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Andersson-Gäre, BoelORCID iD iconorcid.org/0000-0003-1176-8173
Alternative names
Publications (10 of 72) Show all publications
Stevenson, K., Thor, J., D’Eon, M., Headrick, L. A. & Andersson-Gäre, B. (2024). Background and Foreground: Connections & Distinctions when Health Professions Faculty Teach Both Interprofessional Collaborative Practice and Quality Improvement – A Case Study.
Open this publication in new window or tab >>Background and Foreground: Connections & Distinctions when Health Professions Faculty Teach Both Interprofessional Collaborative Practice and Quality Improvement – A Case Study
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2024 (English)Manuscript (preprint) (Other academic)
Abstract [en]

Despite decades of effort, programs continue to struggle to integrate competencies related quality improvement (QI) and interprofessional collaborative practice (ICP) into health professions education. Additionally, while QI and ICP may seem intuitively linked and there exists some examples of a coordinated approach, the literature regarding competencies, including knowledge, skills, and attitudes (KSAs), is still largely focused on QI and ICP as separate fields of knowledge and practice. This study explored distinctions and connections between quality improvement (QI) and interprofessional collaborative practice (ICP) competency domains in health professions education. The authors used a qualitative case study approach with an instrumental case, i.e., the University of Missouri-Columbia (MU), where QI and ICP were intentionally integrated as part of core curricula in health professional schools and programs. Eleven faculty members from medicine, nursing, pharmacy, and health care administration participated in interviews exploring their teaching choices in either classroom or clinical settings. Study participants defined the goal of teaching QI and ICP as enabling learners to deliver safe and patient-centered care and described the knowledge and skills required for QI and the attitudes and skills required for ICP. Furthermore, they described the relationship between QI and ICP as one mediated by systems thinking, where ICP is backgrounded as a critical pre-requisite and QI is foregrounded as a vector for developing interprofessional competencies. The MU case elucidates the potential synergies that occur when faculty address quality improvement and interprofessional collaborative practice competencies with an integrated approach that leverages connections, while also respecting distinctions. For health professions education programs looking to improve the effectiveness and efficiency of their curricular approach to these fields, it may be fruitful to consider ICP as background and QI as foreground, remembering that without each other, ICP risks losing meaning and QI risks losing impact.

National Category
Health Sciences Educational Sciences
Identifiers
urn:nbn:se:hj:diva-65060 (URN);intsam;958339 (ISRN)10.1101/2024.06.11.24308788 (DOI)
Note

Posted June 13, 2024, on medRxiv, a preprint server for health sciences.

Available from: 2024-06-18 Created: 2024-06-18 Last updated: 2024-06-18
Määttä, S., Petersson, C., Andersson-Gäre, B., Henriks, G., Ånfors, H., Lundberg, C. & Nilsagård, Y. (2024). Experiences of co-producing person-centred and cohesive clinical pathways in the national system for knowledge-based management in Swedish healthcare: a qualitative study. Research Involvement and Engagement, 10(1), Article ID 55.
Open this publication in new window or tab >>Experiences of co-producing person-centred and cohesive clinical pathways in the national system for knowledge-based management in Swedish healthcare: a qualitative study
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2024 (English)In: Research Involvement and Engagement, E-ISSN 2056-7529, Vol. 10, no 1, article id 55Article in journal (Refereed) Published
Abstract [en]

Background: When the 21 Swedish county councils decided to collaborate in the creation of a national system for knowledge-based management, patient participation was mandatory. Patient and next-of-kin representatives (PR) co-produced person-centred and cohesive clinical pathways together with healthcare professionals (HPR). Research on co-production in healthcare at the national level is scarce. The aim of this study is to explore experiences of patient participation from the perspectives of both PRs and HPRs when co-producing clinical pathways within the Swedish nationwide healthcare system for knowledge-based management. Methods: A qualitative study was conducted. A strategic sample of nine PRs and eight HPRs were interviewed individually between August 2022 and January 2023 using a semi-structured interview guide. We analysed data using an inductive content analysis. Results: Three main categories were identified: (1) Finding appropriate patient representativeness; (2) Working methods that facilitate a patient perspective; and (3) Influence of the patient perspective in the clinical pathways. Conclusions: The study demonstrates the importance of patient and next-of-kin participation in the construction of clinical pathways at the national level. The results provide a platform for further research on patient participation on the national level and add to studies on if and how patient participation on this level has an impact on how the clinical pathways are put into practice at the micro level, and the support provided at the meso level. The study contributes to the growing body of literature studying patient participation and co-production. Trial registration: Region Örebro County ID 276,940. An advisory opinion was obtained from the Swedish Ethical Review Authority (2021-05899-01).

