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2. Ancestry: How researchers use it and what they mean by it

Author

Bege Dauda, Santiago J. Molina, Danielle Allen, Agustin Fuentes, Nayanika Ghosh, Madelyn Mauro, Benjamin M. Neale, Aaron Panofsky, Mashaal Sohail, Sarah Zhang, and Anna Lewis

Subjects
History, Polymers and Plastics, Genetics, Molecular Medicine, Business and International Management, Industrial and Manufacturing Engineering, Genetics (clinical)
Abstract

Background: Ancestry is often viewed as a more objective and less objectionable population descriptor than race or ethnicity. Perhaps reflecting this, usage of the term “ancestry” is rapidly growing in genetics research, with ancestry groups referenced in many situations. The appropriate usage of population descriptors in genetics research is an ongoing source of debate. Sound normative guidance should rest on an empirical understanding of current usage; in the case of ancestry, questions about how researchers use the concept, and what they mean by it, remain unanswered.Methods: Systematic literature analysis of 205 articles at least tangentially related to human health from diverse disciplines that use the concept of ancestry, and semi-structured interviews with 44 lead authors of some of those articles.Results: Ancestry is relied on to structure research questions and key methodological approaches. Yet researchers struggle to define it, and/or offer diverse definitions. For some ancestry is a genetic concept, but for many—including geneticists—ancestry is only tangentially related to genetics. For some interviewees, ancestry is explicitly equated to ethnicity; for others it is explicitly distanced from it. Ancestry is operationalized using multiple data types (including genetic variation and self-reported identities), though for a large fraction of articles (26%) it is impossible to tell which data types were used. Across the literature and interviews there is no consistent understanding of how ancestry relates to genetic concepts (including genetic ancestry and population structure), nor how these genetic concepts relate to each other. Beyond this conceptual confusion, practices related to summarizing patterns of genetic variation often rest on uninterrogated conventions. Continental labels are by far the most common type of label applied to ancestry groups. We observed many instances of slippage between reference to ancestry groups and racial groups.Conclusion: Ancestry is in practice a highly ambiguous concept, and far from an objective counterpart to race or ethnicity. It is not uniquely a “biological” construct, and it does not represent a “safe haven” for researchers seeking to avoid evoking race or ethnicity in their work. Distinguishing genetic ancestry from ancestry more broadly will be a necessary part of providing conceptual clarity.

Published
2023
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3. Achieving comprehensive integrated ocean management requires normative, applied, and empirical integration

Author

Genevieve Quirk, Anna Lewis, Christopher Kuster, Michelle Voyer, Kirti K. Lal, and Catherine Moyle

Subjects
Sustainable development, Corporate governance, media_common.quotation_subject, Marine spatial planning, Ecosystem-based management, Ecosystem services, Risk analysis (engineering), Sustainability, Earth and Planetary Sciences (miscellaneous), Conceptual model, Normative, Business, General Environmental Science, media_common
Abstract

Summary Our oceans, and the communities that rely on them, are facing diverse, interconnected, and cumulative threats, such as large-scale industrialization, climate change, and pollution. Integrated ocean management (IOM) is a governance approach that is designed to address these threats in a coordinated way while ensuring equitable distribution of resources and a reduction in conflict between invested parties. There are, however, a confusing and often competing array of different approaches to IOM, which can inhibit the success of its application and undermine sustainability efforts. Here, we propose an NAE (normative, applied, and empirical) conceptual model and demonstrate the utility of this approach as a tool through which to categorize the many different IOM frameworks. In doing so, we identify that most IOM frameworks provide for insufficient integration across one or more focus areas. By identifying these gaps, we provide a means through which future ocean governance can support more comprehensive integration.

Published
2021
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4. Returning integrated genomic risk and clinical recommendations: the eMERGE study

Author

Jodell E. Linder, Aimee Allworth, Sarah T. Bland, Pedro J. Caraballo, Rex L. Chisholm, Ellen Wright Clayton, David R. Crosslin, Ozan Dikilitas, Alanna DiVietro, Edward D. Esplin, Sophie Forman, Robert R. Freimuth, Adam S. Gordon, Richard Green, Maegan V. Harden, Ingrid A. Holm, Gail P. Jarvik, Elizabeth W. Karlson, Sofia Labrecque, Niall J. Lennon, Nita A. Limdi, Kathleen F. Mittendorf, Shawn N. Murphy, Lori Orlando, Cynthia A. Prows, Luke V. Rasmussen, Laura Rasmussen-Torvik, Robb Rowley, Konrad Teodor Sawicki, Tara Schmidlen, Shannon Terek, David Veenstra, Digna R. Velez Edwards, Devin Absher, Noura S. Abul-Husn, Jorge Alsip, Hana Bangash, Mark Beasley, Jennifer E. Below, Eta S. Berner, James Booth, Wendy K. Chung, James J. Cimino, John Connolly, Patrick Davis, Beth Devine, Stephanie M. Fullerton, Candace Guiducci, Melissa L. Habrat, Heather Hain, Hakon Hakonarson, Margaret Harr, Eden Haverfield, Valentina Hernandez, Christin Hoell, Martha Horike-Pyne, George Hripcsak, Marguerite R. Irvin, Christopher Kachulis, Dean Karavite, Eimear E. Kenny, Atlas Khan, Krzysztof Kiryluk, Bruce Korf, Leah Kottyan, Iftikhar J. Kullo, Katie Larkin, Cong Liu, Edyta Malolepsza, Teri A. Manolio, Thomas May, Elizabeth M. McNally, Frank Mentch, Alexandra Miller, Sean D. Mooney, Priyanka Murali, Brenda Mutai, Naveen Muthu, Bahram Namjou, Emma F. Perez, Megan J. Puckelwartz, Tejinder Rakhra-Burris, Dan M. Roden, Elisabeth A. Rosenthal, Seyedmohammad Saadatagah, Maya Sabatello, Dan J. Schaid, Baergen Schultz, Lynn Seabolt, Gabriel Q. Shaibi, Richard R. Sharp, Brian Shirts, Maureen E. Smith, Jordan W. Smoller, Rene Sterling, Sabrina A. Suckiel, Jeritt Thayer, Hemant K. Tiwari, Susan B. Trinidad, Theresa Walunas, Wei-Qi Wei, Quinn S. Wells, Chunhua Weng, Georgia L. Wiesner, Ken Wiley, Josh F. Peterson, Adam Gordon, Agboade Sobowale, Akshar Patel, Alanna Strong, Alborz Sherafati, Alborz Sherfati, Alex Bick, Alka Chandel, Alyssa Rosenthal, Amit Khera, Amy Kontorovich, Andrew Beck, Andy Beck, Angelica Espinoza, Anna Lewis, Anya Prince, Ayuko Iverson, Bahram Namjou Khales, Barbara Benoit, Becca Hernan, Ben Kallman, Ben Kerman, Ben Shoemaker, Benjamin Satterfield, Bethany Etheridge, Blake Goff, Bob Freimuth, Bob Grundmeier, Brenae Collier, Brett Harnett, Brian Chang, Brian Piening, Brittney Davis, Candace Patterson, Carmen Demetriou, Casey Ta, Catherine Hammack, Catrina Nelson, Caytie Gascoigne, Chad Dorn, Chad Moretz, Chris Kachulis, Christie Hoell, Christine Cowles, Christoph Lange, Cindy Prows, Cole Brokamp, Courtney Scherr, Crystal Gonzalez, Cynthia Ramirez, Daichi Shimbo, Dan Roden, Daniel Schaid, Dave Kaufman, David Crosslin, David Kochan, Davinder Singh, Debbie Abrams, Digna Velez Edwards, Eduardo Morales, Edward Esplin, Ehsan Alipour, Eimear Kenny, Elisabeth Rosenthal, Eliza Duvall, Elizabeth McNally, Elizabeth Bhoj, Elizabeth Cohn, Elizabeth Hibler, Elizabeth Karlson, Ellen Clayton, Emily Chesnut, Emily DeFranco, Emily Gallagher, Emily Soper, Emma Perez, Erin Cash, Eta Berner, Fei Wang, Firas Wehbe, Francisco Ricci, Gabriel Shaibi, Gail Jarvik, George Hahn, Georgia Wiesner, Gillian Belbin, Gio Davogustto, Girish Nadkarni, Haijun Qiu, Hannah Beasley, Hao Liu, Heide Aungst, Hemant Tiwari, Hillary Duckham, Hope Thomas, Iftikhar Kullo, Ingrid Holm, Isabelle Allen, Iuliana Ionita-Laza, Jacklyn Hellwege, Jacob Petrzelka, Jacqueline Odgis, Jahnavi Narula, Jake Petrzelka, Jalpa Patel, James Cimino, James Meigs, James Snyder, Janet Olson, Janet Zahner, Jeff Pennington, Jen Pacheco, Jennifer Allen Pacheco, Jennifer Morse, Jeremy Corsmo, Jim Cimino, Jingheng Chen, Jocelyn Fournier, Jodell Jackson, Joe Glessner, Joel Pacyna, Johanna Smith, John Lynch, John Shelley, Jonathan Mosley, Jordan Nestor, Jordan Smoller, Joseph Kannry, Joseph Sutton, Josh Peterson, Joshua Smith, Julia Galasso, Julia Smith, Julia Wynn, Justin Gundelach, Justin Starren, Karmel Choi, Kate Mittendorf, Katherine Anderson, Katherine Bonini, Kathleen Leppig, Kathleen Muenzen, Kelsey Stuttgen, Kenny Nguyen, Kevin Dufendach, Kiley Atkins, Konrad Sawicki, Kristjan Norland, Laura Beskow, Li Hsu, Lifeng Tian, Lisa Mahanta, Lisa Martin, Lisa Wang, Lizbeth Gomez, Lorenzo Thompson, Lucas Richter, Luke Rasmussen, Lynn Petukhova, Madison O’Brien, Maegan Harden, Malia Fullerton, Marta Guindo, Martha Horike, Marwah Abdalla, Marwan Hamed, Mary Beth Terry, Mary Maradik, Matt Wyatt, Matthew Davis, Matthew Lebo, Maureen Smith, Maya del Rosario, Meckenzie Behr, Meg Roy-Puckelwartz, Mel Habrat, Melanie Myers, Meliha Yetisgen, Merve Iris, Michael DaSilva, Michael Preuss, Michelle McGowan, Mingjian Shi, Minoli Perera, Minta Thomas, Mitch Elkind, Mohammad Abbass, Mohammad Saadatagah, Molly Hess, Molly Maradik, Nataraja 'RJ' Vaitinadin, Nataraja Vaitinadin, Neil Netherly, Niall Lennon, Ning Shang, Nita Limdi, Noah Forrest, Noheli Romero, Nora Robinson, Noura Abul-Husn, Omar Elsekaily, Patricia Kovatch, Paul Appelbaum, Paul Francaviglia, Paul O’Reilly, Paulette Chandler, Pedro Caraballo, Peter Tarczy-Hornoch, Pierre Shum, Priya Marathe, Qiping Feng, Quinn Wells, Rachel Atchley, Radhika Narla, Rene Barton, Rex Chisholm, Richard Sharp, Riki Peters, Rita Kukafka, Robert Freimuth, Robert Green, Robert Winter, Roger Mueller, Ruth Loos, Ryan Irvin, Sabrina Suckiel, Sajjad Hussain, Samer Sharba, Sandy Aronson, Sarah Jones, Sarah Knerr, Scott Nigbur, Scott Weiss, Sean Mooney, Sharon Aufox, Sharon Nirenberg, Shawn Murphy, Sheila O’Byrne, Shing Wang (Sam) Choi, Sienna Aguilar, S.T. Bland, Stefanie Rodrigues, Stephanie Ledbetter, Stephanie Rutledge, Stuart James Booth, Su Xian, Susan Brown Trinidad, Suzanne Bakken, Teri Manolio, Tesfaye Mersha, Thevaa Chandereng, Tian Ge, Todd Edwards, Tom Kaszemacher, Valerie Willis, Vemi Desai, Vimi Desai, Virginia Lorenzi, Vivian Gainer, Wendy Chung, Wu-Chen Su, Xiao Chang, Yiqing Zhao, Yuan Luo, and Yufeng Shen

Subjects
Genetics (clinical)
Abstract

Assessing the risk of common, complex diseases requires consideration of clinical risk factors as well as monogenic and polygenic risks, which in turn may be reflected in family history. Returning risks to individuals and providers may influence preventive care or use of prophylactic therapies for those individuals at high genetic risk.To enable integrated genetic risk assessment, the eMERGE (electronic MEdical Records and GEnomics) network is enrolling 25,000 diverse individuals in a prospective cohort study across 10 sites. The network developed methods to return cross-ancestry polygenic risk scores (PRS), monogenic risks, family history, and clinical risk assessments via a Genome Informed Risk Assessment (GIRA) report and will assess uptake of care recommendations after return of results.GIRAs include summary care recommendations for 11 conditions, education pages, and clinical laboratory reports. The return of high-risk GIRA to individuals and providers includes guidelines for care and lifestyle recommendations. Assembling the GIRA required infrastructure and workflows for ingesting and presenting content from multiple sources. Recruitment began in February 2022.Return of a novel report for communicating monogenic, polygenic, and family history based risk factors will inform the benefits of integrated genetic risk assessment for routine health care.

