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Östh, J., Danielsson, A. K., Lundin, A., Wennberg, P., Andréasson, S. & Jirwe, M. (2024). Keeping Track of My Drinking: Patient Perceptions of Using Smartphone Applications as a Treatment Complement for Alcohol Dependence. Substance Use & Misuse, 59(2), 291-299
Open this publication in new window or tab >>Keeping Track of My Drinking: Patient Perceptions of Using Smartphone Applications as a Treatment Complement for Alcohol Dependence
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2024 (English)In: Substance Use & Misuse, ISSN 1082-6084, E-ISSN 1532-2491, Vol. 59, no 2, p. 291-299Article in journal (Refereed) Published
Abstract [en]

Background: Alcohol dependence is common, yet highly undertreated. Smartphone applications (apps) have potential to enhance treatment accessibility and effectiveness, however evidence is limited, especially studies focussing on user experiences. The aim was to describe patient perceptions on the usability and acceptability of self-monitoring apps provided as treatment complement for alcohol dependence.

Methods: Individual semi-structured interviews were conducted through video or phone calls with 21 participants, recruited from a randomized controlled trial at a dependency clinic in Stockholm. The participants had used two specific apps for self-monitoring consumption ("Glasklart" and "iBAC") during 12 wk prior to the interviews. Data was analyzed using Qualitative Content Analysis.

Results: Two domains were identified: 1) Smartphone applications as facilitators to treatment, and 2) Barriers to smartphone application use. Using apps within the treatment context was believed to increase the accuracy of the reported consumption. Participants became more aware of their alcohol problem and described the apps as reinforcers that could increase both the motivation to change and the focus on the problem and commitment to treatment. The apps were further described as helpful to control alcohol consumption. However, app usage was constrained by technical problems, unfit app-specific features and procedures, and alcohol-related shame and stigma.

Discussion and Conclusions: Self-monitoring alcohol apps have several beneficial features that can help assess, track, and control alcohol consumption, and improve communication with clinicians. The results indicate they can be useful complements to treatment for patients with alcohol dependence, but their use can be limited by different, foremost technical, issues. Smartphone applications for self-monitoring of alcohol consumption may help provide accurate data, increase consumption awareness, focus, motivation, and perceived control; Smartphone applications for self-monitoring of alcohol consumption are considered helpful complements to alcohol treatment; The use of smartphone applications for self-monitoring of alcohol consumption can be constrained by technical problems, and unfit app-specific features and procedures.

Place, publisher, year, edition, pages
Taylor & Francis, 2024
Keywords
Alcohol drinking, drinking behavior, telemedicine, digital technology, mobile applications, smartphone, qualitative research, technology-based interventions, qualitative content-analysis, consumption, disorders, care
National Category
Health Sciences
Identifiers
urn:nbn:se:rkh:diva-4715 (URN)10.1080/10826084.2023.2269578 (DOI)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2016-07108Forte, Swedish Research Council for Health, Working Life and Welfare, 2016-07113
Note

Forskningsfinansiär: Systembolagets Alkoholforskningsråd

Available from: 2023-11-20 Created: 2023-11-20 Last updated: 2024-01-09Bibliographically approved
Gottvall, M., Kissiti, R., Ainembabazi, R., Bergman, H., Eldebo, A., Isaac, R., . . . Carlsson, T. (2024). Mental health and societal challenges among forced migrants of diverse sexual orientations, gender identities and gender expressions: health professionals’ descriptions and interpretations. Culture, Health and Sexuality
Open this publication in new window or tab >>Mental health and societal challenges among forced migrants of diverse sexual orientations, gender identities and gender expressions: health professionals’ descriptions and interpretations
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2024 (English)In: Culture, Health and Sexuality, ISSN 1369-1058, E-ISSN 1464-5351Article in journal (Refereed) Epub ahead of print
Abstract [sv]

