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Hagberg, Lars
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Publications (10 of 25) Show all publications
Jansson, M., Cao, Y., Nilsson, K., Larsson, P.-G. & Hagberg, L. (2018). Cost-effectiveness of antibiotic prophylaxis in elective cesarean section. Cost Effectiveness and Resource Allocation, 16, Article ID 66.
Open this publication in new window or tab >>Cost-effectiveness of antibiotic prophylaxis in elective cesarean section
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2018 (English)In: Cost Effectiveness and Resource Allocation, ISSN 1478-7547, E-ISSN 1478-7547, Vol. 16, article id 66Article in journal (Refereed) Published
Abstract [en]

Background: The proportion of pregnant women delivered by cesarean section has increased steadily during the past three decades. The risk of infection is 10-fold augmented after elective cesarean section compared to vaginal delivery. Antibiotic prophylaxis may reduce endometritis by 62% and superficial wound infection by 38% after elective cesarean section. International guidelines recommend antibiotic prophylaxis in elective cesarean section, but this procedure is not routinely followed in Sweden. Studies of costs of antibiotic prophylaxis in cesarean section show conflicting results and are based on substantially different incidence of postoperative infections. No study of costs of antibiotic prophylaxis in elective cesarean section in a Swedish or Nordic context has been pursued. The aim of this study was to investigate if antibiotic prophylaxis is cost-reducing in elective cesarean section in orebro County, Sweden.

Methods: All women undergoing elective cesarean in the Region orebro County health care system during 2011-2012 were eligible for inclusion. Postoperative infections and risk factors for infections were registered. A hypothetical situation in which all participants had received antibiotic prophylaxis was compared to the actual situation, in which none of them had received antibiotic prophylaxis. The reduction in the risk of postoperative infections resulting from antibiotic prophylaxis was based on a meta-analysis. Costs for in-patient care of postoperative infections were extracted from the accounting system, and costs for out-patient care were calculated according to standard costs. Costs for antibiotic prophylaxis were calculated and compared with the cost reduction that would be implied by the introduction of such prophylaxis.

Results: The incidences of deep and superficial surgical site infection were 3.5% and 1.3% respectively. Introduction of antibiotic prophylaxis would reduce health care costs by 31 Euro per cesarean section performed (95% credible interval 4-58 Euro). The probability of cost-saving was 99%.

Conclusions: Antibiotic prophylaxis in elective cesarean section is cost-reducing in this health care setting. Our results indicate that the introduction of antibiotic prophylaxis in elective cesarean section can also be cost-saving in low infection rate settings.

Trial registration Ethical approval was given by the Regional Ethical Review Board in Uppsala (registration number 2013/484).

Place, publisher, year, edition, pages
BMC, 2018
Keywords
Cesarean section, Surgical wound infection, Antibiotic prophylaxis, Costs and cost analysis
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:oru:diva-71239 (URN)10.1186/s12962-018-0168-x (DOI)000453740600001 ()30574024 (PubMedID)2-s2.0-85058818087 (Scopus ID)
Available from: 2019-01-09 Created: 2019-01-09 Last updated: 2019-01-09Bibliographically approved
Dahlberg, K., Philipsson, A., Hagberg, L., Jaensson, M., Hälleberg Nyman, M. & Nilsson, U. (2017). Cost-effectiveness of a systematic e-assessed follow-up of postoperative recovery after day surgery: a multicentre randomized trial. British Journal of Anaesthesia, 119(5), 1039-1046
Open this publication in new window or tab >>Cost-effectiveness of a systematic e-assessed follow-up of postoperative recovery after day surgery: a multicentre randomized trial
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2017 (English)In: British Journal of Anaesthesia, ISSN 0007-0912, E-ISSN 1471-6771, Vol. 119, no 5, p. 1039-1046Article in journal (Refereed) Published
Abstract [en]

Background: Most surgeries are done on a day-stay basis. Recovery assessment by phone points (RAPP) is a smartphonebased application (app) to evaluate patients after day surgery. The aim of this study was to estimate the cost-effectiveness of using RAPP for follow-up on postoperative recovery compared with standard care.

