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Jaarsma, Tiny, ProfessorORCID iD iconorcid.org/0000-0002-4197-4026
Alternative names
Publications (10 of 334) Show all publications
Säfström, E., Årestedt, K., Liljeroos, M., Nordgren, L., Jaarsma, T. & Strömberg, A. (2023). Associations between continuity of care, perceived control and self-care and their impact on health-related quality of life and hospital readmission: A structural equation model. Journal of Advanced Nursing, 9(6), 2305-2315
Open this publication in new window or tab >>Associations between continuity of care, perceived control and self-care and their impact on health-related quality of life and hospital readmission: A structural equation model
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2023 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 9, no 6, p. 2305-2315Article in journal (Refereed) Published
Abstract [en]

AIM: The aim of this study is to examine whether a conceptual model including the associations between continuity of care, perceived control and self-care could explain variations in health-related quality of life and hospital readmissions in people with chronic cardiac conditions after hospital discharge.

DESIGN: Correlational design based on cross-sectional data from a multicentre survey study.

METHODS: People hospitalized due to angina, atrial fibrillation, heart failure or myocardial infarction were included at four hospitals using consecutive sampling procedures during 2017-2019. Eligible people received questionnaires by regular mail 4-6 weeks after discharge. A tentative conceptual model describing the relationship between continuity of care, self-care, perceived control, health-related quality of life and readmission was developed and evaluated using structural equation modelling.

RESULTS: In total, 542 people (mean age 75 years, 37% females) were included in the analyses. According to the structural equation model, continuity of care predicted self-care, which in turn predicted health-related quality of life and hospital readmission. The association between continuity of care and self-care was partly mediated by perceived control. The model had an excellent model fit: RMSEA = 0.06, 90% CI, 0.05-0.06; CFI = 0.90; TLI = 0.90.

CONCLUSION: Interventions aiming to improve health-related quality of life and reduce hospital readmission rates should focus on enhancing continuity of care, perceived control and self-care.

IMPACT: This study reduces the knowledge gap on how central factors after hospitalization, such as continuity of care, self-care and perceived control, are associated with improved health-related quality of life and hospital readmission in people with cardiac conditions. The results suggest that these factors together predicted the quality of life and readmissions in this sample. This knowledge is relevant to researchers when designing interventions or predicting health-related quality of life and hospital readmission. For clinicians, it emphasizes that enhancing continuity of care, perceived control and self-care positively impacts clinical outcomes.

PATIENT OR PUBLIC CONTRIBUTION: People and healthcare personnel evaluated content validity and were included in selecting items for the short version.

Place, publisher, year, edition, pages
WILEY, 2023
Keywords
Adult nursing chronic illness, Conceptual models of nursing, Discharge planning, Older people, Quality of life, Self-care
National Category
Nursing
Identifiers
urn:nbn:se:liu:diva-192085 (URN)10.1111/jan.15581 (DOI)000928387700001 ()36744677 (PubMedID)
Note

Funding agencies: The Centre for Clinical Research Sörmland/Uppsala University, Eskilstuna, Sweden: DLL-939621. DLL-930272, DLL-859581, DLL-742221, DLL-642411 and the Medical Research Council of Southeast Sweden: FORSS-607341, FORSS-749931, FORSS-846301.

Available from: 2023-03-01 Created: 2023-03-01 Last updated: 2024-02-02Bibliographically approved
Screever, E. M., van der Wal, M. H. L., van Veldhuisen, D. J., Jaarsma, T., Koops, A., van Dijk, K. S., . . . Meijers, W. C. (2023). Comorbidities complicating heart failure: changes over the last 15 years. Clinical Research in Cardiology, 112(1), 123-133
Open this publication in new window or tab >>Comorbidities complicating heart failure: changes over the last 15 years
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2023 (English)In: Clinical Research in Cardiology, ISSN 1861-0684, E-ISSN 1861-0692, Vol. 112, no 1, p. 123-133Article in journal (Refereed) Published
Abstract [en]

