease (CVD) risk, but whether it leads to long-term shifts in self-rated CVD risk (risk perception) and beliefs about possibility to influence personal risk (efficacy beliefs) is unknown.

Purpose: To study the impact of personalized color-coded and age-related risk communication about atherosclerosis and motivational conversation, compared to traditional risk factor-based communication, on risk perception and efficacy beliefs. Also, whether risk perception increases with message severity.

Method: The effect of the pragmatic RCT Visualization of Asymptomatic Atherosclerotic Disease for Optimum Cardiovascular Prevention (VIPVIZA) was analyzed using a linear mixed effects model with risk perception and efficacy believes at 1-year and 3-year follow up as dependent variables. Participants’ (n = 3532) CVD risk perception and efficacy beliefs were assessed with visual analog scales (0–10). Fixed effects were group (intervention vs control), time point (1 year or 3 years) and interaction between group and time point. Further, the models were adjusted for corresponding baseline measurement of the dependent variable and a baseline × time point interaction. Effect of pictorial color-coded risk in the intervention group was investigated using a corresponding mixed effects model, but with pictorial risk group (message severity) as exposure instead of intervention group.

Results: After one year, the intervention group rated their CVD risk as higher (m = 0.46, 95% CI 0.32–0.59), with an effect also after 3 years (m = 0.57, 95% CI 0.43–0.70). The effect was consistent in stratified analyses by sex and education. Overall, no effect on efficacy beliefs was observed. In the intervention group, differences in CVD risk perception were found between participants with different color-coded risk messages on atherosclerosis status.

Conclusion: Personalized, color-coded and age-related risk communication about atherosclerosis had an effect on risk perception with an effect also after 3 years, whereas overall, no effect on efficacy beliefs was observed.

Place, publisher, year, edition, pages
Elsevier, 2024
Keywords
Atherosclerosis, Cardiovascular disease, Pictorial communication, Prevention, Response efficacy, Risk perception, Self efficacy, Vascular age
National Category
Psychology
Identifiers
urn:nbn:se:umu:diva-218586 (URN)10.1016/j.socscimed.2023.116530 (DOI)38169179 (PubMedID)2-s2.0-85181833982 (Scopus ID)
Funder
Region Västerbotten, ALFVLL-298001Region Västerbotten, AALFVLL- 643391Swedish Research Council, 521-2013-2708Swedish Research Council, 2016–01891Swedish Research Council, 2017–02246Swedish Heart Lung Foundation, 20150369Swedish Heart Lung Foundation, 20170481Swedish Society of MedicineThe Swedish Stroke AssociationSwedish Insurance SocietyVisare NorrThe Swedish Heart and Lung Association
Available from: 2023-12-21 Created: 2023-12-21 Last updated: 2024-01-22
Pitron, V., Köteles, F. G., Nordin, S., Haanes, J. V., Hillert, L., Léger, D., . . . Van den Bergh, O. (2024). Multiple Chemical Sensitivity: Catching up to what kind of science?. Neuroscience and Biobehavioral Reviews, 157, Article ID 105524.
Open this publication in new window or tab >>Multiple Chemical Sensitivity: Catching up to what kind of science?
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2024 (English)In: Neuroscience and Biobehavioral Reviews, ISSN 0149-7634, E-ISSN 1873-7528, Vol. 157, article id 105524Article in journal (Refereed) Published
Place, publisher, year, edition, pages
Elsevier, 2024
Keywords
Idiopathic environmental intolerance, Multiple chemical sensitivity, Persistent symptoms
National Category
Psychology (excluding Applied Psychology)
Identifiers
urn:nbn:se:umu:diva-219832 (URN)10.1016/j.neubiorev.2023.105524 (DOI)38154656 (PubMedID)2-s2.0-85181824284 (Scopus ID)
Available from: 2024-01-22 Created: 2024-01-22 Last updated: 2024-01-22Bibliographically approved
Nordin, S., Norberg, M., Braf, I., Johansson, H., Lindahl, B., Lindvall, K., . . . Näslund, U. (2023). Associations between emotional support and cardiovascular risk factors and subclinical atherosclerosis in middle-age. Psychology and Health
Open this publication in new window or tab >>Associations between emotional support and cardiovascular risk factors and subclinical atherosclerosis in middle-age
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2023 (English)In: Psychology and Health, ISSN 0887-0446, E-ISSN 1476-8321Article in journal (Refereed) Epub ahead of print
Abstract [en]

Objective: To test the hypothesis of low emotional support being associated with lifestyle and biomedical cardiovascular disease (CVD) risk factors, estimated risk of CVD morbidity and mortality, and subclinical atherosclerosis in middle-aged healthy adults.