The aim of this study was to explore health professionals’ descriptions and interpretations of post-migration mental health and societal challenges among forced migrants with diverse sexual orientations, gender identities and gender expressions. Participants representing seven professions were recruited by a combination of convenience, purposive and snowball sampling. Data were collected through focus groups and individual interviews, analysed with systematic text condensation in a collaborative process involving researchers, clinicians and migrants with lived experiences. Participants described a challenging trajectory for migrants, as migrants venture through an uncertain and demanding journey impacting their mental health. Needing to deal with legal requirements, stressful circumstances and normative expectations during the asylum process were highlighted as major challenges, along with exposure to discrimination, violence, abuse and lack of psychosocial safety. Participants described significant psychological distress among migrants, including loneliness and shame. Challenges were also recognised related to exploring, accepting and expressing sexuality and gender. Loneliness and shame are major challenges in need of further attention in research, which could be addressed through the development and evaluation of actions, programmes and interventions to provide peer support.

Place, publisher, year, edition, pages
Taylor & Francis, 2024
Keywords
Asylum seekers, forced migration, mental health, sexual and gender minorities, social marginalisation
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:rkh:diva-4770 (URN)10.1080/13691058.2023.2298479 (DOI)38250794 (PubMedID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, GD-2021/0028
Available from: 2024-02-05 Created: 2024-02-05 Last updated: 2024-02-05Bibliographically approved
Heldring, S., Jirwe, M., Wihlborg, J., Berg, L. & Lindström, V. (2024). Using High-Fidelity Virtual Reality for Mass-Casualty Incident Training by First Responders: A Systematic Review of the Literature. Prehospital and Disaster Medicine, 39(1), 94-105
Open this publication in new window or tab >>Using High-Fidelity Virtual Reality for Mass-Casualty Incident Training by First Responders: A Systematic Review of the Literature
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2024 (English)In: Prehospital and Disaster Medicine, ISSN 1049-023X, E-ISSN 1945-1938, Vol. 39, no 1, p. 94-105Article, review/survey (Refereed) Published
Abstract [en]

Introduction: First responders’ training and learning regarding how to handle a mass-casualty incident (MCI) is traditionally based on reading and/or training through computer-based scenarios, or sometimes through live simulations with actors. First responders should practice in realistic environments to narrow the theory-practice gap, and the possibility of repeating the training is important for learning. High-fidelity virtual reality (VR) is a promising tool to use for realistic and repeatable simulation training, but it needs to be further evaluated. The aim of this literature review was to provide a comprehensive description of the use of high-fidelity VR for MCI training by first responders.

Methods: A systematic integrative literature review was used according to Whittemore and Knafl’s descriptions. Databases investigated were PubMed, CINAHL Complete, Academic Search Ultimate, Web of Science, and ERIC to find papers addressing the targeted outcome. The electronic search strategy identified 797 potential studies. Seventeen studies were deemed eligible for final inclusion.

Results: Training with VR enables repetition in a way not possible with live simulation, and the realism is similar, yet not as stressful. Virtual reality offers a cost-effective and safe learning environment. The usability of VR depends on the level of immersion, the technology being error-free, and the ease of use.

Conclusions: This integrative review shows that high-fidelity VR training should not rule out live simulation, but rather serve as a complement. First responders became more confident and prepared for real-life MCIs after training with high-fidelity VR, but efforts should be made to solve the technical issues found in this review to further improve the usability.

Place, publisher, year, edition, pages
Cambridge University Press, 2024
Keywords
disaster medicine, Emergency Medical Services, high-fidelity simulation, mass-casualty incident, review, simulation training, situated cognition theory, virtual reality
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:rkh:diva-4782 (URN)10.1017/s1049023x24000049 (DOI)38328887 (PubMedID)
Available from: 2024-02-23 Created: 2024-02-23 Last updated: 2024-02-23Bibliographically approved
Pettersson, S., Klompstra, L., Jirwe, M. & Jaarsma, T. (2023). Developing a Culturally Appropriate Tool to Support Self-Care in Migrants with Type 2 Diabetes: A Co-Design Study. Patient Preference and Adherence, 17, 2557-2567
Open this publication in new window or tab >>Developing a Culturally Appropriate Tool to Support Self-Care in Migrants with Type 2 Diabetes: A Co-Design Study
2023 (English)In: Patient Preference and Adherence, E-ISSN 1177-889X, Vol. 17, p. 2557-2567Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: Migrants, especially from the Middle East, experience poorer health outcomes and face greater difficulties in accessing healthcare compared to native populations and there is a need for culturally appropriate education for this vulnerable group. The purpose of this study is to describe the process of developing a culturally appropriate tool to support self-care in migrants with type 2 diabetes.

