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Festin, Karin
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Publications (10 of 31) Show all publications
Odzakovic, E., Hyden, L.-C., Festin, K. & Kullberg, A. (2019). People diagnosed with dementia in Sweden: What type of home care services and housing are they granted? A cross-sectional study. Scandinavian Journal of Public Health, 47(2), 229-239
Open this publication in new window or tab >>People diagnosed with dementia in Sweden: What type of home care services and housing are they granted? A cross-sectional study
2019 (English)In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 47, no 2, p. 229-239Article in journal (Refereed) Published
Abstract [en]

AIMS: This study aims to examine what types of home care services and housing are granted to people with a dementia diagnosis and how these types are associated with socio-demographic factors (sex, age, marital status, native or foreign born, and regional area).

METHODS: A cross-sectional study of all people diagnosed with dementia in three Swedish counties was conducted from the medical records in 2012. Logistic regression analysis was carried out to investigate associations between home care services and housing and socio-demographic variables.

RESULTS: In total, 17,405 people had a dementia diagnosis, and the majority were women, aged 80+ years, and unmarried. Some 72% were living in ordinary housing and 28% lived in special housing. Of those who lived in ordinary housing, 50% did not receive any home care service. Not receiving any type of home care services was less common for older people and was also associated with being married and living in rural municipalities. The most common home care services granted were home help and personal care. Special housing was more common for older people, unmarried persons, and those living in rural municipalities.

CONCLUSIONS: Most people with a dementia diagnosis were living in ordinary housing, and, surprisingly, half of those did not receive any type of home care service. This knowledge is essential for making the living conditions and needs of people living with dementia more visible and to provide good home care services for people with dementia and their families.

Place, publisher, year, edition, pages
Sage Publications, 2019
Keywords
Home care services, cross-sectional study, dementia, foreign born, ordinary housing, special housing
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:liu:diva-146049 (URN)10.1177/1403494818755600 (DOI)000462758700019 ()29409432 (PubMedID)2-s2.0-85042217866 (Scopus ID)
Available from: 2018-03-23 Created: 2018-03-23 Last updated: 2019-04-18Bibliographically approved
Rådholm, K., Festin, K., Falk, M., Midlöv, P., Mölstad, S. & Östgren, C. J. (2016). Blood pressure and all-cause mortality: a prospective study of nursing home residents. Age and Ageing, 45(6), 826-832
Open this publication in new window or tab >>Blood pressure and all-cause mortality: a prospective study of nursing home residents
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2016 (English)In: Age and Ageing, ISSN 0002-0729, E-ISSN 1468-2834, Vol. 45, no 6, p. 826-832Article in journal (Refereed) Published
Abstract [en]

Aim: To explore the natural course of blood pressure development and its relation to mortality in a nursing home cohort.

Methods: A cohort of 406 nursing home residents in south east Sweden was followed prospectively for 30 months. Participants were divided into four groups based on systolic blood pressure (SBP) at baseline. Data were analysed using a Cox regression model with all-cause mortality as the outcome measurement; paired Student t-tests were used to evaluate blood pressure development over time.

Results: During follow-up, 174 (43%) people died. Participants with SBP <120 mmHg had a hazard ratio for mortality of 1.56 (95% confidence interval, 1.08–2.27) compared with those with SBP 120–139 mmHg, adjusted for age and sex. Risk of malnutrition or present malnutrition was most common in participants with SBP <120 mmHg; risk of malnutrition or present malnutrition estimated using the Mini Nutritional Assessment was found in 78 (71%). The levels of SBP decreased over time independent of changes in anti-hypertensive medication.

Conclusions: In this cohort of nursing home residents, low SBP was associated with increased all-cause mortality. SBP decreased over time; this was not associated with altered anti-hypertensive treatment. The clinical implication from this study is that there is a need for systematic drug reviews in elderly persons in nursing homes, paying special attention to those with low SBP.