Place, publisher, year, edition, pages
BioMed Central (BMC), 2024
Keywords
Clinical pathways, Co-production, Experiences, Healthcare, Healthcare system, Macro level, Management, Patient participation
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-64983 (URN)10.1186/s40900-024-00565-3 (DOI)38849932 (PubMedID)2-s2.0-85195592840 (Scopus ID)GOA;;957906 (Local ID)GOA;;957906 (Archive number)GOA;;957906 (OAI)
Available from: 2024-06-17 Created: 2024-06-17 Last updated: 2024-09-27Bibliographically approved
Fröding, E., Vincent, C., Andersson-Gäre, B., Westrin, Å. & Ros, A. (2024). Six Major Steps to Make Investigations of Suicide Valuable for Learning and Prevention. Archives of Suicide Research, 28(1), 1-19
Open this publication in new window or tab >>Six Major Steps to Make Investigations of Suicide Valuable for Learning and Prevention
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2024 (English)In: Archives of Suicide Research, ISSN 1381-1118, E-ISSN 1543-6136, Vol. 28, no 1, p. 1-19Article, review/survey (Refereed) Published
Abstract [en]

OBJECTIVE: The decline in suicide rates has leveled off in many countries during the last decade, suggesting that new interventions are needed in the work with suicide prevention. Learnings from investigations of suicide should contribute to the development of these new interventions. However, reviews of investigations have indicated that few new lessons have been learned. To be an effective tool, revisions of the current investigation methods are required. This review aimed to describe the problems with the current approaches to investigations of suicide as patient harm and to propose ways to move forward.

METHODS: Narrative literature review.

RESULTS: Several weaknesses in the current approaches to investigations were identified. These include failures in embracing patient and system perspectives, not addressing relevant factors, and insufficient competence of the investigation teams. Investigation methods need to encompass the progress of knowledge about suicidal behavior, suicide prevention, and patient safety.

CONCLUSIONS: There is a need for a paradigm shift in the approaches to investigations of suicide as potential patient harm to enable learning and insights valuable for healthcare improvement. Actions to support this paradigm shift include involvement of patients and families, education for investigators, multidisciplinary analysis teams with competence in and access to relevant parts across organizations, and triage of cases for extensive analyses. A new model for the investigation of suicide that support these actions should facilitate this paradigm shift.

HIGHLIGHTS

  • There are weaknesses in the current approaches to investigations of suicide.
  • A paradigm shift in investigations is needed to contribute to a better understanding of suicide.
  • New knowledge of suicidal behavior, prevention, and patient safety must be applied.
Place, publisher, year, edition, pages
Taylor & Francis, 2024
Keywords
Improvement, investigation, patient harm, patient safety, suicide, suicide prevention
National Category
Psychiatry
Identifiers
urn:nbn:se:hj:diva-58722 (URN)10.1080/13811118.2022.2133652 (DOI)000870151100001 ()36259504 (PubMedID)2-s2.0-85140124056 (Scopus ID)HOA;intsam;839465 (Local ID)HOA;intsam;839465 (Archive number)HOA;intsam;839465 (OAI)
Funder
Futurum - Academy for Health and Care, Jönköping County Council, Sweden
Available from: 2022-10-27 Created: 2022-10-27 Last updated: 2025-01-12Bibliographically approved
Lim, E. L., Ong, R. H., Thor, J., Wilińska, M., Andersson-Gäre, B. & Thumboo, J. (2023). An Evaluation of the Relationship between Training of Health Practitioners in a Person-Centred Care Model and their Person-Centred Attitudes. International Journal of Integrated Care, 23(4), Article ID 11.
Open this publication in new window or tab >>An Evaluation of the Relationship between Training of Health Practitioners in a Person-Centred Care Model and their Person-Centred Attitudes
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2023 (English)In: International Journal of Integrated Care, E-ISSN 1568-4156, Vol. 23, no 4, article id 11Article in journal (Refereed) Published
Abstract [en]

