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Finkel, D., Nilsen, C., Sindi, S. & Kåreholt, I. (2024). Impact of childhood and adult socioeconomic position on change in functional aging. Health Psychology
Open this publication in new window or tab >>Impact of childhood and adult socioeconomic position on change in functional aging
2024 (English)In: Health Psychology, ISSN 0278-6133, E-ISSN 1930-7810Article in journal (Refereed) Epub ahead of print
Abstract [en]

OBJECTIVES: To examine life-course models by investigating the roles of childhood and adult socioeconomic position (SEP) in longitudinal changes in a functional aging index.

METHOD: Up to eight waves of testing, covering 25 years, were available from the Swedish Adoption/Twin Study of Aging: N = 654, intake age = 50-82. A two-slope latent growth curve model was applied to the data, and the impact of including childhood and adult SEP as covariates of the intercept (at age 70) and slopes (before and after age 70) was tested.

RESULTS: Both childhood and adult SEP contributed to the best-fitting model. Childhood SEP was significantly associated with intercept and Slope 1 (before age 70) of the latent growth curve model (p < .05). Association of adult SEP with Slope 2 (after age 70) trended toward significance (p < .10). There was a significant interaction effect of childhood and adult SEP on the intercept (p < .05). As a result, intercept at age 70 was highest and change after age 70 was fastest for those whose SEP decreased from childhood to adulthood.

CONCLUSIONS: Both childhood and adult SEP impact change in functional abilities with age, supporting both critical period and social mobility models. The social environment is modifiable by policies at local, national, and international levels, and these policies need to recognize that early social disadvantage can have long-lasting health impacts. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Place, publisher, year, edition, pages
American Psychological Association (APA), 2024
National Category
Public Health, Global Health, Social Medicine and Epidemiology Gerontology, specialising in Medical and Health Sciences
Identifiers
urn:nbn:se:hj:diva-63386 (URN)10.1037/hea0001356 (DOI)001137077200001 ()38190203 (PubMedID);intsam;928824 (Local ID);intsam;928824 (Archive number);intsam;928824 (OAI)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 97:0147:1B, 2009-0795Swedish Research Council, 825-2007-7460, 825-2009-6141Axel and Margaret Ax:son Johnson FoundationVårdal FoundationRiksbankens Jubileumsfond
Available from: 2024-01-17 Created: 2024-01-17 Last updated: 2024-01-17
Nilsen, C., Agerholm, J., Kelfve, S., Wastesson, J. W., Kåreholt, I., Nabe-Nielsen, K. & Meinow, B. (2023). History of working conditions and the risk of old-age dependency: a nationwide Swedish register-based study. Scandinavian Journal of Public Health
Open this publication in new window or tab >>History of working conditions and the risk of old-age dependency: a nationwide Swedish register-based study
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2023 (English)In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905Article in journal (Refereed) Epub ahead of print
Abstract [en]

Aims: There is substantial evidence that previous working conditions influence post-retirement health, yet little is known about previous working conditions' association with old-age dependency. We examined job strain, hazardous and physical demands across working life, in relation to the risk of entering old-age dependency of care.

Methods: Individually linked nationwide Swedish registers were used to identify people aged 70+ who were not receiving long-term care (residential care or homecare) at baseline (January 2014). Register information on job titles between the years 1970 and 2010 was linked with a job exposure matrix of working conditions. Random effects growth curve models were used to calculate intra-individual trajectories of working conditions. Cox regression models with age as the timescale (adjusted for living situation, educational attainment, country of birth, and sex) were conducted to estimate hazard ratios for entering old-age dependency during the 24 months of follow-up (n = 931,819).

Results: Having initial adverse working conditions followed by an accumulation throughout working life encompassed the highest risk of entering old-age dependency across the categories (job strain: HR 1.23, 95% CI 1.19-1.27; physical demands: HR 1.36, 95% CI 1.31-1.40, and hazardous work: HR 1.35, 95% CI 1.30-1.40). Initially high physical demands or hazardous work followed by a stable trajectory, or initially low-level physical demand or hazardous work followed by an accumulation throughout working life also encompassed a higher risk of dependency.