Place, publisher, year, edition, pages
Oxford University Press, 2016
Keywords
older people, prospective study, nursing home, hypertension, hypotension, all-cause mortality
National Category
General Practice Other Health Sciences
Identifiers
urn:nbn:se:liu:diva-121283 (URN)10.1093/ageing/afw122 (DOI)000392702200018 ()
Note

Funding agencies| Health Research Council in south east Sweden (FORSS-8888, FORSS-11636 and FORSS-31811); the County of Östergötland (LIO-11877, LIO-31321 and LIO-79951); the Family Janne Elgqvist Foundation; King Gustaf V and Queen Victoria Freemason Foundation.

At the time for thesis presentation publication was in status: Manuscript

Available from: 2015-09-11 Created: 2015-09-11 Last updated: 2018-01-11Bibliographically approved
Carlfjord, S. & Festin, K. (2015). Association between organizational climate and perceptions and use of an innovation in Swedish primary health care: a prospective study of an implementation. BMC Health Services Research, 15(364)
Open this publication in new window or tab >>Association between organizational climate and perceptions and use of an innovation in Swedish primary health care: a prospective study of an implementation
2015 (English)In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 15, no 364Article in journal (Refereed) Published
Abstract [en]

Background: There is a need for new knowledge regarding determinants of a successful implementation of new methods in health care. The role of a receptive context for change to support effective diffusion has been underlined, and could be studied by assessing the organizational climate. The aim of this study was to assess the association between organizational climate when a computer-based lifestyle intervention tool (CLT) was introduced in primary health care (PHC) and the implementation outcome in terms of how the tool was perceived and used after 2 years. Methods: The CLT was offered to 32 PHC units in Sweden, of which 22 units agreed to participate in the study. Before the introduction of the CLT, the creative climate at each participating unit was assessed. After 24 months, a follow-up questionnaire was distributed to the staff to assess how the CLT was perceived and how it was used. A question on the perceived need for the CLT was also included. Results: The units were divided into three groups according to the creative climate: high, medium and low. The main finding was that the units identified as having a positive creative climate demonstrated more frequent use and more positive perceptions regarding the new tool than those with the least positive creative climate. More positive perceptions were seen at both individual and unit levels. Conclusions: According to the results from this study there is an association between organizational climate at baseline and implementation outcome after 2 years when a tool for lifestyle intervention is introduced in PHC in Sweden. Further studies are needed before measurement of organizational climate at baseline can be recommended in order to predict implementation outcome.

Place, publisher, year, edition, pages
BIOMED CENTRAL LTD, 2015
National Category
Other Social Sciences
Identifiers
urn:nbn:se:liu:diva-121896 (URN)10.1186/s12913-015-1038-2 (DOI)000361290500001 ()26358045 (PubMedID)
Note

Funding Agencies|Swedish Council for Working Life and Social Research (FAS)

Available from: 2015-10-13 Created: 2015-10-12 Last updated: 2017-12-01
Andersson, P., Karlsson, J.-E., Landberg, E., Festin, K. & Nilsson, S. (2015). Consequences of high-sensitivity troponin T testing applied in a primary care population with chest pain compared with a commercially available point-of-care troponin T analysis: an observational prospective study. BMC Research Notes, 8(1), 1-9
Open this publication in new window or tab >>Consequences of high-sensitivity troponin T testing applied in a primary care population with chest pain compared with a commercially available point-of-care troponin T analysis: an observational prospective study
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2015 (English)In: BMC Research Notes, ISSN 1756-0500, E-ISSN 1756-0500, Vol. 8, no 1, p. 1-9Article in journal (Refereed) Published
Abstract [en]