Published
2022

5. Massive presence of off-label medicines in Danish neonatal departments. A nationwide survey using national hospital purchase data

Author

Christina Gade, Stine Trolle, Mette‐Louise Mørk, Anna Lewis, Peter Fruergaard Andersen, Thorkild Jacobsen, Jon Andersen, and Ulrik Lausten‐Thomsen

Subjects
Neurology, Denmark, Infant, Newborn, Humans, Premature Birth, Female, Off-Label Use, General Pharmacology, Toxicology and Pharmaceutics, Practice Patterns, Physicians', Hospitals
Abstract

Background and Purpose Pharmaceutical treatment in the neonatal intensive care unit (NICU) is challenging, and newborns are often exposed to numerous different medicines during their hospitalization. There is currently insufficient knowledge of gestational age dependent medicine disposition, and accordingly the use of off-label medication, i.e., use of medicines outside its approved marketing authorization, is high. This study aims to estimate the off-label medication use in Danish neonatal departments. Experimental Approach By using data from the Danish National Pharmaceutical Hospital Purchase Database, we identified the most commonly occurring medicines and estimated the on/off-label ratios for premature and term neonates. Data was extracted on ATC level 5 and based on defined daily doses as per WHO. Key Results Data included was covering the 4 high-level NICUs and 10 of 13 of the intermediate/standard level neonatal departments in Denmark. Of the identified medication, 87% and 70% did not have approved marketing authorization for use in premature and full-term neonates, respectively. Furthermore one-fifth of the top 100 medicines did not have a (Danish) marketing license. Overall, off-label medication was widespread covering virtually all ATC groups and no ATC group had an off-label level lower than 50%. Finally, in 21% of medications, additives from 8 different chemical groups with potential deleterious effects for neonates were identified. Conclusion Off-label medication in the Danish neonatal departments is widespread, and the current state of neonatal official regulatory drug approval leaves both patients and neonatologists in a limbo between legal pharmaco-regulation and clinical need for pharmacotherapy in neonatology.

Published
2022
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6. Establishing a Peer Support Program for Survivors of COVID-19: A Report From the Critical and Acute Illness Recovery Organization

Author

Cydni N. Williams, Tammy L. Eaton, Rita N. Bakhru, Leanne M. Boehm, Janet A. Kloos, Hali Felt, Verónica Rojas, Christa A. Schorr, Kelly Drumright, Aluko A. Hope, Anna Lewis, James C. Jackson, Mark E. Mikkelsen, Andrea Annie Johnson, Ashley Montgomery-Yates, Sachin Agarwal, Heather Imperato-Shedden, Kimberley J Haines, Theodore J. Iwashyna, Carla M. Sevin, Elizabeth Hibbert, Brad W. Butcher, Karen Sara Hoehn, Joel Meyer, Dorothy Wade, Joanne McPeake, Caroline L. Lassen-Greene, and David Hornstein

Subjects
Coronavirus disease 2019 (COVID-19), business.industry, Psychological intervention, MEDLINE, social sciences, General Medicine, Peer support, Critical Care Nursing, Article, humanities, Test (assessment), Social integration, Nursing, Intervention (counseling), Pandemic, population characteristics, Medicine, business, human activities
Abstract

The COVID-19 pandemic will require health systems to test interventions to improve the recovery and social integration of adult survivors of COVID-19. Peer support is a complex intervention that allows COVID-19 survivors to give and receive practical and emotional support in relationship with other survivors of acute illness. The growing expertise within CAIRO can be leveraged by stakeholders interested in starting and sustaining a peer support program for COVID-19 survivors.

Published
2021
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7. Public Health Messaging for Wildfire Smoke: Cast a Wide Net

Author

Erin M, Shellington, Phuong D M, Nguyen, Karen, Rideout, Prabjit, Barn, Anna, Lewis, Margaret, Baillie, Sue, Lutz, Ryan W, Allen, Jiayun, Yao, Christopher, Carlsten, and Sarah B, Henderson

Subjects
Smoke, Surveys and Questionnaires, Public Health, Environmental and Occupational Health, Humans, Environmental Exposure, Public Health, Wildfires
Abstract

Wildfire smoke events are increasing in British Columbia (BC), Canada and environmental and public health agencies are responsible for communicating the health-related risks and mitigation strategies. To evaluate and identify opportunities for improving public communications about wildfire smoke and associated health risks we collaborated with end-users and developed a 32-question online survey. The survey was deployed province-wide from 29 September to 31 December 2020 following a severe wildfire smoke episode, which impacted large parts of BC. Using a convenience sample, we disseminated the survey through email lists, radio advertisements, a provincial research platform, and snowball methods. There were 757 respondents, who were generally representative of provincial demographics. Respondents indicated that they receive wildfire smoke messages from diverse sources, including: websites, social media, radio, and television. Radio was identified as the most important source of information for populations that may have increased exposure or health risks, including Indigenous respondents and those working in the trades. Respondents with lower educational attainment expressed that messaging should be simplified. Environmental and public health agencies should continue to share wildfire smoke messages using diverse methods, ideally tailoring the messages and methods to specific populations at risk for exposure and health effects.

Published
2022
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8. Surviving the Intensive Care Unit

Author

Nina Laing and Anna Lewis

Abstract

As medical technology becomes more accessible and complex, survival from critical illness is not uncommon, and programs are evolving to meet the post–intensive care unit (ICU) needs of patients and families. Survivors of critical illness are often faced with a constellation of new or worsening physical, psychological, and cognitive disabilities known as postintensive care syndrome (PICS). Family members are also susceptible to mental health concerns as a direct result of their family member’s critical illness and ICU admission. Palliative social workers have expertise in comprehensive assessment, systems analysis, collaborative communication, supportive care, and a range of intervention techniques which inform quality care for patients and their families in the ICU, through discharge or death and, for some, posthospitalization visits to a critical illness recovery center.

Published
2022
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9. Biosecurity hygiene in the Australian high country: footwear cleaning practices, motivations, and barriers among visitors to Kosciuszko National park

Author

Nicholas Gill, Shaun McKiernan, Hillary Cherry, Anna Lewis, and Drauzio Annunciato

Subjects
0106 biological sciences, National park, Visitor pattern, media_common.quotation_subject, Geography, Planning and Development, Biosecurity, Climate change, 010501 environmental sciences, Management, Monitoring, Policy and Law, 01 natural sciences, Social marketing, 010601 ecology, Geography, Hygiene, Socioeconomics, Tourism, 0105 earth and related environmental sciences, media_common
Abstract

Conservation areas face growing visitor numbers and heightened biosecurity risks from vectors such as bushwalkers and mountain bikers. For mountain areas, such pressures, with climate change, may b...

Published
2020
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10. Examining the needs of survivors of critical illness through the lens of palliative care: A qualitative study of survivor experiences

Author

Tammy L. Eaton, Anna Lewis, Heidi S. Donovan, Brian C. Davis, Brad W. Butcher, Sheila A. Alexander, Theodore J. Iwashyna, Leslie P. Scheunemann, and Jennifer Seaman

Subjects
Critical Care Nursing
Abstract

To examine the needs of adult survivors of critical illness through a lens of palliative care.A qualitative study of adult survivors of critical illness using semi-structured interviews and framework analysis.Participants were recruited from the post-intensive care unit clinic of a mid-Atlantic academic medical center in the United States.Seventeen survivors of critical illness aged 34-80 (median, 66) participated in the study. The majority of patients were female (64.7 %, n = 11) with a median length of index ICU stay of 12 days (interquartile range [IQR] 8-19). Interviews were conducted February to March 2021 and occurred a median of 20 months following the index intensive care stay (range, 13-33 months). We identified six key themes which align with palliative care principles: 1) persistent symptom burden; 2) critical illness as a life-altering experience; 3) spiritual changes and significance; 4) interpreting/managing the survivor experience; 5) feelings of loss and burden; and 6) social support needs.Our findings suggest that palliative care components such as symptom management, goals of care discussions, care coordination, and spiritual and social support may assist in the assessment and treatment of survivors of critical illness.

Published
2022

11. Whisker growth in Tasmanian devils ( Sarcophilus harrisii ) and applications for stable isotope studies

Author

Channing Hughes, Tracey L. Rogers, Marie R. G. Attard, Stephen Wroe, and Anna Lewis

Subjects
animal structures, integumentary system, Ecology, biology, Stable isotope ratio, Chemistry, biomarkers, Zoology, biology.organism_classification, Sarcophilus, growth models, Tasmanian devil, Sarcophilus harrisii, foraging ecology, Temporal change, diet, keratin, QH540-549.5, Ecology, Evolution, Behavior and Systematics
Abstract

Individual longitudinal records of diet, movement, and physiological state of endangered Tasmanian devils (Sarcophilus harrisii) are needed for effective management of wild populations, yet most traditional techniques are expensive or labor‐intensive. Stable isotope analysis of inert tissue, such as vibrissae (whiskers), provides a viable and minimally invasive solution to chronologically record the foraging ecology and habitat use of individuals. Species‐specific information on whisker growth (i.e., time‐position growth of isotopic signatures), retention time, and arrangement on the face is required before the implementation of stable isotope analysis in wild populations. Here, whiskers of six captive Tasmanian devils were internally marked with 13C‐ and 15N‐labeled glycine at three‐month intervals followed by isotopic analysis of the longest whisker to provide a time stamp for whisker growth and estimate retention time. Intradermal and extradermal lengths of wild Tasmanian devil whiskers were used to assess the arrangement and relative length of whiskers on the face. We found that whiskers can record at least nine months of an animal's ecological history and that whisker growth is not linear, the growth gradually slows down as the whisker lengthens. Our findings demonstrate that sequentially sampled whiskers have the potential to track monthly and seasonal isotopic changes of an individual animal in the wild, both within its historical range and in areas to which it has recently been introduced. Such information can be used to identify temporal shifts in habitat and prey preferences within populations and help select suitable individuals for translocations. We recommend that the longest mystacial whiskers, positioned posteriorly at the third and fourth row, should be preferentially used for stable isotope studies in this species. The timeframe represented by the root of the whisker (˜3–63 d) can be used to adjust the base of cut whiskers to the correct time period.

Published
2021
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12. Examining youth perceptions and social contexts of litter to improve marine debris environmental education

Author

C. J. Reynolds, Frank E. Muller-Karger, Kamal A. Alsharif, Hannah Torres, Katie Mastenbrook, and Anna Lewis

Subjects
business.industry, Ecology (disciplines), Knowledge level, 05 social sciences, Behavior change, Environmental resource management, Wildlife, 050301 education, 010501 environmental sciences, 01 natural sciences, Education, Environmental education, Geography, Marine debris, Litter, sense organs, skin and connective tissue diseases, business, Water pollution, 0503 education, 0105 earth and related environmental sciences
Abstract

Youth have astute observations about site-specific personal and environmental factors that contribute to littering and marine debris, and they have a strong potential to act as change agents in com...