Conclusions: A history of adverse working conditions increased the risk of old-age dependency. Reducing the accumulation of adverse working conditions across the working life may contribute to postponing old-age dependency.

Place, publisher, year, edition, pages
Sage Publications, 2023
Keywords
Older age, later life, dependency, long-term care, physical working conditions, psychosocial working conditions, work-related stress, longitudinal, Sweden
National Category
Gerontology, specialising in Medical and Health Sciences
Identifiers
urn:nbn:se:hj:diva-62244 (URN)10.1177/14034948231188999 (DOI)001042373400001 ()37537973 (PubMedID)2-s2.0-85166902323 (Scopus ID)HOA;intsam;898013 (Local ID)HOA;intsam;898013 (Archive number)HOA;intsam;898013 (OAI)
Funder
Swedish Research Council, 2016-00197Forte, Swedish Research Council for Health, Working Life and Welfare, 2019-01141, 2016-01072Riksbankens Jubileumsfond, P21-0173
Available from: 2023-08-22 Created: 2023-08-22 Last updated: 2023-08-28
Ekezie, P. E., Eriksson, U., Shaw, B. A., Agahi, N. & Nilsen, C. (2023). Is the mental health of older adults receiving care from their children related to their children's dual burden of caregiving and work stress?: A linked lives perspective. Aging & Mental Health, 27(9), 1796-1802
Open this publication in new window or tab >>Is the mental health of older adults receiving care from their children related to their children's dual burden of caregiving and work stress?: A linked lives perspective
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2023 (English)In: Aging & Mental Health, ISSN 1360-7863, E-ISSN 1364-6915, Vol. 27, no 9, p. 1796-1802Article in journal (Refereed) Published
Abstract [en]

Objectives

Mental health problems are a major concern in the older population in Sweden, as is the growing number of older adults aging alone in their homes and in need of informal care. Using a linked lives perspective, this study explored if older parents' mental health is related to their children's dual burden of informal caregiving and job strain.

Methods

Data from a nationally representative Swedish survey, SWEOLD, were used. Mental health problems in older age (mean age 88) were measured with self-reported 'mild' or 'severe' anxiety and depressive symptoms. A primary caregiving adult child was linked to each older parent, and this child's occupation was matched with a job exposure matrix to assess job strain. Logistic regression analyses were conducted with an analytic sample of 334.

Results

After adjusting for covariates, caregiving children's lower job control and greater job strain were each associated with mental health problems in their older parents (OR 2.52, p = 0.008 and OR 2.56, p = 0.044, respectively). No association was found between caregiving children's job demands and their older parents' mental health (OR 1.08, p = 0.799).

Conclusion

In line with the linked lives perspective, results highlight that the work-life balance of informal caregiving adult children may play a role in their older parent's mental health.

Place, publisher, year, edition, pages
Taylor & Francis, 2023
Keywords
Older adults, informal care, mental health symptoms, linked lives, job strain
National Category
Geriatrics Nursing
Identifiers
urn:nbn:se:hj:diva-58596 (URN)10.1080/13607863.2022.2126820 (DOI)000857115700001 ()36137944 (PubMedID)2-s2.0-85138564269 (Scopus ID)HOA;intsam;835827 (Local ID)HOA;intsam;835827 (Archive number)HOA;intsam;835827 (OAI)
Funder
Swedish Research Council, 2019-01429Forte, Swedish Research Council for Health, Working Life and Welfare, 2019-01141
Available from: 2022-10-07 Created: 2022-10-07 Last updated: 2023-09-07Bibliographically approved
Sindi, S., Kiasat, S., Kåreholt, I. & Nilsen, C. (2023). Psychosocial working conditions and cognitive and physical impairment in older age. Archives of gerontology and geriatrics (Print), 104, Article ID 104802.
Open this publication in new window or tab >>Psychosocial working conditions and cognitive and physical impairment in older age
2023 (English)In: Archives of gerontology and geriatrics (Print), ISSN 0167-4943, E-ISSN 1872-6976, Vol. 104, article id 104802Article in journal (Refereed) Published
Abstract [en]

Background

Psychosocial working conditions are associated with cognitive and physical impairments. The aim of this study was to investigate the associations between mid-late life psychosocial working conditions and the combination of physical and cognitive impairment among older adults, and the potential sex differences in these associations.