Aims Management of comorbidities represents a critical step in optimal treatment of heart failure (HF) patients. However, minimal attention has been paid whether comorbidity burden and their prognostic value changes over time. Therefore, we examined the association between comorbidities and clinical outcomes in HF patients between 2002 and 2017. Methods and results The 2002-HF cohort consisted of patients from The Coordinating Study Evaluating Outcomes of Advising and Counseling in Heart Failure (COACH) trial (n = 1,032). The 2017-HF cohort were outpatient HF patients enrolled after hospitalization for HF in a tertiary referral academic hospital (n = 382). Kaplan meier and cox regression analyses were used to assess the association of comorbidities with HF hospitalization and all-cause mortality. Patients from the 2017-cohort were more likely to be classified as HF with preserved ejection fraction (24 vs 15%, p < 0.001), compared to patients from the 2002-cohort. Comorbidity burden was comparable between both cohorts (mean of 3.9 comorbidities per patient) and substantially increased with age. Higher comorbidity burden was significantly associated with a comparable increased risk for HF hospitalization and all-cause mortality (HR 1.12 [1.02-1.22] and HR 1.18 [1.05-1.32]), in the 2002- and 2017-cohort respectively. When assessing individual comorbidities, obesity yielded a statistically higher prognostic effect on outcome in the 2017-cohort compared to the 2002-HF cohort (p for interaction 0.026). Conclusion Despite major advances in HF treatment over the past decades, comorbidity burden remains high in HF and influences outcome to a large extent. Obesity emerges as a prominent comorbidity, and efforts should be made for prevention and treatment. [GRAPHICS] .

Place, publisher, year, edition, pages
Springer Heidelberg, 2023
Keywords
Comorbidities; Heart failure; Hospitalization; Mortality; Obesity
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:liu:diva-187859 (URN)10.1007/s00392-022-02076-1 (DOI)000842585000003 ()35976430 (PubMedID)2-s2.0-85136144227 (Scopus ID)
Note

Funding Agencies|Dutch Heart Foundation [2017-21, 2017-11, 2018-30, 2020B005, 2000Z003, 03-005-2021-T005]; leDucq Foundation (Cure PhosphoLambaN induced Cardiomyopathy (Cure-PLaN)); European Research Council (SECRETE-HF) [ERC CoG 818715]; Mandema-Stipendium of the Junior Scientific Masterclass of the University Medical Center Groningen [202010]

Available from: 2022-08-30 Created: 2022-08-30 Last updated: 2023-03-31
Verheijden Klompstra, L., Lans, C., Mercke, E., Strömberg, A. & Jaarsma, T. (2023). Comparison of the 6-minute walk distance measured on a 30 m track with guidance of a healthcare professional and those measured with a mobile application outdoors by participants themselves: a validation study. European Journal of Cardiovascular Nursing, 22(5), 544-546
Open this publication in new window or tab >>Comparison of the 6-minute walk distance measured on a 30 m track with guidance of a healthcare professional and those measured with a mobile application outdoors by participants themselves: a validation study
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2023 (English)In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 22, no 5, p. 544-546Article in journal (Refereed) Published
Abstract [en]

To improve the practical application of measuring exercise capacity, the purpose of this study was to compare the 6 min walk distance (6MWD) obtained at a 30 m track with the guidance of healthcare professionals vs. the 6MWD obtained by participants themselves using an app. In total, 37 participants performed both tests. The mean of the differences between the 6MWD on the tests was -4 +/- 45 m (95% limits of agreement: 84 to -99 m). The overall agreement between the two 6MWD measures was 97% with an intraclass correlation coefficient of 0.96 (95% confidence interval: 0.91-0.98, P < 0.001). The use of an app is feasible, reliable, and valid to assess the 6MWD.