Methods and measures: Cross-sectional data were obtained from participants aged 40–60 years who had one or more conventional CVD risk factor. They underwent assessment based on questionnaires, clinical examination, blood sampling, and carotid ultrasound of plaque formation and carotid intima-media wall thickness (cIMT). Based on the Interview Schedule for Social Interaction, the participants were categorised as either low in emotional support (n = 884) or as a referent (n = 2570). Logistic regression analyses were conducted to study the associations.

Results: Logistic regression analyses showed that low emotional support was significantly associated with smoking, alcohol consumption and physical inactivity (OR = 1.53 − 1.94), estimated risk of CVD morbidity and mortality (OR = 1.56 − 1.68), and plaque formation (OR = 1.39). No significant associations were found regarding biomedical CVD risk factors or cIMT.

Conclusion: The findings suggest that low social support is associated with lifestyle CVD risk factors, estimated risk of CVD morbidity and mortality, and subclinical atherosclerosis in middle-aged healthy adults, encouraging causal evaluation with longitudinal data investigating an impact of emotional support on mechanisms underlying CVD.

Place, publisher, year, edition, pages
Routledge, 2023
Keywords
Cardiovascular disease, cardiovascular risk score, carotid artery plaque, carotid vascular ultrasound, social support
National Category
Public Health, Global Health, Social Medicine and Epidemiology Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-217344 (URN)10.1080/08870446.2023.2286296 (DOI)37994844 (PubMedID)2-s2.0-85177567916 (Scopus ID)
Available from: 2023-12-01 Created: 2023-12-01 Last updated: 2023-12-01
Köteles, F., Nordin, S. & Claeson, A.-S. (2023). Associations between symptoms, modern health worries, and somatosensory amplification in patients with building-related symptoms. Journal of Psychosomatic Research, 173, Article ID 111476.
Open this publication in new window or tab >>Associations between symptoms, modern health worries, and somatosensory amplification in patients with building-related symptoms
2023 (English)In: Journal of Psychosomatic Research, ISSN 0022-3999, E-ISSN 1879-1360, Vol. 173, article id 111476Article in journal (Refereed) Published
Abstract [en]

Objective: The objective of the present study was to investigate the associations between somatosensory amplification, modern health worries (MHWs), and symptoms among patients with building-related symptoms (BRS).

Methods: Patients with self-reported and medically confirmed BRS (n = 83) were included in this cross-sectional study. The Somatosensory Amplification Scale (SSAS) was used to quantify the tendency to amplify somatic sensations and perceive them as unpleasant and dangerous. Concerns about harmful effects of modern technologies were assessed with the Modern Health Worries Scale (MHWS). Symptoms commonly found in different forms of environmental intolerance were assessed with the Environmental Hypersensitivity Symptom Inventory (EHSI).

Results: Patients with BRS were characterized by more frequent and more severe environmental hypersensitivity symptoms compared to a reference population. Females and those with co-morbid self-reported chemical intolerance reported even more symptoms. MHWS and SSAS scores showed weak to moderate associations with symptoms, even after adjusting for socio-economic variables. However, neither the mean MHWS score or the SSAS score of our sample differed from normative scores.

Conclusion: Patients with BRS are not characterized by elevated levels of MHWs and somatosensory amplification, thus other, psychosocial and/or environmental, factors may have contributed to the development of the condition. However, the associations between severity of symptoms and MHWs and somatosensory amplification suggest that psychosocial characteristics may substantially influence symptom experience in this group.

