Critical Care - Research Publications

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Type: Journal Article × Start date: 2010 × End date: 2019 ×

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    Factors Associated with Long-Term Functional and Psychological Outcomes in Persons with Moderate to Severe Traumatic Brain Injury
    Khan, F ; Amatya, B ; Judson, R ; Chung, P ; Truesdale, M ; Elmalik, A ; Galea, MP (Medical Journals Sweden, 2016-05-01)
    Objective: To examine factors impacting long-term functional and psychological outcomes in persons with moderate-severe traumatic brain injury. Methods: A prospective cross-sectional study (n = 103) assessed the long-term (up to 5 years) impact of traumatic brain injury on participants’ current activity and restriction in participation using validated questionnaires. Results: Participants’ median age was 49. 5 years (interquartile range (IQR) 20. 4–23. 8), the majority were male (77%), and 49% had some form of previous rehabilitation. The common causes of traumatic brain injury were falls (42%) and motor vehicle accidents (27%). Traumatic brain injury-related symptoms were: pain/headache (47%), dizziness (36%), bladder/bowel impairment (34%), and sensory-perceptual deficits (34%). Participants reported minimal change in their physical function and cognition (Functional Assessment Measure: motor (median 102, IQR 93–111) and cognition (median 89, IQR 78–95)). Participants were well-adjusted to community-living; however, they reported high levels of depression. Factors significantly associated with poorer current level of functioning/well-being included: older age (≥ 60 years), presence of traumatic brain injury-related symptoms, a lack of previous rehabilitation and those classified in “severe disability categories” at admission. Caregivers reported high levels of strain and burden (55%). Conclusion: Cognitive and psychosocial problems are more commonly reported than physical disability in the longer-term. A greater focus on participation and ageing with disability in these persons is needed.
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    Chronic pain in multiple sclerosis: A 10-year longitudinal study
    Young, J ; Amatya, B ; Galea, M ; Khan, F (sevier B.V. on behalf of Scandinavian Association for the Study of Pain, 2017-07-01)
    BACKGROUND AND PURPOSE: Pain is a common symptom associated with multiple sclerosis (MS), and has lasting effects on an individual's functional capacity and quality of life. A wide range of prevalence rates of pain (between 23% and 90% )have been reported in MS and this is mainly due to the methodological differences amongst the studies such as variability in patient sources, method of sampling and the definition of pain used. Chronic pain in MS, defined as pain lasting for greater than 3-6 months, can have a significant impact on their biopsychosocial health, including negative impact on activities of daily living, relationships and social participation. The long-term course of MS-related pain and its impact in an Australian cohort over a 7-year period has been investigated earlier. The aim of this longitudinal study was to describe the impact of chronic pain, pain-related disability and carer burden in persons with MS over a 10-year period. The aim of this longitudinal study was to describe the impact of chronic pain, pain-related disability and carer burden in persons with MS over a 10-year period. METHODS: This was a prospective longitudinal study conducted at the Rehabilitation Department of Royal Melbourne Hospital (RMH), a tertiary referral hospital in Victoria and Australia. The source of participants was from the RMH MS database and contains detailed MS patient information including demographic data, diagnosis details (using McDonald's criteria), pain characteristics. Structured face-face interviews and validated measures were used, which include the visual analogue scale (VAS); chronic pain grade (CPG); the assessment of quality of life (AQoL) and the carer strain index (CSI). The mean age of the participants (n=70) was 55.3 years and majority (70%) were female. RESULTS: The mean age of the participants (n=70) was 55.3 years and majority (70%) were female. The findings show that over time (10 years), participants report having greater bilateral bodily pain and greater description of pain as 'worse as it could be'. Pain types were similar to 7-years follow-up but remained higher than baseline. There was a significant deterioration in quality of life in those with more severe CPG over time. Almost half of the participants 31 (44%) required care either from a private carer, institution or from a family member. Although fear of taking medications and side effects were common barriers to treatment for pain, there was an increase in the use of pharmacological treatment over time and an increase in the use of healthcare services, mainly neurologists and general practitioners. CONCLUSIONS: The pain measures reported by the participants were similar to those at the 7-year follow-up except there was a greater representation of bilateral pain locations (limb, trunk and facial pain) compared to baseline and 7-year follow-up. At 10-year follow-up, more participants used medications compared to 7-year follow-up and there was an increase in the use of health professionals at the 10-year follow-up. At the 10-year follow up QoL of the participants deteriorated significantly and more participants had progressed to higher CPG III and CPG IV. This study demonstrates that chronic pain is a significant issue over time in MS, with clinical and health implications, impact on quality of life, disability and healthcare utilization. IMPLICATIONS: Greater awareness of chronic pain in pwMS, cognitive classifications and an interdisciplinary approach is required to improve long-term patient outcomes and well-being.
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    Chronic pain in persons with multiple sclerosis
    Amatya, B ; Young, J ; Galea, M ; Khan, F (Elsevier, 2018-07)
    Introduction/Background: Pain can be a significant long-term problem for a substantial proportion of persons with multiple sclerosis (pwMS). The aim of this study was to examine the course and impact of chronic pain over a span of 10-years. Material and method: A longitudinal, cross-sectional study assessed pwMS residing in the community at seven and ten years using validated measures: Visual Analogue Scale; Numerical Rating Scale; Chronic Pain Grade (CPG); Assessment of Quality of Life and the Carer Strain Index (CSI). Results: Mean age of the participants (n = 70) was 59.8 ± 9 years (range: 39–74 years) and majority (70%) were female. The findings show that over 10-year period, majority report bilateral lower limb dysesthesia (40%), mixed pain (35.2%) and widespread pain (17.1%). There was a significant deterioration in quality of life (QoL) in those with more severe CPG. Almost half of the participants (44%) required care either from a private carer/family or institution. The carers (n = 13) reported higher carer strain (mean CSI = 5.2), with over half reporting sleep disturbance, inconvenience, physical strains, family and personal constraints. Although fear of taking medications and side effects were common barriers to treatment for pain, there was an increase in the use of pharmacological treatment and healthcare services, mainly neurologists and general practitioners over time. Conclusion: This study demonstrates that persistent chronic pain is a significant issue over time in pwMS, with clinical and health implications, poorer QoL, and increased healthcare utilisation. Greater awareness of chronic pain in pwMS and interdisciplinary approach is required to improve long-term patient outcomes and well-being.
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    Protocol for a prospective, school-based standardisation study of a digital social skills assessment tool for children: The Paediatric Evaluation of Emotions, Relationships, and Socialisation (PEERS) study
    Thompson, EJ ; Beauchamp, MH ; Darling, SJ ; Hearps, SJC ; Brown, A ; Charalambous, G ; Crossley, L ; Darby, D ; Dooley, JJ ; Greenham, M ; Jaimangal, M ; McDonald, S ; Muscara, F ; Turkstra, L ; Anderson, VA (BMJ PUBLISHING GROUP, 2018-05)
    BACKGROUND: Humans are by nature a social species, with much of human experience spent in social interaction. Unsurprisingly, social functioning is crucial to well-being and quality of life across the lifespan. While early intervention for social problems appears promising, our ability to identify the specific impairments underlying their social problems (eg, social communication) is restricted by a dearth of accurate, ecologically valid and comprehensive child-direct assessment tools. Current tools are largely limited to parent and teacher ratings scales, which may identify social dysfunction, but not its underlying cause, or adult-based experimental tools, which lack age-appropriate norms. The present study describes the development and standardisation of Paediatric Evaluation of Emotions, Relationships, and Socialisation (PEERS®), an iPad-based social skills assessment tool. METHODS: The PEERS project is a cross-sectional study involving two groups: (1) a normative group, recruited from early childhood, primary and secondary schools across metropolitan and regional Victoria, Australia; and (2) a clinical group, ascertained from outpatient services at The Royal Children's Hospital Melbourne (RCH). The project aims to establish normative data for PEERS®, a novel and comprehensive app-delivered child-direct measure of social skills for children and youth. The project involves recruiting and assessing 1000 children aged 4.0-17.11 years. Assessments consist of an intellectual screen, PEERS® subtests, and PEERS-Q, a self-report questionnaire of social skills. Parents and teachers also complete questionnaires relating to participants' social skills. Main analyses will comprise regression-based continuous norming, factor analysis and psychometric analysis of PEERS® and PEERS-Q. ETHICS AND DISSEMINATION: Ethics approval has been obtained through the RCH Human Research Ethics Committee (34046), the Victorian Government Department of Education and Early Childhood Development (002318), and Catholic Education Melbourne (2166). Findings will be disseminated through international conferences and peer-reviewed journals. Following standardisation of PEERS®, the tool will be made commercially available.