Introduction: The Esther Network (EN) person-centred care (PCC) advocacy training aims to promote person-centred attitudes among health practitioners in Singapore. This study aimed to assess the relationship between the training and practitioners’ PCC attributes over a 3-month period, and to explore power sharing by examining the PCC dimensions of “caring about the service user as a whole person” and the “sharing of power, control and information”. Methods: A repeated-measure study design utilising the Patient-Practitioner Orientation Scale (PPOS), was administered to 437 training participants at three time points – before training (T1), immediately after (T2) and three months after training (T3). A five-statement questionnaire captured knowledge of person-centred care at T1 and T2. An Overall score, Caring and Sharing sub-scores were derived from the PPOS. Scores were ranked and divided into three groups (high, medium and low). Ordinal Generalised Estimating Equation (GEE) model analysed changes in PPOS scores over time. Results: A single, short-term training appeared to result in measurable improvements in person-centredness of health practitioners, with slight attenuation at T3. There was greater tendency to “care” than to “share power” with service users across all three time points, but the degree of improvement was larger for sharing after training. The change in overall person-centred scores varied by sex and profession (females score higher than males, allied health showed a smaller attenuation at T3). Conclusion: Training as a specific intervention, appeared to have potential to increase health practitioners’ person-centredness but the aspect of equalising power was harder to achieve within a hierarchical structure and clinician-centric culture. An ongoing network to build relationships, and a supportive system to facilitate individual and organisational reflexivity can reinforce learning.

Place, publisher, year, edition, pages
Ubiquity Press, 2023
Keywords
advocacy, coproduction, integrated care, person-centred care, power, practitioners, training, article, attitude, care behavior, controlled study, female, health practitioner, human, knowledge, learning, male, physician, questionnaire, Singapore
National Category
Nursing Learning
Identifiers
urn:nbn:se:hj:diva-63032 (URN)10.5334/ijic.7564 (DOI)2-s2.0-85178114411 (Scopus ID)GOA;intsam;920193 (Local ID)GOA;intsam;920193 (Archive number)GOA;intsam;920193 (OAI)
Available from: 2023-12-11 Created: 2023-12-11 Last updated: 2024-01-12Bibliographically approved
Gäre, K., Andersson, A.-C., Andersson-Gäre, B. & Thor, J. (2023). Evidence informed healthcare improvement: Design and evaluation. Jönköping: Jönköping University, School of Health and Welfare
Open this publication in new window or tab >>Evidence informed healthcare improvement: Design and evaluation
2023 (English)Report (Other academic)
Abstract [en]

Healthcare is in constant change with fast development in knowledge, new technology and varying needs and expectations from patients, citizens, management, and politicians. There is a challenge in balancing the involved actors´ focus, needs, preferences, and resources for healthcare improvement. Improvement of healthcare is an ongoing activity, sometimes managed and controlled, often not. A key ingredient for success is competence where the need for competence varies with perspectives of the improving actors. Actors in healthcare improvement are professionals, patients, politicians, management, citizens, researchers, research foundations and others. In this report a review of frameworks in healthcare improvement are presented together with management myths and questions around needs for healthcare improvement competence and capabilities currently on the agenda.

Most improvement initiatives of some size have substantial parts of IT and have had so for a considerable time. This rather long experience of more and less successful IT implementation and use is transparent and useful in all kinds of healthcare improvement. One important issue in this report is what has real impact is the actual understanding and use of innovations and artefacts by healthcare actors in a broad sense for healthcare improvement (e.g., new clinical evidence, clinical guidelines, process changes, information systems and more). The aim in this report is to review frameworks which can be useful in healthcare improvement as well as in the study of healthcare improvement.