BACKGROUND:There is a demand for a highly sensitive and specific point-of care test to detect acute myocardial infarction (AMI). It is unclear if a high-sensitivity troponin assay will have enough discriminative power to become a decision support in primary care. The aim of this study was to evaluate a high-sensitivity troponin T assay performed in three primary health care centres in southeast Sweden and to compare the outcome with a point-of-care troponin T test.METHODS:This study included 115 patients who consulted their general practitioner for chest pain, dyspnoea on exertion, unexplained weakness and/or fatigue in the last 7days. Troponin T was analysed by a point-of-care test and a high-sensitivity method together with N-terminal pro-B-type natriuretic peptide (NT-proBNP) and creatinine. All patients were checked for AMI or unstable angina (UA) within 30days of study enrolment. Univariate and multivariate logistic regression was carried out to examine possible connections between troponin T[greater than or equal to]15ng/L, clinical variables and laboratory findings at baseline. In addition, 21 patients with troponin T[greater than or equal to]15ng/L and no signs of AMI or UA were followed up for 2-3years.RESULTS:Three patients were diagnosed with AMI and three with UA. At the [greater than or equal to]15ng/L cut-off, the troponin T method had 100% sensitivity, 75% specificity for AMI and a positive predictive value of 10%. The troponin T point-of-care test missed one case of AMI and the detection limit was 50ng/L. Troponin T[greater than or equal to]15ng/L was correlated to age [greater than or equal to]65years (odds ratio (OR), 10.9 95% CI 2.28-51.8) and NT-proBNP in accordance with heart failure (OR 8.62 95% CI 1.61-46.1). Fourteen of the 21 patients, without signs of AMI or UA at baseline, still had increased troponin T at follow-up after 2-3years.CONCLUSIONS:A high-sensitivity troponin T assay could become useful in primary care as a point-of-care test for patients <65years. For patients older than 65-70years, a higher decision limit than [greater than or equal to]15ng/L should be considered and used in conjunction with clinical parameters and possibly with NT-proBNP.

Keywords
Primary health care, Acute coronary syndrome, Chest pain, Troponin T, Point-of-care testing
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:liu:diva-122874 (URN)10.1186/s13104-015-1174-0 (DOI)26036786 (PubMedID)
Available from: 2015-11-26 Created: 2015-11-26 Last updated: 2017-12-01
Blomstrand, P., Engvall, M., Festin, K., Lindström, T., Länne, T., Maret, E., . . . Engvall, J. (2015). Left ventricular diastolic function, assessed by echocardiography and tissue Doppler imaging, is a strong predictor of cardiovascular events, superior to global left ventricular longitudinal strain, in patients with type 2 diabetes.. European heart journal cardiovascular Imaging, 16(9), 1000-1007
Open this publication in new window or tab >>Left ventricular diastolic function, assessed by echocardiography and tissue Doppler imaging, is a strong predictor of cardiovascular events, superior to global left ventricular longitudinal strain, in patients with type 2 diabetes.
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2015 (English)In: European heart journal cardiovascular Imaging, ISSN 2047-2412, Vol. 16, no 9, p. 1000-1007Article in journal (Refereed) Published
Abstract [en]

AIMS: The aim of the study was to determine whether left ventricular systolic function, in terms of global left ventricular longitudinal strain (GLS), and diastolic function, expressed as the ratio between early diastolic transmitral flow and mitral annular motion velocities (E/e'), can predict cardiovascular events in patients with diabetes mellitus type 2.

METHODS AND RESULTS: We prospectively investigated 406 consecutive patients, aged 55-65 years, with diabetes mellitus, who participated in the CARDIPP study. Echocardiography, pulse pressure (pp), and glycosylated haemoglobin (HbA1c) were analysed. Twelve cases of myocardial infarction and seven cases of stroke were identified during the follow-up period of 67 ± 17 months. Univariate Cox regression analysis showed that E/e' was a strong predictor of cardiovascular events (hazards ratio 1.12; 95% confidence interval 1.06-1.18, P < 0.001). E/e' was prospectively associated with cardiovascular events independent of age, sex, GLS, left ventricular ejection fraction (LVEF), pp, and HbA1c in multivariate analysis. Receiver operating characteristic curves showed that E/e' and HbA1c were the strongest predictors for cardiovascular events, both having an area under the curve (AUC) of 0.71 followed by LVEF with an AUC of 0.65 and GLS of 0.61. In a Kaplan-Meyer analysis, the cumulative probability of an event during the follow-up period was 8.6% for patients with an E/e' ratio >15 compared with 2.6% for patients with E/e' ≤15, P = 0.011.