Methods: This study was a prospective parallel single-blind multicentre randomized controlled trial. Participants were randomly allocated to the intervention group using RAPP or the control group receiving standard care. A cost-effectiveness analysis was performed based on individual data and included costs for the intervention, health effect [quality-adjusted life-years (QALYs)], and costs or savings in health-care use.

Results: The mean cost for health-care consumption during 2 weeks after surgery was estimated at e37.29 for the intervention group and e60.96 for the control group. The mean difference was e23.66 (99% confidence interval 46.57 to0.76; P¼0.008). When including the costs of the intervention, the cost-effectiveness analysis showed net savings of e4.77 per patient in favour of the intervention. No difference in QALYs gained was seen between the groups (P¼0.75). The probability of the intervention being cost-effective was 71%.

Conclusions: This study shows that RAPP can be cost-effective but had no effect on QALY. RAPP can be a cost-effective toolin providing low-cost health-care contacts and in systematically assessing the quality of postoperative recovery.

Clinical trial registration:NCT02492191

Place, publisher, year, edition, pages
Oxford University Press, 2017
Keywords
Ambulatory surgery, cost effectiveness, mobile applications, postoperative period
National Category
Anesthesiology and Intensive Care
Identifiers
urn:nbn:se:oru:diva-61954 (URN)10.1093/bja/aex332 (DOI)000413642900027 ()29077819 (PubMedID)2-s2.0-85034731856 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2013-4765Swedish Research Council, 2015-02273
Available from: 2017-10-25 Created: 2017-10-25 Last updated: 2018-08-07Bibliographically approved
Hagberg, L., Hermansson, L. M., Fredriksson, C. & Pettersson, I. (2017). Cost-effectiveness of powered mobility devices for elderly people with disability. Disability and Rehabilitation: Assistive Technology, 12(2), 115-120
Open this publication in new window or tab >>Cost-effectiveness of powered mobility devices for elderly people with disability
2017 (English)In: Disability and Rehabilitation: Assistive Technology, ISSN 1748-3107, E-ISSN 1748-3115, Vol. 12, no 2, p. 115-120Article in journal (Refereed) Published
Abstract [en]

Purpose: The aim of this study was to analyse the cost-effectiveness of prescribing powered mobility devices (PMDs) to elderly users.

Methods: Forty-five persons participated in the preand post-intervention study with a follow-up at four months. All participants were prescribed a scooter model and were offered individual support to get started using the PMD. In the analysis, the use of the PMD was compared to the situation prior to its use. The cost-utility analysis takes a societal perspective and considers costs, savings and quality of life (QoL) using answers to the EQ-5D questionnaire.

Results: Costs for the first year with the PMD were 1395 USD and then 592 USD per subsequent year. There was a significant decrease in transportation costs and in relatives' time use, but the increase in QoL of 0.041 was not significant. Costs per gained quality adjusted life year (QALY) were 12 400-14 700 USD/QALY if the value of time saved not was considered and 600-2900 USD/QALY when an hour was valued at 3.6 USD.

Conclusion: Prescription of PMDs to elderly users might be cost-effective. However, there are shortcomings in measuring QALY gains from the use of a PMD, and it is unclear how time savings among relatives should be valued.

Implications for Rehabilitation

  • Prescription of powered mobility devices for the elderly with disability seems to be cost effective and should be a standard intervention.

  • In economic evaluations of powered mobility devices and other assistive devices, the commonly used analyses methods are not always appropriate and therefore need to be adjusted.