Published
2019
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13. Workshop PresentationsPromoting inclusion and a sense of belonging: A citywide attachment aware approach to behaviourTowards the nurturing city: Including and listening to the children of GlasgowAre you listening? Echoing the voices of looked after children about school transition and belongingWhat do we want education to do for children and societyGiving children a voice in the early years: Using psychological skills to make a differenceListening to, and acting on the views of children and young people in Cornwall: A team improvement plan projectTowards the Nurturing City: Including and listening to the children of GlasgowCan appreciative inquiry give all children in a primary class voice and influence over curriculum decisions affecting their learning?The dimensions of health and wellbeing – a Swiss army knife for mental health support across a communityGiving every young learner a voice: Introducing my learner ID – On becoming and becoming and being a learnerSpiritual listening: Using A Little Box Of Big Questions as a tool for promoting change and reflection opportunities with young people with social, emotional and behavioural difficulties and moderate learning difficultiesThe role of the educational psychologist in responding to youth suicide in schoolsASPIRE to school and student wellbeingMapping, metaphors and models to therapeutically explore a young person’s understanding of their world and their psychological wellbeing

Author

Dave Traxson, Sue Roffey, Alish Rodgers, Nina Robinson, Suzanne Parkinson, Heather Moran, Anna Lewis, Catherine Jennings, Hayley Jarrett, Mallory Henson, Simon Gibbs, Yvonne Francis, Sarah Ahmed, Hilary Smith, Jenni Kerr, Alison Greenwood, Sarah Humrich, Laura Rowland, Sally Taylor, Chelsea Moore, Stacy N’Jie, Sam Beasley, and Anna Cox

Published
2019
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14. Perpetual motion

Author

Anna Lewis

Subjects
History, Aesthetics, law, Reading (process), media_common.quotation_subject, Perpetual motion, media_common, law.invention, Cultural significance
Published
2020
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17. Observational study investigating Tolerance Of Anticancer Systemic Therapy In the Elderly (TOASTIE): a protocol

Author

Sarah Taylor, Eleanor Smith, Christopher Mark Jones, Daniel Swinson, Mark A Baxter, Fiona Smith, R D Petty, Helen Dearden, Sally Martin, Michael Rowe, Kieran Zucker, Anna C Olsson-Brown, Clair Brunner, Anna Lewis, Lisa Rodgers, and Anthea Cree

Subjects
medicine.medical_specialty, Population, Prevalence, Antineoplastic Agents, chemotherapy, Systemic therapy, Neoplasms, Internal medicine, medicine, Humans, Prospective Studies, education, Prospective cohort study, Aged, Retrospective Studies, Geriatrics, education.field_of_study, Research ethics, Frailty, geriatric medicine, business.industry, toxicity, Cancer, General Medicine, medicine.disease, Observational Studies as Topic, Oncology, adult oncology, Medicine, Observational study, business
Abstract

IntroductionThe number of older adults diagnosed with cancer is increasing. Older adults are more likely to have pre-existing frailty, which is associated with greater chemotherapy-related toxicity. Early identification of those at risk of toxicity is important to reduce patient morbidity and mortality. Current chemotherapy toxicity prediction tools including the Cancer and Ageing Research Group (CARG) tool exist but are not in routine clinical use and have not been prospectively validated in a UK population. This study is the first prospective study to investigate the CARG tool in a UK population with cancer.Methods and analysisTolerance Of Anticancer Systemic Therapy In the Elderly is a prospective observational study of patients, aged ≥65 years, commencing first-line (any indication) chemotherapy for a solid-organ malignancy. Patients receiving other systemic anticancer agents or radiotherapy will be excluded. The primary objective will be to validate the ability of the CARG score to predict grade 3+ toxicity in this population. Secondary objectives include describing the feasibility of screening for frailty, as well as the prevalance of frailty in this population and assessing patient and clinician perception of chemotherapy toxicity risk. 500 patients will be recruited over a two year period. Baseline assessments will be recorded. At the end of the 6-month follow-up period, toxicity data will be retrospectively collected. A descriptive analysis of the recruited population will be performed. The validity of the CARG model will be analysed using receiver-operating characteristic curves and calculation of the area under the curve (c-statistic).Ethics and disseminationThe study has received ethical approval from the East of Scotland Research Ethics Service 20/ES/0114. Results will be reported in peer-reviewed scientific journals and disseminated to patient organisations and media.

Published
2021
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18. Delirium is prevalent in older hospital inpatients and associated with adverse outcomes: results of a prospective multi-centre study on World Delirium Awareness Day

Author

Ijeoma Obi, Simon Stapley, Farrah Bahsoon, Alice Wheeler, William McKeown, Taran Nandra, Rahul Mahida, Daniel Furmedge, Sarah Richardson, Emma Elliott, Nisha Rai, Aaron Kay, Thomas A Jackson, Olivia Evans, Dorothy Kuek, Sinead Quinn, Jane Masoli, Alex Hornsby, Ana Andrusca, Emma Astaire, Elizabeth Ellis, Alison McCulloch, Guy Tinson, James Gaywood, Eliza Griffiths, Hannah Morgan, Sanojan Bremakumar, Nedaa Haddad, Alexis Giles, Matthew Ansell, Kumudhini Giridharan, Laura Babb, Helen Chamberlain, Tamsin Critchlow, Mary Ni Lochlainn, Sejlo Koshedo, Parrthiepan Visvaratnam, Felicia Tan, Pryankaran Mithrakumar, Elizabeth Lonsdale-Eccles, Jacqueline Ibanichuka, Ahmad Alareed, Grace Fennelly, Arunkumar Annamalai, Deborah Scott, Victoria Gaunt, Esther Hindley, Elizabeth Holmes, Peter Jackson, Sneha Gurung, Huma Naqvi, Janine Valentine, Abdullah B. Khalid, Hannah Moorey, Aayenah Yunus, Adam Swietoslawski, Holly Jacques, Freya Cooper, Roisin McCormack, Alice Moseley, Zahid Subhan, Olivia Cooper, Clare Hughes, Jemima Taylor, Sohail Shakeel, Kirsty Moore, Rajeev Mishra, Ruth Willott, Georgia R. Layton, Natalie Grundmann, Ahmed Abras, Claire Copeland, Sarah B. McClelland, Natasha Christodoulides, Hannah Currie, Asiodu Nneamaka, Asma Khan, George Naish, David Saliu, Eilidh McKenzie, Emmy Abu, Nihaad Syed, Hannah Pendleton, Tammy Lee, Joanne Taylor, Simon Tetlow, Darmiga Thayabaran, Carly Welch, Frances Rickard, Saurav Bhattacharya, Wan Idoracaera Calisa Ikhwan, Oluwatosin O. Abiola, Shiv Bhakta, Martin Glasser, Kwasi Debrah, Rose Laud, Neil Henderson, Imola Bargaoanu, Awolkhier Mohammedseid-Nurhussien, Keziah Austin, Ani Tencheva, Elizabeth Deacon, Sam Cohen, Oliver Todd, James Wilcockson, Matthew Kearney, Amy Walker, Louise Beveridge, Ayoub Behbahani, Lindsay Ronan, Alex McQuillan, Adam McClean, Sureena Janagal, Emma Jay, Michael Sen, Emma Stratton, Emily Williamson, Hamza Ahmed, Roisin Healy, Katrin Hoffman, Ajay MacHarouthu, Sasha Porter-Bent, Amaka Achara, Lauren McCluskey, Hanna Waraich, Peter Nightingale, Laura Briggs, Chioma Iwu, Laurence Caines, Kara Mayor, Nader Nashed, Leeying Giet, Norman Pang, Philip Thomas, Ciaran Barlow, John Marshall, Pranav Mishra, Steve Rutter, Howell Jones, Celine Bultynck, Saad Abdullah, Tarunya Vedutla, Emily Rose, Jane Noble, Edward Bilton, Clare Hunt, Zarah Amin, Caroline Rice, Anum Cheema, Michael Haley, Natalie J. Cox, Gary Kumbun, Edward Wu, Wioletta Pyc, Emma Norman, Christopher James Miller, Olugbenro Akintade, Angela Kabia, Sherif Abdelbadiee, Karen Beharry, Riana Patel, Charlotte Chuter, Laura Jayne Beeley, Shoaib Iqbal, Mark Studley, Miriam Thake, Catherine Bryant, Stuart Winearls, Cal Doherty, Victoria Gaent, Martin Taylor-Rowan, Khai Lee Cheah, Sarah Ahmad, Thomas Pinkney, Emily Moore, Katie Houldershaw, Elaine Seymour, Zhao Xiao Bei, Victoria Clayton, Benjamin Jelley, Vincent McCormack, Daisy Wilson, Zeinab Majid, Moe Su Su San, John Frewen, Bilquis Ahmed, Rory Durcan, Lucy Porter, James Speed, Ghazal Hodhody, Ganapathy Bhat, Kim Kirrane, Emma Louise Cunningham, Rachel King, Megan Offer, Zainab Hussain, Jabed Ahmed, Katherine Williamson, Gladys Ofoche, Olivia B. Morrow, Ismail Kadir, Roxana Taranu, Helen McDonald, Helena Lee, Jennifer Champion, Sophie Pettler, Clementine Anderson, Abhishek Gupta, Teresa Harkin, Bethan Morgan, Shonit Nagumantry, Bushra Khizar, Sharan Ramakrishna, Ayesha Aamir, Harriet Brown, Isabelle Nicholls, Andre Le Poideven, Rodric Jenkin, Isabel Greaves, James Dove, Kelli Torsney, Emily Bowen, Charlotte Bell, Christian Chourot, Robbie Horton, Claire Wilkes, Anna Lewis, Rachael Bygate, Anjli Krishan, George E. Chapman, Muhammad Adam, Jamal Bhatti, Daniel Davis, Katie Ball, James Reid, Karthika Velusamy, Natalie Gaskell, Puja Jatti, Jonathan Treml, Abolfazl Behbahani, Luke Wynne, Jasmine Hart, Nathan Ingamells, Angharad Chilton, James Allen, Emma Mumtaz, Megan Parkinson, Terrence Quinn, Helen Bowden, Laura Jones, Paapa A-Odame, Bogna A Drozdowska, Emma Fisken, Vishnu Prasad, Sam Mills, Kate Foster, Paul Croft, Valerie J. Page, Sandra Darko, and Pedro Vila De Mucha

Subjects
Male, medicine.medical_specialty, Adverse outcomes, lcsh:Medicine, behavioral disciplines and activities, 03 medical and health sciences, 0302 clinical medicine, mental disorders, medicine, Prevalence, Humans, 030212 general & internal medicine, Prospective Studies, Multi centre, Aged, Aged, 80 and over, Inpatients, Frailty, business.industry, lcsh:R, Delirium, General Medicine, Collaboration, nervous system diseases, Hospitalization, Older adults, Emergency medicine, Female, medicine.symptom, business, 030217 neurology & neurosurgery, Research Article
Abstract

Background Delirium is a common severe neuropsychiatric condition secondary to physical illness, which predominantly affects older adults in hospital. Prior to this study, the UK point prevalence of delirium was unknown. We set out to ascertain the point prevalence of delirium across UK hospitals and how this relates to adverse outcomes. Methods We conducted a prospective observational study across 45 UK acute care hospitals. Older adults aged 65 years and older were screened and assessed for evidence of delirium on World Delirium Awareness Day (14th March 2018). We included patients admitted within the previous 48 h, excluding critical care admissions. Results The point prevalence of Diagnostic and Statistical Manual on Mental Disorders, Fifth Edition (DSM-5) delirium diagnosis was 14.7% (222/1507). Delirium presence was associated with higher Clinical Frailty Scale (CFS): CFS 4–6 (frail) (OR 4.80, CI 2.63–8.74), 7–9 (very frail) (OR 9.33, CI 4.79–18.17), compared to 1–3 (fit). However, higher CFS was associated with reduced delirium recognition (7–9 compared to 1–3; OR 0.16, CI 0.04–0.77). In multivariable analyses, delirium was associated with increased length of stay (+ 3.45 days, CI 1.75–5.07) and increased mortality (OR 2.43, CI 1.44–4.09) at 1 month. Screening for delirium was associated with an increased chance of recognition (OR 5.47, CI 2.67–11.21). Conclusions Delirium is prevalent in older adults in UK hospitals but remains under-recognised. Frailty is strongly associated with the development of delirium, but delirium is less likely to be recognised in frail patients. The presence of delirium is associated with increased mortality and length of stay at one month. A national programme to increase screening has the potential to improve recognition.

