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Emami, A., Theorell, T., Kim, H., Berglund, L., Hallinder, H. & Engström, G. (2023). Assessing stress using repeated saliva concentration of steroid hormones in dementia care dyads: results from a controlled pilot care music intervention. Upsala Journal of Medical Sciences, 128(1), Article ID e9340.
Open this publication in new window or tab >>Assessing stress using repeated saliva concentration of steroid hormones in dementia care dyads: results from a controlled pilot care music intervention
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2023 (English)In: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 128, no 1, article id e9340Article in journal (Refereed) Published
Abstract [en]

Background: Stress-related biomarkers have the potential to provide objective measures of whether interventions directed at people with dementia (PWD) and their family caregivers (FCG) are successful. The use of such biomarkers has been limited by logistical barriers to sample collection.

Objective: Explore saliva concentration of steroid hormones in dementia care dyads during a music intervention.

Methods: Consecutive PWD attending a memory evaluation center and their FCG were allocated to either an intervention-with-music or a non-intervention control group. All were living at home. Stress biomarkers, salivary cortisol and dehydroepiandrosterone sulfate (DHEA-S) samples were collected by the PWD and their FCG, in the morning and evening, 5 days a week, for 8 consecutive weeks. Biomarker concentrations of the intervention and the control groups were compared at week 8, in an intention-to-treat approach with adjustment for baseline value.

Results: Twenty-four PWD in the intervention group and 10 in the control group, and their FCG were included in the analyses. The mean number of morning saliva collections was similar in the intervention and the control groups, ranging from 4.3 to 4.9 per participant weekly during the first 7 weeks, declining to 3.3 during week 8. Median log morning cortisol (pg/mL) among caregivers was lower in the intervention group than in the control group (8.09 vs. 8.57, P = 0.0133).

Conclusion: This study demonstrates that music intervention was associated with lower morning saliva cortisol concentrations for FCGs.

Place, publisher, year, edition, pages
Upsala Medical Society, 2023
Keywords
caregivers, dementia, music, saliva, stress, cortisol, DHEA-S
National Category
Geriatrics Psychology
Research subject
Psychology
Identifiers
urn:nbn:se:su:diva-220563 (URN)10.48101/ujms.v128.9340 (DOI)000999751800001 ()37265585 (PubMedID)2-s2.0-85160969025 (Scopus ID)
Available from: 2023-09-04 Created: 2023-09-04 Last updated: 2024-01-11Bibliographically approved
Bojner Horwitz, E., Korošec, K. & Theorell, T. (2022). Can Dance and Music Make the Transition to a Sustainable Society More Feasible?. Behavioral Sciences, 12(1), Article ID 11.
Open this publication in new window or tab >>Can Dance and Music Make the Transition to a Sustainable Society More Feasible?
2022 (English)In: Behavioral Sciences, E-ISSN 2076-328X, Vol. 12, no 1, article id 11Article in journal (Refereed) Published
Abstract [en]

Transition to sustainability is a process that requires change on all levels of society from the physical to the psychological. This review takes an interdisciplinary view of the landscapes of research that contribute to the development of pro-social behaviors that align with sustainability goals, or what we call ‘inner sustainability’. Engaging in musical and dance activities can make people feel trust and connectedness, promote prosocial behavior within a group, and also reduce prejudices between groups. Sustained engagement in these art forms brings change in a matter of seconds (such as hormonal changes and associated stress relief), months (such as improved emotional wellbeing and learning outcomes), and decades (such as structural changes to the brains of musicians and dancers and superior skills in expressing and understanding emotion). In this review, we bridge the often-separate domains of the arts and sciences by presenting evidence that suggests music and dance promote self-awareness, learning, care for others and wellbeing at individual and group levels. In doing so, we argue that artistic practices have a key role to play in leading the transformations necessary for a sustainable society. We require a movement of action that provides dance and music within a constructive framework for stimulating social sustainability.