Place, publisher, year, edition, pages
Oxford University Press, 2023
Keywords
Exercise capacity; Mobile applications; App; Cardiac; Validation
National Category
Physiotherapy
Identifiers
urn:nbn:se:liu:diva-189796 (URN)10.1093/eurjcn/zvac091 (DOI)000869727400001 ()36131494 (PubMedID)
Note

Funding Agencies|Swedish Research Council for Medicine and Health-VR [2018-02719]; Swedish Research Council for Health, Working Life and Welfare-FORTE [2018-00650]; Swedish Heart-Lung Foundation [20170766]; FORSS [941180]

Available from: 2022-11-08 Created: 2022-11-08 Last updated: 2023-11-23Bibliographically approved
Verheijden Klompstra, L., Mourad, G., Jaarsma, T., Strömberg, A. & Alwin, J. (2023). Costs of an Off-the-Shelve Exergame Intervention in Patients with Heart Failure. Games for Health Journal, 12(3), 242-248
Open this publication in new window or tab >>Costs of an Off-the-Shelve Exergame Intervention in Patients with Heart Failure
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2023 (English)In: Games for Health Journal, ISSN 2161-783X, E-ISSN 2161-7856, Vol. 12, no 3, p. 242-248Article in journal (Refereed) Published
Abstract [en]

Objectives: Exergaming is promising for patients with heart failure who are less inclined to start or maintain exercise programs involving traditional modes of physical activity. Although no effect on exercise capacity was found for an off-the-shelf exergame, it is important to gain insights into aspects related to costs to develop such interventions further.Materials and Methods: In a randomized controlled trial, the Heart Failure Wii study (HF-Wii study), the intervention group (exergame group) received an introduction to the exergame, the exergame was installed at home and help was offered when needed for 3 months. Patients received telephone follow-ups at 2, 4, 8, and 12 weeks after the installation. The control group (motivational support group) received activity advice and telephone follow-ups at 2, 4, 8, and 12 weeks. We collected data on hospital use and costs, costs of the exergame intervention, patient time-related costs, and willingness to pay.Results: No significant differences were found between the exergame group (n = 300) versus the motivational support group (n = 305) in hospital use or costs (1-year number of hospitalizations: P = 0.60, costs: P = 0.73). The cost of the intervention was 190 Euros, and the patient time-related costs were 98 Euros. Of the total estimated costs for the intervention, 287 Euros, patients were willing to pay, on average, 58%.Conclusion: This study shows that the costs of an intervention using an off-the-shelve exergame are relatively low and that the patients were willing to pay for more than half of the intervention costs. The trial is registered in ClinicalTrials.gov (NCT01785121).

Place, publisher, year, edition, pages
MARY ANN LIEBERT, INC, 2023
Keywords
Exergame; Heart failure; Cost; Serious games; Willingness to pay; Physical activity
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:liu:diva-190944 (URN)10.1089/g4h.2022.0013 (DOI)000893719200001 ()36473172 (PubMedID)
Available from: 2023-01-09 Created: 2023-01-09 Last updated: 2024-02-06Bibliographically approved
Säfström, E., Arestedt, K., Hadjistavropoulos, H. D., Liljeroos, M., Nordgren, L., Jaarsma, T. & Strömberg, A. (2023). Development and psychometric properties of a short version of the Patient Continuity of Care Questionnaire. Health Expectations, 26(3), 1137-1148
Open this publication in new window or tab >>Development and psychometric properties of a short version of the Patient Continuity of Care Questionnaire
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2023 (English)In: Health Expectations, ISSN 1369-6513, E-ISSN 1369-7625, Vol. 26, no 3, p. 1137-1148Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: Hospitalization due to cardiac conditions is increasing worldwide, and follow-up after hospitalization usually occurs in a different healthcare setting than the one providing treatment during hospitalization. This leads to a risk of fragmented care and increases the need for coordination and continuity of care after hospitalization. Furthermore, international reports highlight the importance of improving continuity of care and state that it is an essential indicator of the quality of care. Patients' perceptions of continuity of care can be evaluated using the Patient Continuity of Care Questionnaire (PCCQ). However, the original version is extensive and may prove burdensome to complete; therefore, we aimed to develop and evaluate a short version of the PCCQ.