METHODS: In this Co-design study, a tool for supporting self-care in migrants with type 2 diabetes was developed. Migrant patients with type 2 diabetes, healthcare providers and researchers participated in the process, which was based on six elements; engage, plan, explore, develop, decide and change. From February 2021 to December 2022, idea groups were conducted, and a tool was developed through brainstorming, prioritizing and prototyping.

RESULTS: In total, 14 migrant patients, ten health care providers and four researchers participated in the Co-design process. The patients wished to receive information about type 2 diabetes self-care behaviour in their own languages. The healthcare providers asked for clear instructions on where to guide their patients regarding reliable information about diabetes in the patient's own language. All participants agreed that information can be presented in different formats, either: text (paper or online), audio-visual via recorded videos and/or lectures and pictures.

DISCUSSION: The Co-design process led to several important insights and experiences related to the importance of diverse cultural backgrounds. When conducting a Co-design study with end-users as stakeholders, it is significant that the stakeholders have a diverse background in experiences, both as patients as well as those who deliver or implement the health service. In this study it was of great importance to include patients with diverse backgrounds regarding; gender, age, health literacy, occupation, years living in Sweden and duration of diabetes.

Place, publisher, year, edition, pages
Dove Medical Press, 2023
Keywords
culture, patient education, primary healthcare, self-care, type 2 diabetes
National Category
Nursing
Identifiers
urn:nbn:se:rkh:diva-4684 (URN)10.2147/PPA.S426908 (DOI)37854029 (PubMedID)
Available from: 2023-10-24 Created: 2023-10-24 Last updated: 2024-01-17Bibliographically approved
Kokkonen Nassef, S., Blennow Bohlin, M. & Jirwe, M. (2023). Experiences of parents whose school-aged children were treated with therapeutic hypothermia as newborns: A focus group study. Nursing Open, 10(11), 7411-7421
Open this publication in new window or tab >>Experiences of parents whose school-aged children were treated with therapeutic hypothermia as newborns: A focus group study
2023 (English)In: Nursing Open, E-ISSN 2054-1058, Vol. 10, no 11, p. 7411-7421Article in journal (Refereed) Published
Abstract [en]

Aim: To describe parents' past and present experiences of their newborn infant's therapeutic hypothermia (TH) treatment after perinatal asphyxia 10-13 years after the event.

Background: Newborn infants are treated with TH following perinatal asphyxia to improve neurodevelopmental outcomes.

Design: A qualitative descriptive design using focus groups (FGs).

Methods: Twenty one parents to 15 newborn infants treated with TH between 2007 and 2009 participated in five FGs. The FGs were transcribed verbatim and analysed using framework approach. The SRQR checklist was followed for study reporting.

Results: Two main categories were identified: hardships and reliefs during TH treatment and struggles of everyday life. Both categories include three subcategories, the first: (1) concern and gratitude for the unrecognized treatment, (2) insufficiency of information and proposed participation and (3) NICU nurses instilled security and hope. The second with subcategories: (1) unprocessed experiences of the TH treatment, (2) later challenges at school and (3) existential and psychological challenges in everyday life.

Conclusion: TH of their newborns affected the parents psychologically not only during the treatment, but lasted months and years later. Information and communication with health care professionals and school management were inefficient and inadequate. The parents' concerns could be prevented by an improved identification and understanding of the problems and the needs of the infants and their families before discharge.