Methods

Data were derived from two Swedish nationally representative surveys (n = 839; follow-up: 20–24 years). Multinomial and binary logistic regressions assessed the associations between work stressors (job demand-control model), and a combination of cognitive and physical impairment.

Results

Low control jobs were significantly associated with higher odds of cognitive (OR: 1.41, CI: 1.15–1.72) and physical impairment (OR: 1.23, CI: 1.02–1.47), and cognitive and physical impairment combined (OR: 1.50, CI: 1.19–1.89). Passive jobs (low control, low demand) were associated with higher odds of cognitive impairment (OR: 1.57, CI: 1.12–2.20), and combined cognitive and physical impairment (OR: 1.59, CI: 1.07–2.36). Active jobs (high control, high demand) were associated with lower odds of cognitive impairment (OR: 0.48, CI: 0.29–0.80). Sex-stratified analyses showed stronger associations among men; passive jobs were associated with both cognitive (OR: 2.18, CI: 1.31–3.63) and physical impairment (OR: 1.78, CI: 1.13–2.81), while low strain jobs were associated with less physical impairment (OR: 0.55, CI: 0.33-0.89). No significant associations between work stressors and impairment were found for women.

Conclusions

These results highlight the importance of psychosocial working conditions for late-life physical and cognitive impairment, especially among men. Jobs characterised by low control and low demands are associated with higher risk for impairments.

Place, publisher, year, edition, pages
Elsevier, 2023
Keywords
Work stressors, Psychosocial working conditions, Cognition, Physical function, Aging, Sex differences, Longitudinal
National Category
Gerontology, specialising in Medical and Health Sciences
Identifiers
urn:nbn:se:hj:diva-58438 (URN)10.1016/j.archger.2022.104802 (DOI)000854055700002 ()36084608 (PubMedID)2-s2.0-85137742510 (Scopus ID)HOA;intsam;830153 (Local ID)HOA;intsam;830153 (Archive number)HOA;intsam;830153 (OAI)
Funder
Marcus Wallenbergs Foundation for International Scientific Collaboration, MMW 2016.0081Forte, Swedish Research Council for Health, Working Life and Welfare, 2019–01141Riksbankens Jubileumsfond, P21-0173
Available from: 2022-09-08 Created: 2022-09-08 Last updated: 2022-09-29Bibliographically approved
Kåreholt, I., Nilsen, C., Agerholm, J., Kelfve, S., Wastesson, J., Nabe-Nielsen, K. & Meinow, B. (2022). History of Job Strain And Risk of Late-Life Dependency: A Nationwide Swedish Registerbased Study. Innovation in Aging, 6(Supplement 1), 502-503
Open this publication in new window or tab >>History of Job Strain And Risk of Late-Life Dependency: A Nationwide Swedish Registerbased Study
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2022 (English)In: Innovation in Aging, E-ISSN 2399-5300, Vol. 6, no Supplement 1, p. 502-503Article in journal, Meeting abstract (Refereed) Published
Abstract [en]

There is substantial evidence that work plays a significant role in post-retirement health. Yet little is known about its role in when late-life dependency may occur. We examined associations between job strain and the risk of entering late-life dependency. Individually linked nationwide Swedish registers were used to identify people 70+ alive in January 2014, and who did not experience the outcome (late-life dependency) during two months prior to the start of the follow-up. Late-life dependency was operationalized as use of long-term care. Information about job strain was obtained via a job exposure matrice and matched with job titles. Cox regression models with age as time-scale (adjusted for living situation, educational attainment, country of birth, and sex) were conducted to estimate hazard ratios (HR) for entering late-life dependency during the 24 months of follow-up (n=993,595). Having an initial high starting point of job strain followed by an increasing trajectory throughout working life implied a 23% higher risk of entering late-life dependency at a younger age, compared with the reference group (low starting point with a decreasing trajectory). High initial starting point followed by a stable trajectory implied a 12% higher risk of entering late-life dependency at a younger age. High initial starting point followed by a decreasing trajectory implied a 10% risk reduction, and a low starting point with a stable trajectory implied a 22% risk reduction, of entering late-life dependency at a younger age. Reducing stressful jobs across working life may contribute to postponing late-life dependency.