Place, publisher, year, edition, pages
Taylor & Francis, 2017
Keywords
Assistive devices; cost-utility analysis; QALY
National Category
Occupational Therapy
Research subject
Nursing Science w. Occupational Therapy Focus
Identifiers
urn:nbn:se:oru:diva-40113 (URN)10.3109/17483107.2014.1002540 (DOI)000396533100002 ()25634493 (PubMedID)2-s2.0-84938500069 (Scopus ID)
Note

Funding Agencies:

Swedish Institute of Assistive Technology

Promobilia Foundation, Sweden

Available from: 2015-01-02 Created: 2015-01-02 Last updated: 2017-12-05Bibliographically approved
Wilhelmsson, A., Roos, M., Hagberg, L., Wengström, Y. & Blomberg, K. (2017). Motivation to uphold physical activity in women with breast cancer during adjuvant chemotherapy treatment. European Journal of Oncology Nursing, 29, 17-22, Article ID S1462-3889(17)30039-X.
Open this publication in new window or tab >>Motivation to uphold physical activity in women with breast cancer during adjuvant chemotherapy treatment
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2017 (English)In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 29, p. 17-22, article id S1462-3889(17)30039-XArticle in journal (Refereed) Published
Abstract [en]

PURPOSE: Physical activity (PA) is important for recovery after a breast cancer diagnosis; however, women's motivation to engage in PA can be impacted by disease and/or treatment, and can therefore be a challenge. This study explored factors associated with PA levels during chemotherapy among women with breast cancer.

METHOD: The study had a cross-sectional descriptive and comparative design using a study-specific questionnaire. One hundred women with breast cancer receiving adjuvant chemotherapy were included. Data were analysed by Pearson's correlation coefficient and linear regression. The open question was subjected to manifest content analysis.

RESULTS: Identified factors associated with engaging in PA during chemotherapy treatment were: being physically active before diagnosis, and the information given by the oncology nurse before the treatment start. The physically active women experienced higher psychological wellbeing, less fatigue, and faster recovery after treatment. They also experienced an overall feeling of fitness.

CONCLUSION: It seems that PA is associated with less fatigue, better recovery between chemotherapy treatments, and a better mental condition leading to wellbeing. Information given by the oncology nurse may be an important factor for being physically active. Women with breast cancer need to get specific advice about and support in engaging in PA to feel better during chemotherapy treatment. Further research is required to develop guidelines for advice about and support regarding PA during chemotherapy treatment.

Place, publisher, year, edition, pages
Elsevier, 2017
Keywords
Breast cancer, Chemotherapy, Physical activity, Symptoms
National Category
Nursing Cancer and Oncology
Research subject
Caring sciences
Identifiers
urn:nbn:se:oru:diva-59082 (URN)10.1016/j.ejon.2017.03.008 (DOI)000407405700004 ()28720261 (PubMedID)2-s2.0-85018950656 (Scopus ID)
Available from: 2017-08-12 Created: 2017-08-12 Last updated: 2018-09-13Bibliographically approved
Lundqvist, S., Börjesson, M., Larsson, M. E. H., Hagberg, L. & Cider, Å. (2017). Physical Activity on Prescription (PAP), in patients with metabolic risk factors: A 6-month follow-up study in primary health care. PLoS ONE, 12(4), Article ID e0175190.
Open this publication in new window or tab >>Physical Activity on Prescription (PAP), in patients with metabolic risk factors: A 6-month follow-up study in primary health care
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2017 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 12, no 4, article id e0175190Article in journal (Refereed) Published
Abstract [en]

There is strong evidence that inadequate physical activity (PA) leads to an increased risk of lifestyle-related diseases and premature mortality. Physical activity on prescription (PAP) is a method to increase the level of PA of patients in primary care, but needs further evaluation. The aim of this observational study was to explore the association between PAP-treatment and the PA level of patients with metabolic risk factors and the relationship between changes in the PA level and health outcomes at the 6 month follow-up. This study included 444 patients in primary care, aged 27-85 years (56% females), who were physically inactive with at least one component of metabolic syndrome. The PAP-treatment model included: individualized dialogue concerning PA, prescribed PA, and a structured follow-up. A total of 368 patients (83%) completed the 6 months of follow-up. Of these patients, 73% increased their PA level and 42% moved from an inadequate PA level to sufficient, according to public health recommendations. There were significant improvements (p <= 0.05) in the following metabolic risk factors: body mass index, waist circumference, systolic blood pressure, fasting plasma glucose, cholesterol, and low density lipoprotein. There were also significant improvements regarding health-related quality of life, assessed by the Short Form 36, in: general health, vitality, social function, mental health, role limitation-physical/emotional, mental component summary, and physical component summary. Regression analysis showed a significant association between changes in the PA level and health outcomes. During the first 6-month period, the caregiver provided PAP support 1-2 times. This study indicates that an individual-based model of PAP-treatment has the potential to change people's PA behavior with improved metabolic risk factors and self-reported quality of life at the 6 month follow-up. Thus, PAP seems to be feasible in a clinical primary care practice, with minimum effort from healthcare professionals.