Keywords
dance, inner sustainability, mind-shift, music, transition
National Category
Psychology
Identifiers
urn:nbn:se:su:diva-202652 (URN)10.3390/bs12010011 (DOI)000756923100001 ()35049622 (PubMedID)
Available from: 2022-03-16 Created: 2022-03-16 Last updated: 2023-02-02Bibliographically approved
Kim, H., Engström, G., Theorell, T., Hallinder, H. & Emami, A. (2022). In-home online music-based intervention for stress, coping, and depression among family caregivers of persons with dementia: A pilot study. Geriatric Nursing, 46, 137-143
Open this publication in new window or tab >>In-home online music-based intervention for stress, coping, and depression among family caregivers of persons with dementia: A pilot study
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2022 (English)In: Geriatric Nursing, ISSN 0197-4572, E-ISSN 1528-3984, Vol. 46, p. 137-143Article in journal (Refereed) Published
Abstract [en]

Little is known about how music affects family caregivers who provide care to persons with dementia at home. We examined the effects of an 8-week online music-based intervention on self-reported stress, coping, and depression among dementia family caregivers. Mann-Whitney U test and Wilcoxon signed-ranked tests were performed to examine between- and within-group differences between intervention (n = 24) and comparison (n = 11) groups from baseline to post-test. The coping subscale yielded a significant difference between the groups at post-test (U=76.50, Z=-1.978, p=0.048), indicating the intervention group had better coping than the comparison group at post-test. Significant within-group differences in overall stress (Z=-2.200, p=0.028) and coping subscale (Z=-1.997, p=0.046) in the comparison group at post-test suggest that overall stress and coping were maintained throughout the study in the intervention group, whereas the comparison group had higher overall stress and lower coping at post-test. Our in-home music-based intervention showed potential benefits for dementia family caregivers.

Keywords
caregivers, dementia, depression, music, stress
National Category
Psychology
Research subject
Psychology
Identifiers
urn:nbn:se:su:diva-211574 (URN)10.1016/j.gerinurse.2022.05.011 (DOI)000879439700007 ()35700681 (PubMedID)2-s2.0-85131837804 (Scopus ID)
Available from: 2022-11-23 Created: 2022-11-23 Last updated: 2023-01-03Bibliographically approved
Clausen, T., Rosendahl Meldgaard Pedersen, L., Andersen, M. F., Theorell, T. & Madsen, I. E. H. (2022). Job autonomy and psychological well-being: A linear or a non-linear association?. European Journal of Work and Organizational Psychology, 31(3), 395-405
Open this publication in new window or tab >>Job autonomy and psychological well-being: A linear or a non-linear association?
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2022 (English)In: European Journal of Work and Organizational Psychology, ISSN 1359-432X, E-ISSN 1464-0643, Vol. 31, no 3, p. 395-405Article in journal (Refereed) Published
Abstract [en]

This study investigates whether increasing levels of job autonomy are linearly associated with improved psychological well-being, or whether the association is non-linear with higher levels of job autonomy being negatively associated with psychological well-being. The study is based on a survey in 4,340 individuals. After six months a follow-up survey was conducted. Associations were analysed using spline models in cross-sectional and prospective analyses of the full study population. We stratified the study population in four types of work for further cross-sectional analyses. The cross-sectional analysis of the full study population indicated a non-linear relationship as the association attenuated but remained positive at all levels of job autonomy. The prospective analysis indicated a positive linear association. The stratified cross-sectional analyses indicated a linear association in three of the four types of work and a non-linear but positive association among respondents in client-related work. Findings are supported in sensitivity analyses using alternative outcomes: vigour, job satisfaction and work stress. We conclude that job autonomy is positively associated with psychological well-being. Findings have relevance for job redesign by indicating that higher levels of job autonomy are beneficial for the psychological well-being of workers – especially among workers with low levels of job autonomy.