CONCLUSION: In middle-aged patients with type 2 diabetes, E/e' is a strong predictor of myocardial infarction and stroke, comparable with HbA1c and superior to GLS and LVEF.

Place, publisher, year, edition, pages
Oxford University Press, 2015
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:liu:diva-115748 (URN)10.1093/ehjci/jev027 (DOI)000364539700011 ()25750201 (PubMedID)
Note

Funding agencies: FORSS; Research Council of Southeastern Sweden; King Gustaf V and Queen Victoria Freemason Foundation, Sweden; Linkoping University; Futurum-the Academy for Healthcare, Jonkoping County Council

Available from: 2015-03-18 Created: 2015-03-18 Last updated: 2017-03-27
Detert, H., Hedlund, S., Anderson, C., Rodvall, Y., Festin, K., Whiteman, D. C. & Falk, M. (2015). Validation of sun exposure and protection index (SEPI) for estimation of sun habits. Cancer Epidemiology, 39(6), 986-993
Open this publication in new window or tab >>Validation of sun exposure and protection index (SEPI) for estimation of sun habits
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2015 (English)In: Cancer Epidemiology, ISSN 1877-7821, E-ISSN 1877-783X, Vol. 39, no 6, p. 986-993Article in journal (Refereed) Published
Abstract [en]

Background: In both Sweden and Australia high incidence rates of skin cancer have become a major health problem. In prevention and risk communication, it is important to have reliable ways for identifying people with risky sun habits. In this study the validity and reliability of the questionnaire Sun Exposure Protection Index (SEPI), developed to assess individuals sun habits and their propensity to increase sun protection during routine, often brief, clinical encounters, has been evaluated. The aim of our study was to evaluate validity and reliability of the proposed SEPI scoring instrument, in two countries with markedly different ultraviolet radiation environments (Sweden and Australia). Method: Two subpopulations in Sweden and Australia respectively were asked to fill out the SEPI together with the previously evaluated Readiness to Alter Sun Protective Behaviour questionnaire (RASP-B) and the associated Sun-protective Behaviours Questionnaire. To test reliability, the SEPI was again filled out by the subjects one month later. Results: Comparison between SEPI and the questions in the Sun-protective Behaviours Questionnaire, analyzed with Spearmans Rho, showed good correlations regarding sun habits. Comparison between SEPI and RASP-B regarding propensity to increase sun protection showed concurrently lower SEPI mean scores for action stage, but no difference between precontemplation and contemplation stages. The SEPI test-retest analysis indicated stability over time. Internal consistency of the SEPI, assessed with Cronbachs alpha estimation showed values marginally lower than the desired &gt;0.70 coefficient value generally recommended, and was somewhat negatively affected by the question on sunscreen use, likely related to the classic "sunscreen paradox". There were some differences in the performance of the SEPI between the Swedish and Australian samples, possibly due to the influence of "available" sunlight and differing attitudes to behaviour and protection "at home" and on vacation. Conclusions: SEPI appears to be a stable instrument with an overall acceptable validity and reliability, applicable for use in populations exposed to different UVR environments, in order to evaluate individual sun exposure and protection. (C) 2015 The Authors. Published by Elsevier Ltd.

Place, publisher, year, edition, pages
ELSEVIER SCI LTD, 2015
Keywords
Skin cancer; Sun habits; Sun protection; Ultraviolet exposure; Questionnaire
National Category
Basic Medicine
Identifiers
urn:nbn:se:liu:diva-124511 (URN)10.1016/j.canep.2015.10.022 (DOI)000367444300028 ()26547793 (PubMedID)
Note

Funding Agencies|County Council of Ostergotland, Sweden

Available from: 2016-02-02 Created: 2016-02-01 Last updated: 2018-01-10
Carlfjord, S. & Festin, K. (2014). Primary health care staffs opinions about changing routines in practice: a cross-sectional study. BMC Family Practice, 15(2)
Open this publication in new window or tab >>Primary health care staffs opinions about changing routines in practice: a cross-sectional study
2014 (English)In: BMC Family Practice, ISSN 1471-2296, E-ISSN 1471-2296, Vol. 15, no 2Article in journal (Refereed) Published
Abstract [en]