Place, publisher, year, edition, pages
Public Library of Science, 2017
National Category
Gerontology, specialising in Medical and Health Sciences
Identifiers
urn:nbn:se:oru:diva-57776 (URN)10.1371/journal.pone.0175190 (DOI)000399955200040 ()28403151 (PubMedID)2-s2.0-85017651246 (Scopus ID)
Note

Funding Agency:

Närhälsan Research & Development Primary Health Care, Region Västra Götaland

Available from: 2017-05-23 Created: 2017-05-23 Last updated: 2018-09-04Bibliographically approved
Blomberg, K., Carlsson, A. A., Hagberg, L., Jonsson, Ö., Leissner, L. & Eriksson, M. (2017). Quality of life and trust among young people with narcolepsy and their families, after the Pandemrix® vaccination: Protocol for a case-control study. BMC Pediatrics, 17(1), Article ID 183.
Open this publication in new window or tab >>Quality of life and trust among young people with narcolepsy and their families, after the Pandemrix® vaccination: Protocol for a case-control study
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2017 (English)In: BMC Pediatrics, ISSN 1471-2431, E-ISSN 1471-2431, Vol. 17, no 1, article id 183Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The extensive vaccination programme against swine flu resulted in an increased incidence of narcolepsy among children and adolescents. There is a need to explore if these young persons' experiences have affected their trust in healthcare, their willingness to participate in future prevention programmes, and their contacts with the healthcare system. The overall aim is to identify factors important for the life-situation of children and adolescents with narcolepsy and their families, and factors that correlate with trust in healthcare.

METHODS/DESIGN: Data will be collected via questionnaires from all available children with narcolepsy following the vaccination and their families, as well as a control group of children with diabetes and their families. Longitudinal descriptive interviews will also be conducted with a selection of 20-25 children and their families. Techniques from media research will be used for Internet-based data collection and analysis of information relating to narcolepsy from social media.

DISCUSSION: This project will use the situation of young persons with narcolepsy after the swine flu vaccination as a case to build a model that can be used in situations where trust in healthcare is essential. This model will be based on findings from the included studies on how trust is influenced by support, quality of life, burden of disease, impact on family, and use of social media. The model developed in this project will be beneficial in future situations where trust in healthcare is essential, such as new pandemic outbreaks but also for "everyday" adherence to health advice.

Place, publisher, year, edition, pages
BioMed Central, 2017
Keywords
Life change events, Mass vaccination, Narcolepsy, Quality of life, Trust
National Category
Pediatrics
Identifiers
urn:nbn:se:oru:diva-59389 (URN)10.1186/s12887-017-0935-4 (DOI)000408327800002 ()28835221 (PubMedID)2-s2.0-85028313608 (Scopus ID)
Note

Funding Agencies:

Örebro University Hospital Research Foundation

Available from: 2017-08-25 Created: 2017-08-25 Last updated: 2018-08-05Bibliographically approved
Månsdotter, A., Ekman, B., Feldman, I., Hagberg, L., Hurtig, A.-K. & Lindholm, L. (2017). We Propose a Novel Measure for Social Welfare and Public Health: Capability-Adjusted Life-Years, CALYs. Applied Health Economics and Health Policy, 15(4), 437-440
Open this publication in new window or tab >>We Propose a Novel Measure for Social Welfare and Public Health: Capability-Adjusted Life-Years, CALYs
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2017 (English)In: Applied Health Economics and Health Policy, ISSN 1175-5652, E-ISSN 1179-1896, Vol. 15, no 4, p. 437-440Article in journal (Refereed) Published
Place, publisher, year, edition, pages
Springer, 2017
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:oru:diva-57341 (URN)10.1007/s40258-017-0323-0 (DOI)000411078700001 ()28374165 (PubMedID)2-s2.0-85017027546 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2014-1452
Available from: 2017-05-30 Created: 2017-05-30 Last updated: 2018-07-31Bibliographically approved
Molin, M., von Hausswolff-Juhlin, Y. L., Norring, C. E. A., Hagberg, L. A. & Gustafsson, S. A. (2016). Case management at an outpatient unit for severe and enduring eating disorder patients at Stockholm Centre for Eating Disorders: a study protocol. International Journal of Eating Disorders, 4, Article ID 24.
Open this publication in new window or tab >>Case management at an outpatient unit for severe and enduring eating disorder patients at Stockholm Centre for Eating Disorders: a study protocol
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2016 (English)In: International Journal of Eating Disorders, ISSN 0276-3478, E-ISSN 1098-108X, Vol. 4, article id 24Article in journal (Refereed) Published
Abstract [en]

Background: Patients with severe and enduring eating disorders (SEED) are seriously ill and have a low quality of life. Case management (CM), originally developed for adult patients with severe mental disabilities, has been shown to enhance social functioning and improve quality of life, while reducing the number and length of hospitalizations. In 2014, a special unit based on CM, for patients with SEED (the Eira unit) was started at Stockholm Centre for Eating Disorders, Sweden.

Method/Design: This study aims to investigate if CM can improve SEED patients' quality of life, and reduce their eating disorder symptoms as well as their health care consumption. Methods for data collection are a semi-structured diagnostic interview, self-report questionnaires, and a qualitative interview. The diagnostic interview and the self-report assessments will be done at start of treatment and at follow-ups after 1, 2, and 3years. The qualitative interview will be conducted 1 year after start of treatment. The study is approved by the ethical review board in Stockholm in compliance with the Helsinki Declaration.

Discussion: CM is a possible new contribution to the treatment methods for SEED. It does not aim at remission, but rather to accept life as it is, and to enhance quality of life in the presence of the ED. This study will investigate the potential benefits of this novel intervention in a special unit for SEED patients.

Trail Registration: Clinicaltrials.gov Id: NCT02897622.

Place, publisher, year, edition, pages
London, United Kingdom: BioMed Central, 2016
Keywords
Eating disorders, Case management, SEED, AN, Quality of life
National Category
Psychiatry Nutrition and Dietetics
Identifiers
urn:nbn:se:oru:diva-53354 (URN)10.1186/s40337-016-0121-3 (DOI)000395713700001 ()27800159 (PubMedID)2-s2.0-84992445217 (Scopus ID)
Available from: 2016-11-02 Created: 2016-11-02 Last updated: 2018-09-13Bibliographically approved
Nilsson, U., Jaensson, M., Dahlberg, K., Odencrants, S., Grönlund, Å., Hagberg, L. & Eriksson, M. (2016). RAPP, a systematic e-assessment of postoperative recovery in patients undergoing day surgery: study protocol for a mixed-methods study design including a multicentre, two-group, parallel, single-blind randomised controlled trial and qualitative interview studies. BMJ Open, 6(1), Article ID e009901.
Open this publication in new window or tab >>RAPP, a systematic e-assessment of postoperative recovery in patients undergoing day surgery: study protocol for a mixed-methods study design including a multicentre, two-group, parallel, single-blind randomised controlled trial and qualitative interview studies
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2016 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 6, no 1, article id e009901Article in journal (Refereed) Published
Abstract [en]

Introduction: Day surgery is a well-established practice in many European countries, but only limited information is available regarding postoperative recovery at home though there is a current lack of a standard procedure regarding postoperative follow-up. Furthermore, there is also a need for improvement of modern technology in assessing patient-related outcomes such as mobile applications. This article describes the Recovery Assessment by Phone Points (RAPP) study protocol, a mixed-methods study to evaluate if a systematic e-assessment follow-up in patients undergoing day surgery is cost-effective and improves postoperative recovery, health and quality of life.