Keywords
job control, job resources, job stress, psychosocial working conditions, spline models
National Category
Psychology Occupational Health and Environmental Health
Research subject
Psychology
Identifiers
urn:nbn:se:su:diva-197297 (URN)10.1080/1359432X.2021.1972973 (DOI)000693047400001 ()2-s2.0-85114508691 (Scopus ID)
Available from: 2021-10-26 Created: 2021-10-26 Last updated: 2022-08-12Bibliographically approved
Emami, A., Hallinder, H., Theorell, T., Kim, H. & Engström, G. (2022). The Feasibility and Acceptability of In-Home Saliva Collection for Stress in Persons With Dementia and Their Family Caregivers. Biological Research for Nursing, 24(3), 308-315
Open this publication in new window or tab >>The Feasibility and Acceptability of In-Home Saliva Collection for Stress in Persons With Dementia and Their Family Caregivers
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2022 (English)In: Biological Research for Nursing, ISSN 1099-8004, E-ISSN 1552-4175, Vol. 24, no 3, p. 308-315Article in journal (Refereed) Published
Abstract [en]

Background: Although increasing attention is being paid to cortisol and the sulfated form of dehydroepiandrosterone (DHEA-S) as stress biomarkers, the feasibility of saliva collection of such biomarkers has yet to be investigated among dementia care dyads (persons with dementia [PWD] and family caregivers) living in a home setting. We explored the feasibility and acceptability of in-home saliva collection for cortisol and DHEA-S as stress biomarkers among dementia care dyads.

Methods: Dementia care dyads were recruited from a memory evaluation center. After pre-evaluation and education sessions, participants collected their saliva 3 times a day, 5 days a week, for 8 consecutive weeks. We calculated frequency counts and percentages to assess enrollment rate, retention rate, the completion rate of saliva collection, and valid samples of cortisol and DHEA-S. Independent samples t-tests were performed to compare mean differences in the total number of collected samples and valid samples between PWD and family caregivers at each time point of saliva collection.

Results: A total of 46 dyads were referred to this study; 32 dyads (69.6%) agreed to participate, and 26 started collecting saliva. Twenty-four dyads (75%) completed 8 weeks of saliva collection. There were no significant differences (p > 0.05) in the number of collected samples and valid samples between PWD and caregiver participants.

Conclusion: This study supports the feasibility of in-home saliva collection for stress biomarker assay and the need for further investigation into self-administered collection of stress biomarkers with a particular focus on dementia care dyads living at home.

Keywords
dementia, feasibility study, patient-focused care, physiological stress, saliva
National Category
Nursing
Identifiers
urn:nbn:se:su:diva-203158 (URN)10.1177/10998004221076554 (DOI)000765277700001 ()35238213 (PubMedID)2-s2.0-85126013953 (Scopus ID)
Available from: 2022-03-24 Created: 2022-03-24 Last updated: 2022-08-17Bibliographically approved
Horwitz, E. B., Theorell, E., Thyrén, D., Scheja, S. & Theorell, T. (2022). Using Transdisciplinary Interpretative Analysis to Understand the Reactions of Preschoolers to Live Classical Music. Creative Education, 13(08), 2417-2432
Open this publication in new window or tab >>Using Transdisciplinary Interpretative Analysis to Understand the Reactions of Preschoolers to Live Classical Music
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2022 (English)In: Creative Education, ISSN 2151-4755, E-ISSN 2151-4771, Vol. 13, no 08, p. 2417-2432Article in journal (Refereed) Published
Abstract [en]

What researchers see in pre-school children’s reactions to live classical piano music, and how this knowledge can be interpreted into a broader societal context, is the focus of this study. The specific purpose was to see how a transdisciplinary group of researchers, interpreted 32 pre-school children’s reactions when listening to a short live classical professional piano concert, Beethoven’s piano sonata No. 23, Op. 57 “Appassionata”, first movement. The children were video recorded before, during and after the piano concert and were asked to draw self-figure drawings before and after the live concert. Through body language and cognitive/verbal reactions, interviews, analyses of movements and self-figure drawings, rich data from the pre-school child- ren were analyzed and discussed. The concert affected the children in differ- ent ways and as interpreted from the narratives from the pre-school teachers; the children were absorbed and energized many days after the concert. Re- search collaborations across disciplinary boundaries are needed to deepen the knowledge of how music can contribute to children’s creativity, curiosity, physical security, and creative learning for the coming school year. We need to look deeper into the meaning of kinesthetic musicality in pre-school con- texts and more frequently ask in what ways knowledge is taught and orga- nized.