Relevance for Clinical Practice: Through more personalized and efficient preparation and communication by the nursing staff before discharge, many of the parents' worries and problems could be reduced. Check-up of parents' needs of psychosocial support before and after discharge and offering counselling should become routine. Also, nurses at Well-Baby Clinics and in school health care should receive knowledge about TH treatment and the challenges the children and the parents experience.

Patient or Public Contribution: Participation of parents was limited to the data provided through interviews.

Place, publisher, year, edition, pages
John Wiley & Sons, 2023
National Category
Nursing
Identifiers
urn:nbn:se:rkh:diva-4678 (URN)10.1002/nop2.1994 (DOI)001070679900001 ()37752681 (PubMedID)
Available from: 2023-10-17 Created: 2023-10-17 Last updated: 2023-10-17Bibliographically approved
Gunillasdotter, V., Andreasson, S., Jirwe, M., Ekblom, Ö. & Hallgren, M. (2023). Getting fit for change: exercise as treatment for alcohol use disorder. Addiction science & clinical practice, 18(SUPPL 1), Article ID P21.
Open this publication in new window or tab >>Getting fit for change: exercise as treatment for alcohol use disorder
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2023 (English)In: Addiction science & clinical practice, ISSN 1940-0632, E-ISSN 1940-0640, Vol. 18, no SUPPL 1, article id P21Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
BioMed Central (BMC), 2023
National Category
Substance Abuse
Identifiers
urn:nbn:se:rkh:diva-4665 (URN)
Available from: 2023-07-13 Created: 2023-07-13 Last updated: 2023-08-17Bibliographically approved
Gottvall, M., Brunell, C., Eldebo, A., Kissiti, R., Mattsson, E., Jirwe, M. & Carlsson, T. (2023). Nurse education about forced migrants with diverse sexual orientations, gender identities, and gender expressions: An exploratory focus group study. Nurse Education Today, 128, 105880, Article ID 105880.
Open this publication in new window or tab >>Nurse education about forced migrants with diverse sexual orientations, gender identities, and gender expressions: An exploratory focus group study
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2023 (English)In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 128, p. 105880-, article id 105880Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: In many countries, forced migrants can seek asylum based on persecution and danger related to self-identifying as having diverse sexual orientations, gender identities, and gender expressions; herein defined as lesbian, gay, bisexual, transgender, queer, or other non-heterosexual orientations, non-cisgender identities, gender expressions and/or reproductive development considered beyond cultural, societal or physiological norms. Nurse education has a significant role in promoting cultural competence among future health professionals.

OBJECTIVES: To explore the experiences and views regarding education about forced migrants with diverse sexual orientations, gender identities, and gender expressions, among students and lecturers in nurse education.

DESIGN: Explorative qualitative study with focus group discussions.

SETTINGS: Swedish nursing programs.

PARTICIPANTS: Final-year nursing students and lecturers (n = 25 participants) at nursing programs were recruited with convenience and snowball sampling.

METHODS: Semi-structured digital focus group discussions (n = 9) were audio recorded and transcribed verbatim. Data were analyzed with inductive qualitative content analysis.

RESULTS: Promoting a broader understanding regarding societal structures and preparing students to provide culturally sensitive care were considered as essential components in nurse education. Challenges and problems involved a need for increased awareness, the associated topics and target populations seldom being addressed, and a need for improvements within clinical placements. Participants suggested the utilization of external resources, presented a range of different specific learning activities that would promote in-depth understanding, and articulated a need for overarching decisions and guidelines regarding mandatory inclusion in nurse education.

CONCLUSIONS: Students and lecturers describe several challenges and problems that need to be addressed in regard to forced migration, sexual health, and inclusion health. There seems to be a need for utilization of external competence in learning activities as well as establishing clearer guidelines, which may increase the quality of education and better prepare future nurses to support patients with diverse backgrounds and identities.