Published
2019

22. Abstract 1231: Targeting JNK1/2 induces a potent cytostatic response in estrogen receptor expressing breast cancer cells, with induction of autophagy and senescence as measurable outcomes

Author

Allison Jo Anna Lewis, Jingwen Cai, Patricia V. Schoenlein, Yutao Liu, Kyler Herrington, Carol Joseph, Hannah Youngblood, and Samar Abdulmoneim

Subjects
Cancer Research, Programmed cell death, business.industry, Cellular differentiation, Autophagy, Estrogen receptor, Cancer, medicine.disease, Cytostasis, Metastasis, Oncology, Cancer cell, Cancer research, medicine, business
Abstract

The c-Jun N-terminal kinases, JNK1/2 are members of the mitogen activated protein kinase (MAPK) family that can mediate inflammatory responses, cell differentiation, cell proliferation, and/or cell death. In breast cancer, JNK signaling has been associated with increased proliferation, angiogenesis, and tumor metastasis. Also, inhibition of JNK has been shown to promote tumor cytostasis, but this inhibition also attenuates the cytotoxic effects of certain chemotherapeutics, calling into question the therapeutic potential of JNK inhibitors. In this study, we hypothesized that JNK1/2 inhibition induced autophagy, as a mechanism of protection against chemotherapy- and endocrine-induced apoptosis. Autophagy is a normal physiologic process required for the elimination of damaged mitochondria and misfolded proteins that can be induced in cancer cells under certain stresses such as hypoxia and drug insult to provide protection from death. To characterize the role of JNK1/2 in autophagy, we utilized two ERα expressing human breast cancer cell lines, T47-D and MCF-7. Autophagy flux experiments were performed in which the steady state levels of the autophagy protein LC3 II were analyzed in control cells versus cells undergoing JNK1/2 inhibition with the non-reversible JNK-IN8 inhibitor. JNK-IN8 was used as a single agent or in combination with estradiol and/or antiestrogen treatment. These studies reproducibly identified JNK1/2 inhibition as a mechanism of autophagy activation. The induction of autophagy correlated with sustained inhibition of proliferation as determined by cell counts, MTT, and clonogenic assays, and induction of senescence (in T47-D cells) as determined by the expression of β-galactosidase. In contrast, induction of apoptosis was not a major outcome of JNK1/2 inhibition. These pre-clinical studies provide strong evidence that JNK1/2 is an attractive molecular target to improve the treatment of endocrine responsive breast cancer, but they also emphasize that cells are surviving by autophagy and/or senescence. Because cell survival by autophagy and/or senescence could ultimately lead to breast cancer relapse, ongoing studies are addressing approaches to effectively kill these surviving cell populations. Citation Format: Kyler Herrington, Carol Joseph, Samar Abdulmoneim, Allison Lewis, Jingwen Cai, Hannah Youngblood, Yutao Liu, Patricia Schoenlein. Targeting JNK1/2 induces a potent cytostatic response in estrogen receptor expressing breast cancer cells, with induction of autophagy and senescence as measurable outcomes [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 1231.

Published
2020
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25. Cancelled operations: a 7-day cohort study of planned adult inpatient surgery in 245 UK National Health Service hospitals