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    Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries The International Surgical Outcomes Study group
    Ahmad, T ; Bouwman, RA ; Grigoras, I ; Aldecoa, C ; Hofer, C ; Hoeft, A ; Holt, P ; Fleisher, LA ; Buhre, W ; Pearse, RM ; Ferguson, M ; MacMahon, M ; Shulman, M ; Cherian, R ; Currow, H ; Kanathiban, K ; Gillespie, D ; Pathmanathan, E ; Phillips, K ; Reynolds, J ; Rowley, J ; Douglas, J ; Kerridge, R ; Garg, S ; Bennett, M ; Jain, M ; Alcock, D ; Terblanche, N ; Cotter, R ; Leslie, K ; Stewart, M ; Zingerle, N ; Clyde, A ; Hambidge, O ; Rehak, A ; Cotterell, S ; Huynh, WBQ ; McCulloch, T ; Ben-Menachem, E ; Egan, T ; Cope, J ; Halliwell, R ; Fellinger, P ; Haisjackl, M ; Haselberger, S ; Holaubek, C ; Lichtenegger, P ; Scherz, F ; Schmid, W ; Hoffer, F ; Cakova, V ; Eichwalder, A ; Fischbach, N ; Klug, R ; Schneider, E ; Vesely, M ; Wickenhauser, R ; Grubmueller, KG ; Leitgeb, M ; Lang, F ; Toro, N ; Bauer, M ; Laengle, F ; Haberl, C ; Mayrhofer, T ; Trybus, C ; Buerkle, C ; Forstner, K ; Germann, R ; Rinoesl, H ; Schindler, E ; Trampitsch, E ; Bogner, G ; Dankl, D ; Duenser, M ; Fritsch, G ; Gradwohl-Matis, I ; Hartmann, A ; Hoelzenbein, T ; Jaeger, T ; Landauer, F ; Lindl, G ; Lux, M ; Steindl, J ; Stundner, O ; Szabo, C ; Bidgoli, J ; Verdoodt, H ; Forget, P ; Kahn, D ; Lois, F ; Momeni, M ; Pregardien, C ; Pospiech, A ; Steyaert, A ; Veevaete, L ; De Kegel, D ; De Jongh, K ; Foubert, L ; Smitz, C ; Vercauteren, M ; Poelaert, J ; Van Mossevelde, V ; Abeloos, J ; Bouchez, S ; Coppens, M ; De Baerdemaeker, L ; Deblaere, I ; De Bruyne, A ; De Hert, S ; Fonck, K ; Heyse, B ; Jacobs, T ; Lapage, K ; Moerman, A ; Neckebroek, M ; Parashchanka, A ; Roels, N ; Van Den Eynde, N ; Vandenheuvel, M ; Van Limmen, J ; Vanluchene, A ; Vanpeteghem, C ; Wouters, P ; Wyffels, P ; Huygens, C ; Vandenbempt, P ; Van de Velde, M ; Dylst, D ; Janssen, B ; Schreurs, E ; Aleixo, FB ; Candido, K ; Batista, HD ; Guimaraes, M ; Guizeline, J ; Hoffmann, J ; Lobo, S ; Marques Lobo, FR ; Nascimento, V ; Nishiyama, K ; Pazetto, L ; Souza, D ; Rodrigues, RS ; Vilela dos Santos, AM ; Jardim, J ; Sa Malbouisson, LM ; Silva, J ; do Nascimento Junior, P ; Baio, TH ; Pereira de Castro, GI ; Watanabe Oliveira, HR ; Amendola, CP ; Cardoso, G ; Ortega, D ; Brotto, AF ; De Oliveira, MC ; Rea-Neto, A ; Dias, F ; Travi, ME ; Zerman, L ; Azambuja, P ; Knibel, MF ; Martins, A ; Almeida, W ; Neder Neto, C ; Tardelli, MA ; Caser, E ; Machado, M ; Aguzzoli, C ; Baldisserotto, S ; Tabajara, FB ; Bettega, F ; Rodrigues Junior, LHC ; de Gasperi, J ; Faina, L ; Nolasco, MF ; da Costa Fischer, BF ; de Campos Ferreira, MF ; Hartmann, C ; Kliemann, M ; Ribeiro, GLH ; Fraga, JM ; Netto, TM ; Pozza, LV ; Wendling, PR ; Azevedo, C ; Garcia, J ; Lopes, M ; Maia, B ; Maselli, P ; Melo, R ; Mendes, W ; Neves, M ; Ney, J ; Piras, C ; Applewhaite, C ; Carr, A ; Chow, L ; Duttchen, K ; Foglia, J ; Greene, M ; Hinther, A ; Houston, K ; McCormick, TJ ; Mikhayel, J ; Montasser, S ; Ragan, A ; Suen, A ; Woolsey, A ; Yu, HC ; Funk, D ; Kowalski, S ; Legaspi, R ; McDonald, H ; Siddiqui, F ; Pridham, J ; Rowe, B ; Sampson, S ; Thiessen, B ; Zbitnew, G ; Bernard, A ; George, R ; Jones, P ; Moor, R ; Siddiqui, N ; Wolfer, A ; Tran, D ; Winch, D ; Dobson, G ; McCormick, T ; Montasser, O ; Hall, R ; Baghirzada, L ; Curley, G ; Dai, SY ; Hare, G ; Lee, E ; Shastri, U ; Tsui, A ; Yagnik, A ; Alvares, D ; Choi, S ; Dwyer, H ; Flores, K ; McCartney, C ; Somascanthan, P ; Beattie, S ; Carroll, J ; Pazmino-Canizares, J ; Wijeysundera, D ; Ami, N ; Chan, V ; Perlas, A ; Argue, R ; Huang, Y ; Lavis, K ; Mayson, K ; Cao, Y ; Gao, H ; Hu, T ; Lv, J ; Yang, J ; Yang, Y ; Zhong, Y ; Zhou, J ; Zou, X ; He, M ; Li, X ; Luo, D ; Wang, H ; Yu, T ; Chen, L ; Wang, L ; Cai, Y ; Cao, Z ; Li, Y ; Lian, J ; Sun, H ; Wang, S ; Wang, Z ; Wang, K ; Zhu, Y ; Du, X ; Fan, H ; Fu, Y ; Huang, L ; Huang, Y ; Hwan, H ; Luo, H ; Qu, P-S ; Tao, F ; Wang, Z ; Wang, G ; Wang, S ; Zhang, Y ; Zhang, X ; Chen, C ; Wang, W ; Liu, Z ; Fan, L ; Tang, J ; Chen, Y ; Chen, Y ; Han, Y ; Huang, C ; Liang, G ; Shen, J ; Wang, J ; Yang, Q ; Zhen, J ; Zhou, H ; Chen, J ; Chen, Z ; Li, X ; Meng, B ; Ye, H ; Zhang, X ; Bi, Y ; Cao, J ; Guo, F ; Lin, H ; Liu, Y ; Lv, M ; Shi, P ; Song, X ; Sun, C ; Sun, Y ; Wang, Y ; Wang, S ; Zhang, M ; Chen, R ; Hou, J ; Leng, Y ; Meng, Q-T ; Qian, L ; Shen, Z-Y ; Xia, Z-Y ; Xue, R ; Zhang, Y ; Zhao, B ; Zhou, X-J ; Chen, Q ; Guo, H ; Guo, Y ; Qi, Y ; Wang, Z ; Wei, J ; Zhang, W ; Zheng, L ; Bao, Q ; Chen, Y ; Chen, Y ; Fei, Y ; Hu, N ; Hu, X ; Lei, M ; Li, X ; Lv, X ; Lv, J ; Miao, F ; Ouyang, L ; Qian, L ; Shen, C ; Sun, Y ; Wang, Y ; Wang, D ; Wu, C ; Xu, L ; Yuan, J ; Zhang, L ; Zhang, H ; Zhang, Y ; Zhao, J ; Zhao, C ; Zhao, L ; Zheng, T ; Zhou, D ; Zhou, H ; Zhou, C ; Lu, K ; Zhao, T ; He, C ; Chen, H ; Chen, S ; Cheng, B ; He, J ; Jin, L ; Li, C ; Li, H ; Pan, Y ; Shi, Y ; Wen, XH ; Wu, S ; Xie, G ; Zhang, K ; Zhao, B ; Lu, X ; Chen, F ; Liang, Q ; Lin, X ; Ling, Y ; Liu, G ; Tao, J ; Yang, L ; Zhou, J ; Chen, F ; Cheng, Z ; Dai, H ; Feng, Y ; Hou, B ; Gong, H ; Hu, CH ; Huang, H ; Huang, J ; Jiang, Z ; Li, M ; Lin, J ; Liu, M ; Liu, W ; Liu, Z ; Liu, Z ; Luo, F ; Ma, L ; Min, J ; Shi, X ; Song, Z ; Wan, X ; Xiong, Y ; Xu, L ; Yang, S ; Zhang, Q ; Zhang, H ; Zhang, H ; Zhang, X ; Zhao, L ; Zhao, W ; Zhao, W ; Zhu, X ; Bai, Y ; Chen, L ; Chen, S ; Dai, Q ; Geng, W ; Han, K ; He, X ; Huang, L ; Ji, B ; Jia, D ; Jin, S ; Li, Q ; Liang, D ; Luo, S ; Lwang, L ; Mo, Y ; Pan, Y ; Qi, X ; Qian, M ; Qin, J ; Ren, Y ; Shi, Y ; Wang, J ; Wang, J ; Wang, L ; Xie, J ; Yan, Y ; Yao, Y ; Zhang, M ; Zhao, J ; Zhuang, X ; Ai, Y ; Du, F ; He, L ; Huang, L ; Li, Z ; Li, H ; Li, Y ; Li, L ; Meng, S ; Yuan, Y ; Zhang, E ; Zhang, J ; Zhao, S ; Ji, Z ; Pei, L ; Wang, L ; Chen, C ; Dong, B ; Li, J ; Miao, Z ; Mu, H ; Qin, C ; Su, L ; Wen, Z ; Xie, K ; Yu, Y ; Yuan, F ; Hu, X ; Zhang, Y ; Xiao, W ; Zhu, Z ; Dai, Q ; Fu, K ; Hu, R ; Hu, X ; Huang, S ; Li, Y ; Liang, Y ; Yu, S ; Guo, Z ; Jing, Y ; Tang, N ; Wu, J ; Yuan, D ; Zhang, R ; Zhao, X ; Li, Y ; Bai, H-P ; Liu, C-X ; Liu, F-F ; Ren, W ; Wang, X-L ; Xu, G-J ; Hu, N ; Li, B ; Ou, Y ; Tang, Y ; Yao, S ; Zhang, S ; Kong, C-C ; Liu, B ; Wang, T ; Xiao, W ; Lu, B ; Xia, Y ; Zhou, J ; Cai, F ; Chen, P ; Hu, S ; Wang, H ; Wu, J ; Xu, Q ; Hu, L ; Jing, L ; Li, J ; Li, B ; Liu, Q ; Liu, Y ; Lu, X ; Peng, ZD ; Qiu, X ; Ren, Q ; Tong, Y ; Wang, Z ; Wang, J ; Wen, Y ; Wu, Q ; Xia, J ; Xie, J ; Xiong, X ; Xu, S ; Yang, T ; Ye, H ; Yin, N ; Yuan, J ; Zeng, Q ; Zhang, B ; Zheng, K ; Cang, J ; Chen, S ; Du, F ; Fan, Y ; Fu, S ; Ge, X ; Guo, B ; Huang, W ; Jiang, L ; Jiang, X ; Jin, L ; Liu, Y ; Pan, Y ; Ren, Y ; Shan, Q ; Wang, J ; Wang, F ; Wu, C ; Zhang, X ; Christiansen, IC ; Granum, SN ; Rasmussen, BS ; Daugaard, M ; Gambhir, R ; Brandsborg, B ; Steingrimsdottir, GE ; Jensen-Gadegaard, P ; Olsen, KS ; Siegel, H ; Eskildsen, KZ ; Gatke, MR ; Wibrandt, I ; Heintzelmann, SB ; Lange, KHW ; Lundsgaard, RS ; Amstrup-Hansen, L ; Hovendal, C ; Larsen, M ; Lenstrup, M ; Kobborg, T ; Larsen, JR ; Pedersen, AB ; Smith, SH ; Oestervig, RM ; Rasmussen, L ; Afshari, A ; Andersen, C ; Ekelund, K ; Secher, EL ; Beloeil, H ; Lasocki, S ; Venara, A ; Biais, M ; Ouattara, A ; Sineus, M ; Molliex, S ; Legouge, ML ; Wallet, F ; Tesniere, A ; Gaudin, C ; Lehur, P ; Forsans, E ; de Rudnicki, S ; Maudet, VS ; Mutter, D ; Sojod, G ; Ouaissi, M ; Regimbeau, J-M ; Futier, E ; Desbordes, J ; Comptaer, N ; el Manser, D ; Ethgen, S ; Lebuffe, G ; Auer, P ; Haertl, C ; Deja, M ; Legashov, K ; Sonnemann, S ; Wiegand-Loehnert, C ; Falk, E ; Habicher, M ; Angermair, S ; Laetsch, B ; Schmidt, K ; Von Heymann, C ; Ramminger, A ; Jelschen, F ; Pabel, S ; Weyland, A ; Czeslick, E ; Gille, J ; Malcharek, M ; Sablotzki, A ; Lueke, K ; Wetzel, P ; Weimann, J ; Lenhart, F-P ; Reichle, F ; Schirmer, F ; Hueppe, M ; Klotz, K ; Nau, C ; Schoen, J ; Mencke, T ; Wasmund, C ; Bankewitz, C ; Baumgarten, G ; Fleischer, A ; Guttenthaler, V ; Hack, Y ; Hoeft, A ; Kirchgaessner, K ; Maenner, O ; Schurig-Urbaniak, M ; Struck, R ; van Zyl, R ; Wittmann, M ; Goebel, U ; Harris, S ; Veit, S ; Andreadaki, E ; Souri, F ; Katsiadramis, I ; Skoufi, A ; Vasileiou, M ; Aimoniotou-Georgiou, E ; Katsourakis, A ; Veroniki, F ; Vlachogianni, G ; Petra, K ; Chlorou, D ; Oloktsidou, E ; Ourailoglou, V ; Papapostolou, K ; Tsaousi, G ; Daikou, P ; Dedemadi, G ; Kalaitzopoulos, I ; Loumpias, C ; Bristogiannis, S ; Dafnios, N ; Gkiokas, G ; Kontis, E ; Kozompoli, D ; Papailia, A ; Theodosopoulos, T ; Bizios, C ; Koutsikou, A ; Moustaka, A ; Plaitakis, I ; Armaganidis, A ; Christodoulopoulou, T ; Lignos, M ; Theodorakopoulou, M ; Asimakos, A ; Ischaki, E ; Tsagkaraki, A ; Zakynthinos, S ; Antoniadou, E ; Koutelidakis, I ; Lathyris, D ; Pozidou, I ; Voloudakis, N ; Dalamagka, M ; Elena, G ; Chronis, C ; Manolakaki, D ; Mosxogiannidis, D ; Slepova, T ; Tsakiridou, I-S ; Lampiri, C ; Vachlioti, A ; Panagiotakis, C ; Sfyras, D ; Tsimpoukas, F ; Tsirogianni, A ; Axioti, E ; Filippopoulos, A ; Kalliafa, E ; Kassavetis, G ; Katralis, P ; Komnos, I ; Pilichos, G ; Ravani, I ; Totis, A ; Apagaki, E ; Efthymiadi, A ; Kampagiannis, N ; Paraforou, T ; Tsioka, A ; Georgiou, G ; Vakalos, A ; Bairaktari, A ; Charitos, E ; Markou, G ; Niforopoulou, P ; Papakonstantinou, N ; Tsigou, E ; Xifara, A ; Zoulamoglou, M ; Gkioni, P ; Karatzas, S ; Kyparissi, A ; Mainas, E ; Papapanagiotou, I ; Papavasilopoulou, T ; Fragandreas, G ; Georgopoulou, E ; Katsika, E ; Psarras, K ; Synekidou, E ; Verroiotou, M ; Vetsiou, E ; Zaimi, D ; Anagnou, A ; Apostolou, K ; Melissopoulou, T ; Rozenberg, T ; Tsigris, C ; Boutsikos, G ; Kalles, V ; Kotsalas, N ; Lavdaiou, C ; Paikou, F ; Panagou, G-L ; Spring, A ; Arvaniti, K ; Botis, I ; Drimala, M ; Georgakakis, G ; Kiourtzieva, E ; Ntouma, P ; Prionas, A ; Xouplidis, K ; Dalampini, E ; Giannaki, C ; Iasonidou, C ; Ioannidis, O ; Lavrentieva, A ; Lavrentieva, A ; Papageorgiou, G ; Kokkinoy, M ; Stafylaraki, M ; Gaitanakis, S ; Karydakis, P ; Paltoglou, J ; Ponireas, P ; Chaloulis, P ; Provatidis, A ; Sousana, A ; Gardikou, VV ; Konstantivelli, M ; Lataniotou, O ; Lisari, E ; Margaroni, M ; Stamatiou, K ; Nikolaidis, E ; Pnevmatikos, I ; Sertaridou, E ; Andreou, A ; Arkalaki, E ; Athanasakis, E ; Chaniotaki, F ; Chatzimichali, CA ; Christofaki, M ; Dermitzaki, D ; Fiorentza, K ; Frantzeskos, G ; Geromarkaki, E ; Kafkalaki, K ; Kalogridaki, M ; Karydi, K ; Kokkini, S ; Kougentakis, G ; Lefaki, T ; Lilitsis, E ; Makatounaki, A ; Malliotakis, P ; Michelakis, D ; Neonaki, M ; Nyktari, V ; Palikyra, I ; Papadakis, E ; Papaioannou, A ; Sfakianakis, K ; Sgouraki, M ; Souvatzis, X ; Spartinou, A ; Stefanidou, N ; Syrogianni, P ; Tsagkaraki, G ; Arnaoutoglou, E ; Arnaoutoglou, C ; Bali, C ; Bouris, V ; Doumos, R ; Gkini, K-P ; Kapaktsi, C ; Koulouras, V ; Lena, A ; Lepida, D ; Michos, E ; Papadopoulos, D ; Paschopoulos, M ; Rompou, VA ; Siouti, I ; Tsampalas, S ; Ververidou, O ; Zilis, G ; Charlalampidoy, A ; Christodoulidis, G ; Flossos, A ; Stamoulis, K ; Chan, M ; Tsang, MSC ; Tsang, MS ; Lai, ML ; Yip, CP ; Chan, HMH ; Law, B ; Li, WS ; Chu, HM ; Koo, EGY ; Lam, CCJ ; Cheng, KH ; Lam, T ; Chu, S ; Lam, WY ; Wong, KWK ; Kwok, D ; Hung, CYJ ; Chan, WKJ ; Wong, WL ; Chung, CKE ; Ma, SK ; Kaushik, S ; Shah, B ; Shah, D ; Shah, S ; Ar, P ; Muthuchellappan, R ; Agarwal, V ; Divatia, J ; Kulkarni, A ; Mishra, S ; Nimje, G ; Pande, S ; Savarkar, S ; Shrivastava, A ; Thomas, M ; Yegnaram, S ; Hidayatullah, R ; Chandra, S ; Tantri, A ; Puar, N ; Niman, S ; Indra, I ; Hamzah, Z ; Yuliana, A ; Abidin, UN ; Dursin, AN ; Kurnia, A ; Susanti, A ; Handayani, D ; Alit, MA ; Arya, A ; Senapathi, TGA ; Utara, UH ; Wid, WM ; Wima, S ; Wir, WM ; Jehosua, B ; Kaunang, J ; Lantang, EY ; Najoan, R ; Waworuntu, N ; Awad, H ; Fuad, A ; Geddoa, E ; Geddoa, B ; Khalaf, AR ; Al hussaini, S ; Albaj, S ; Kenber, M ; Bettinelli, A ; Spadaro, S ; Volta, CA ; Giancarlo, L ; Sottosanti, V ; Copetti, E ; Della Rocca, G ; Spagnesi, L ; Toretti, I ; Alloj, C ; Cardellino, S ; Carmino, L ; Costanzo, E ; Fanfani, LC ; Novelli, MT ; Roasio, A ; Bellandi, M ; Beretta, L ; Bignami, E ; Bocchino, S ; Cabrini, L ; Corti, D ; Landoni, G ; Meroni, R ; Moizo, E ; Monti, G ; Pintaudi, M ; Plumari, VP ; Taddeo, D ; Testa, V ; Winterton, D ; Zangrillo, A ; Cloro, LM ; Colangelo, C ; Colangelo, A ; Rotunno, G ; Paludi, MA ; Maria, CP ; Pata, A ; Parrini, V ; Gatta, A ; Nastasi, M ; Tinti, C ; Baroselli, A ; Arrigo, M ; Benevento, A ; Bottini, C ; Cannavo, M ; Gastaldi, C ; Marchesi, A ; Pascazio, A ; Pata, F ; Pozzi, E ; Premoli, A ; Tessera, G ; Boschi, L ; D'Andrea, R ; Ghignone, F ; Poggioli, G ; Sibilio, A ; Taffurelli, M ; Ugolini, G ; Ab Majid, MA ; Ab Rahman, R ; Joseph, J ; Pathan, F ; Shah, MHS ; Yap, HL ; Cheah, S ; Chin, II ; Looi, JK ; Tan, SC ; Visvalingam, S ; Kwok, FY ; Lee, CK ; Tan, TS ; Wong, SM ; Abdullah, NH ; Liew, CF ; Luxuman, L ; Zin, NHM ; Norddin, MF ; Alias, RLR ; Wong, JY ; Yong, J ; Bin Mustapha, MT ; Chan, WK ; Dzulkipli, N ; Kuan, PX ; Lee, YC ; Alias, A ; Guok, EC ; Jee, CC ; Ramon, BR ; Wong, CW ; Ghafar, FNIA ; Aziz, FZ ; Hussain, N ; Lee, HS ; Sukawi, I ; Woon, YL ; Hadi, HZA ; Azam, UAA ; Alias, AH ; Kesut, SA ; Lee, JM ; Ooi, DV ; Sulaiman, HA ; Lih, TAT ; Mansor, M ; Veerakumaran, J ; Luna, P ; Rojas, E ; Resendiz, GEA ; Zapata, DDM ; Lopez, JCJA ; Flores, AAA ; Amador, JCB ; Avila, EJD ; Aquino, LPG ; Rodriguez, RL ; Landa, MT ; Urias, E ; Hollmann, M ; Hulst, A ; Preckel, OKB ; Koopman-van Gemert, A ; Bouwman, A ; Buise, M ; Tolenaar, N ; Weber, E ; de Fretes, J ; Houweling, P ; Ormskerk, P ; Van Bommel, J ; Buhre, W ; Lance, M ; Smit-Fun, V ; van Zundert, T ; Baas, P ; de Boer, HD ; Sprakel, J ; Elferink-Vonk, R ; Noordzij, P ; van Zeggeren, L ; Brand, B ; Spanjersberg, R ; ten Bokkel-Andela, J ; Numan, S ; van Klei, W ; van Zaane, B ; Boer, C ; van Duivenvoorde, Y ; Hering, JP ; van Rossum, S ; Zonneveldt, H ; Campbell, D ; Hoare, S ; Santa, S ; Ali, M ; Allen, SJ ; Beavis, V ; Bell, R ; Campbell, D ; Choi, H-MD ; Drake, M ; Farrell, H ; Hayes, K ; Higgie, K ; Holmes, K ; Jenkins, N ; Kim, CJ ; Kim, S ; Law, KC ; McAllister, D ; Park, K ; Pedersen, K ; Pfeifer, L ; Pozaroszczyk, A ; Salmond, T ; Steynor, M ; Tan, M ; Short, T ; Waymouth, E ; Ab Rahman, AS ; Armstrong, J ; Dudson, R ; Jenkins, N ; Nilakant, J ; Richard, S ; Virdi, P ; Dixon, L ; Donohue, R ; Farrow, M ; Kennedy, R ; Marissa, H ; McKellow, M ; Nicola, D ; Pascoe, R ; Roberts, SJ ; Rowell, G ; Sumner, M ; Templer, P ; Chandrasekharan, S ; Fulton, G ; Jammer, I ; More, R ; Wilson, L ; Chang, YH ; Foley, J ; Fowler, C ; Panckhurst, J ; Sara, R ; Stapelberg, F ; Cherrett, V ; Ganter, DL ; McCann, L ; Gilmour, F ; Lumsden, R ; Moores, M ; Olliff, S ; Sardareva, E ; Tai, J ; Wikner, M ; Wong, C ; Chaddock, M ; Czepanski, C ; McKendry, P ; Polakovic, D ; Polakovich, D ; Robert, A ; Belda, MT ; Norton, T ; Alherz, F ; Barneto, L ; Ramirez, A ; Sayeed, A ; Smith, N ; Bennett, C ; McQuoid, S ; Jansen, T-L ; Nico, Z ; Scott, J ; Freschini, D ; Freschini, A ; Hopkins, B ; Manson, L ; Stoltz, D ; Bates, A ; Davis, S ; Freeman, V ; McGaughran, L ; Williams, M ; Sharma, SB ; Burrows, T ; Byrne, K ; English, D ; Johnson, R ; Manikkam, B ; Naidoo, S ; Rumball, M ; Whittle, N ; Franks, R ; Gibson-Lapsley, H ; Salter, R ; Walsh, D ; Cooper, R ; Perry, K ; Obobolo, A ; Sule, UM ; Ahmad, A ; Atiku, M ; Mohammed, AD ; Sarki, AM ; Adekola, O ; Akanmu, O ; Durodola, A ; Olukoju, O ; Raji, V ; Olajumokex, T ; Oyebamiji, E ; Adenekan, A ; Adetoye, A ; Faponle, F ; Olateju, S ; Owojuyigbe, A ; Talabi, A ; Adenike, O ; Adewale, B ; Collins, N ; Ezekiel, E ; Fatungase, OM ; Grace, A ; Sola, S ; Stella, O ; Ademola, A ; Adeolu, AA ; Adigun, T ; Akinwale, M ; Fasina, O ; Gbolahan, O ; Idowu, O ; Olonisakin, RP ; Osinaike, BB ; Asudo, F ; Mshelia, D ; Abdur-Rahman, L ; Agodirin, O ; Bello, J ; Bolaji, B ; Oyedepo, OO ; Ezike, H ; Iloabachie, I ; Okonkwo, I ; Onuora, E ; Onyeka, T ; Ugwu, I ; Umeh, F ; Alagbe-Briggs, O ; Dodiyi-Manuel, A ; Echem, R ; Obasuyi, B ; Onajin-Obembe, B ; Bandeira, ME ; Martins, A ; Tome, M ; Martins Costa, ACM ; Krystopchuk, A ; Branco, T ; Esteves, S ; Melo, MA ; Monte, J ; Rua, F ; Martins, I ; Pinho-Oliveira, VM ; Rodrigues, CM ; Cabral, R ; Marques, S ; Rego, S ; Teixeira Jesus, JS ; Marques, MC ; Romao, C ; Dias, S ; Santos, AM ; Alves, MJ ; Salta, C ; Cruz, S ; Duarte, C ; Furtado Paiva, AA ; Cabral, TDN ; Faria e Maia, D ; Correia da Silva, RFM ; Langner, A ; Resendes, HO ; Soares, MDC ; Abrunhosa, A ; Faria, F ; Miranda, L ; Pereira, H ; Serra, S ; Ionescu, D ; Margarit, S ; Mitre, C ; Vasian, H ; Manga, G ; Stefan, A ; Tomescu, D ; Filipescu, D ; Paunescu, M-A ; Stefan, M ; Stoica, R ; Gavril, L ; Patrascanu, E ; Ristescu, I ; Rusu, D ; Diaconescu, C ; Iosep, GF ; Pulbere, D ; Ursu, I ; Balanescu, A ; Grintescu, I ; Mirea, L ; Rentea, I ; Vartic, M ; Lupu, M-N ; Stanescu, D ; Streanga, L ; Antal, O ; Hagau, N ; Patras, D ; Petrisor, C ; Tosa, F ; Tranca, S ; Copotoiu, SM ; Ungureanu, LL ; Harsan, CR ; Papurica, M ; Cernea, DD ; Dragoescu, NA ; Aflori, L ; Vaida, C ; Ciobotaru, OR ; Aignatoaie, M ; Carp, CP ; Cobzaru, I ; Mardare, O ; Purcarin, B ; Tutunaru, V ; Ionita, V ; Arustei, M ; Codita, A ; Busuioc, M ; Chilinciuc, I ; Ciobanu, C ; Belciu, I ; Tincu, E ; Blaj, M ; Grosu, R-M ; Sandu, G ; Bruma, D ; Corneci, D ; Dutu, M ; Krepil, A ; Copaciu, E ; Dumitrascu, CO ; Jemna, R ; Mihaescu, F ; Petre, R ; Tudor, C ; Ursache, E ; Kulikov, A ; Lubnin, A ; Grigoryev, E ; Pugachev, S ; Protsenko, D ; Tolmasov, A ; Hussain, A ; Ilyina, Y ; Kirov, M ; Roshchina, A ; Iurin, A ; Ayyaz, H ; Chazova, E ; Dunay, A ; Karelov, A ; Khvedelidze, I ; Voldaeva, O ; Belskiy, V ; Dzhamullaev, P ; Grishkowez, E ; Kretov, V ; Levin, V ; Molkov, A ; Puzanov, S ; Samoilenko, A ; Tchekulaev, A ; Tulupova, V ; Utkin, I ; Allorto, NL ; Bishop, DG ; Builu, PM ; Cairns, C ; Dasrath, A ; de Wet, J ; den Hoedt, M ; Grey, B ; Hayes, MP ; Kusel, BS ; Shangase, N ; Wise, R ; Cacala, S ; Farina, Z ; Govindasamy, V ; Kruse, C-H ; Lee, C ; Marais, L ; Naidoo, TD ; Rajah, C ; Rodseth, RN ; Ryan, L ; von Rhaden, R ; Adam, S ; Alphonsus, C ; Ameer, Y ; Anderson, F ; Basanth, S ; Bechan, S ; Bhula, C ; Biccard, BM ; Biyase, T ; Buccimazza, I ; Cardosa, J ; Chen, J ; Daya, B ; Drummond, L ; Elabib, A ; Goad, EHA ; Goga, IE ; Goga, R ; Harrichandparsad, R ; Hodgson, RE ; Jordaan, J ; Kalafatis, N ; Kampik, C ; Landers, AT ; Loots, E ; Madansein, R ; Madaree, A ; Madiba, TE ; Manzini, VT ; Mbuyisa, M ; Moodley, R ; Msomi, M ; Mukama, I ; Naidoo, D ; Naidoo, R ; Naidu, TK ; Ntloko, S ; Padayachee, E ; Padayachee, L ; Phaff, M ; Pillay, B ; Pillay, D ; Pillay, L ; Ramnarain, A ; Ramphal, SR ; Ryan, P ; Saloojee, A ; Sebitloane, M ; Sigcu, N ; Taylor, JL ; Torborg, A ; Visser, L ; Anderson, P ; Conradie, A ; de Swardt, M ; de Villiers, M ; Eikman, J ; Liebenberg, R ; Mouton, J ; Paton, A ; van der Merwe, L ; Wilscott-Davids, C ; Barrett, WJ ; Bester, M ; de Beer, J ; Geldenhuys, J ; Gouws, H ; Potgieter, J-H ; Strydom, M ; Turton, EW ; Chetty, RR ; Chirkut, S ; Cronje, L ; de Vasconcellos, K ; Dube, NZ ; Gama, NS ; Green, GM ; Green-Thompson, R ; Kinoo, SM ; Kistnasami, P ; Maharaj, K ; Moodley, MS ; Mothae, SJ ; Naidoo, R ; Noorbhai, MAF ; Rughubar, V ; Reddy, J ; Singh, A ; Skinner, DL ; Smith, MJ ; Singh, B ; Misra, R ; Naidoo, M ; Ramdharee, P ; Selibea, Y ; Sewpersad, S ; Sham, S ; Wessels, JD ; Africander, C ; Bejia, T ; Blakemore, SP ; Botes, M ; Bunwarie, B ; Hernandez, CB ; Jeeraz, MA ; Legutko, DA ; Lopez, AG ; De Meyer, JN ; Muzenda, T ; Naidoo, N ; Patel, M ; Pentela, R ; Junge, M ; Mansoor, N ; Rademan, L ; Scislowski, P ; Seedat, I ; van den Berg, B ; van der Merwe, D ; van Wyk, S ; Govender, K ; Naicker, D ; Ramjee, R ; Saley, M ; Kuhn, WP ; Matos-Puig, R ; Moolla, Z ; Lisi, A ; Perez, G ; Valle Beltran, A ; Lozano, A ; Delgado Navarro, C ; Duca, A ; Martinez Ernesto, EP ; Ferrando, C ; Fuentes, I ; Luisa Garcia-Perez, M ; Gracia, E ; Izquierdo Palomares, A ; Katime, A ; Minana, A ; Raul Incertis, R ; Romero, E ; Romero Garcia, CS ; Rubio, C ; Socorro Artiles, T ; Soro, M ; Valls, P ; Alaman Laguarda, G ; Benavent, P ; Chisbert Cuenca, V ; Cueva, A ; Lafuente, M ; Marques Parra, A ; Romero Rodrigo, A ; Sanchez-Morcillo, S ; Tormo, S ; Javier Redondo, F ; De Andres Ibanez, JA ; Gomez Diago, L ; Hernandez Cadiz, MJ ; Gil Manuel, G ; Peris, R ; Saiz, C ; Tatay Vivo, J ; Tebar Soto, MT ; Brunete, T ; Cancho, D ; Delgado Garcia, DR ; Zamudio, D ; Garcia Del Valle, S ; Luz Serrano, M ; Alonso, E ; Anillo, V ; Maseda, E ; Salgado, P ; Suarez, L ; Suarez-de-la-Rica, A ; Jose Villagran, M ; Aldecoa, C ; Ignacio Alonso, J ; Cabezuelo, E ; Garcia-Saiz, I ; Lopez del Moral, O ; Martin, S ; Perez Gonzalez, A ; Tovar Doncel, MS ; Aguero Vera, M ; Avila Sanchez, FJ ; Castano, B ; Castano Moreira, B ; Flores Risco, S ; Paz Martin, D ; Perez Martín, F ; Poza, P ; Ruiz, A ; Serna Martinez, WF ; Vazquez Vicente, B ; Velaz Dominguez, S ; Fernandez, S ; Munoz-Lopez, A ; Jose Bernat, M ; Mas, A ; Planas, K ; Jawad, M ; Saeed, Y ; Hedin, A ; Levander, H ; Chew, M ; Holmstrom, S ; Lonn, D ; Zoerner, F ; Akring, I ; Widmark, C ; Zettergren, J ; Liljequist, VA ; Nystrom, L ; Odeberg-Wernerman, S ; Oldner, A ; Fagerlund, MJ ; Reje, P ; Lyckner, S ; Sperber, J ; Adolfsson, A ; Klarin, B ; Ogren, K ; Barras, J-P ; Buhrer, T ; Despotidis, V ; Helmy, N ; Holliger, S ; Raptis, DA ; Schmid, R ; Meyer, A ; Jaquet, Y ; Kessler, U ; Muradbegovic, M ; Nahum, SR ; Rotunno, T ; Schiltz, B ; Voruz, F ; Worreth, M ; Christoforidis, D ; Popeskou, SG ; Furrer, M ; Prevost, GA ; Stocker, A ; Lang, K ; Breitenstein, S ; Ganter, MT ; Geisen, M ; Soll, C ; Korkmaz, M ; Lubach, I ; Schmitz, M ; Schwabedissen, MMZ ; Moritz, MZS ; Zingg, U ; Hillermann, T ; Wildi, S ; Hofer, C ; Pinto, BB ; Walder, B ; Hubner, M ; Mariotti, G ; Slankamenac, K ; Namuyuga, M ; Kyomugisha, E ; Kituuka, O ; Shikanda, AW ; Kakembo, N ; Tom, CO ; Antonina, W ; Bua, E ; Ditai, J ; Ssettabi, EM ; Epodoi, J ; Kabagenyi, F ; Kirya, F ; Dempsey, G ; Seasman, C ; Khan, RBN ; Kurasz, C ; Macgregor, M ; Shawki, B ; Francis, D ; Hariharan, V ; Chau, S ; Ellis, K ; Butt, G ; Chicken, D-W ; Christmas, N ; Allen, S ; Daniel, GD ; Dempster, A ; Kemp, J ; Matthews, L ; Mcglone, P ; Tambellini, J ; Trodd, D ; Freitas, K ; Garg, A ; Gupta, JK ; Karpate, S ; Kulkarni, A ; O'Hara, C ; Troko, J ; Angus, K ; Bradley, J ; Brennan, E ; Brooks, C ; Brown, J ; Brown, G ; Finch, A ; Gratrix, K ; Hesketh, S ; Hill, G ; Jeffs, C ; Morgan, M ; Pemberton, C ; Slawson, N ; Spickett, H ; Swarbrick, G ; Thomas, M ; Van Duyvenvoorde, G ; Brennan, A ; Briscoe, R ; Cooper, S ; Lawton, T ; Northey, M ; Senaratne, R ; Stanworth, H ; Burrows, L ; Cain, H ; Craven, R ; Davies, K ; Jonas, A ; Pachucki, M ; Walkden, G ; Davies, H ; Gudaca, M ; Hobrok, M ; Arawwawala, D ; Fergey, L ; Gardiner, M ; Gunn, J ; Johnson, L ; Lofting, A ; Lyle, A ; Mc Neela, F ; Smolen, S ; Topliffe, J ; Williams, S ; Bland, M ; Balaji, P ; Kaura, V ; Lanka, P ; Naylor, C ; Smith, N ; Ahmed, A ; Myatt, J ; Shenoy, R ; Soon, WC ; Tan, J ; Karadia, S ; Self, J ; Durant, E ; Tripathi, S ; Bullock, C ; Campbell, D ; Ghosh, A ; Hughes, T ; Zsisku, L ; Bengeri, S ; Cowton, A ; Khalid, MS ; Limb, J ; McAdam, C ; Porritt, M ; Rafi, MA ; Shekar, P ; Adams, D ; Harden, C ; Hollands, H ; King, A ; March, L ; Minto, G ; Patrick, A ; Squire, R ; Waugh, D ; Kumara, P ; Simeson, K ; Yarwood, J ; Browning, J ; Hatton, J ; Julian, H ; Mitra, A ; Newton, M ; Pernu, PK ; Wilson, A ; Commey, T ; Foot, H ; Glover, L ; Gupta, A ; Lancaster, N ; Levin, J ; Mackenzie, F ; Mestanza, C ; Nofal, E ; Pout, L ; Varden, R ; Wild, J ; Jones, S ; Moreton, S ; Pulletz, M ; Davies, C ; Martin, M ; Thomas, S ; Burns, K ; McArthur, C ; Patel, P ; Lau, G ; Rich, N ; Davis, F ; Lyons, R ; Port, B ; Prout, R ; Smith, C ; Adelaja, Y ; Bennett, V ; Bidd, H ; Dumitrescu, A ; Murphy, JF ; Keen, A ; Mguni, N ; Ong, C ; Adams, G ; Boshier, P ; Brown, R ; Butryn, I ; Chatterjee, J ; Freethy, A ; Lockwood, G ; Tsakok, M ; Tsiligiannis, S ; Peat, W ; Stephenson, L ; Bradburn, M ; Pick, S ; Cunha, P ; Olagbaiye, O ; Tayeh, S ; Packianathaswamy, B ; Abernethy, C ; Balasubramaniam, M ; Bennett, R ; Bolton, D ; Martinson, V ; Bell, S ; Heather, B ; Kushakovsky, V ; Alcock, L ; Alexander, H ; Anderson, C ; Baker, P ; Brookes, M ; Cawthorn, L ; Cirstea, E ; Clarkson, R ; Colling, K ; Coulter, I ; Das, S ; Haigh, K ; Hamdan, A ; Hugill, K ; Kottam, L ; Lisseter, E ; Mawdsley, M ; McGivern, J ; Padala, K ; Phelps, V ; kumar, VR ; Stewart, K ; Towse, K ; Tregonning, J ; Vahedi, A ; Walker, A ; Baines, D ; Bilolikar, A ; Chande, S ; Copley, E ; Dunk, N ; Kulkarni, R ; Kumar, P ; Metodiev, Y ; Ncomanzi, D ; Raithatha, B ; Raymode, P ; Szafranski, J ; Twohey, L ; Watt, P ; Weatherall, L ; Weatherill, J ; Whitman, Z ; Wighton, E ; Abayasinghe, C ; Chan, A ; Darwish, S ; Gill, J ; Glasgow, E ; Hadfield, D ; Harris, C ; Hopkins, P ; Kochhar, A ; Kunst, G ; Mellis, C ; Pool, A ; Riozzi, P ; Selman, A ; Smith, E-J ; Vele, L ; Gercek, Y ; Guy, K ; Holden, D ; Watson, N ; Whysall, K ; Andreou, P ; Hales, D ; Thompson, J ; Bowrey, S ; McDonald, S ; Gilmore, J ; Hills, V ; Kelly, C ; Kelly, S ; Lloyd, G ; Abbott, T ; Gall, L ; Torrance, H ; Vivian, M ; Berntsen, E ; Nolan, T ; Turner, A ; Vohra, A ; Brown, A ; Clark, R ; Coughlan, E ; Daniel, C ; Patvardhan, C ; Pearson, R ; Predeep, S ; Saad, H ; Shanmugam, M ; Varley, S ; Wylie, K ; Cooper, L ; Makowski, A ; Misztal, B ; Moldovan, E ; Pegg, C ; Donovan, A ; Foot, J ; Large, S ; Claxton, A ; Netke, B ; Armstrong, R ; Calderwood, C ; Kwok, A ; Mohr, O ; Oyeniyi, P ; Patnaik, L ; Post, B ; Ali, S ; Arshad, H ; Baker, G ; Brenner, L ; Brincat, M ; Brunswicker, A ; Cox, H ; Cozar, OI ; Cheong, E ; Durst, A ; Fengas, L ; Flatt, J ; Glister, G ; Narwani, V ; Photi, E ; Rankin, A ; Rosbergen, M ; Tan, M ; Beaton, C ; Horn, R ; Hunt, J ; Rousseau, G ; Stancombe, L ; Absar, M ; Allsop, J ; Drinkwater, Z ; Hodgkiss, T ; Smith, K ; Brown, J ; Alexander-Sefre, F ; Campey, L ; Dudgeon, L ; Hall, K ; Hitchcock, R ; James, L ; Smith, K ; Winstone, U ; Ahmad, N ; Bauchmuller, K ; Harrison, J ; Jeffery, H ; Miller, D ; Pinder, A ; Pothuneedi, S ; Rosser, J ; Sanghera, S ; Swift, D ; Walker, R ; Bester, D ; Cavanagh, S ; Cripps, H ; Daniel, H ; Lynch, J ; Paton, A ; Pyke, S ; Scholefield, J ; Whitworth, H ; Bottrill, F ; Ramalingam, G ; Webb, S ; Akerman, N ; Antill, P ; Bourner, L ; Buckley, S ; Castle, G ; Charles, R ; Eggleston, C ; Foster, R ; Gill, S ; Lindley, K ; Lklouk, M ; Lowery, T ; Martin, O ; Milne, D ; O'Connor, P ; Ratcliffe, A ; Rose, A ; Smith, A ; Varma, S ; Ward, J ; Barcraft-Barnes, H ; Camsooksai, J ; Colvin, C ; Reschreiter, H ; Tbaily, L ; Venner, N ; Hamilton, C ; Kelly, L ; Toth-Tarsoly, P ; Dodsworth, K ; Foord, D ; Gordon, P ; Hawes, E ; Lamb, N ; Mouland, J ; Nightingale, J ; Rose, S ; Schrieber, J ; Al 'Amri, K ; Aladin, H ; Arshad, MA ; Barraclough, J ; Bentley, C ; Bergin, C ; Carrera, R ; Clarkson, A ; Collins, M ; Cooper, L ; Denham, S ; Griffiths, E ; Ip, P ; Jeyanthan, S ; Joory, K ; Kaur, S ; Marriott, P ; Mitchell, N ; Nagaiah, S ; Nilsson, A ; Parekh, N ; Pope, M ; Seager, J ; Serag, H ; Tameem, A ; Thomas, A ; Thunder, J ; Torrance, A ; Vohra, R ; whitehouse, A ; Wong, T ; Blunt, M ; Wong, K ; Giles, J ; Reed, I ; Weller, D ; Bell, G ; Birch, J ; Damant, R ; Maiden, J ; Mewies, C ; Prince, C ; Radford, J ; Reynolds, T ; Balain, B ; Banerjee, R ; Barnett, A ; Ben, B ; Davies, K ; Edwards, J ; Evans, C ; Ford, D ; Gallacher, P ; Hill, S ; Jaffray, D ; Karlakki, S ; Kelly, C ; Kennedy, J ; Kiely, N ; Lewthwaite, S ; Marquis, C ; Ockendon, M ; Phillips, S ; Pickard, S ; Richardson, J ; Roach, R ; Smith, T ; Spencer-Jones, R ; Steele, N ; Steen, J ; Van Liefland, M ; White, S ; Faulds, M ; Harris, M ; Kelly, C ; Nicol, S ; Pearson, SA ; Chukkambotla, S ; Andrew, A ; Attrill, E ; Campbell, G ; Datson, A ; Fouracres, A ; Graterol, J ; Graves, L ; Hong, B ; Ishimaru, A ; Karthikeyan, A ; King, H ; Lawson, T ; Lee, G ; Lyons, S ; Hall, AM ; Mathoulin, S ; Mcintyre, E ; Mclaughlin, D ; Mulcahy, K ; Paddle, J ; Ratcliffe, A ; Robbins, J ; Sung, W ; Tayo, A ; Trembath, L ; Venugopal, S ; Walker, R ; Wigmore, G ; Boereboom, C ; Downes, C ; Humphries, R ; Melbourne, S ; Smith, C ; Tou, S ; Ullah, S ; Batchelor, N ; Boxall, L ; Broomby, R ; Deen, T ; Hellewell, A ; Helliwell, L ; Hutchings, M ; Hutchins, D ; Keenan, S ; Mackie, D ; Potter, A ; Smith, F ; Stone, L ; Thorpe, K ; Wassall, R ; Woodgate, A ; Baillie, S ; Campbell, T ; James, S ; King, C ; de Araujo, DM ; Martin, D ; Morkane, C ; Neely, J ; Rajendram, R ; Burton, M ; James, K ; Keevil, E ; Minik, O ; Morgan, J ; Musgrave, A ; Rajanna, H ; Roberts, T ; Szakmany, T ; Adamson, M ; Jumbe, S ; Kendall, J ; Muthuswamy, MB ; Anderson, C ; Cruikshanks, A ; Wrench, I ; Zeidan, L ; Ardern, D ; Harris, B ; Hellstrom, J ; Martin, J ; Thomas, R ; Varsani, N ; Brown, CW ; Docherty, P ; Gillies, M ; McGregor, E ; Usher, H ; Craig, J ; Smith, A ; Ahmad, T ; Bodger, P ; Creary, T ; Everingham, K ; Fowler, A ; Hewson, R ; Ijuo, E ; Januszewska, M ; Jones, T ; Kantsedikas, I ; Lahiri, S ; McLean, AL ; Niebrzegowska, E ; Phull, M ; Wang, D ; Wickboldt, N ; Baldwin, J ; Doyle, D ; Mcmullan, S ; Oladapo, M ; Owen, T ; Williams, A ; Daniel, H ; Gregory, P ; Husain, T ; Kirk-Bayley, J ; Mathers, E ; Montague, L ; Harper, M ; White, S ; Jack, J ; Ridley, C ; Avis, J ; Cook, T ; Dali-Kemmery, L ; Kerslake, I ; Lambourne, V ; Pearson, A ; Boyd, C ; Callaghan, M ; Lawson, C ; McCrossan, R ; Nesbitt, V ; O'connor, L ; Scott, J ; Sinclair, R ; Farid, N ; Morgese, C ; Bhatia, K ; Karmarkar, S ; Ahmed, J ; Branagan, G ; Hutton, M ; Swain, A ; Brookes, J ; Cornell, J ; Dolan, R ; Hulme, J ; van Vuuren, AJ ; Jowitt, T ; Kalashetty, G ; Lloyd, F ; Patel, K ; Sherwood, N ; Brown, L ; Chandler, B ; Deighton, K ; Emma, T ; Haunch, K ; Cheeseman, M ; Dent, K ; Garg, S ; Gray, C ; Hood, M ; Jones, D ; Juj, J ; Rao, R ; Walker, T ; Al Anizi, M ; Cheah, C ; Cheing, Y ; Coutinho, F ; Gondo, P ; Hadebe, B ; Hove, MO ; khader, A ; Krishnachetty, B ; Rhodes, K ; Sokhi, J ; Baker, K-A ; Bertram, W ; Looseley, A ; Mouton, R ; Hanna, G ; Arnold, G ; Arya, S ; Balfoussia, D ; Baxter, L ; Harris, J ; Jones, C ; Knaggs, A ; Markar, S ; Perera, A ; Scott, A ; Shida, A ; Sirha, R ; Wright, S ; Frost, V ; Gray, C ; Andrews, E ; Arrandale, L ; Barrett, S ; Cifra, E ; Cooper, M ; Dragnea, D ; Elna, C ; Maclean, J ; Meier, S ; Milliken, D ; Munns, C ; Ratanshi, N ; Ramessur, S ; Salvana, A ; Watson, A ; Ali, H ; Campbell, G ; Critchley, R ; Endersby, S ; Hicks, C ; Liddle, A ; Pass, M ; Ritchie, C ; Thomas, C ; Too, L ; Welsh, S ; Gill, T ; Johnson, J ; Reed, J ; Davis, E ; Papadopoullos, S ; Attwood, C ; Biffen, A ; Boulton, K ; Gray, S ; Hay, D ; Mills, S ; Montgomery, J ; Riddell, R ; Simpson, J ; Bhardwaj, N ; Paul, E ; Uwubamwen, N ; Alexander, M ; Arrich, J ; Arumugam, S ; Blackwood, D ; Boggiano, V ; Brown, R ; Chan, YL ; Chatterjee, D ; Chhabra, A ; Christian, R ; Costelloe, H ; Matthewman, MC ; Dalton, E ; Darko, J ; Davari, M ; Dave, T ; Deacon, M ; Deepak, S ; Edmond, H ; Ellis, J ; El-Sayed, A ; Eneje, P ; English, R ; Ewe, R ; Foers, W ; Franklin, J ; Gallego, L ; Garrett, E ; Goldberg, O ; Goss, H ; Greaves, R ; Harris, R ; Hennings, C ; Jones, E ; Kamali, N ; Kokkinos, N ; Lewis, C ; Lignos, L ; Malgapo, EV ; Malik, R ; Milne, A ; Mulligan, J-P ; Nicklin, P ; Palipane, N ; Parsons, T ; Piper, R ; Prakash, R ; Ramesh, B ; Rasip, S ; Reading, J ; Rela, M ; Reyes, A ; Stephens, R ; Rooms, M ; Shah, K ; Simons, H ; Solanki, S ; Spowart, E ; Stevens, A ; Thomas, C ; Waggett, H ; Yassaee, A ; Kennedy, A ; Scott, S ; Somanath, S ; Berg, A ; Hernandez, M ; Nanda, R ; Tank, G ; Wilson, N ; Wilson, D ; Al-Soudaine, Y ; Baldwin, M ; Cornish, J ; Davies, Z ; Davies, L ; Edwards, M ; Frewer, N ; Gallard, S ; Glasbey, J ; Harries, R ; Hopkins, L ; Kim, T ; Koompirochana, V ; Lawson, S ; Lewis, M ; Makzal, Z ; Scourfield, S ; Ahmad, Y ; Bates, S ; Blackwell, C ; Bryant, H ; Collins, H ; Coulter, S ; Cruickshank, R ; Daniel, S ; Daubeny, T ; Edwards, M ; Golder, K ; Hawkins, L ; Helen, B ; Hinxman, H ; Levett, D ; Salmon, K ; Seaward, L ; Skinner, B ; Tyrell, B ; Wadams, B ; Walsgrove, J ; Dickson, J ; Constantin, K ; Karen, M ; O'Brien, P ; O'Donohoe, L ; Payne, H ; Sundayi, S ; Walker, E ; Brooke, J ; Cardy, J ; Humphreys, S ; Kessack, L ; Kubitzek, C ; Kumar, S ; Cotterill, D ; Hodzovic, E ; Hosdurga, G ; Miles, E ; Saunders, G ; Campbell, M ; Chan, P ; Jemmett, K ; Raj, A ; Naik, A ; Oshowo, A ; Ramamoorthy, R ; Shah, N ; Sylvan, A ; Blyth, K ; Burtenshaw, A ; Freeman, D ; Johnson, E ; Lo, P ; Martin, T ; Plunkett, E ; Wollaston, J ; Allison, J ; Carroll, C ; Craw, N ; Craw, S ; Pitt-Kerby, T ; Rowland-Axe, R ; Spurdle, K ; McDonald, A ; Simon, D ; Sinha, V ; Smith, T ; Banner-Goodspeed, V ; Boone, M ; Campbell, K ; Lu, F ; Scannell, J ; Sobol, J ; Balajonda, N ; Clemmons, K ; Conde, C ; Elgasim, M ; Funk, B ; Hall, R ; Hopkins, T ; Olaleye, O ; Omer, O ; Pender, M ; Porto, A ; Stevens, A ; Waweru, P ; Yeh, E ; Bodansky, D ; Evans, A ; Kleopoulos, S ; Maril, R ; Mathney, E ; Sanchez, A ; Tinuoye, E ; Bateman, B ; Eng, K ; Jiang, N ; Ladha, K ; Needleman, J ; Chen, L-L ; Lane, R ; Robinowitz, D ; Ghushe, N ; Irshad, M ; O'Connor, J ; Patel, S ; Takemoto, S ; Wallace, A ; Mazzeffi, M ; Rock, P ; Wallace, K ; Zhu, X ; Chua, P ; Fleisher, L ; Mattera, M ; Sharar, R ; Thilen, S ; Treggiari, M ; Morgan, A ; Sofjan, I ; Subramaniam, K ; Avidan, M ; Maybrier, H ; Muench, M ; Wildes, T (ELSEVIER SCI LTD, 2016-11)
    BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN51817007
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    Organising health care services for people with an acquired brain injury: an overview of systematic reviews and randomised controlled trials
    Laver, K ; Lannin, NA ; Bragge, P ; Hunter, P ; Holland, AE ; Tavender, E ; O'Connor, D ; Khan, F ; Teasell, R ; Gruen, R (BMC, 2014-09-17)
    BACKGROUND: Acquired brain injury (ABI) is the leading cause of disability worldwide yet there is little information regarding the most effective way to organise ABI health care services. The aim of this review was to identify the most up-to-date high quality evidence to answer specific questions regarding the organisation of health care services for people with an ABI. METHODS: We conducted a systematic review of English papers using MEDLINE, EMBASE, PsycINFO, CINAHL and the Cochrane Library. We included the most recently published high quality systematic reviews and any randomised controlled trials, non-randomised controlled trials, controlled before after studies or interrupted time series studies published subsequent to the systematic review. We searched for papers that evaluated pre-defined organisational interventions for adults with an ABI. Organisational interventions of interest included fee-for-service care, integrated care, integrated care pathways, continuity of care, consumer engagement in governance and quality monitoring interventions. Data extraction and appraisal of included reviews and studies was completed independently by two reviewers. RESULTS: A total of five systematic reviews and 21 studies were included in the review; eight of the papers (31%) included people with a traumatic brain injury (TBI) or ABI and the remaining papers (69%) included only participants with a diagnosis of stroke. We found evidence supporting the use of integrated care to improve functional outcome and reduce length of stay and evidence supporting early supported discharge teams for reducing morbidity and mortality and reducing length of stay for stroke survivors. There was little evidence to support case management or the use of integrated care pathways for people with ABI. We found evidence that a quality monitoring intervention can lead to improvements in process outcomes in acute and rehabilitation settings. We were unable to find any studies meeting our inclusion criteria regarding fee-for-service care or engaging consumers in the governance of the health care organisation. CONCLUSIONS: The review found evidence to support integrated care, early supported discharge and quality monitoring interventions however, this evidence was based on studies conducted with people following stroke and may not be appropriate for all people with an ABI.