METHODS: This was a psychometric validation study. Content validity was evaluated among user groups, including patients (n = 7), healthcare personnel (n = 15), and researchers (n = 7). Based on the results of the content validity and conceptual discussions among the authors, 12 items were included in the short version. Data from patients were collected using a consecutive sampling procedure involving patients 6 weeks after hospitalization due to cardiac conditions. Rasch analysis was used to evaluate the psychometric properties of the short version of the PCCQ.

RESULTS: A total of 1000 patients were included [mean age 72 (SD = 10), 66% males]. The PCCQ-12 presented a satisfactory overall model fit and a person separation index of 0.79 (Cronbach's α: .91, ordinal α: .94). However, three items presented individual item misfits. No evidence of multidimensionality was found, meaning that a total score can be calculated. A total of four items presented evidence of response dependence but, according to the analysis, this did not seem to affect the measurement properties or reliability of the PCCQ-12. We found that the first two response options were disordered in all items. However, the reliability remained the same when these response options were amended. In future research, the benefits of the four response options could be evaluated.

CONCLUSION: The PCCQ-12 has sound psychometric properties and is ready to be used in clinical and research settings to measure patients' perceptions of continuity of care after hospitalization.

PATIENT OR PUBLIC CONTRIBUTION: Patients, healthcare personnel and researchers were involved in the study because they were invited to select items relevant to the short version of the questionnaire.

Place, publisher, year, edition, pages
WILEY, 2023
Keywords
Continuity of care, Patient discharge, Psychometrics, Quality of care, Reproducibility of results, Surveys and questionnaires, Validation studies
National Category
Nursing
Identifiers
urn:nbn:se:liu:diva-192084 (URN)10.1111/hex.13728 (DOI)000939223500001 ()36797976 (PubMedID)
Note

Funding agencies: The Center for Clinical Research Sörmland/Uppsala University, Eskilstuna, Sweden: DLL-939621. DLL-930272, DLL-859581, DLL-742221, DLL-642411, and the Medical Research Council of Southeast Sweden: FORSS-607341, FORSS-749931, FORSS-846301

Available from: 2023-03-01 Created: 2023-03-01 Last updated: 2024-02-02Bibliographically approved
Mourad, G., Jaarsma, T., Strömberg, A. & Johansson, P. (2022). Somatization in women and men with non-cardiac chest pain compared to the general Swedish population. Psychiatry Research Communications, 2(2), Article ID 100047.
Open this publication in new window or tab >>Somatization in women and men with non-cardiac chest pain compared to the general Swedish population
2022 (English)In: Psychiatry Research Communications, ISSN 2772-5987, Vol. 2, no 2, article id 100047Article in journal (Refereed) Published
Abstract [en]

We compare the prevalence of somatization in women and men with NCCP in relation to the general Swedish population, analyze the overlap between somatization, cardiac anxiety, and depressive symptoms, and explore variables associated with somatization. A cross sectional design is implemented with data collected between late October 2013 and early January 2014 from 552 patients with NCCP (mean age of 64 ​± ​17 years, 51% women) from four hospitals in southeast Sweden. Somatization was measured with the Patient Health Questionnaire-15, cardiac anxiety with the Cardiac Anxiety Questionnaire, and depressive symptoms with the Patient Health Questionnaire-9. Data were self-reported. The general population consists of 1898 females and 1508 males. Compared to the general population, somatization was significantly (p ​< ​.001) more common in both women and men with NCCP. Women with NCCP had significantly (p ​= ​.003) higher prevalence of somatization than men with NCCP. In patients with NCCP, 12% had only somatization, whereas 39% also reported cardiac anxiety and depressive symptoms. Younger age in women tended to be associated with somatization (OR ​= ​0.98, p ​< ​.073), but also being non-worker (OR ​= ​0.40, p ​= ​.024). In men, somatization tended to be associated with increased healthcare contacts (OR ​= ​1.82, p ​= ​.051). Furthermore, in both women and men, number of co-morbidities (OR ​= ​9.69 p ​< ​.001 and OR ​= ​3.45, p ​= ​.002), cardiac anxiety (OR ​= ​2.93 and OR ​= ​2.09, p ​< ​.001), and depressive symptoms (OR ​= ​8.71 and OR ​= ​4.44, p ​< ​.001) were significantly associated with somatization. Our study demonstrates that somatization is very common among patients with NCCP, especially in women. Patients with NCCP have higher somatization and greater overlap with psychological distress compared to the general population.