Author

Jennifer Morrish, Emily J Robson, Georgina Ashfield, Karuna Kotur, Jashmin Maria, Charlotte Downes, Shweta Patro, Mark Scrutton, George Gladstone, Andy Burton, Paula Mulligan, Wei Lin Allen, Michael McCusker, Dee Leonard, James Edwards, Sarah Dolling, Katherine Pass, Hywel Garrard, Francis Young, Paul Edgar, Elaine Matthews, Douglas Findlay, Helen Whittle, Aillison MacLean, Chris Levett, Claire-Marie Agius, Kim Porter, Nurse Charlotte White, Bridget Campbell, Gemma Scotland, Patrick Haywood, Liz Shenton, Tom Hatton, Laura McAffrey, Jane Hunt, Jaime Carungcong, Sara Owen, Fiona Christie, Lesley Milne, Liza Tharakan, Ruth Smith, Henry Nash, Timothy Gould, Jodie Fitzgerald, Wael Zghaibe, Mark Gaskell, Dushyanthi Jayasekera, Elana Owen, Kinga Dwornik, Amr Ali, Donna Cotterill, Martyn Cain, Peter Wicks, Daniel West, Catriona Walker, Rebecca Lee, Amanda Isaac, Naresh Rajasekar, Sally Collins, Laura Hammon, Tim Hendra, Yemi Adelaja, Mike Pollard, Ellen L. Brown, Matt Clayton, Rachel Bown, Sally Moore, Keyury Desai, Tony Kinsey, Charlotte Dunn, Li Lian Loh, Emelia Passaro, Timothy Faccini, Stephen Linter, Sumant Shanbhag, David Lee, David Restall, Angela Cook, Simon Ripoll, Rachael Bird, Vicky Murray, Alex Wollaston, Daniel Yarwood, Sonia Bhangu, Sahar Biuk, Jenny Ferry, Alexander Michael Stewart, Ceri Lynch, Lucy Sheppard, Denise Webster, Jamie Allen, Merle Cohen, James Hanison, Shilpa Rawat, Prabhakaran Premraj, Gamunu Ratnayake, Clare Bird, Lorna Filby, Clare Allcock, Babak Sedghi, Celly Weegenaar, Dawn Collier, Sreekanth Rayalu Uppugonduri, Amanda Whileman, Su Ying Ong, Jack Carmichael, Victoria O'Loughlin, Barbara Linklater-Jones, Maria Lackmann, Vitul Manhas, Albert Brennan, Alasdair Waite, Andrew Smallwood, Salvatore Bruni, Catriona Barr, Thomas Murphy, Gemma Hudson, Khalid Hasan, Alison J. Campbell, Radu Chiravasuta, Charlotte Maden, Roddy Chapman, Jon Clark, Nauman Iftikhar, Sarah Hagyard, Denis O'Leary, Steven Forde, Joanne Webb, Ryan W Haines, Andrea Galloway, Richard Siviter, Heidi Lightfoot, Hew D.T. Torrance, Christopher Smith, Hollie Robinson-Perrie, Josh Wall, Carina Cruz, Andrew Song, Stephen T. Webb, Nurse Sara-Beth Sutherland, Carol-Ann Woolley, Susan Martin, S.L.M. Walker, George Koshy, Renee Ford, Mona Mubarak, Robert Stuart, Keshava Reddy Burijinti Chenna, Rizana Ghafoor, Katie Hanlon, Fiona Faulds, Hiba Khaled, Richard Jones, Karin Duckett, Cathryn Matthews, Charles Chan, Sanjeewa Ranaweera, Nurse Rebecca Hinch, Richard Shawyer, Jo Cudlip, Marion Ashe, Steve Harris, Ravi K. Alagar, Jonathan Hetherington, Sara Churchill, Yolanda Baird, Maria Tritean, Gabriela Wong, Dermot Moloney, Lee Tbaily, Jonathan Finnity, Norbert Bokor, Peter Indoe, Lucy Stelfox, Simon Marcus, Bryony Burrill, Ellie Roderick, Carina Lilley, Alex Yusaf, Lucy Corbett, Esther Neilly, Christine Ryan, Amon Wijunamai, Katie Atterbury, Abigail Clarke, Josh Patch, Otto Mohr, Ronan Mukherjee, Asokan Krishnaier, Chen Yun-Han, Prasan Panagoda, Polly Rice, Katherine Jones, James Hudson, Sophie Uren, Peter Sutton, Evangelia Poimenidi, Tracy Marsden, Veronica Barnes, Alice Drysdale, Tara Lawrence, Lisa Sharpe, John G. Francis, N. M. Wharton, Claire Kurasz, Marina Iaverdino, Caradog Thomas, Emma Gold, Raj McNab, Tom E.F. Abbott, Claire Dowse, Jane Hamilton, Tony Sutherland, Robert P. Jones, Peter Alston, Daniel Haslam, Philippa Marshall, Bernadette Tilley, Cathleen Chabo, Adam Carpenter, Steve Cole, Nicholas Hooper, Kate Arrow, Alka Shah, Rosie Furness, Susie Chapman, Sachini Dhamaratne, Constandinos Papageorgiou, Michael Girgis, Sandra Pearson, Andrew W. Wood, Jaya Nariani, Sonia White, Christopher Godden, Mary Bellamy, Indra Chadbourn, Laura Parker, Peter Knowlden, Cat Griffiths, Jeanette Smith, David Brooks, Jonathan Smith-Williams, Elizabeth Barnes, Sunil Jamadarkhana, Andrew Feneley, Maria Croft, Tom Disney, Paramesh Kumara, Anna Warrington, Seetal Aggarwal, Zackriah Badsha, Suman Biswas, Suzanne Shuttleworth, Ben Jones, Jose Lourtie, Mark Stubbington, Asya Mussad, Patrick Johnson, Sister Amanda Cowton, James Spargo, Kelly Hard, Annette Fraine, William Weston, Farrukh Ameer, Andrew Prenter, Lisa Bacon, Sunil kumar Chaurasia, Claire Nicholas, Amy Kitching, Sneha Prasad, Catriona Ferguson, Martin P. Huntley, Claire Cameron, Hugh Cutler, Anne Harrison, Kunal Joshi, Anna Cormack, Rebecca Jones, Martin Paul, Jean Bage, Stephen Cole, Usman Razaque, Robert Lewis, David O'Callaghan, Samantha Strong, Victoria Frost, Peter Ip, Victoria Male, Mat Molyneux, Christopher Worth, Michael Brett, Megan Smith, Shayan Arshed, Timothy McMillan, Lorri James, Frances Lay, Jennifer Bennett-Britton, Patrick Colhoun, Alison Shaw, Michael Stewart, Maie Templeton, Karin Gupwell, Mujeeb Khan, Elena Stanton, Chandini Chuni, Janette Brown, Mariam Latif, Rebecca L. Wilson, Felix Fombon, Jo Novaga, Cindy Persad, Matthew Thomas, Maryna Garmash, Metod Oblak, Sarah Maher, Rahul Muddanyake, Morgan Foster, Kris Parker, Tim Sutton, Ndi Ekwere, Samuel Armanious, Mohammad Bhatti, Steve Phillips, Maria Rivero-Bosch, Nick Spittle, David Harding, Henry Hammerbeck, Rose Buckley, Jonathan Hatton, Ahmed Gilani, Ali Watts, Neeraj Bhardwaj, Lesley McShane, Simon Ridler, Martin Murphy, Vandana Goel, S Ramani Moonesinghe, Sophie Scutt, Sanniah Hussain, Hannah Donaldson, Tom Bennett, Helen Boys, David Steven Davies, Bev Hammond, Bryan Yates, Victoria Hawley, Chris Gibb, Ulrika Winstone, Keith Couper, Benedict Williams, Louise Duncan, Georgina Wilson, Anil Hormis, Emily Dana, Jens Full, Amina Chohan, Amanda Ebejer, Sian McKillop, Tomas Bakonyi, Georgina Bird, George Davies, Christina Penny, Helen Thornley, Karen Jewers, Kingsin Ang, Mishell Cunningham, Conny Blunt, Ronald Carrera, Kay Finney, Alvin Soosay, Nagaraj Rao, Jason Mann, Carol Edwards, Richard Lowe, Paul Stevens, Hilary Ashton, Rachel Codling, Rhys Davies, Muthuraj Kanakaraj, Zoe Apple, Kirsty Meats, Tammy Smith, Charmaine Beirnes, John Gardner, Peter Featherstone, Claire Williams, Rohit Mittal, Emma Shinn, Alex Moore, Michael Whitear, Hannah Rose, Paul Kelly, Megan Thomas, Matthew Gibbins, Jack Reid, Caroline Clarke, Victoria Irvine, Bhavesh Pratap, Ella Buchanan, Nurse Francesca Wright, Vatsharlan Santhirapala, Richard Gould, Dionne Dervin, Behzad Sohail, Lauren Duraman, Thecla Scully, Adnaan Qureshi, Muditha Peiris, Thomas Ratcliffe-Law, Samuel J. Clark, Ben Vowles, Sam Keable, Hoda Abou Ghoneim, Becky Morris, Aidan Hulbert, Rachael Craven, Ashish Kundu, Emma M. Casely, Maya Kommer, Tom Poulton, Greg Nussbaum, Ahmad Huda, Caroline Davis, Suzanne Gleeson, Paul Clements, Matt Willis, Isobel Amey, David J. Perry, Rachel Harford, Bianca Hulance, Kirsty Baron, Charlotte Grove, Sergio Dominguez, Susanna Richie-Mclean, John Stones, Ioana Simionescu, Khaled Razouk, Cristina Niciu, Ben Hyams, Mark Doran, Carolyn Colvin, Jonathan Rivers, Raluca Ene, Rebecca Jackson, Jonathan Edgar, Ben Robinson, Lisa Wilkinson-Guy, Aji Mathew, Christopher Patrick, Gauhar Sharih, Ismail Tariq, Andrea Kay, Joshua O'Donnell, Dafydd Watterson, Lail Zaheer, Fiona Reed, Tom Johnson, Christopher Oscier, Mirain Phillips, Edmund Gerrans, Joanna Hackney, Sally M. Dunlop, Elizabeth Willetts, Jiang Yuchen, Lizzie Ashton, Theresa Cooper, Paul W. Davies, Carly Brown, James Small, Julie Lowe, Amarjeet Patil, Filipe Helder, Joshua Cuddihy, Faisal Sheikh, Hayley Tarft, Enid Leung, Adrian Percuin, Paolo Mazzone, Rochelle Rhodes, Jane Pilsbury, Kerry Cullis, Peter Brook, Helen McNamara, Carin Swanevelder, Claire Frith, Adrian Clarke, Stuart Watson, Glenn Vetuz, Zoe Riddell, Drew Welch, Geoff Warnock, Lalani Induruwage, Paul Mallett, Elizabeth Cervi, Santinder Dalay, Supriya Antrolikar, Sinead O'Kane, Toby Hoskins, Stephen Duberley, Sophie Parcell, Jayne Sutherland, Lynn Fairless, Dave Parkinson, Matron Beryl Davis, Abigail Patrick, Jithu Jayan, Nicola Harvey, Catherine Pitman, Donata Banni, Samuel Passey, Omar Alex Pemberton, Becky Sands, Hon Sum Liu, Alexandra Mudd, Sheldon Zhang, Ange Lise John-Baptiste, Thomas Clayton, Charlotte Marriot, Tom Reevell, Nicola Mackenzie, Temitope Aiyedun, Andy Cruickshanks, Jacqueline Gunn, Alison Moss, Martyn Clark, Swetha Rambhatla, Claire Matata, Ben Cracknell, Pauline Mercer, Matthew Morgans, Catrin Williams, Shareef Madhi, Jane Montgomery, George Kohler, Yasir Hameed, Muneeba Ahmed, Glenn Saunders, Anand Kulkarni, Craig Pinner, Lauren Pearce, Vishnu Bhardwa, Judi Ramsey, Meghna Sharma, Rob Hull, Srinivasan Perumal, Julia Critchley, Stephen Hill, Bethany Fitzmaurice, Robert Crichton, Cormac O'Connor, M. Dickinson, Alison Pearce-Smith, Julie Toms, Kathleen Horan, Ammy Dodd, Rachel Crone, Graeme Finnie, Suman Shrestha, Saul Sundayi, Shamini Sivakumaran, Robert Collin, Janine Musselwhite, Yuvaraj Kummur, Mariana Bernardo, Amrinda Sayan, Gabrielle De Selincourt, Laura Bridge, Melissa Rosbergen, Philip Barclay, Garry Davenport, Daniel Murrell, Andrew Drummond, Eireann Allen, Emma Fadden, Subha Arunachalam, David Robinson, Stephanie Dukes, Catherine Jardine, Sunny Bhat, Hemantha Shiva, Amy Kerr, Henry Elms, Anam Asif, Sandra Evans, Girish Rangaswamy, Laura Thomson, Asad Javed, Jenny Shuttleworth Davies, Maren Kleine-Brueggeney, Sian Edwards, Jean-Paul Zahra, Jo simpson, Priya Verma, Bhamini Tharmalingam, Matthew Edmunds, Stephen Adshead, Hannah Luckhurst, Lara Allen, Colin Merrill, Fiona Lyle, Falguni Choksey, Mohyman El Habishi, Holly Notman, Lisa Murthen, Christiana Georgiou, Georgina Singleton, Tim Cook, Melba Knighton, Shirley Pyke, Amit Gadre, Maria Rehnstrom, Helen Hothersall, Anja Kuttler, Anita Boltres, Sarah Williams, Sarah Welch, Yamuna Madhu, Pramod Nalwaya, Alistair Coleman, Jeanie Worthington, Jasmine Samuel, Rajashekar Gowni, Karen Burt, Shamim Haque, Reynard Knoetze, Hakeem Yusuff, Tom Taylor, Val Parkinson, Sheik Pahary, Jonathan Fortune, Natalie Long, David Gilhooly, Karthick Duraisamy, Duncan Baines, Shondipon Laha, Marie Appleby, Jyothi Hosahalli, Christine Catley, Jasmine Jose, Damien Mantle, Dinkar Gowda, Permendra Singh, Ramesh Khoju, Carol Bradbury, Sarah Hazeldine, Karan Kanal, Sonal Lodhi, James Craig, Rachel Wong, Teresa Ferreira, Charis Banks, Ben Chandler, Asia Sarwar, Sivaprakash Vaitheeswaran, Sam Bews, Katie Hunter, Sohan Bisonoothan, Lauren Hunt, Melony Hayes, Nilesh Chauhan, Janet Pickett, Sharon Dealing, Jamie Plumb, Thomas Hollins, Claire Hill, Claire Hindmoor, Nicolas Hooker, Hannah Davis, Laura Mee, Elizabeth Thomas, James Self, Jenny May-Ling Cheung, Jane Varin, Manish Kakkar, Anuj Wali, Omar Siddique, Sophie Earl, Elizabeth Longdon, Alison Meadows, Shafi Ahmed, David MacPherson, Shaima Elnour, Suzi Hale, Ramez Ibrahim, Fei Long, Orlanda Allen, Alice Groves, Mohammed