Place, publisher, year, edition, pages
Elsevier, 2023
Keywords
Building related symptoms, Modern health worries, Sick building syndrome, Somatosensory amplification
National Category
Psychiatry
Identifiers
urn:nbn:se:umu:diva-214027 (URN)10.1016/j.jpsychores.2023.111476 (DOI)37643562 (PubMedID)2-s2.0-85169055894 (Scopus ID)
Funder
Swedish Research Council Formas, 2014-1229
Available from: 2023-09-08 Created: 2023-09-08 Last updated: 2023-09-08Bibliographically approved
Andersson, E. M., Johansson, H., Nordin, S. & Lindvall, K. (2023). Cognitive and emotional reactions to pictorial-based risk communication on subclinical atherosclerosis: a qualitative study within the VIPVIZA trial. Scandinavian Journal of Primary Health Care, 41(1), 69-80
Open this publication in new window or tab >>Cognitive and emotional reactions to pictorial-based risk communication on subclinical atherosclerosis: a qualitative study within the VIPVIZA trial
2023 (English)In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 41, no 1, p. 69-80Article in journal (Refereed) Published
Abstract [en]

Objectives, setting and subjects: Atherosclerosis screening with ultrasound is non-invasive and can be used as part of risk communication. The potential of personalised and pictorial-based risk communication is assessed in VIPVIZA, a population-based randomised controlled trial that aims at optimising cardiovascular disease (CVD) prevention by investigating the impact of visualisation of subclinical atherosclerosis. The present aim was to explore cognitive and emotional reactions evoked by the intervention as well as attitudes to any implemented life style changes in VIPVIZA participants in the intervention group with improved health status and furthermore to study possible interactions between these factors. Understanding mechanisms of action was central since non-adherence to preventive guidelines are often faced in clinical practice. Design: In-depth interviews with 14 individuals were analysed with qualitative content analysis. Results: Cognitive and emotional processes were highly interlinked and described by the main theme Cognitive and emotional reactions in strong interplay for orchestration of health oriented behavioural change. The informants’ descriptions revealed two distinctly different psychological processes which constituted the two subthemes, Problem-focused coping and Encouragement-driven process. Conclusions: The results highlight that an interaction between emotional reactions and efficacy beliefs is important in facilitating behavioural change. Furthermore, the results underscore the importance of the risk message being perceived as clear, accurate, reliable and also emotionally engaging and thereby show why atherosclerosis screening and pictorial-based risk communication have the potential to contribute to effective CVD prevention strategies and shared decision making in primary care.

Place, publisher, year, edition, pages
Taylor & Francis, 2023
Keywords
Cardiovascular disease, decision making, health behaviour, prevention, qualitative content analysis
National Category
Health Care Service and Management, Health Policy and Services and Health Economy Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-205734 (URN)10.1080/02813432.2023.2178850 (DOI)000942309100001 ()36855328 (PubMedID)2-s2.0-85149358906 (Scopus ID)
Funder
Region Västerbotten, ALFVLL-298001Region Västerbotten, ALFVLL-643391Swedish Research Council, 521-2013-2708Swedish Research Council, 2016-0189Swedish Heart Lung Foundation, 20150369Swedish Heart Lung Foundation, 20170481Swedish Society of MedicineThe Swedish Stroke AssociationVisare Norr
Available from: 2023-03-17 Created: 2023-03-17 Last updated: 2023-06-20Bibliographically approved
Sundström, A., Söderholm, A., Nordin, M. & Nordin, S. (2023). Construct validation and normative data for different versions of the Shirom-Melamed burnout questionnaire/measure in a Swedish population sample. Stress and Health, 39(3), 499-515
Open this publication in new window or tab >>Construct validation and normative data for different versions of the Shirom-Melamed burnout questionnaire/measure in a Swedish population sample
2023 (English)In: Stress and Health, ISSN 1532-3005, E-ISSN 1532-2998, Vol. 39, no 3, p. 499-515Article in journal (Refereed) Published
Abstract [en]

The overall aim of the present study was to examine the construct validity of different versions of the Shirom-Melamed Burnout Questionnaire/Measure (SMBQ/M) suggested in previous work, as well as to provide normative data for a large population-based sample in Sweden with a broad range in age. Cross-sectional data from the Västerbotten Environmental Health Study in Sweden were used. The 3406 participants (56% women) in this study, aged 18–79 years, constituted a random sample stratified for age and sex. Participants responded to a questionnaire including the 4-factor 22-item version of the SMBM as well as background questions and a number of validated questionnaire instruments assessing for example, sleep disturbance, depression, anxiety, perceived stress, and somatic symptoms. The dimensionality of different versions of the SMBM were examined with confirmatory factor analysis. A modified 4-factor 19-item model of the SMBM provided good model-fit, and two 2-factor models (11-item and 6-item) provided excellent model fit. The relationships to relevant psychological constructs provided support for convergent validity for the suggested versions of the SMBM. Finally, normative data were obtained for a broad age group for the different versions. In conclusion, we suggest that for assessing the core of the burnout construct in terms of emotional and physical exhaustion and cognitive weariness, the SMBM-11 or SMBM-6 for repeated measures, are to be used. For a broader assessment of burnout incorporating both symptoms and information about the process of exhaustion via the subscales of listlessness and tension, we recommend the use of the modified 4-factor SMBM-19.