Keywords
Appassionata, Live Classical Music, Transdisciplinary Research, Pre-School Children, Self-Figure Drawing
National Category
Humanities and the Arts
Research subject
Arts, Humanities and Social Science Education
Identifiers
urn:nbn:se:su:diva-208031 (URN)10.4236/ce.2022.138153 (DOI)
Available from: 2022-08-16 Created: 2022-08-16 Last updated: 2023-04-27Bibliographically approved
Kivimäki, M., Walker, K. A., Pentti, J., Nyberg, S., Mars, N., Vahtera, J., . . . Lindbohm, J. (2021). Cognitive stimulation in the workplace, plasma proteins, and risk of dementia: three analyses of population cohort studies. The BMJ, 374, Article ID 374:n1804.
Open this publication in new window or tab >>Cognitive stimulation in the workplace, plasma proteins, and risk of dementia: three analyses of population cohort studies
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2021 (English)In: The BMJ, E-ISSN 1756-1833, Vol. 374, article id 374:n1804Article in journal (Refereed) Published
Abstract [en]

Objectives To examine the association between cognitively stimulating work and subsequent risk of dementia and to identify protein pathways for this association.

Design Multicohort study with three sets of analyses.

Setting United Kingdom, Europe, and the United States.

Participants Three associations were examined: cognitive stimulation and dementia risk in 107 896 participants from seven population based prospective cohort studies from the IPD-Work consortium (individual participant data meta-analysis in working populations); cognitive stimulation and proteins in a random sample of 2261 participants from one cohort study; and proteins and dementia risk in 13 656 participants from two cohort studies.

Main outcome measures Cognitive stimulation was measured at baseline using standard questionnaire instruments on active versus passive jobs and at baseline and over time using a job exposure matrix indicator. 4953 proteins in plasma samples were scanned. Follow-up of incident dementia varied between 13.7 to 30.1 years depending on the cohort. People with dementia were identified through linked electronic health records and repeated clinical examinations.

Results During 1.8 million person years at risk, 1143 people with dementia were recorded. The risk of dementia was found to be lower for participants with high compared with low cognitive stimulation at work (crude incidence of dementia per 10 000 person years 4.8 in the high stimulation group and 7.3 in the low stimulation group, age and sex adjusted hazard ratio 0.77, 95% confidence interval 0.65 to 0.92, heterogeneity in cohort specific estimates I2=0%, P=0.99). This association was robust to additional adjustment for education, risk factors for dementia in adulthood (smoking, heavy alcohol consumption, physical inactivity, job strain, obesity, hypertension, and prevalent diabetes at baseline), and cardiometabolic diseases (diabetes, coronary heart disease, stroke) before dementia diagnosis (fully adjusted hazard ratio 0.82, 95% confidence interval 0.68 to 0.98). The risk of dementia was also observed during the first 10 years of follow-up (hazard ratio 0.60, 95% confidence interval 0.37 to 0.95) and from year 10 onwards (0.79, 0.66 to 0.95) and replicated using a repeated job exposure matrix indicator of cognitive stimulation (hazard ratio per 1 standard deviation increase 0.77, 95% confidence interval 0.69 to 0.86). In analysis controlling for multiple testing, higher cognitive stimulation at work was associated with lower levels of proteins that inhibit central nervous system axonogenesis and synaptogenesis: slit homologue 2 (SLIT2, fully adjusted β −0.34, P<0.001), carbohydrate sulfotransferase 12 (CHSTC, fully adjusted β −0.33, P<0.001), and peptidyl-glycine α-amidating monooxygenase (AMD, fully adjusted β −0.32, P<0.001). These proteins were associated with increased dementia risk, with the fully adjusted hazard ratio per 1 SD being 1.16 (95% confidence interval 1.05 to 1.28) for SLIT2, 1.13 (1.00 to 1.27) for CHSTC, and 1.04 (0.97 to 1.13) for AMD.

Conclusions The risk of dementia in old age was found to be lower in people with cognitively stimulating jobs than in those with non-stimulating jobs. The findings that cognitive stimulation is associated with lower levels of plasma proteins that potentially inhibit axonogenesis and synaptogenesis and increase the risk of dementia might provide clues to underlying biological mechanisms.