Background: In health care organizations, there is a mutual interest from politicians, managers, practitioners and patients that the best available care is provided. Efforts are made to translate new knowledge and evidence-based practices into routine care, but there are a number of obstacles to this translation process. Factors related to the new practice as well as factors related to the implementation process are important, but there is still a knowledge gap regarding how to achieve effective implementation. The aim of the present study was to assess opinions about practice change among staff in primary health care (PHC), focusing on factors related to a new practice and factors related to the implementation process. Methods: A questionnaire was sent to 470 staff members at 22 PHC centres where a new tool for lifestyle intervention had recently been implemented. Thirteen items regarding the characteristics of the new practice and nine items regarding the implementation process were to be judged from not at all important to very important. A factor analysis was performed, and statistical analysis was done using the Kruskal-Wallis nonparametric test. Results: Four factors regarding the characteristics of the new practice were identified. Most important was Objective characteristics, followed by Evidence base, Subjectively judged characteristics and Organizational level characteristics. Two factors were identified regarding the implementation process: Bottom-up strategies were judged most important and Top-down strategies less important. The most important single items regarding characteristics were "easy to use" and "respects patient privacy", and the most important implementation process item was "information about the new practice". Nurses differed most from the other professionals, and judged the factors Evidence base and Organizational level characteristics more important than the others. Staff with more than 10 years experience in their profession judged the Evidence base factor more important than those who were less experienced. Conclusions: To incorporate new practices in PHC, objective characteristics of the new practice and the evidence base should be considered. Use of bottom-up strategies for the implementation process is important. Different opinions according to profession, gender and years in practice should be taken into account when planning the implementation.

Place, publisher, year, edition, pages
BioMed Central, 2014
Keywords
Primary health care; Implementation; Staff opinions; Change
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-103865 (URN)10.1186/1471-2296-15-2 (DOI)000329528100001 ()
Available from: 2014-01-31 Created: 2014-01-30 Last updated: 2017-12-06
Trinks, A., Festin, K., Bendtsen, P. & Nilsen, P. (2013). What makes emergency department patients reduce their alcohol consumption? - A computer-based intervention study in Sweden. International Emergency Nursing, 21(1), 3-9
Open this publication in new window or tab >>What makes emergency department patients reduce their alcohol consumption? - A computer-based intervention study in Sweden
2013 (English)In: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, Vol. 21, no 1, p. 3-9Article in journal (Refereed) Published
Abstract [en]

Objectives: This study investigates the effectiveness of a computerized emergency department intervention for alcohol consumption and identifies explanation factors associated with reduced alcohol consumption from risk to non-risk drinking. less thanbrgreater than less thanbrgreater thanMethods: Patients aged 18-69 years registered at the ED triage answered alcohol-related questions on a touch-screen computer. Follow-up data were collected by means of a postal questionnaire that was mailed to the patients 6 months after their ED visit. less thanbrgreater than less thanbrgreater thanResults: There were four independent explanations for reduced alcohol consumption: being motivated to reduce alcohol consumption at baseline, influenced by just visiting the emergency department, considering the alcohol-related feedback information and impact from a health care provider. 339 patients could be followed up and of these were 97 categorized as risk drinkers at baseline and 45 became non-risk drinker 6 month later. less thanbrgreater than less thanbrgreater thanConclusions: Being motivated to reduce alcohol consumption at baseline, influenced by just visiting the emergency department, considering the alcohol-related feedback information and impact from a health care provider were predictors for change from risk to non-risk drinking 6 months later.