Wahid, Angela Stevens, Carl Ilyas, Richard Robley, Nichola Bleasby, Peter Havalda, Ursula McHugh, Judith Brade, Georgia Monantera, Stuart Younie, Brian Johnston, Jamie Brookes, Linda Park, Graeme Wilson, Mark Greasley, Lohita Nanda, Vineetha Jayakumar, Ian M. Lyons, Ayman Abdu, Paul Athanasopoulos, Justin Woods, Kariem El-Boghdadly, Diane Simpson, Georgina Williamson, Jonathan McCarter, Anil Golhar, Alicia Waite, Claire Halligan, Sarah Anne Leir, Joanne Turner, Matthew O'Meara, Claire Atkinson, Adam Yarnold, Mark Fernie, Rhiann Marie O'Shaughnessy, Jamie Elwood, Laura Harvey, Ali Atrah, Helen Terrett, Sam Scholes, Rebecca E. Saunders, Vin Vyapury, Amir Rafi, Peter Bradley, Srikant Ganesh, Zehrin Nassa, Ulf Buhmann, Laura Carrick, Natalie Rogers, Said Seifalan, Ian Ryder, Jennifer Partridge, Tim Lovell, Martin Priestley, Caroline Wrey Brown, Joanna Moore, Vidhya Nagaratnam, Saba Iqbal, Francesca Mazzola, Samantha Weller, Laura Gould, Helen Johnston, Jenny Spimpolo, Carmen Scott, Stephen J. Brett, Paul Cripps, Amit Kurani, Alexander Knight, Nirav Shah, Pushkar Patankar, Fraser Waterson, Sarah Martindale, Johannes Mellinghoff, Joanne Wootton, Sarah McCormick, Sameer Somanath, Bilal Yasin, Christopher Skeoch, Toby Jacobs, Katrina Eaton, Lynne Connell, Harry Soar, Yvonne Bramma, Tom Gately, Renjith Joseph, Anish Gupta, Lucie Hobson, Charindri Wariyapola, Maryam Zaky, Nimu Varsani, Gerhardus Van Rensberg, Jackie Evans, Rosahn Saleh, William Sutcliffe, Louise Potter, Harvey Dymond, Catherine (Katie) Patton, Andrew Selman, Stephen Traynor, Kate Tizzard, Rumyana Nyathi, Caroline Reavley, Saima Hashmi, Kerry Hughes, Isabelle Sykes, Kate Slade, Anne Troy, David Castillo, Jennifer Quinton, Anne Adams, Joanne Gresty, Stella Wright, Victoria Christenssen, Iain Mooney, Fiqry Fadhlillah, Seema Pai, Gabor Debreceni, Aleinmar Winthein, Denise Griffin, Hannah Beadle, Elisa Kam, Marie Williams, Helen Howes, Tariq Tabiner, Saxon Prentice, James Bedford, Emma Craig, Peter Standen, Stephen Petley, Janaki Pearson, Cheryl Marriott, Harry Barclay, Alexandra Matson, Michael P.W. Grocott, Alison Thorne, Joanne Humphreys, Vishal Patil, Nick Greenwood, Richard Wassall, S.K. Harris, Valpuri Luoma, Dancho Ignatov, Rebecca Fry, Anamika Sehgal, Antonio Paredes-Guerra, Manjula Yadagiri, Yuvraj Doriaswami, Benjamin O'Donovan, Adam Mounce, Stephanie Wright, Linda Webber, Tracy Hazelton, Ethan Bateson, Theresa Garrett, Chris Honstvet, John Scriven, Rahul Dimber, Phillip Lo, Jenny Stead, Catherine Plowright, Rachel Morris, Pallavbhai Desai, Nicola Johnson, Neil Muchatuta, Vijayakumar Gopal, Sherma Turner, Karina Fitzgibbon, John B. Davis, Sarah Patch, Erica Jolly, Rob Gregory, Christopher Lochrin, Geoffrey Ryder, Sam Michlig, Liana Zucco, Susan Nimmo, Jessica Whiston, Sarah Goellner, Rohan Babla, Deborah Skelton, Lucy Mcmanoman, Darcy Pearson, Diane Forrest, Sanjeev Garg, Joanne Bradley-Potts, Joel Perfitt, Danny J.N. Wong, Mike Weisz, Caroline Lowrie, Timothy Alce, Alice Michell, Charlotte Soulsby, Dominic Hayes, Arnab Mandal, Stephanie Ridgway, Angela Willberry, Alka Grover, Simran Minhas, Kerwei Tan, Sharon Jones, Sam Marcangelo, Ben Millette, Hilary Thatcher, Greg Foster, Krishna Balachandar, Megan McAtear, Richard Shellard, Chris Littler, Thunga Setty, Kavita Sasi-Kumar, Theodore Floyd, Duncan Adshead, Stephen Hickey, South Yorkshire Hospitals Audit, Amy Barker, Ewen Cameron, Dawn Trodd, Wendy Nichols, Beth Farr, Mike Salmon, Naomi Fleming, Umairali Ikram, Ben Straughan, Peter J O'Brien, Laura Purandare, Janine Thomas, Elizabeth Wood, Kate Bosworth, Stewart Mckie, Samantha Evans, Tamilselvan Rajamanickam, Srinivasan Dhileepan, Paul Hindmarch, Colin Bergin, Sange Mansoor, Lisa Armstrong, Nagendra Natarajan, Irmeet Banga, Fiona Osborne, Lynne Williams, Pieter Bothma, Jade Woolley, Joanne Finn, Bernd Oliver Rose, Shaman Jhanji, Bennur Katyayani, Gillian Robertson, Laura Bird, Pauline Fitzell, Sally Anne Smith, Serena Yen, Stuart Clelland, Thomas Urwin, Luff Delme, Rocio Ochoa Ferraro, Nurse Cheryl Padilla Harris, Asad Naqvi, Andy Cumpstey, Natalie C. Wood, Samar Al-Rawi, Pulak Padhi, Claire Botfield, Bhavesh Raithatha, Michael Briskoe, Jolyon Cohen, Ben Gibbison, John John, Stephen Washington, Jayne Foot, Karen Chadwick, Naomi Cochrane, Sophie Spencer, Alexandra Gatehouse, Susan Smolen, Aaron D'Sa, John Sturrock, Christopher P Bourdeaux, Kumud Bhandari, Neil Kellie, Elizabeth Denman, Samson Tou, Laura Kettley, Alex Eros, Stuart McLellan, Nicola Ball, Emily Kirk, Sue Smyth, Kim Gibson, Oliver Barker, Mohammad Masood, Dabeeruddeen Ahmed, Geoff Thorning, Jennifer Van Ross, Esme Elloway, Kat Rhead, Sei Nishimura, Maximiliane Kellner, Benjamin Jacobs, Sanjoy Shah, Matthew Stubbs, Faye Moore, Greg Cox, Nishita Patel, Ashok Nair, Elizabeth Hawes, A Espinosa, Kavita Wankhade, Vladimir Bashliyski, Carina Bautista, Susan Lyjko, Michelle Rowe, Nikita Whotton, Julie Temple, Inthu Kangesan, Gemma McIntosh, Samir Nazir, R. N. Kumar, Jen Warren, Alex Coombs, Marilyn Boampomaa, Kaya Jeyarajah, Heather Savill, Claudette Jones, Vinayak Vanjari, Caroline Tierney, Santhana Kannan, Jennifer Aston, Helen Melsom, Valantine Woodham, Nichola White, Niraj Barot, Paolo Perella, Mayumi Vianzon, Padmanabhan Vatsala, Claire Boynton, Alexandra Edwards, Elisa Masoni, Jayne Edwards, Julie Edwards, Thomas Garth, Amanda Skinner, Kate Blethyn, Jonathan Chambers, Katie Ramm, Rosada Jackson, Thomas Coleman, Tracey White, Emma McKenna, Kanchan Umbarje, Thomas Sheppard, Deepa Jumani, Emma Murphy, Peter Lawley, David Howe, Daisy Alston, Ania Dean, Prasun Mukerjee, Julian Hood, Mahmoud Alkholany, Sarah Goff, Gillian Rennie, Bridget Fuller, Ciara Walker, Jonathan Pipe, Alex Eeles, Wai Soon, Catherine McMillan, Martha Wrigley, Neil Brown, Peter Sandbach, Claire McCahill, Anna Wilson Charlotte Yates, Paul Sampson, Natasha Muzengi, Colum Slorach, Moyra Hynd, Arjun Ardeshna, Trish Boateng, James C. Geoghegan, Rhys Williams, Karoline Middleton, Brian Campbell, Srikanth Chukkambotla, Daniel Leslie, Sherrie Samuels, Michael Allan, Ruth Clarke, Christopher Nutt, Kirsten Reid, Hannah Smith, Surabhi Jain, Stephanie Reed, Hywel Evans, Irene Gardner, Ben Griffiths, Guy Shinner, Marek Frenkiel, Jacek Zeber, Gary Minto, Simon Parrington, Louise Harrison, Carlos Kidel, Hawa Desai, Lois Steuart, Claire Hirst, Johann Harten, Marc Slorach, Angela Christofides, Claire Macey, Helen Moore, Chantal Busby, Andrew Robertson, Leanne Milner, Catherine Chapman, Rebecca Reeves, Lawrence Wilson, Alice Aarvold, Lizzie Irvine, Narayanan Suresh, Kirsteen Brown, James Dalton, Sam Miller, Yasir Rashid, Andrew Swain, Liliana Czukowska, Natasha Permall, Carys Durie, Peter Carroll, Lauren Cooper, Prerna Mehrotra, Sarah Clayton, Martina McMonagle, Sarah Buckley, Enoch Onya, Elizabeth Perritt, Domonique Georgiou, Manjeet Save, Lauren Friedman, David W. Hewson, Katherine McAndrew, Simon Morton, James Morgan, Susan Underwood, Helen Bowyer, Avninder Chana, Lucy Sootheran, Kieron Rooney, Pooja Patel, Jessica Summers, Laura Farmer, Kiran Keshvara, Victoria Richardson, Hannah Crowther, Geejo Rappai, Adam E. Green, Sarah Willcock, Smitangshu Mukherjee, Samuel Tyrrell, Geraldine Landers, Claire McAteer, Jennifer Awolesi, Sarah Higgin, Orla O'Neill, Chrissie Chevis, Paul Winwright, Vikram Malhotra, Jonathan Ogor, Maria Muelmenstaedt, Richard Stead, Lindsay Roughley, Sara Balliston, Nevena Kalcheva, Marc Wittenberg, Adrian Taylor, Lydia Shatanda, Anjali Soodan, Angela Moon, Sarah Elgarf, Matthew Roche, Sanchita Bhatia, Clare Howcroft, Emma Butterfield, Emily Gannon, Matthew Needham, Jacqueline McCormick, Daniel Bendel, Victoria Martinson, David Hall, Richard A. Armstrong, Lara Herbert, Beverly Kilner, Kathy Dent, Victoria Thwaites, Issy Thomas, Maggie Peat, Lisa Macbeth, Alex James, Rachel Flight, Nick Black, Elizabeth Boyd, Catherine Gedling, Suzanne Body, Nadine Farrell, Samantha Clayton, Paula Hiltout, Richard Haddon, Bethany Philpott, Victoria A Burgess, John Jackson, Anita Patil, Chris Platt, Lindsey Iles, Chrissy Braybrook, Katherine Morris, Emma Karsten, Minna Meritahti, Anastasia Lynn-Smith, Dorothy Hutchinson, Rebecca Darbyshire, Joanne Riches, Astri Luoma, Andy Gibson, Dushanthi Thurairasa, Roisin Baker, Xantha Holmwood, Alda Remegoso, Trusha Mistry, Sarah Hennell, Suganthi Joachim, Stephen Harris, Sam Eggleston, Melanie Morrison, Boon Ang, Natalie Jackson, Nicola Jones, Zena Haslam, Beata Iwanicka, Laura Graham, King Dhar, Melanie Kent, Daniel Wirth, Umakanth Kempanna, Laura Troth, Robert Orme, D. Campbell, Raquel Duarte, Muzaffar Sheik, Robert Maher, Jon Bramall, Rebecca Coates, Tracey Cosier, Sarah Vest, Kajan Kamalanathan, Graeme Foggo, Amanda Mohabir, Ritoo Kapoor, Precious Basvi, Jamie McCanny, Christian Frey, Bruce Emerson, Anantharaman Venkataraman, Karen Burns, Gail Pottinger, Mohamed Elwkhiee, Farkhunda Waqas, Alison Loftus, Amanda Kirrage, Ilma Songaile, Craig Smith, Jo Mullender, Hannah McPhee, Miriam Namih, Linda Gregson, Rachel K. Walker, Iain K. Moppett, Christine Adamson, Katie Flower, Tina Stoycheva, Beena Parker, Caroline Thompson, Kootharajan Kamraj, Vignesh Ashok, Ranjit Gidda, Istvan Koczka, Sadie Perkin, Vandita Ralhan, Arun Sengottaiyans, Ruth Hodgson, Peter Valentine, David Nunn, John Hickman, Molly Waldron, Lauren Elliott, Irene Echaveznaguicni, Lisa Dunlop, Julian Sonksen, Robert Fallon, Huw Griffiths, Thoy Ruth, Olivia Clancy, Lucy Dudgeon, Alicia Rodgers, Pamela Oracki, Phoebe Syme, Maria Newton, Stuart P. D. Gill, Julie Foxton, Jane Perez, Liam Gleeson, Richard Green, Sally Beer, Rohit Juneja, Loretta Barnett, Alex Bonner, Eunice Emeakaroha, Andrew V. Bradley, Ravishankar Jakkala Saibaba, Dipali Verma, J. Joseph Kinsella, Swee Ang Tung, Anju Raina, Verity Calder, Andrea Ortu, Chris Walmsley, Suneal Sharma, Michelle Reichman, Tom Stocks, Annika Smith, Ross Cruikshank, Sharon Storton, Matyas Andorka, Abhishek Kakkar, Allison Daniels, Priya Datar, Nichola Wakeford, Sheila Black, Usman Choudhry, Stephen Hackett, Huw Wilkins, Kirtida Mukherjee, Tim Green, Rebecca Hill, Ishan Dharmarathna, Jennifer Crooks, Serah Mungai, Luisa Howlett, Niveen El-Wahab, Linda Prasad, Amy Sadler, David Sharpley, Daphne Varveris, Victoria Ashton, Rajeev Jeevananthan, Safia Begum, Helen Anderson, Katherine Nahajski, Vanessa Linnett, Laura Morland, Stephen Mowat, Nenette Abano, Kathryn James, Ian Butler, Madelaine Ocampo, D. Williams, Gabriella Frunza, Wendy Deamer, Dominic Espitalier-Noel, Sian Liddle, Jane McConniffe, Anthony E. Pickering, Lisha Aju, Catherine Morgan, Hao Ern Tan, Jemma Tate, Emma Dooks, Anna Moore, Alison Hardwick, Liam Scott, Zak Rob, Rajeev Jha, Sujesh Bansal, Lynda Connor, Seliat