Place, publisher, year, edition, pages
Oxford University Press, 2022
National Category
Geriatrics
Identifiers
urn:nbn:se:hj:diva-60009 (URN)10.1093/geroni/igac059.1927 (DOI)000913044002360 ()
Funder
Riksbankens JubileumsfondForte, Swedish Research Council for Health, Working Life and Welfare
Available from: 2023-03-21 Created: 2023-03-21 Last updated: 2023-03-23Bibliographically approved
Finkel, D., Nilsen, C., Sindi, S. & Kåreholt, I. (2022). Impact of Objective and Subjective Sep on Aging Trajectories of Functional Capacity. Innovation in Aging, 6(Supplement 1), 220-220
Open this publication in new window or tab >>Impact of Objective and Subjective Sep on Aging Trajectories of Functional Capacity
2022 (English)In: Innovation in Aging, E-ISSN 2399-5300, Vol. 6, no Supplement 1, p. 220-220Article in journal, Meeting abstract (Refereed) Published
Abstract [en]

Long-term stress is associated with adverse health outcomes in aging. It is important to identify not only factors that influence functioning in late adulthood, such as accumulated stress, but also the timing of such factors. The aim of the current analysis was to examine how socioeconomic stressors throughout the life course are associated with aging in functional capacity. Data were available from 740 adults ranging in age from 40 to 83 at intake (mean = 62.4, SD = 8.2) who participated in up to 8 waves of data collection (mean = 3.9, SD = 2.4). A Functional Aging Index (FAI) was created by combining measures of sensory, pulmonary, gait, and grip functioning. Both childhood and adulthood measures of objective socioeconomic position (SEP) and perceived SEP (financial strain) were available. Latent growth curve models (corrected for twinness) were used to estimate the trajectory of change in FAI over age and the impact of child and adult SEP measures on the trajectories. Results indicated that both childhood and adult objective SEP independently influenced rates of change in FAI in adulthood: higher SEP was associated with higher mean functioning and slower rates of decline. In combination, model fitting indicated that if SEP is above the median in adulthood, then childhood SEP has no impact on FAI trajectories; however, if SEP is below the median in adulthood, then childhood SEP can play a role. In addition, results indicated possible long-term effects of childhood financial strain on rates of change in FAI in adulthood.

Place, publisher, year, edition, pages
Oxford University Press, 2022
National Category
Geriatrics
Identifiers
urn:nbn:se:hj:diva-60006 (URN)10.1093/geroni/igac059.876 (DOI)000913044001090 ()
Funder
Riksbankens Jubileumsfond
Available from: 2023-03-21 Created: 2023-03-21 Last updated: 2023-03-23Bibliographically approved
Piiroinen, I., Tuomainen, T.-P., Tolmunen, T., Kauhanen, J., Kurl, S., Nilsen, C., . . . Voutilainen, A. (2022). Long-term changes in sense of coherence and mortality among middle-aged men: A population -based follow-up study. Advances in Life Course Research, 53, Article ID 100494.
Open this publication in new window or tab >>Long-term changes in sense of coherence and mortality among middle-aged men: A population -based follow-up study
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2022 (English)In: Advances in Life Course Research, E-ISSN 1040-2608, Vol. 53, article id 100494Article in journal (Refereed) Published
Abstract [en]