Place, publisher, year, edition, pages
Elsevier, 2013
Keywords
Alcohol, Brief intervention, Emergency care
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-92623 (URN)10.1016/j.ienj.2011.11.004 (DOI)000317022200002 ()
Available from: 2013-05-14 Created: 2013-05-14 Last updated: 2017-12-06
Trinks, A., Festin, K., Bendtsen, P., Cherpitel, C. J. & Nilsen, P. (2012). Acute Alcohol Consumption and Motivation to Reduce Drinking Among Injured Patients in a Swedish Emergency Department. Journal on Addictions Nursing, 23(3), 152-158
Open this publication in new window or tab >>Acute Alcohol Consumption and Motivation to Reduce Drinking Among Injured Patients in a Swedish Emergency Department
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2012 (English)In: Journal on Addictions Nursing, ISSN 1088-4602, E-ISSN 1548-7148, Vol. 23, no 3, p. 152-158Article in journal (Refereed) Published
Abstract [en]

Abstract: Injuries constitute a major public health problem. Millions of people are injured each year, and acute drinking is a well-known risk factor for injuries. Research suggests that acknowledgment of alcohol as a factor in an injury enhances willingness to change drinking behavior, possibly because the patient becomes aware of the negative consequences of their drinking. This study aims to investigate the prevalence of acute alcohol consumption (drinking before the event) among injury patients and to examine the importance of factors potentially associated with motivation to reduce alcohol consumption among these patients. All patients aged 18-69 years were requested to answer alcohol-related questions on a touchscreen computer. Fifteen percent of injured patients were categorized as acute drinkers, and of these, 64% reported that their injury was connected to alcohol. There were significant differences for all sociodemographic and drinking characteristics between acute drinkers and nonacute drinkers. Acute drinkers were categorized as risky drinkers to a much higher extent than nonacute drinkers. Acute drinkers had a considerably higher average weekly alcohol consumption and engaged far more frequently in heavy episodic drinking than nonacute drinkers. Acute drinkers were motivated to reduce their alcohol intake to a greater extent than nonacute drinkers; 51% were in the action, preparation, and contemplation stages, compared with 19% of the nonacute drinkers. Acute drinkers had considerably more detrimental alcohol consumption than nonacute drinkers, and the acute drinkers were more motivated to reduce their drinking than the nonacute drinkers.

Keywords
Alcohol consumption; acute drinking; motivation to change; injured patients; emergency department
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-72331 (URN)10.1097/JAN.0b013e31826f4bbd (DOI)000321968500002 ()24335731 (PubMedID)
Available from: 2011-11-25 Created: 2011-11-25 Last updated: 2017-12-08Bibliographically approved
Timpka, T., Nordqvist, C., Festin, K. & Lindqvist, K. (2012). Quality indicators for implementation of safety promotion: Towards valid and reliable global certification of local programmes. Global Public Health, 7(6), 588-602
Open this publication in new window or tab >>Quality indicators for implementation of safety promotion: Towards valid and reliable global certification of local programmes
2012 (English)In: Global Public Health, ISSN 1744-1692, E-ISSN 1744-1706, Vol. 7, no 6, p. 588-602Article in journal (Refereed) Published
Abstract [en]

The theoretical underpinnings of safety promotion have not yet been integrated with implementation practice to ascertain between-community programme quality. This study sets out to develop a framework for verifying of the quality of community-based safety-promotion programmes in the global context. We analysed the certification indicators deployed in the international Safe Community movement in light of systems theory. Data were collected from focus group interviews with representatives from 10 certified Swedish communities and then analysed by qualitative methods. The community representatives were found to have used the present indicators mainly for marketing the safety-promotion concept to stakeholders rather than as benchmarks for safety practice. When appraised in regard to systems theory, it was found that the indicators did not cover important aspects of health-services implementation. Attainment of outcomes at the population level was not included. Consequently, that information about programme effects in high-risk groups and in risk environments could be neglected. We conclude that programme processes and outcomes at both organisational and population levels must be assessed when the quality of safety-promotion programmes is being certified. A revised set of indicators for certification of safety-promotion programmes fulfilling these criteria is presented.

Place, publisher, year, edition, pages
Taylor and Francis (Routledge): STM, Behavioural Science and Public Health Titles / Taylor and Francis (Routledge), 2012
Keywords
public-health service quality, safety promotion, injury control, implementation, focus group interviews
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-79115 (URN)10.1080/17441692.2011.641989 (DOI)000304805000003 ()
Available from: 2012-06-29 Created: 2012-06-29 Last updated: 2017-12-07
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