National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:su:diva-198444 (URN)10.1136/bmj.n1804 (DOI)000687459800008 ()34407988 (PubMedID)
Available from: 2021-11-09 Created: 2021-11-09 Last updated: 2023-08-28Bibliographically approved
Ervasti, J., Pentti, J., Nyberg, S. T., Shipley, M. J., Leineweber, C., Sørensen, J. K., . . . Kivimäki, M. (2021). Long working hours and risk of 50 health conditions and mortality outcomes: a multicohort study in four European countries. The Lancet Regional Health: Europe, 11, Article ID 100212.
Open this publication in new window or tab >>Long working hours and risk of 50 health conditions and mortality outcomes: a multicohort study in four European countries
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2021 (English)In: The Lancet Regional Health: Europe, E-ISSN 2666-7762, Vol. 11, article id 100212Article in journal (Refereed) Published
Abstract [en]

Background: Studies on the association between long working hours and health have captured only a narrow range of outcomes (mainly cardiometabolic diseases and depression) and no outcome-wide studies on this topic are available. To achieve wider scope of potential harm, we examined long working hours as a risk factor for a wide range of disease and mortality endpoints.

Methods: The data of this multicohort study were from two population cohorts from Finland (primary analysis, n=59 599) and nine cohorts (replication analysis, n=44 262) from Sweden, Denmark, and the UK, all part of the Individual-participant Meta-analysis in Working Populations (IPD-Work) consortium. Baseline-assessed long working hours (≥55 hours per week) were compared to standard working hours (35-40 h). Outcome measures with follow-up until age 65 years were 46 diseases that required hospital treatment or continuous pharmacotherapy, all-cause, and three cause-specific mortality endpoints, ascertained via linkage to national health and mortality registers.

Findings: 2747 (4·6%) participants in the primary cohorts and 3027 (6·8%) in the replication cohorts worked long hours. After adjustment for age, sex, and socioeconomic status, working long hours was associated with increased risk of cardiovascular death (hazard ratio 1·68; 95% confidence interval 1·08-2·61 in primary analysis and 1·52; 0·90-2·58 in replication analysis), infections (1·37; 1·13-1·67 and 1·45; 1·13-1·87), diabetes (1·18; 1·01-1·38 and 1·41; 0·98-2·02), injuries (1·22; 1·00-1·50 and 1·18; 0·98-1·18) and musculoskeletal disorders (1·15; 1·06-1·26 and 1·13; 1·00-1·27). Working long hours was not associated with all-cause mortality.

Interpretation: Follow-up of 50 health outcomes in four European countries suggests that working long hours is associated with an elevated risk of early cardiovascular death and hospital-treated infections before age 65. Associations, albeit weak, were also observed with diabetes, musculoskeletal disorders and injuries. In these data working long hours was not related to elevated overall mortality.

Keywords
long working hours, health, mortality, multicohort, Europe
National Category
Psychology
Research subject
Psychology
Identifiers
urn:nbn:se:su:diva-199893 (URN)10.1016/j.lanepe.2021.100212 (DOI)000734491900009 ()
Note

Funding: NordForsk, the Medical Research Council, the National Institute on Aging, the Wellcome Trust, Academy of Finland, and Finnish Work Environment Fund.

Available from: 2021-12-16 Created: 2021-12-16 Last updated: 2022-02-25Bibliographically approved
Kikuchi, H., Odagiri, Y., Ohya, Y., Nakanishi, Y., Shimomitsu, T., Theorell, T. & Inoue, S. (2020). Association of overtime work hours with various stress responses in 59,021 Japanese workers: Retrospective cross-sectional study. PLOS ONE, 15(3), Article ID e0229506.
Open this publication in new window or tab >>Association of overtime work hours with various stress responses in 59,021 Japanese workers: Retrospective cross-sectional study
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2020 (English)In: PLOS ONE, E-ISSN 1932-6203, Vol. 15, no 3, article id e0229506Article in journal (Refereed) Published
Abstract [en]