Sense of coherence (SOC) scale measures one’s orientation to life. SOC is the core construct in Antonovsky's salutogenic model of health. It has been shown that weak SOC correlates with poor perceived health, low quality of life, and increased mortality. Some studies have indicated that SOC is not stable across life, but there are no previous studies on how a change of SOC is reflected in mortality. However, there is some evidence that a change in perceived quality of life is associated with mortality. The study explores the association between the change in SOC and mortality using longitudinal data from a cohort of middle-aged Finnish men recruited between 1986 and 1989. Approximately 11 years after the baseline examinations, between 1998 and 2001, 854 men returned the SOC questionnaire a second time. The baseline SOC was adjusted for the regression to the mean phenomenon between the two measurements. The hazard ratios of the SOC difference scores were adjusted for initial SOC age and 12 somatic risk factors of mortality (alcohol consumption, blood pressure, body mass index, cholesterol concentration, physical activity, education, smoking, marital status, employment status, history of cancer, history of cardiovascular disease and diabetes). SOC was not stable among middle-aged Finnish men and a decline in SOC was associated with an increased hazard of all-cause mortality. In the fully adjusted model, a decrease of one standard deviation (SD) of the SOC mean difference increased the mortality hazard by about 35 %, two SDs decrease about 70 %, and 2.5 SDs about 100 %. Strengthening SOC showed a limited association with decreasing mortality hazards in the age-adjusted model. Policies, strategies, or plans, supporting SOC in the middle-age may help to decrease mortality and increase quality of life in later years.

Place, publisher, year, edition, pages
Elsevier, 2022
Keywords
Sense of coherence, Salutogenesis, Mortality, Aging, Life span development, Psycho-social change
National Category
Gerontology, specialising in Medical and Health Sciences
Identifiers
urn:nbn:se:hj:diva-58210 (URN)10.1016/j.alcr.2022.100494 (DOI)000861098100002 ()2-s2.0-85146532129 (Scopus ID)HOA;intsam;825819 (Local ID)HOA;intsam;825819 (Archive number)HOA;intsam;825819 (OAI)
Available from: 2022-08-16 Created: 2022-08-16 Last updated: 2023-01-30Bibliographically approved
Nilsen, C., Celeste, R. K., Lennartsson, C., McKee, K. J. & Dahlberg, L. (2022). Long-term risk factors for old-age social exclusion in Sweden: a 30-year longitudinal study. Archives of gerontology and geriatrics (Print), 103, Article ID 104760.
Open this publication in new window or tab >>Long-term risk factors for old-age social exclusion in Sweden: a 30-year longitudinal study
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2022 (English)In: Archives of gerontology and geriatrics (Print), ISSN 0167-4943, E-ISSN 1872-6976, Vol. 103, article id 104760Article in journal (Refereed) Published
Abstract [en]

Purpose of the research: Social exclusion threatens quality of life in older age. However, there is a lack of research on social exclusion from life-course and gender perspectives. We investigated early-and midlife risk factors for old-age social exclusion among women and men.

Materials and methods: Two individually linked studies of Swedish nationally representative samples provided longitudinal data over a 30-year period on 1,819 people at baseline. Indicators of economic exclusion, leisure/ social exclusion, and civic exclusion were assessed at early late life (M=70 years) and late life (M=81). Educational attainment, non-employment, psychological health problems and mobility problems were measured as risk factors at midlife (M=54) and late midlife (M=61). Path analysis derived a model of old-age social exclusion.

Results: Exclusion on a domain in early late life led to exclusion on the same domain in late life, except for the economic domain. Leisure/social exclusion in early late life also led to civic exclusion in late life. Midlife risk factors influenced late-life exclusion almost exclusively through early late-life exclusion. While model fit could not be significantly improved by allowing coefficients to vary freely by gender, there was a stronger effect of non -employment on exclusion in women and a stronger effect of psychological health problems on exclusion in men.

Conclusions: This study confirms that old-age exclusion is persistent and dynamic, and influenced by risk factors experienced earlier in life. A holistic approach with integrated efforts across different policy areas is needed to efficiently reduce old-age social exclusion.

Place, publisher, year, edition, pages
Elsevier, 2022
Keywords
Life course, Midlife, Late life, Social exclusion, Sweden, Path analysis
National Category
Geriatrics Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:hj:diva-58153 (URN)10.1016/j.archger.2022.104760 (DOI)000830297700001 ()35797759 (PubMedID)HOA;intsam;824513 (Local ID)HOA;intsam;824513 (Archive number)HOA;intsam;824513 (OAI)
Funder
Swedish Research Council, 2017-00668Forte, Swedish Research Council for Health, Working Life and Welfare, 2019-01141
Available from: 2022-08-10 Created: 2022-08-10 Last updated: 2022-08-16Bibliographically approved
Sindi, S., Kiasat, S., Kåreholt, I. & Nilsen, C. (2022). Psychosocial Working Conditions in Midlife And Cognitive and Physical Impairment in Older Age. Innovation in Aging, 6(Supplement 1), 610-610
Open this publication in new window or tab >>Psychosocial Working Conditions in Midlife And Cognitive and Physical Impairment in Older Age
2022 (English)In: Innovation in Aging, E-ISSN 2399-5300, Vol. 6, no Supplement 1, p. 610-610Article in journal, Meeting abstract (Refereed) Published
Abstract [en]