Place, publisher, year, edition, pages
John Wiley & Sons, 2023
Keywords
burnout, confirmatory factor analysis, convergent validity, epidemiology, SMBM, SMBQ
National Category
Public Health, Global Health, Social Medicine and Epidemiology Applied Psychology
Research subject
Psychology
Identifiers
urn:nbn:se:umu:diva-200240 (URN)10.1002/smi.3200 (DOI)000862958100001 ()36166816 (PubMedID)2-s2.0-85139006816 (Scopus ID)
Funder
AFA Insurance, 190082
Note

First published online: 27 September 2022

Available from: 2022-10-13 Created: 2022-10-13 Last updated: 2023-09-04Bibliographically approved
Pitron, V., Haanes, J. V., Hillert, L., Köteles, F. G., Léger, D., Lemogne, C., . . . Van den Bergh, O. (2023). Electrohypersensitivity is always real. Environmental Research, 218, Article ID 114840.
Open this publication in new window or tab >>Electrohypersensitivity is always real
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2023 (English)In: Environmental Research, ISSN 0013-9351, E-ISSN 1096-0953, Vol. 218, article id 114840Article in journal (Refereed) Published
Abstract [en]

Highlights:

  • Electrohypersensitivty (EHS) represents a severely disabling condition.
  • Symptom reports in EHS are unrelated to actual electromagnetic field exposure.
  • A reductionist bio-electromagnetic approach fails to explain EHS.
  • Empirical evidence suggests that nocebo effects strongly contribute to EHS.
  • Spreading the myth about a (non-existing) EHS epidemic causes harm.
Place, publisher, year, edition, pages
Elsevier, 2023
Keywords
Electromagnetic fields, Idiopathic environmental intolerance, IEI-EMF, Nocebo
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-201946 (URN)10.1016/j.envres.2022.114840 (DOI)36463993 (PubMedID)2-s2.0-85143879868 (Scopus ID)
Note

Corrigendum: Victor Pitron, Jan Vilis Haanes, Lena Hillert, Ferenc Gàbor Köteles, Damien Léger, Cédric Lemogne, Steven Nordin, Renáta Szemerszky, Irene van Kamp, Christoph van Thriel, Michael Witthöft, Omer Van den Bergh, Corrigendum to “Electrohypersensitivity is always real” Environmental Research, Volume 251, Part 1, 2024,118546, ISSN 0013-9351. DOI: 10.1016/j.envres.2024.118546

Available from: 2022-12-29 Created: 2022-12-29 Last updated: 2024-03-15Bibliographically approved
Andersson, E. M., Lindvall, K., Wennberg, P., Johansson, H. & Nordin, S. (2023). From risk communication about asymptomatic atherosclerosis to cognitive and emotional reactions and lifestyle modification. BMC Psychology, 12(1), Article ID 47.
Open this publication in new window or tab >>From risk communication about asymptomatic atherosclerosis to cognitive and emotional reactions and lifestyle modification
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2023 (English)In: BMC Psychology, E-ISSN 2050-7283, Vol. 12, no 1, article id 47Article in journal (Refereed) Published
Abstract [en]

Background: Non-adherence in the general population to preventive guidelines on cardiovascular disease calls for an interdisciplinary approach acknowledging psychological factors of relevance for risk communication and lifestyle modification. Evidence is building up regarding the advantage of sharing arterial imaging evidence of subclinical atherosclerosis with asymptomatic individuals, but there is limited understanding of how this relates to mechanisms of importance for behavioural change. Longitudinal studies on associations between patients’ reactions and lifestyle modification are missing. The population-based randomized controlled trial VIPVIZA investigates the impact of pictorial information about subclinical atherosclerosis, added to traditional risk factor-based communication. The intervention includes a personalized, colour-coded and age-related risk communication strategy and a motivational conversation, and has been shown to reduce cardiovascular disease risk. 