Sanusi, Sophie Mason, Nipun Agarwal, James Woodier, Julian Giles, Lauren Collis, Jill Brown, Natalie Constable, Nichola Cahill, Anne Cowley, Mai Wakatsuki, Kelly Mintrim, Glenn Arnold, Donna Doyle, Ryhs Millington, Richard Dobson, Monica Serrano, Saqib Naji, Walid Hammad, Jacob Osbourne-Wylde, David Rollins, Claudia Paoloni, Nathan Anderson, Rachel Ingham, Alison Whitcher, Vicky Hills, Nina Toms, Jon Witby, Amy Nash, Marcus Fletcher, Jane Gibson, Martin Warin, Katherine McDowall, William Malein, Madhurima Das, Wael Abdelrhamen, Tom Neal, Sister Jenny Ritzema, James Collins, Chandana Rao, Joyce Yeung, Nadeem Shakir, Andrea Weigert, Atideb Mitra, Hari Arunachalam, Amy Morgan, Richard J. Jackson, Julie Chadwick, Debbie Callaghan, Frank Swinton, Lorraine Lock, Rahul Wakhle, Krish Kapoor, Ryan Humphries, Sarah Beavis, John-Paul Cutts, Julie Wilson, Keith Kelly, James Gill, Angela Loughlin, Rhys Rhidian, Christopher McGovern, Tom Hickish, Rachel Campbell, James Pennington, James Tozer, Philip Coakley, Lynn Fenner, Sally Tomkins, Lester Ribeiro, Shabir Qadri, Hristina Petkova, Christina Timmons, Katy Smith, Jonathan Perry, Stephen Crotty, Tanmay Patil, Mayavan Abayalingam, Ahmed Foly, Anna Wahed, Lewys Winfield-Young, Naomi Goodwin, Mark Verlander, Clare Donovan, Milena Vannahme, David Helm, Murali Vallabhaneni, Clare Ingram, Neil Moreland, Lorraine Stephenson, Jenny Jackson, Lindsay McOwat, Sathya Visvendra, Rhiannon Jones, Sarah Bird, M. H. Nathanson, Beryl Jones, Claire Davies, Beena David, Ian Sheldrake, Jeremy Guilford, Sister Bryony Storey, Rajeev Mishra, Irina Halfacree, Kiran Rait, Sameer Ahmed, Victoria Poyntz, Pamela Birks, Tom Kennedy, Angiy Michael, Michael McEvoy, Ian Davies, James Chan, Sajjad Ahmed, Laura Sweeney, Anne Whaley, Andrew Moores, Stella Gillies, Gearoid Crosbie, Antoinette Wilson, Iain Walker, Fiona Brailsford, Virginia Solanki, Elizabeth Turnbull, Lyndon Harkett, Sarah Ramsay, Thomas Syratt, Pushpaj Gajendragadkar, Cathal Small, Joanna Poole, Annabelle Whapples, Raghavendran Krishnaiyan, Elizabeth Smee, Richard Pierson, Taslima Rabbi, Alexandra Murphy, Angela Rooney, Sarah Crawford, Peter Bamford, Stephen Worthy, Sarah Munsie, Lucy Venyo, Henry Wang, Aditya Kuravi, Dennis Barnes, Ruth Han, Benjamin Gupta, Nurse Lynn Wren, Robert Hartley, Emma Edmunds, Laura Blood, Valerie J. Page, Thomas Judd, Puvan Suppiah, Emma Jenkins, Kate Gallagher, Fionnuala Lenehen, Rashidat Adeniba, Julius Cranshaw, Julie Wollaston, Kathryn Allison, Richard Kirkdale, Samantha Griffith-Norris, Jenna Kelly, Snehasish Guha, Stefan Schraag, Joy Dearden, Elizabeth Bell, Stephen Smith, Sarah Longhurst, Elizabeth Wilby, Annaliza Sevillano, Raksha Mistry, Aalisha Mariam Karimi, Kaung Pyae, Sarang Puranik, Maggie Collingborn, Karen Cranmer, Chandrashekhar Vaidyanath, M. Chincholkar, Narendra Siddaiah, Gillian Bell, Edward Rintoul, Nicki Devooght-Johnson, Tom Lovejoy, Eleanor Roscoe, Zoe Neilson, Joanne Hill, Kamal Sharif, Sharon Meehan, Bassey Nkanang, Thomas Georgiou, Martin Goodman, Prashant Kakodkar, Rebecca Martin, Philip Roddam, Evanna McEvoy, Peter Tsim, Janakan Anandarajah, Shub Gupta, Oliver Pratt, Yang Ng, Francesca Th'ng, Linda Kent, Graham Soulsby, Danielle Kirk, Ramana Govindaraju, Rebecca McClean, Samantha Harkett, Obaid Tarin, Shalini Chinna, Susan Gallagher, Laura Gardiner, Marc Turnbull, James Briscoe, Anna McSkeane, Melanie Claridge, Gillian Fleming, Thomas Huttley, Elaine Spruce, Lianne Hufton, Susan Hendy, Adrian Barry, Jeremy Drake, Cody Allen, James Hillier, Manju Patel, C. Gray, Nasreen Iqbal, Karen Markwell, Linzi Heaton, Michelle Nicholas, Gary Lau, Laura Catchpole, Nurse Sonia Walia, Kerry Elliott, Jake Hartford-Beynon, Amee Samani, Kathryn King, José William Martínez, Skylar Paulich, Ifan Patchell, Killian McCourt, Rebekah Rodgers, Christine Wood, Richard Wan, Karan Verma, H. W. Cain, Eleonore Quinn, Lisa Richardson, Muhammad Usman Latif, Nicholas Hingley, Rajesh Gilla, Roopa McCrossan, Mayeth Recto, Russell Hedley, Lucy McClelland, Suzie Marriott, Deepak Seharawat, Gururaj Mudimadagu, Claire Jones, Michelle Yare, Sophia Henderson, Rupinder Kaur, Emily Spence, David Wright, Bhaskar Dutta, Tom Pettigrew, Vikki Atkinson, Lorna Sissons, Segun Oladele, Sue Thomas, Hani Ali, Rebecca Robson, David Buckley, Kevin Hamilton, Amanda Hall, Anaesthetic Audit, Anna Watkin, Donna Kelly, Graham White, Sarah Sanders, Henry Boyle, Joao Galente, Thomas Williams, Justin Ang, Sarah Horton, Abdelrahman Soliman, Vijay Jeganath, Kavita Upadhyaya, Plamen Stoyanov, Murray Geddes, Alan Pope, Khaled Ellisy, Thomas Walker, Emma Finlay, Penny Parsons, McDonald Mupudzi, Adam Duffen, James Goodwin, Rob Penson, Laura O'Sullivan, Vinesh Mistry, Ravindra Mallavalli, Krzysztos Guz, Deepti Bhuwanee, Eleanor Andrews, Justine Burns, Sarah Kirk, Faith Kibutu, Sam Stafford, Julia Blackburn, Joellene Mitchell, Robert Spencer, Helen Williams, Karen Riley, Gabbie Young, Tom Williams, James Wu, Emma Wheatley, Alistair Johnstone, Rachel Stoeter, Timothy Cominos, Guy Coady, Ruth Mawhinney, Sam Spinney, ruthy Arumugam, Myura Nagendram, Jason Lie, Sian Hughes, Linda Bairkdar, Peter Evans, Daniel Pygall, Graeme Brown, Susan Livingstone, Norbert Skarbit, Amit Pruthi, Zakaulla Belagodu, Ben Linton-Willoughby, Richard A Cowan, Helena Prady, Mike Raffles, Sonia Rasoli, Katherine Cullen, Jessica Lees, Peter Lax, Ashok Puttapa, Fran Millinchamp, Aneta Oborska, Benita Adams, Kathryn Newton, Mrutyunjaya Rao Rambhatla, Sunny Nayee, Madlena Ivanova Vrazhalska, Jonathan Clarke, Aariana Sohal, Siobhan King, James Bain, Jessica Wilson, Anthony Carver, Jack Davies, Lucy Connolly, Samuel Morrish, Robyn Lee, Lucia Stancombe, Satyanarayan Jakkampudi, Kath Rosedale, Philip Hopkins, Clovis Rau, Katherine Hunter, Amy Farrow, Kathleen Holding, Elizabeth Vassell, Oliver Boney, Julia Icke, Ewa Prusack, Osi Egole, Fiona Linton, Suresh Eapen, Wendy Goddard, Ayda Borjian Boroojeny, Simon J. Davies, Jackie Terry, Fiona Graham, Thomas Pratt, Hanzla Naeem, Viv Colclough, Yeng Yap, Tejuswi Patel, Susan Midgley, Mark MacGregor, Ben Marshall, Talitha Devries, Cheng Ong, Katie Molloy, Kat Walker, Katy Irwin, Abbas Majeed, Mark Pinkerton, Nicki Russell, Sibtain Anwar, Ian A Jenkins, Lucy Allen, Elaine Coulborn, Ganesh Nair, Stewart Brown, Melissa Addy, Matt Milner, Amr Hassan, Victoria Millar, Sarah Turner, Gary Baigel, Amanda Lyle, Simon Young, Kathy Malinovszky, Heather Short, Mary Newmarch, Colin McAdam, Andrew Robert Bailey, Kevin Draper, Michael Agyemang, Kieran Oglesby, Clare Mewies, Ruth Ugochukwu, Shibu Jacob, Susan O'Connell, Charlotte Topham, Xiao Zhao, Shay Willoughby, Ossian Aukland Child, Manish Torne, Ben Wetherell, Divya Veluvolu, Dominic Wu, Elizabeth Evans, Daniel Eden, Suzannah Peggler, Lucy Emmett, Romit Samanta, Ravi Parekh, Jane Hermanowski, Will Shankey-Smith, Sam Papadopoullos, Julie Camsooksai, Sara Mistry, James Wigley, Anna Todd, Bally Purewal, Natalie Baldry, Kate Wilkinson, Aalia Sange, Kirsty Baillie, Joanne Topliffe, Denise McSorland, Saheli Das, Nikki Staines, Catherine Harris, Anna-Marie Boniface, Gemma Milne, Tessa Rowlands, Leanne Quinn, Svetlana Kulikouskaya, Christopher Bull, Angus Sutherland, Mihir Desai, Hannah Goodhand, Meenal Rana, John Bugo, Maria Chazapis, Sarah Kent, Sarah Siew, Marcin Pachucki, Tim Forsyth-Jones, John McKenna, Sarah Driscoll, Laura Hunter, Penny Bedoes, Natasha Santana-Vaz, Sandra Latham, Robert Coe, Sharon Christie, Lawrence R Kidd, Katy Redington, Alastair Sawyer, Abdalla Ali, Rekha Jayapal, Manfred Staber, Emma Pearson, Stuart Reilley, Tom Bird, Kristofor Inkpin, Annette Haines, Manish Verma, Naomi Wee, Ozerah Choudhry, Daniel Tucker, Euan Campbell, Aaron Stokes, Ashley Allan, Emma Reeves, Helen Fenner, Melanie Cockroft, Tom Nicholls, Sinan Bahlool, Sharon Drake, Nalini Sethia, Lesley Jordan, Martin Northey, Paul Glyn Jones, Lara Jeanes, Emma Simpson, Julia Brown, Samantha Coetzee, James Nicholas, Adam Samways, Ritesh Ganesh, Martin Ward Platt, Mizan Khondoker, Helen Wibberley, Lauren Simmonds, Sunita Agarwal, Linda Titinchi, Fran O'Higgins, David Pritchard, Laura Beard, Yvonne Lester, Charlotte Hirst, Louise Wills, Kevin Windsor, Haren Jyothiraj, Carmela Martella, Stephanie Bell, Christopher Nwaefulu, Hemamangala Venkatesh, Camilla Stagg, Soumi Ghosh, Thomas Dawes, Jennifer Lockhart, Stavros Papadopoulos, Nanci Doyle, Gillian Whalley, Rachael Britton, James Goddin, Maggie Dawson, Carole Holder, Elaine Morsman, Rachel Lovatt, Venu Mehta, John J.B. Allen, Anna Perham, Stephanie Wallis, Dmitry Zabauski, Peter Hart, Tracy Sharp, Martin Pope, Jo Knight, Jane Wright, Nageena Hussain, Josie Snell, Thomas Knight, Philippa Hill, Nic Martins, Robin Williams, Beverley Stidolph, Beth Peers, Brian Lafferty, Alicja A'Court, Joanna Collins, Charlie Kennedy, Andy Bates, Graham Walkden, Mia Marsden, Lauren Shillito, Poonam Bopanna, Raheel Ahmed, Ada Ezihe-Ejiofor, Kate Driver, Mevan Gooneratne, Carolyn Smith, Caroline Abernethy, Kathy Shammas, Chanice Alcock, Yin Yong Choo, Mark Vertue, Ratna Makker, Victoria C. Smith, Sachin Mehta, Clare Denford, Wint Mon, Jose Miguel Sabugueiro, Liz Varghese, Mohamed Ahmed, Rebekah Chan, Alexandra Williams, Stephanie Pauling, Maria Faulkner, Ryan Wilkins, Sara Stevenson, Kathryn Simpson, Moiz Alibhai, Patricia Williams, Pascal Defeyter, Siva Sangaralingham, Lucy Evans, Shirley Cocks, Simon Dyer, William Rea, Caroline Renton, Karl Braid, Ranjit Bains, Holly Owen, Sue Brixey, Calum Taylor, Laura Coleman, Andrew Peeling, Daniel Solomon, Christopher Perman, Roisin McCallum, Helen Church, Martin Watson, Amy Bamford, Elizabeth Bradshaw, Elizabeth Turner, Owen Vale, Suneetha Ramani Moonesinghe, Preeti Mahidik, Lynsey Cubitt, Catherine Hunter, Eleanor Warwick, Sam McAleer, Suresh Singaravelu, James Hilton, Rebecca Aspinall, Icel Souleimanova, Muna Elsheikh Idris, Wei Teo, Sarah El-Sheika, Adrienne Stewart, Sadia Habib, Emily Wade, Liesl Despy, Sharmin Shohelly, Colin Williams, Louise Shaw, Shree Voralia, Dafydd Lloyd, Barbara A. Crooks, Laura D Howe, Una Gunter, Edward Hare, Louise Nimako, Ruth Young, Helen Doherty, Sock Huang Koh, Stephen Merron, Martina Coulding, Agilan Kaliappan, Clare Bolton-Hill, Jill Wain, Maria O'Callaghan, Catherine Cartmell, Nicola Pemberton, Hannah Bennett, Lynda Garcia, Riquella Abbott, Sally Jeffrey, Thomas McLoughlin, Andrew Gratrix, Christopher Harrison, Matt Mackenzie, Jayshree Gracey, Chris Moore, Benjamin Parsons, Nehal Patel, Stephanie Brooks, Catherine Riley, Jemma Gilmore, Ilya Kantsedikas, Simon Whiteley, Emily Pallister, Angie Organ, Yohinee Rajendran, Gopinath Selvraj, Priya Thorat, Ilona Schmidt, Pauline Austin, Nitin Madhukar Sadavarte, James