Background: Psychosocial working conditions have been associated with cognitive and physical impairment among older adults. However, less is known on whether psychosocial working conditions are associated with a combination of cognitive and physical impairments. The aim of this study was to investigate the associations between midlife psychosocial working conditions and physical and cognitive impairment among older adults, and to assess whether there are sex differences in these associations. Methods: The data were derived from two Swedish nationally representative surveys (n=839) with a follow-up time of 20-24 years. Multinomial and binary logistic regressions were used to assess the associations between work stressors according to the job demand-control model, and a combination of cognitive and physical impairment. Results: Low control jobs were significantly associated with higher odds of both cognitive and physical impairment as well as a combination of cognitive and physical impairment. Passive jobs (low control, low demand) were associated with higher odds of cognitive impairment, and cognitive and physical impairment in combination. Active jobs (high control, high demand) were associated with lower odds of cognitive impairment. Sex-stratified analyses showed stronger associations among men than among women. Among men passive jobs were significantly associated with both cognitive and physical impairment. Low strain jobs were significantly associated with less physical impairment. Conclusions: These results highlight the importance of midlife psychosocial working conditions for late-life physical and cognitive impairment, and especially among men. Jobs characterised by higher control, lower strain and active jobs may promote resilience and cognitive reserve among older populations.

Place, publisher, year, edition, pages
Oxford University Press, 2022
National Category
Geriatrics
Identifiers
urn:nbn:se:hj:diva-60004 (URN)000913044003050 ()
Funder
Riksbankens Jubileumsfond
Available from: 2023-03-21 Created: 2023-03-21 Last updated: 2023-03-23Bibliographically approved
Nilsen, C., Andel, R., Agahi, N., Fritzell, J. & Kåreholt, I. (2021). Association between psychosocial working conditions in mid-life and leisure activity in old age. Scandinavian Journal of Public Health, 49(2), 168-175
Open this publication in new window or tab >>Association between psychosocial working conditions in mid-life and leisure activity in old age
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2021 (English)In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 49, no 2, p. 168-175Article in journal (Refereed) Published
Abstract [en]

Aims:

Leisure activity helps people engage with life, and it promotes health and well-being as we age. This study investigated whether individuals with active jobs (high psychological demands, high control) in mid-life were more active during leisure time in old age compared with those with less active jobs.

Methods:

Two individually linked Swedish surveys were used (N=776) with 23 years of follow-up. Data were analysed with logistic regression.

Results:

Having an active job in mid-life was associated with greater engagement in intellectual/cultural, social and physical activity in old age, even when leisure activity in mid-life was taken into account.

Conclusions:

The results suggest that active jobs in mid-life may be replaced by active leisure during retirement. Active job conditions may promote engagement in society in old age, which in turn may have positive health consequences. 

Place, publisher, year, edition, pages
Sage Publications, 2021
Keywords
active aging, active jobs, continuity, leisure activity, longitudinal, old age, Psychosocial working conditions, Sweden, adult, article, female, follow up, healthy aging, human, major clinical study, male, physical activity, retirement, social behavior, work environment
National Category
Gerontology, specialising in Medical and Health Sciences
Identifiers
urn:nbn:se:hj:diva-47934 (URN)10.1177/1403494820901404 (DOI)000512267900001 ()32031469 (PubMedID)2-s2.0-85079444014 (Scopus ID);intsam;1412067 (Local ID);intsam;1412067 (Archive number);intsam;1412067 (OAI)
Available from: 2020-03-05 Created: 2020-03-05 Last updated: 2021-04-16Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0003-3662-5486

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