Methods: In the present study we assessed cognitive and emotional reactions to the intervention, and how these reactions are associated to lifestyle modification. The participants’ evaluation of the risk communication was assessed in the intervention group (n=1749). Lifestyle modification was assessed with a lifestyle index based on physical activity, diet, smoking and alcohol consumption at baseline and after 3 years. Associations between cognitive and emotional response and lifestyle modification were tested with analyses of covariance in a subset of participants (n=714-857).

Results: The intervention increased understanding of personal CVD risk, the possibility to influence the risk, and how to influence the risk. Severity of atherosclerosis was associated with emotional reactions, but emotions of strong negative valence were uncommon. Cognitive response and emotional arousal evoked by the intervention were positively associated with lifestyle modification, whereas negative emotions in isolation were not. High level of cognitive response in combination with high level of emotional arousal was found to be most beneficial for lifestyle modification.

Conclusions: The results demonstrate the potential of communicating asymptomatic atherosclerosis with a pictorial, colour-coded and age-related strategy, also including a motivational conversation. Furthermore, the results show the importance of CVD risk communication evoking engagement, and that an interaction between cognitive and emotional reactions might be central for sustained lifestyle modification. Our results also indicate that, in an asymptomatic population, atherosclerosis screening may strengthen disease prevention and health promotion.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2023
Keywords
Atherosclerosis, Lifestyle, Health behaviour, Prevention, Health promotion, Decision making, Cognition, Emotion 
National Category
Psychology Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-218585 (URN)10.1186/s40359-023-01467-x (DOI)001148313000002 ()38268015 (PubMedID)2-s2.0-85182977469 (Scopus ID)
Funder
Region Västerbotten, Central ALFRegion Västerbotten, ALFVLL-298001Region Västerbotten, ALFVLL- 643391Swedish Research Council, 521–2013-2708Swedish Research Council, 2016- 01891Swedish Research Council, 2017–02246Swedish Heart Lung Foundation, 20150369Swedish Heart Lung Foundation, 20170481The Swedish Stroke AssociationSwedish Insurance SocietyVisare Norr
Available from: 2023-12-21 Created: 2023-12-21 Last updated: 2024-02-07Bibliographically approved
Van den Bergh, O., Pitron, V., Nordin, S. & Witthöft, M. (2023). Idiopathic environmental intolerances (4ed.). In: Philip Wexler (Ed.), Encyclopedia of toxicology: volume 5 (pp. 449-462). Elsevier
Open this publication in new window or tab >>Idiopathic environmental intolerances
2023 (English)In: Encyclopedia of toxicology: volume 5 / [ed] Philip Wexler, Elsevier, 2023, 4, p. 449-462Chapter in book (Refereed)
Abstract [en]

Idiopathic Environmental Intolerances (IEI) are a group of acquired health conditions characterized by multiple recurrent symptoms associated with environmental factors in the absence of any known causal pathophysiological mechanism. We discuss IEI in response to chemicals and to electromagnetic radiation. Although various potential explanations have been advanced, provocation studies and experimental studies with expectation induction suggest to consider these IEI as nocebo responses that result from strong causal perceptions in vulnerable persons. A recent account of symptom perception allows to understand how experiences of symptoms come about in the absence of pathophysiological mechanisms.

Place, publisher, year, edition, pages
Elsevier, 2023 Edition: 4
Keywords
Causal perception, Chemical intolerance, Electromagnetic hypersensitivity, Multiple chemical sensitivity, Nocebo, Symptom perception, Symptoms associated with environmental factors
National Category
Psychology (excluding Applied Psychology) Psychiatry
Identifiers
urn:nbn:se:umu:diva-222692 (URN)10.1016/B978-0-12-824315-2.00595-9 (DOI)2-s2.0-85188066769 (Scopus ID)9780128243152 (ISBN)9780323854344 (ISBN)
Available from: 2024-03-26 Created: 2024-03-26 Last updated: 2024-03-26Bibliographically approved
Projects
Specific reactive substances causing sensitization in sick building syndrome and chemical sensitivity? Sampling, analysis and health effects. [2010-965_Formas]; Umeå UniversityA chemosensory stress model for health symptoms in chemical environments [2011-00396_Forte]; Umeå UniversityThe effects of noise, socioeconomic status and genetics in the relationship between air pollution and dementia [2015-1099_Formas]; Umeå University
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0003-1699-1681

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