Methods and analysis: This study has a mixed-methods study design that includes a multicentre, two-group, parallel, single-blind randomised controlled trial and qualitative interview studies. 1000 patients >17 years of age who are undergoing day surgery will be randomly assigned to either eassessed postoperative recovery follow-up daily in 14 days measured via smartphone app including the Swedish web-version of Quality of Recovery (SwQoR) or to standard care (ie, no follow-up). The primary aim is cost-effectiveness. Secondary aims are (A) to explore whether a systematic e-assessment follow-up after day surgery has a positive effect on postoperative recovery, health-related quality of life (QoL) and overall health; (B) to determine whether differences in postoperative recovery have an association with patient characteristic, type of surgery and anaesthesia; (C) to determine whether differences in health literacy have a substantial and distinct effect on postoperative recovery, health and QoL; and (D) to describe day surgery patient and staff experiences with a systematic e-assessment follow-up after day surgery.

The primary aim will be measured at 2 weeks postoperatively and secondary outcomes (A–C) at 1 and 2 weeks and (D) at 1 and 4 months.

Place, publisher, year, edition, pages
London, United Kingdom: B M J Group, 2016
National Category
Medical and Health Sciences Surgery
Research subject
Caring Sciences w. Medical Focus
Identifiers
urn:nbn:se:oru:diva-47385 (URN)10.1136/bmjopen-2015-009901 (DOI)000369993900142 ()26769788 (PubMedID)2-s2.0-84960371476 (Scopus ID)
Projects
RAPP http://www.oru.se/Forskning/Forskningsprojekt/Forskningsprojekt-efter-amne/Forskningsprojekt/?rdb=1027
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2013-4765Swedish Research Council, 2015-02273
Available from: 2016-01-12 Created: 2016-01-12 Last updated: 2017-11-30Bibliographically approved
Pettersson, I., Hagberg, L., Fredriksson, C. & Hermansson, L. M. (2016). The effect of powered scooters on activity, participation and quality of life in elderly users. Disability and Rehabilitation: Assistive Technology, 11(7), 558-563
Open this publication in new window or tab >>The effect of powered scooters on activity, participation and quality of life in elderly users
2016 (English)In: Disability and Rehabilitation: Assistive Technology, ISSN 1748-3107, E-ISSN 1748-3115, Vol. 11, no 7, p. 558-563Article in journal (Refereed) Published
Abstract [en]

Purpose: The aim was to explore the effect of using a powered mobility device (PMD) on older peoples’ activity, participation and quality of life (QoL).

Method: A pre- and post-intervention design with outcome measures for activity, participation (Individually Prioritized Problem Assessment, IPPA; World Health Organization Disability Assessment Schedule, WHODAS 2.0) and QoL (SF-36) were used. T-test was used to analyse the data. The magnitude of the effects was measured by Cohen’s criteria for effect sizes (d).

Results: The sample consisted of 45 individuals (36 men) aged 66–88 years referred for prescription of a PMD. All were prescribed a powered scooter (PS). A statistically significant improvement with a large effect on IPPA in the ICF domains of Self-care (d¼2.47), Domestic life (d¼2.40), Interpersonal interactions and relationships (d¼2.08), and Community, social, and civic life (d¼2.36) was found. Medium-sized improvement on the WHODAS 2.0 domain of Participation and small improvements in the SF-36 domains of Physical Health and Role-Physical were also found.

Conclusion: A PS has significant effects on the areas of activity, participation and QoL in elderly people. These findings have implications for prescriptions of a PS to this population.

Place, publisher, year, edition, pages
Taylor & Francis, 2016
Keywords
Aged, assistive technology, ICF, mobility, limitation, powered mobility devices
National Category
Gerontology, specialising in Medical and Health Sciences
Identifiers
urn:nbn:se:oru:diva-40304 (URN)10.3109/17483107.2015.1027301 (DOI)000386460300003 ()25799878 (PubMedID)2-s2.0-84984620299 (Scopus ID)
Available from: 2015-01-08 Created: 2015-01-08 Last updated: 2018-07-09Bibliographically approved
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