Conclusions concern what is found to be important to study and understand healthcare improvement, considering the presented frameworks. Improvement of healthcare is present in all the frameworks but in different ways and what is emphasized concerning scope and focus. Improving healthcare take place in the interaction of at least two parts, one of which is healthcare professionals, and another is the patient/next-of-kin. Professionals and patient populations interact in processes of social networks and structures. Actors and context are useful concepts for understanding action (use) and its social contexts. The actual use of innovations is best understood in terms of integration into clinical activities and processes – actors’ interaction, coordination and communication activities and processes.

Theoretical implications are that there is a need for more research concerning meso and macro perspectives on methods for healthcare improvement, and the interplay of perspectives regarding the understanding of improvement in healthcare. Of course, a challenge is that the objects of improvement are complex adaptive systems of healthcare is not easily to catch in simple rules. They are genuinely difficult both to change and evaluate changes. Practical implications of the report support design and contents of education programs in improvement of healthcare, in better understanding usefulness, practice, use, and experience base. To help the understanding of the need and usefulness of integrating different perspectives for successful healthcare improvement, e.g., micro, meso, and macro perspectives, use of mixed methods and more. 

Place, publisher, year, edition, pages
Jönköping: Jönköping University, School of Health and Welfare, 2023. p. 48
Series
Arbetsrapporter från Hälsohögskolan ; 2023:1
Keywords
healthcare improvement, complex adaptive systems, frameworks, co-production, sensemaking, sensegiving, adoption, implementation, organizing
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:hj:diva-61123 (URN)
Available from: 2023-06-15 Created: 2023-06-15 Last updated: 2023-06-15Bibliographically approved
Stevenson, K., Thor, J., D'Eon, M., Headrick, L. & Andersson-Gäre, B. (2023). From Theory to Practice: The Enacted Curriculum of a Successful Master's Program in Quality Improvement and Leadership. Journal of Continuing Education in the Health Professions, 43(4), 234-240
Open this publication in new window or tab >>From Theory to Practice: The Enacted Curriculum of a Successful Master's Program in Quality Improvement and Leadership
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2023 (English)In: Journal of Continuing Education in the Health Professions, ISSN 0894-1912, E-ISSN 1554-558X, Vol. 43, no 4, p. 234-240Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: Blended learning has taken on new prominence in the fields of higher and continuing education, especially as programs have shifted in response to teaching in a global pandemic. The faculty at the Jönköping Academy's Masters in Quality Improvement and Leadership program has been offering a blended learning curriculum, based on four core design principles, since 2009. We studied key features of the enacted curriculum to understand conditions that can support an effective blended learning model. METHODS: We used a case study approach underpinned by interactive research. Document analysis, a focus group, individual interviews, and stimulated recall interviews were used for data collection. Themes were identified through qualitative content analysis and data reduction, data display, and conclusion drawing. RESULTS: We grouped data into six emergent themes that clarify the enacted curriculum of an established Master's program: focusing on a common purpose, developing technical and relational knowledge and skills, linking theory and practice in the workplace, leveraging collaboration for mutual benefit, concentrating on leadership and coaching, and applying a blended and interprofessional learning model. CONCLUSION: Educators faced with increased demands to be flexible and to offer opportunities for distance education can learn from this case example of effective teaching of quality improvement and leadership in a blended format.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2023
Keywords
Curriculum, Faculty, Focus Groups, Humans, Leadership, Quality Improvement, human, information processing, total quality management, university
National Category
Health Care Service and Management, Health Policy and Services and Health Economy Pedagogy
Identifiers
urn:nbn:se:hj:diva-63031 (URN)10.1097/CEH.0000000000000463 (DOI)001109893800006 ()37092547 (PubMedID)2-s2.0-85178497214 (Scopus ID)HOA;intsam;920155 (Local ID)HOA;intsam;920155 (Archive number)HOA;intsam;920155 (OAI)
Available from: 2023-12-11 Created: 2023-12-11 Last updated: 2024-06-18Bibliographically approved
Andersson-Gäre, B. & Andersson, A.-C. (2023). Från kunskap till handling – för barnens bästa. Stockholm: Stiftelsen Allmänna Barnhuset
Open this publication in new window or tab >>Från kunskap till handling – för barnens bästa
2023 (Swedish)Report (Other academic)
Place, publisher, year, edition, pages
Stockholm: Stiftelsen Allmänna Barnhuset, 2023
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hj:diva-63260 (URN)
Available from: 2024-01-09 Created: 2024-01-09 Last updated: 2024-02-14Bibliographically approved
Thor, J., Andersson, A.-C. & Andersson-Gäre, B. (2023). Förbättringskunskap behöver fortsatt tillämpas i vården [Improvement knowledge has been applied when changing health services - and continues to be needed]. Läkartidningen, 120, Article ID 22154.
Open this publication in new window or tab >>Förbättringskunskap behöver fortsatt tillämpas i vården [Improvement knowledge has been applied when changing health services - and continues to be needed]
2023 (Swedish)In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 120, article id 22154Article in journal (Refereed) Published
Abstract [sv]