Place, publisher, year, edition, pages
Elsevier, 2022
Keywords
Cardiac anxiety, Depressive symptoms, Non-cardiac chest pain, Sex differences, Somatization
National Category
Nursing
Identifiers
urn:nbn:se:liu:diva-185757 (URN)10.1016/j.psycom.2022.100047 (DOI)
Note

Funding: The study was funded by the County Council of Östergötland, Sweden (LIO-439131), and the Medical Research of Southeast Sweden (FORSS-475291), but they were not involved in any part of the study.

Available from: 2022-06-10 Created: 2022-06-10 Last updated: 2022-08-03Bibliographically approved
Girerd, N., Von Hunolstein, J.-J., Pellicori, P., Bayes-Genis, A., Jaarsma, T., Lund, L. H., . . . Seronde, M.-F. (2022). Therapeutic inertia in the pharmacological management of heart failure with reduced ejection fraction. ESC Heart Failure, 9(4), 2063-2069
Open this publication in new window or tab >>Therapeutic inertia in the pharmacological management of heart failure with reduced ejection fraction
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2022 (English)In: ESC Heart Failure, E-ISSN 2055-5822, Vol. 9, no 4, p. 2063-2069Article in journal, Editorial material (Other academic) Published
Place, publisher, year, edition, pages
Oxford, United Kingdom: John Wiley & Sons, 2022
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:liu:diva-184529 (URN)10.1002/ehf2.13929 (DOI)000782670700001 ()35429120 (PubMedID)2-s2.0-85133667397 (Scopus ID)
Available from: 2022-04-26 Created: 2022-04-26 Last updated: 2023-04-28Bibliographically approved
Tromp, J., Jindal, D., Redfern, J., Bhatt, A., Severin, T., Banerjee, A., . . . Cowie, M. (2022). World Heart Federation Roadmap for Digital Health in Cardiology. GLOBAL HEALTH: the International Conference on Global Health Challenges, 17(1), Article ID 61.
Open this publication in new window or tab >>World Heart Federation Roadmap for Digital Health in Cardiology
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2022 (English)In: GLOBAL HEALTH: the International Conference on Global Health Challenges, ISSN 2211-8160, E-ISSN 2308-4553, Vol. 17, no 1, article id 61Article in journal (Refereed) Published
Abstract [en]

More than 500 million people worldwide live with cardiovascular disease (CVD). Health systems today face fundamental challenges in delivering optimal care due to ageing populations, healthcare workforce constraints, financing, availability and affordability of CVD medicine, and service delivery. Digital health technologies can help address these challenges. They may be a tool to reach Sustainable Development Goal 3.4 and reduce premature mortality from non-communicable diseases (NCDs) by a third by 2030. Yet, a range of fundamental barriers prevents implementation and access to such technologies. Health system governance, health provider, patient and technological factors can prevent or distort their implementation. World Heart Federation (WHF) roadmaps aim to identify essential roadblocks on the pathway to effective prevention, detection, and treatment of CVD. Further, they aim to provide actionable solutions and implementation frameworks for local adaptation. This WHF Roadmap for digital health in cardiology identifies barriers to implementing digital health technologies for CVD and provides recommendations for overcoming them.