Place, publisher, year, edition, pages
Elsevier, 2023
Keywords
Focus group discussion, Forced migrants, Nurse education, Nursing, Refugees, Sexual and gender minorities
National Category
Nursing
Identifiers
urn:nbn:se:rkh:diva-4669 (URN)10.1016/j.nedt.2023.105880 (DOI)001033515400001 ()37356186 (PubMedID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, GD-2021/0028
Available from: 2023-08-23 Created: 2023-08-23 Last updated: 2023-08-23Bibliographically approved
Englid, M. B., Jirwe, M. & Conte, H. (2023). Perioperative Comfort and Discomfort: Transitioning From Epidural to Oral Pain Treatment After Pancreas Surgery. Journal of Perianesthesia Nursing, 38(3), 414-420.e1, Article ID S1089-9472(22)00259-3.
Open this publication in new window or tab >>Perioperative Comfort and Discomfort: Transitioning From Epidural to Oral Pain Treatment After Pancreas Surgery
2023 (English)In: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 38, no 3, p. 414-420.e1, article id S1089-9472(22)00259-3Article in journal (Refereed) Published
Abstract [en]

PURPOSE: To explore patients' experiences of pain treatment in the perioperative period after surgery for pancreatic cancer.

DESIGN: A qualitative descriptive design using semi-structured interviews.

METHODS: This study was a qualitative study based on 12 interviews. Participants were patients that had undergone surgery for pancreatic cancer. The interviews were conducted 1 to 2 days after the epidural was turned off, in a surgical department in Sweden. The interviews were analysed with qualitative content analysis. The Standard for Reporting Qualitative Research checklist was used for reporting the qualitative research study.

FINDINGS: The analysis of the transcribed interviews, generated one theme: Maintaining a sense of control in the perioperative phase, and two subthemes: (i) Sense of vulnerability and safety, and (ii) Sense of comfort and discomfort, were found.

CONCLUSIONS: The participants experienced comfort after pancreas surgery if they maintained a sense of control in the perioperative phase and when the epidural pain treatment provided pain relief without any side effects. The transition from epidural pain treatment to oral pain treatment with opioid tablets was experienced individually, from an almost unnoticed transition to the experience of severe pain, nausea, and fatigue. The sense of vulnerability and safety among the participants were affected by nursing care relationship and the environment on the ward.

Place, publisher, year, edition, pages
Elsevier, 2023
Keywords
epidural analgesia, pancreas cancer, patient comfort, perioperative nursing, postoperative pain, sense of control
National Category
Nursing
Identifiers
urn:nbn:se:rkh:diva-4609 (URN)10.1016/j.jopan.2022.06.007 (DOI)36803736 (PubMedID)
Available from: 2023-05-29 Created: 2023-05-29 Last updated: 2023-05-29Bibliographically approved
Gottvall, M., Brunell, C., Eldebo, A., Johansson Metso, F., Jirwe, M. & Carlsson, T. (2023). Post‐migration psychosocial experiences and challenges amongst LGBTQ + forced migrants: A meta‐synthesis of qualitative reports. Journal of Advanced Nursing, 79(1), 358-371
Open this publication in new window or tab >>Post‐migration psychosocial experiences and challenges amongst LGBTQ + forced migrants: A meta‐synthesis of qualitative reports
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2023 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 79, no 1, p. 358-371Article in journal (Refereed) Published
Abstract [en]

Aims: Synthesize qualitative research to illuminate the post-migration psychosocial experiences amongst LGBTQ+ forced migrants.

Design: Meta-synthesis of qualitative reports.

Data sources: Systematic searches in seven databases and manual screenings were performed in July 2021 (21,049 entries screened in total). The final sample included 29 English-language reports containing empirical qualitative findings about post-migration experiences and published 10 years prior to the searches, based on migrants as the primary source.

Review Methods: Methodological quality was appraised using the CASP and JBI checklists. Through a collaborative process involving nurse-midwife researchers and experienced clinical professionals, reports were analysed with a two-stage qualitative meta-synthesis including an inductive qualitative content analysis.