Förbättringskunskap har tillämpats i förändringsarbetet inom vården i Sverige i stor utsträckning sedan ämnet introducerades i Läkartidningen år 2002.

Flera tillämpningar har dokumenterats i vetenskapliga publikationer med koppling till förbättrade kliniska utfall, ofta visade i nationella kvalitetsregister.

Förbättringsvetenskap bidrar till utvärdering och utveckling av förbättringskunskapstillämpning.

Patienters och närståendes erfarenhet och kunskap integreras i nyare beskrivningar och tillämpning av förbättringskunskap.

Förbättringskunskap behöver tillämpas av såväl kliniska medarbetare som ledare och uppdragsgivare för att möta kommande utmaningar för hälso- och sjukvården.

Abstract [en]

In 2002, Läkartidningen published a call to apply improvement knowledge in efforts to change health services. Looking back over the past 20 years, we highlight many scientifically documented examples of such application. Many efforts, often within »breakthrough collaboratives«, have included Swedish national quality registries, with documented health outcome improvements related to application of Improvement Knowledge. Applications have been evaluated through improvement science studies. A literature review documented 32 PhD theses addressing healthcare improvement published by Swedish universities. Increasingly, improvement knowledge definitions and applications include - and harness - the experiences and knowledge among patients and their families. To meet challenges in the future, all health care stakeholders will need to master and apply improvement knowledge.

Place, publisher, year, edition, pages
Läkartidningen Förlag AB, 2023
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:hj:diva-63593 (URN)36757306 (PubMedID)POA;;1837573 (Local ID)POA;;1837573 (Archive number)POA;;1837573 (OAI)
Note

Medicinsk kommentar.

Available from: 2024-02-14 Created: 2024-02-14 Last updated: 2024-03-21Bibliographically approved
Ramfelt, K., Andersson-Gäre, B., Andersson, A.-C. & Petersson, C. (2023). ‘It's like a never-ending diabetes youth camp’: Co-designing a digital social network for young people with type 1 diabetes. Health Expectations, 26, 662-669
Open this publication in new window or tab >>‘It's like a never-ending diabetes youth camp’: Co-designing a digital social network for young people with type 1 diabetes
2023 (English)In: Health Expectations, ISSN 1369-6513, E-ISSN 1369-7625, Vol. 26, p. 662-669Article in journal (Refereed) Published
Abstract [en]

Introduction: Living with a chronic condition such as type 1 diabetes (T1D) affects everyday life and support from others experiencing a similar situation can be helpful. A way to receive such support is to use an online network where people can connect and share experiences. Research has described the benefits of using such tools for connecting patients. The aim of this study was to describe the co-design of a social network for young people with T1D and to describe their experiences when using this network.