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    Why don't hospital staff activate the rapid response system (RRS)? How frequently is it needed and can the process be improved?
    Marshall, SD ; Kitto, S ; Shearer, W ; Wilson, SJ ; Finnigan, MA ; Sturgess, T ; Hore, T ; Buist, MD (BMC, 2011-04-16)
    BACKGROUND: The rapid response system (RRS) is a process of accessing help for health professionals when a patient under their care becomes severely ill. Recent studies and meta-analyses show a reduction in cardiac arrests by a one-third in hospitals that have introduced a rapid response team, although the effect on overall hospital mortality is less clear. It has been suggested that the difficulty in establishing the benefit of the RRS has been due to implementation difficulties and a reluctance of clinical staff to call for additional help. This assertion is supported by the observation that patients continue to have poor outcomes in our institution despite an established RRS being available. In many of these cases, the patient is often unstable for many hours or days without help being sought. These poor outcomes are often discovered in an ad hoc fashion, and the real numbers of patients who may benefit from the RRS is currently unknown. This study has been designed to answer three key questions to improve the RRS: estimate the scope of the problem in terms of numbers of patients requiring activation of the RRS; determine cognitive and socio-cultural barriers to calling the Rapid Response Team; and design and implement solutions to address the effectiveness of the RRS. METHODS: The extent of the problem will be addressed by establishing the incidence of patients who meet abnormal physiological criteria, as determined from a point prevalence investigation conducted across four hospitals. Follow-up review will determine if these patients subsequently require intensive care unit or critical care intervention. This study will be grounded in both cognitive and socio-cultural theoretical frameworks. The cognitive model of situation awareness will be used to determine psychological barriers to RRS activation, and socio-cultural models of interprofessional practice will be triangulated to inform further investigation. A multi-modal approach will be taken using reviews of clinical notes, structured interviews, and focus groups. Interventions will be designed using a human factors analysis approach. Ongoing surveillance of adverse outcomes and surveys of the safety climate in the clinical areas piloting the interventions will occur before and after implementation.
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    Measurement of Exercise Tolerance before Surgery (METS) study: a protocol for an international multicentre prospective cohort study of cardiopulmonary exercise testing prior to major non-cardiac surgery
    Wijeysundera, DN ; Pearse, RM ; Shulman, MA ; Abbott, TEF ; Torres, E ; Croal, BL ; Granton, JT ; Thorpe, KE ; Grocott, MPW ; Farrington, C ; Myles, PS ; Cuthbertson, BH (BMJ PUBLISHING GROUP, 2016)
    INTRODUCTION: Preoperative functional capacity is considered an important risk factor for cardiovascular and other complications of major non-cardiac surgery. Nonetheless, the usual approach for estimating preoperative functional capacity, namely doctors' subjective assessment, may not accurately predict postoperative morbidity or mortality. 3 possible alternatives are cardiopulmonary exercise testing; the Duke Activity Status Index, a standardised questionnaire for estimating functional capacity; and the serum concentration of N-terminal pro-B-type natriuretic peptide (NT pro-BNP), a biomarker for heart failure and cardiac ischaemia. METHODS AND ANALYSIS: The Measurement of Exercise Tolerance before Surgery (METS) Study is a multicentre prospective cohort study of patients undergoing major elective non-cardiac surgery at 25 participating study sites in Australia, Canada, New Zealand and the UK. We aim to recruit 1723 participants. Prior to surgery, participants undergo symptom-limited cardiopulmonary exercise testing on a cycle ergometer, complete the Duke Activity Status Index questionnaire, undergo blood sampling to measure serum NT pro-BNP concentration and have their functional capacity subjectively assessed by their responsible doctors. Participants are followed for 1 year after surgery to assess vital status, postoperative complications and general health utilities. The primary outcome is all-cause death or non-fatal myocardial infarction within 30 days after surgery, and the secondary outcome is all-cause death within 1 year after surgery. Both receiver-operating-characteristic curve methods and risk reclassification table methods will be used to compare the prognostic accuracy of preoperative subjective assessment, peak oxygen consumption during cardiopulmonary exercise testing, Duke Activity Status Index scores and serum NT pro-BNP concentration. ETHICS AND DISSEMINATION: The METS Study has received research ethics board approval at all sites. Participant recruitment began in March 2013, and 1-year follow-up is expected to finish in 2016. Publication of the results of the METS Study is anticipated to occur in 2017.
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    The Global Evidence Mapping Initiative: Scoping research in broad topic areas
    Bragge, P ; Clavisi, O ; Turner, T ; Tavender, E ; Collie, A ; Gruen, RL (BIOMED CENTRAL LTD, 2011-06-17)
    BACKGROUND: Evidence mapping describes the quantity, design and characteristics of research in broad topic areas, in contrast to systematic reviews, which usually address narrowly-focused research questions. The breadth of evidence mapping helps to identify evidence gaps, and may guide future research efforts. The Global Evidence Mapping (GEM) Initiative was established in 2007 to create evidence maps providing an overview of existing research in Traumatic Brain Injury (TBI) and Spinal Cord Injury (SCI). METHODS: The GEM evidence mapping method involved three core tasks:1. Setting the boundaries and context of the map: Definitions for the fields of TBI and SCI were clarified, the prehospital, acute inhospital and rehabilitation phases of care were delineated and relevant stakeholders (patients, carers, clinicians, researchers and policymakers) who could contribute to the mapping were identified. Researchable clinical questions were developed through consultation with key stakeholders and a broad literature search. 2. Searching for and selection of relevant studies: Evidence search and selection involved development of specific search strategies, development of inclusion and exclusion criteria, searching of relevant databases and independent screening and selection by two researchers. 3. Reporting on yield and study characteristics: Data extraction was performed at two levels - 'interventions and study design' and 'detailed study characteristics'. The evidence map and commentary reflected the depth of data extraction. RESULTS: One hundred and twenty-nine researchable clinical questions in TBI and SCI were identified. These questions were then prioritised into high (n = 60) and low (n = 69) importance by the stakeholders involved in question development. Since 2007, 58 263 abstracts have been screened, 3 731 full text articles have been reviewed and 1 644 relevant neurotrauma publications have been mapped, covering fifty-three high priority questions. CONCLUSIONS: GEM Initiative evidence maps have a broad range of potential end-users including funding agencies, researchers and clinicians. Evidence mapping is at least as resource-intensive as systematic reviewing. The GEM Initiative has made advancements in evidence mapping, most notably in the area of question development and prioritisation. Evidence mapping complements other review methods for describing existing research, informing future research efforts, and addressing evidence gaps.
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    Improving the care of people with traumatic brain injury through the Neurotrauma Evidence Translation (NET) program: protocol for a program of research
    Green, SE ; Bosch, M ; McKenzie, JE ; O'Connor, DA ; Tavender, EJ ; Bragge, P ; Chau, M ; Pitt, V ; Rosenfeld, JV ; Gruen, RL (BMC, 2012-08-07)
    The Neurotrauma Evidence Translation (NET) program was funded in 2009 to increase the uptake of research evidence in the clinical care of patients who have sustained traumatic brain injury. This paper reports the rationale and plan for this five-year knowledge translation research program. The overarching aims of the program are threefold: to improve outcomes for people with traumatic brain injury; to create a network of neurotrauma clinicians and researchers with expertise in knowledge translation and evidence-based practice; and to contribute knowledge to the field of knowledge translation research. The program comprises a series of interlinked projects spanning varying clinical environments and disciplines relevant to neurotrauma, anchored within four themes representing core knowledge translation activities: reviewing research evidence; understanding practice; developing and testing interventions for practice change; and building capacity for knowledge translation in neurotrauma. The program uses a range of different methods and study designs, including: an evidence fellowship program; conduct of and training in systematic reviews; mixed method study designs to describe and understand factors that influence current practices (e.g., semi-structured interviews and surveys); theory-based methods to develop targeted interventions aiming to change practice; a cluster randomised trial to test the effectiveness of a targeted theory-informed intervention; stakeholder involvement activities; and knowledge translation events such as consensus conferences.