Results: The methodological quality was high and the reports included 636 participants in total. Two themes were identified through the meta-synthesis. The first theme illustrates the psychological distress and numerous challenges and stressors forced migrants face after arrival, including challenges encountered as an LGBTQ+ forced migrant, psychological reactions and manifestations, and practical issues related to resettlement and living conditions. The second theme highlights the resilience and strength they find through various internal processes and external resources, including resilience and strengthening resources, identity formation and establishing and maintaining social relationships.

Conclusion: After arrival in the host country, forced migrants identifying as LGBTQ+ face numerous societal and personal challenges whilst being at risk of experiencing significant psychological distress. These migrants utilize a wide range of resources that may strengthen their resilience. Peer support stands out as a highly appreciated and promising resource that needs further attention in experimental research.

Impact: Forced migrants identifying as LGBTQ+ need access to adequate and sufficient support. The findings emphasize several strength-building resources that may inform nurses, midwives, researchers and other professionals when providing psychosocial support for these persons.

Patient or Public Contribution: No patient or public contribution.

Place, publisher, year, edition, pages
John Wiley & Sons, 2023
Keywords
forced migrants, lesbian, gay, bisexual, transgender, and queer (LGBTQ+), meta-synthesis, psychosocial health, psychosocial support systems, public health nursing, refugees, review, sexual and gender minorities, sexual health
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:rkh:diva-4422 (URN)10.1111/jan.15480 (DOI)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, GD‐2021/0028
Available from: 2022-11-21 Created: 2022-11-21 Last updated: 2023-01-03Bibliographically approved
Pettersson, S., Holstein, J., Jirwe, M., Jaarsma, T. & Klompstra, L. (2022). Cultural competence in healthcare professionals, specialised in diabetes, working in primary healthcare — A descriptive study. Health & Social Care in the Community, 30(3), e717-e726
Open this publication in new window or tab >>Cultural competence in healthcare professionals, specialised in diabetes, working in primary healthcare — A descriptive study
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2022 (English)In: Health & Social Care in the Community, ISSN 0966-0410, E-ISSN 1365-2524, Vol. 30, no 3, p. e717-e726Article in journal (Refereed) Published
Abstract [en]

Self-care is the most important cornerstone of diabetes treatment. As self-care is affected by cultural beliefs, it is important for healthcare professionals to be able to adapt their educational approach and to be culturally competent. The aim of this study was to describe the cultural competence in Swedish healthcare professionals, specialised in diabetes care and to examine related factors for cultural competence. The healthcare professionals' perceived level of cultural competence was measured across three domains-Openness and awareness, Workplace support and Interaction skills-in 279 Swedish healthcare professionals from all 21 regions of Sweden, using the Cultural Competence Assessment Instrument (Swedish version-CCAI-S). Descriptive statistics were used to describe cultural competence in healthcare professionals, and linear regression was conducted to examine factors related to cultural competence. Of the healthcare professionals studied, 58% perceived that they had a high level of Openness and awareness, 35% perceived that they had a high level of Interaction skills and 6% perceived that they had a high level of Workplace support. Two factors were found to be related to cultural competence, namely, high percentage of migrant clients at the healthcare clinic and whether the healthcare professionals previously had developed cultural competence through practical experience, education and/or by themselves. In conclusion, most healthcare professionals perceived that they had cultural openness and awareness but need more support from their workplace to improve their interaction skills. Cultural competence-related education could support the healthcare professionals to develop interaction skills.

Place, publisher, year, edition, pages
John Wiley & Sons, 2022
Keywords
cultural background, cultural competence, diabetes mellitus, healthcare professionals, primary healthcare, self-care
National Category
Nursing
Identifiers
urn:nbn:se:rkh:diva-4069 (URN)10.1111/hsc.13442 (DOI)34145649 (PubMedID)
Available from: 2021-06-22 Created: 2021-06-22 Last updated: 2022-07-15Bibliographically approved
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Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0003-4570-4047

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