Methods: A co-design approach was used, following three steps adapted from Sanders and Stappers (2008). In all, 36 adolescents with T1D participated. Data in the form of recordings and notes from telephone interviews, workshops and focus groups were collected and then analysed using content analysis. Numerical data from the digital platform were also used.

Findings: For the interpersonal values, supporting, learning and relating to emerge, the framework of the network must be appealing and user-friendly. The limits of time and place are eliminated, and there is a possibility for many more to join in.

Conclusion: Co-design ensures that what stakeholders think is important forms the basis for the design. The interpersonal values that are promoted are ones that only the exchange of lived knowledge and experience can generate. It is complementary to the support that healthcare professionals can offer; thus, this kind of social network is important for improved, coproduced care.

Patient or Public Contribution: The participants in the present study were persons living with T1D. They were active co-creators from the start to the end. An adult person with experience of living with T1D was involved as an advisor in the research team when drafting the manuscript.

Place, publisher, year, edition, pages
John Wiley & Sons, 2023
Keywords
adolescents, co-design, improvement, social network, type 1-diabetes, value creation
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-59284 (URN)10.1111/hex.13690 (DOI)000899348900001 ()36541231 (PubMedID)2-s2.0-85144285388 (Scopus ID)GOA;;851400 (Local ID)GOA;;851400 (Archive number)GOA;;851400 (OAI)
Funder
Vinnova, 2018‐01442
Available from: 2023-01-03 Created: 2023-01-03 Last updated: 2024-10-17Bibliographically approved
Persson, S., Andersson, A.-C., Andersson-Gäre, B., Lindenfalk, B. & Lind, J. (2023). Lived experience of persons with multiple sclerosis: A qualitative interview study. Brain and Behavior, 13(7), Article ID e3104.
Open this publication in new window or tab >>Lived experience of persons with multiple sclerosis: A qualitative interview study
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2023 (English)In: Brain and Behavior, E-ISSN 2162-3279, Vol. 13, no 7, article id e3104Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: Multiple sclerosis (MS) is a chronic autoimmune disease with a substantial impact on quality of life and functional capability. The prognosis of MS has changed over time due to the development of increasingly effective therapies. As the knowledge and perceptions of persons living with chronic conditions increasingly have been acknowledged, it has become important to understand lived experiences with a focus on everyday events and experiences as a way of knowing and interpreting the world. Exploring context-specific lived experiences as a source of knowledge about the disease and care may contribute to more precision in designing care services. The aim of this study was to explore the lived experience of persons living with MS in a Swedish context.

MATERIALS AND METHODS: A qualitative interview study was conducted with both purposeful and random sampling strategies, resulting in 10 interviews. Data were analyzed using inductive thematic content analysis.

RESULTS: The analysis generated 4 overarching themes with 12 subthemes, the 4 themes were: perspectives on life and health, influence on everyday life, relations with healthcare, and shared healthcare processes. The themes are concerned with the patients' own perspectives and context as well as medical and healthcare-related perspectives. Patterns of shared experiences were found, for example, in the diagnosis confirmation, future perspectives, and planning and coordination. More diverse experiences appeared concerning relations with others, one's individual requirements, symptoms and consequences, and knowledge building.

CONCLUSION: The findings suggest a need for a more diverse and coproduced development of healthcare services to meet diverse needs in the population with greater acknowledgement of the person's lived experience, including consideration of the complexity of the disease, personal integrity, and different ways of knowing. Findings from this study will be further explored together with other quantitative and qualitative data.

Place, publisher, year, edition, pages
John Wiley & Sons, 2023
Keywords
coproduction, multiple sclerosis care, patient experience, quality improvement
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:hj:diva-60518 (URN)10.1002/brb3.3104 (DOI)000995986100001 ()37246453 (PubMedID)2-s2.0-85160921603 (Scopus ID)GOA;;882813 (Local ID)GOA;;882813 (Archive number)GOA;;882813 (OAI)
Funder
Futurum - Academy for Health and Care, Jönköping County Council, Sweden
Available from: 2023-05-30 Created: 2023-05-30 Last updated: 2024-09-04Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0003-1176-8173

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