This study aims to clarify the relationships between length of overtime work and various stress responses using large-scale cross-sectional data of Japanese workers. This study's participants are 59,021 Japanese workers in 117 companies. Data was collected by self-reporting questionnaire. The Brief Job Stress Questionnaire was used to measure stress responses on six scales (i.e. lack of vigor, irritability, fatigue, anxiety, depression, and somatic responses). Length of overtime work hours were classified as 0-20, 21-30, 31-40, 41-50, 51-60, 61-70, 71-80, and >80 hours/month. Multiple linear regression analyses were used to examine the association of stress responses with overtime while adjusting all possible confounders. In result, workers with longer overtime showed significantly higher irritability, fatigue, anxiety, depression, and somatic responses for both genders (p-for-trend <0.001), however, length of overtime was negatively associated with lack of vigor among men (p-for-trend <0.001). Men with 61-80 hours of overtime showed high fatigue with high vigor at the same time. Length of overtime was linearly associated with various stress responses, except for lack of vigor. Length of overtime shows linear associations with various psychosomatic stress responses. However, lack of vigor was not consistently associated with overtime. Male workers with 61-80 hours of monthly overtime were more likely to feel vigorous than workers with shorter overtime. However, potential longterm effects of such extreme overtime should not be underestimated and must be paid attention to.

Keywords
overtime, work hours, stress responses, Japan
National Category
Occupational Health and Environmental Health Psychology
Research subject
Psychology
Identifiers
urn:nbn:se:su:diva-182902 (URN)10.1371/journal.pone.0229506 (DOI)000535253100028 ()32126094 (PubMedID)
Available from: 2020-06-30 Created: 2020-06-30 Last updated: 2022-03-23Bibliographically approved
Heikkila, K., Pentti, J., Madsen, I. E. H., Lallukka, T., Virtanen, M., Alfredsson, L., . . . Kivimaki, M. (2020). Job Strain as a Risk Factor for Peripheral Artery Disease: A Multi-Cohort Study. Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, 9(9), Article ID e013538.
Open this publication in new window or tab >>Job Strain as a Risk Factor for Peripheral Artery Disease: A Multi-Cohort Study
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2020 (English)In: Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, ISSN 2047-9980, E-ISSN 2047-9980, Vol. 9, no 9, article id e013538Article in journal (Refereed) Published
Abstract [en]

Background: Job strain is implicated in many atherosclerotic diseases, but its role in peripheral artery disease (PAD) is unclear. We investigated the association of job strain with hospital records of PAD, using individual-level data from 11 prospective cohort studies from Finland, Sweden, Denmark, and the United Kingdom.

Methods and Results: Job strain (high demands and low control at work) was self-reported at baseline (1985-2008). PAD records were ascertained from national hospitalization data. We used Cox regression to examine the associations of job strain with PAD in each study, and combined the study-specific estimates in random effects meta-analyses. We used tau(2), I-2, and subgroup analyses to examine heterogeneity. Of the 139 132 participants with no previous hospitalization with PAD, 32 489 (23.4%) reported job strain at baseline. During 1 718 132 person-years at risk (mean follow-up 12.8 years), 667 individuals had a hospital record of PAD (3.88 per 10 000 person-years). Job strain was associated with a 1.41-fold (95% CI, 1.11-1.80) increased average risk of hospitalization with PAD. The study-specific estimates were moderately heterogeneous (tau(2)=0.0427, I-2: 26.9%). Despite variation in their magnitude, the estimates were consistent in both sexes, across the socioeconomic hierarchy and by baseline smoking status. Additional adjustment for baseline diabetes mellitus did not change the direction or magnitude of the observed associations.

Conclusions: Job strain was associated with small but consistent increase in the risk of hospitalization with PAD, with the relative risks on par with those for coronary heart disease and ischemic stroke.

Keywords
epidemiology, job strain, meta-analysis, peripheral artery disease, risk factors
National Category
Public Health, Global Health, Social Medicine and Epidemiology Cardiac and Cardiovascular Systems Psychology
Research subject
Psychology
Identifiers
urn:nbn:se:su:diva-183098 (URN)10.1161/JAHA.119.013538 (DOI)000538145600010 ()32342765 (PubMedID)
Available from: 2020-07-08 Created: 2020-07-08 Last updated: 2022-03-23Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0003-1956-7931

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