Place, publisher, year, edition, pages
UBIQUITY PRESS LTD, 2022
Keywords
digital health interventions for CVD; e-health; health system governance
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:liu:diva-193353 (URN)10.5334/gh.1141 (DOI)000850732400001 ()36051317 (PubMedID)
Note

Funding Agencies|Astra Zeneca

Available from: 2023-05-02 Created: 2023-05-02 Last updated: 2023-05-02
Andreae, C., van der Wal, M. H. L., van Veldhuisen, D. J., Yang, B., Strömberg, A. & Jaarsma, T. (2021). Changes in Appetite During the Heart Failure Trajectory and Association With Fatigue, Depressive Symptoms, and Quality of Life. Journal of Cardiovascular Nursing, 36(6), 539-545
Open this publication in new window or tab >>Changes in Appetite During the Heart Failure Trajectory and Association With Fatigue, Depressive Symptoms, and Quality of Life
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2021 (English)In: Journal of Cardiovascular Nursing, ISSN 0889-4655, E-ISSN 1550-5049, Vol. 36, no 6, p. 539-545Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Decreased appetite can contribute to malnutrition in patients with heart failure (HF). Little is known about the trajectory of appetite over time in patients with HF and the factors associated with decreased appetite after discharge from the hospital.

OBJECTIVE: The aims of this study were to investigate changes in appetite over time and explore how fatigue, depressive symptoms, and quality of life are associated with decreased appetite.

METHODS: Data from the multicenter randomized Coordinating study evaluating Outcomes of Advising and Counseling in Heart Failure were used. Logistic regression and mixed-effects logistic regression were used to investigate changes in appetite over time and to explore the relationship between appetite and fatigue, depressive symptoms, and quality of life.

RESULTS: A total of 734 patients with HF (mean age, 69 years) were included. Decreased appetite was present at all follow-up measurements; however, decreased appetite was significantly lower at the 1-month (odds ratio [OR], 0.43; confidence interval [CI], 0.29-0.63), 6-month (OR, 0.31; CI, 0.20-0.47), 12-month (OR, 0.22; CI, 0.14-0.34), and 18-month (OR, 0.24; CI, 0.15-0.37) follow-ups compared with baseline. Decreased appetite was associated with fatigue (OR, 3.09; CI, 1.98-4.84), depressive symptoms (OR, 1.76; CI, 1.35-2.29), and low quality of life (OR, 1.01; CI, 1.01-1.02) across all measurement points adjusted for covariates.

CONCLUSIONS: Appetite improved after discharge; however, at all time points, at least 22% of patients reported decreased appetite. Fatigue, depressive symptoms, and low quality of life are factors associated with decreased appetite. Decreased appetite is a long-standing problem in that it does not disappear spontaneously after an acute HF deterioration.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2021
Keywords
appetite, depressive symptoms, fatigue, heart failure, quality of life
National Category
Nursing Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:liu:diva-171162 (URN)10.1097/JCN.0000000000000756 (DOI)000756652700005 ()33136703 (PubMedID)
Note

Funding: Netherlands Heart FoundationNetherlands Heart Foundation [2000Z003]; Biosite France SAS; Jouy-en-Josas, France (brain natriuretic peptide); Roche Diagnostics Nederland BV, Venlo, the Netherlands; Novartis Pharma BV, Arnhem, the NetherlandsNetherlands Government

Available from: 2020-11-06 Created: 2020-11-06 Last updated: 2022-03-08Bibliographically approved
Johansson, P., Andersson, G., Jaarsma, T., Lundgren, J., Westas, M. & Mourad, G. (2021). Psychological distress in patients with cardiovascular disease: time to do something about it?. European Journal of Cardiovascular Nursing, 20(4), 293-294
Open this publication in new window or tab >>Psychological distress in patients with cardiovascular disease: time to do something about it?
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2021 (English)In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 20, no 4, p. 293-294Article in journal, Editorial material (Other academic) Published
Place, publisher, year, edition, pages
Oxford University Press, 2021
Keywords
Advanced and Specialised Nursing, Medical–Surgical, Cardiology and Cardiovascular Medicine
National Category
Nursing
Identifiers
urn:nbn:se:liu:diva-179747 (URN)10.1093/eurjcn/zvab007 (DOI)000728163700001 ()33842974 (PubMedID)2-s2.0-85107088679 (Scopus ID)
Available from: 2021-09-30 Created: 2021-09-30 Last updated: 2022-06-14Bibliographically approved
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Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-4197-4026

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