Haddock, Alastair Duncan, Richard Bateman, Elaine Chinery, Martin Gray, Felicity Corcoran, Shanelle Tharuka Wijesuria, Bryany Bond, Charlene Otieno, Sion Lewis, Cieron Roe, Dan Freshwater-Turner, Annette Bolger, Sarah Steynberg, Louie Saclot, Charlotte Busby, Jack Roberts, Richard Dagnan, Jasna Comara, Krishnakar Melachuri, Sian Gibson, Joanne Taylor, Manju Agarwal, Mark Sheils, Matthew Bell, Rosemary Anna Lewis, Kiran Patel, Mansoor Siddiqui, Christopher J. Groves, Mini Thankachen, Sharon Turney, Viral Dalal, Pele Banugo, Andrew Baird, Euan Kerr, Simon Tomlins, Laura Osbourne, Nicola Pattison, Stuart Joy, Susan Merotra, Lorna Ryan, Lisa-Jayne Cottam, Chye Siaw, Keelan Jerram, Nurse Diane Scarletta, Carole Paley, Jennie Smith, Will Gatfield, Stephen Alderson, Claire Swarbrick, Amelia van Manen, Stephan Clements, Sophia Strong-Sheldrake, Jake Drinkwater, John McLenachan, Lucinda Williams, Dianne Heaton, Sandor Orosz, Chloe O'Hara, Nina Barratt, Justine Elliot, Michael Gardner, Nicola Crowther, Bharati Rajdev, Linda Hall, Youssef Girgis, Michael Kinsella, Alison Potter, Matthew Martin, Rosie Reece-Anthony, Richard Pugh, Tracey Taylor, Esme Marshall, Wendy Stoker, Helen Worrell, Kay Housley, Rebecca Leslie, Helen Jewitt, Sandeep Sharma, Maire Gallagher, Jon Fenn, Jade Harrison, Hannah Watson, Natalie Morris, Lewis Schofield, Nisha Pattni, Charlotte Thomas, Eleanor Walshe, Richard Snooks, Ruth Murphy, Emily Pickford, Gnanshree Krishnamurthy, Donna McIntosh, Rachel Dolan, Emma Stoddard, Kelly Goffin, Shady Elhallous, Adrian Butler, Ildiko Nemeth, Hannah Wilson, James Sylvester, Melanie Sahni, James Wardlow, Ann Lachana, Emma Barr, Kayleigh Gilbert, Yazzim Hammoud, Peter Csabi, Maqsood Bajwa, James D Turner, Alex Hunt, Samantha Moore, Stephanie Hii, Philip Atkinson, Michelle Walter, Elizabeth Bailey, Frances Tait, Annie Newby, Jane Martin, Greg Forshaw, Bert Quartermain, Sally Humphreys, Aoife Hegarty, Caroline Bennett, Satyajeet Ghatge, Charles Prior, Kribashnie Nundlall, Priaykam Chowdhury, Jill Fitchett, Daiva Bernotaitis, Sandeep Varma, Alex Dunn, Rebecca Dooley, Mahamed Mostafa, Shelly Wood, James Humphreys, Anna Celnik, John Bailes, Mark Snazelle, Christina McCarroll, Matthew Govier, Emert White, Matthew Taylor, Alastair Rose, Brigid Hairsine, Natalie Whybro, Allen George, Robin Wilson, Filipe Vieira, Leon Cohen, Jonathan Womack, Thomas Woodward, Nimali Lochanie, Ben Howes, Joshua Nelson, Preea Gill, Gayle Clifford, Lushani Suntharanathan, Duncan Wagstaff, Steve Pryn, Lalindra Bandara, Sneh Shah, Nowfal Rahman, Iolo Roberts, Mirriam Sangombe, Shaik Subhani, Hannah Phelan, William Udall, Katy Allan, Nicola Zondo, Tim J Peters, James Roe, Catherine Addleton, Angus McKnight, James McCaul, Flora Kormendy, Anil Rao, Luke Vamplew, Andrew Rees, Jeanette Gilbert, Mandy Austin, Thomas Hunt, Sian Birch, Catherine Lloyd, Stewart D'Sylva, Jill Smith, Wendy Lum Hee, Michael Munro, Jean Denton, Julia Hindle, Alice Brown, Ursula Kirwan, Dinithi Yogya, Maria Mclaughlin, Nurse Louise Moran, Larysa Duniec, Sophie Benoliel, Gail Evans, Linda Bailey, Colin Hall, Katie Rowland, Krupali Patel, Ashwini Keshkamat, Zorba Begum, Resti Varquez, Victoria Apps, Giles Bond-Smith, Shirin Dastur, Andy Chapman, Amy Smith, Sarada Gurung, Ruth Delascasas, Nicole Issit, Pauline Sibley, Jaina Parmar, George Madden, Eveliina Nurmi, Katja van de Snepscheut-Jones, Louise Peacock, Vanja Srbljak, Kellie Allen, Andy Chamberlain, Suhail Zaidi, Andrew Boyle, Daniel Stolady, Rita Saha, Mark Clayton, Mitul Patel, Emily King, Hannah Oliver, Ewa Werpachowska, Holly Coles, John Dereix, Agnieszka Kubisz-Pudelko, Clare Watkinson, David Rogerson, Laurence Inman, Jaspreet Rayet, Jenny Finch, Emma Stewart, K. E. Wilson, Emma Tyson, Asif Gani, Reni Jacob, Neil Smith, Johnny Holland, Max Richardson, Mark Chen, Richard George, Helen Laycock, Anoushka Winton, Emily Hignell, Li Fang, Emma Welfare, Rochelle Velho, Fayaz Baba, Finbar O'Sullivan, Lisa Zeidan, N. Beauchamp, Neil Rasburn, Guy Rousseau, Victoria Roberts, Hollie Bancroft, Holly Maguire, Mechele Couch-Upite, Rahul Kumar, Chandra Bhimarasetty, Matt Lovell, Sujata Anipindi, Charlotte Small, Matthew Faulds, Alex Mattin, Alice O'Donnell, James Jack, Richard Boulding, Tarek Mostafa, Rhian Bull, Corinne Pawley, Ruth Killen, Jessica Lowe, Frances Taylor, Ethel Black, Michael F. M. James, Jenny Child, Lisa Emery, Kim Hoyland, David Hay, Janet Cotta, Josephine Stewart, Sue Spearritt, Laura MacNally, Fatma Lahloub, Katie Welham, Sanjoy Bhattacharyya, Shanteela McCooty, Heena Bidd, Hugo Buckley, Ervin Shpuza, Zaid Ahmed, Emily Craven, Amanda Cook, Caroline Dixon, Tara Pauley, Tariq Azad, Helena Barcraft-Barnes, Sindy Lee, Kate Penhaligon, Bernice Dudkowsky, Karen Ellis, Laura Montague, Ching Pang, Elsie Bickmore, Veronica Marsh, Toby Winterbottom, Marta Campbell, Rhys Hughes, Issie Gardner, Elizabeth Steel, Ramai Santhirapala, Katie Sweet, Michelle Scott, John Ekpa, Bhavia Janardhana, Catriona Frankling, Julia Ottaway, Alexander Middleditch, Elna Cifre, Annabel Pearson, Amanda Cotterill, Sarah Raut, Hannah Blanshard, Sara Eddy, Garry Henry, Elizabeth Hood, Maria Loy, Matthew Campbell, Marc Gimenez, Jessica Thrush, Jeremy Henning, Vlad Kushakavsky, Nikolaos Makris, Deborah Fradkin, Karen Fan, Fiona Hammonds, Kathryn Jackson, John Hadfield, Pyda Venkatesh, David Read, Daniel Zeinali, Ryan Hynd, James Carvell, Richard McCormick, Emily Dodds, Sana Rizvi, Amelia Daniel, Dan Sellers, Thomas E. Miller, Daniel Haigh, Nicky Moss, Patrick Dill-Russell, Priya Shekar, Teresa Melody, Randeep Dhaliwal, Nigel Hollister, Andrew Burtenshaw, Adrian Wagstaff, Ben Scoones, Eduardo Osorio, Joanna Allison, Lucy Willsher, Carol McArthur, Stephan Dalchow, Elaine Winkley, Eleanor Reeves, Ben Eden Green, Andrea Ingham, Mohammad Auldin, Freda Amoakwa-Adu, Jonathan Adams, Fiona Oglesby, Charlotte Steeds, Nurse Sara Greig, Obla Suganthi, Puja Chhaniyara, Clare De'Ath, Chandrakant Gosavi, Bart Ordys, Adele Flowerdew, Doug Tunney, Rachel Alexander, Oliver Griffith, Thomas Saunders, Matthew Maton-Howarth, Gabi Metiu, Akmal Shakoor, Elizabeth Willard, Katherine Russell, Matthew Robinson, Emma O'Kane, Meera Raja, Phillippa Falkner, Kerry Colling, Natasha Joshi, Laura Pearse, Tim J. Smith, Anitha James, Mona Mohamed, Richard Kennedy, Samson Ma, Tasmeen Ghafoor, Matthew N. Davies, Henry Lewith, Samuel Mindel, Sarah-Jane Dunn, Hemangini Barot, Sadie Diamond-Fox, Jenny Macallan, Arun Menon, Helen Farrah, Emma Plunkett, Brendon Spooner, Sorana White, Katie Samuel, David Crabtree, Katherine Cheshire, Gareth Harrop, Dionne Wortley, Tim Warrener, Joanne Mullen, Peter Taysum, John Whitaker, Kathy Wilkinson, Jean Dent, Nicola Farmer, Thelma Darian, Guru Hosdurga, Phillipa Wakefield, Christopher W Horner, Julie Steen, Elena Teh, Helen Gerrish, Betty Travasso, Mhairi Jhugursing, Michelle Gardener, Alexandra Crook, Edward W. Miles, Patricia Doble, Ashok Raj, Hanna Wong, Kay Protheroe, Chiraag Talati, Banher Sandhu, Cara Marshall, Matt Holl, Julie Sheriff, Frances Forrest, Adam Mitchell, Hindusha Keerthikumar, Mohamad Mahmoud, Simon Ben-Nathan, Janice Hartley, Danielle Ormandy, Hayleigh Morris, Steven Tran, Imogen Hayes, Trudy Smith, Kirsty Duell, Jennifer Cunningham, Richard Appleton, Lucy Pippard, Debroah Beeby, Hayley Bridger, Manuel Pinto, Susan Beames, Huiqi Wang, Cain Hunter, Flora Darch, Debbie Weller, Jonathan Hulme, Jacqueline Howes, Michael Kriger, Badrinath Manikundalam, D.J.N. Wong, Tim Arnold, Belinda Wroath, Rachel McKendry, Harry Knight, Caroline Bushell, Victoria Siddons, Louise Humphries, Joanne Vere, Vinanti Cherian, Janine Birch, Kate Blyth, Tatyana Bolonenkova, Meredith Harris, Alice Sisson, Sarah Clark, Sandeep Saxena, Samira Green, Amit Ranjan, Gillian Bennett, Chris Smales, Laura Ferguson, Ash Bharti, Francisca Mautadin, Katherine Brown, Lydia Jones, Christopher Adeney, Nikkita Carden, Sanjay Behl, Sonia Sathe, Elizabeth Neale, Helen French, Charlotte Mundy, Anna Batchelor, David Morris, Nithin Roy, Evelyn Philip, P.A.-A. Marc Hastie, Andrea Cole, Edmund Quak, Claire Totten, Karen McIntosh, Fiona Davis, Søren Kudsk-Iversen, Vanessa Unsworth, Andrew McIndoe, Jeremy Bewley, Sarbpreet Sarao, Laura Wood, Elaine Walker, Egidio Da Silva, Danielle Gilmour, Richard Yardley, Zara Eagle, Vijay Ragothaman, Sean Rayappu, Moira Tait, Alex Hamilton, Chris Gillett, Adeel Majeed, John Elton, Arlo Whitehouse, Fiona Robertson, Tim Martindale, Kin So, Kathryn Dixon, Toby Shipway, Fiona Mcneela, Simon Cousins, Brian Conway, Merate Place, Phil Duggleby, Rhian Morgan, Racquel Carpio, Carina Casey, Edward Mew, Jo Han Gan, Caroline Clark, Natasha Sharma, Kay Anne Mak, Gahan Bose, Chris Ford, Ruoling Yan, Anand Sathiapillai, Panagiotis Sgardelis, Sue Redhead, Arjun Alva, Cathy Jones, Vincent Hamlyn, Gemma Squires, Karen Smallshaw, John Whitwell, Sarah Shaw, Paul Watson, Michelle Cheeseman, Kimberley Netherton, Juneenath Karattuparambil, Niyesa Ranasinghe, Jeet Patel, Rob Lyons, Gemma Bown, Helen Bromhead, Zhana Ignatova, Kudakwashe Nyangoni, Linden Baxter, Thomas Moody, Sachin Valap, Esme Sleap, Mario Fernandes, Kinga Bodo, Jane Silk, Charlie Pope, Donna Ferraioli, Chloe Billingham, Rachel Butterworth, Andrew Kelly, Lesley Hawkins, Issac Gill, Hannah Greenlee, Sue Kirby, Jessica Giles, Anna Pierson, Roxana Sandhar, Claire Smyth, Rhona Younger, Ciara Coary, Arif Qureshi, Tahir Abbas, Corinne Rimmer, James Evans, Ida Ponce, Fenner Christoper, Buzz Shephard, Sophie Tang, Lauren Milian, Joanne Hiden, Dhania Haron, Jamie Calderwood, David Freeman, Virginia McTaggart, Carla Lewis, Chai Obeysekera, Alan H. Cohen, Melvin Leong, Jenni Law, Noor Elahi, Kim Holland, Victor Maduekwe, James Garwood, Lizzie Dawson, Virginia Iqbal, Thomas J Craig, Daniel Shuttleworth, Anand Perumal, Mahmood Saad, Seema Charters, Bethany Tookey, P Gunning, Suresh Panchakshariah, I.J. Wrench, Mayur Murali, Susan McInerney, Paul Foley, Charlotte Perkins, Marie-Louise Svensson, Karen Birnie, Samantha Hagan, Emily Hetherington, Anna-Marie Love, Annette Woods, Karen Green, Steve Hillier, Hannah Conway, Rebecca Reilly, Laura Bubb, Amy Ashford, Andrew Savva, Melody MacGregor, Stephen Lord, Ahmed Hassanin, Ramdas Howard, Laura Ashton, Arihant Jain, Simon Williams, Michael Shaw, Jill Deane, Abbie Singleton, Catriona Routley, Christopher Hall, Robin Webber, Tressy Pitt-Kerby, Stuart M. White, Shannon Gawley, Nick Heseltine, Christina Lalani, Claudia Dulea, Arindam Biswas, Rebecca Harris, Aislinn Brown, Nicholas Francis, Ben Holst, Ryan Perry, Cathie Melvin, Mark Darbyshire, Stephen Mulvany, Amy Ashton, Petrus Fourie, Emma Temlett, Jason Cupitt, Vanisha Patel, Alice Trimble, Andrew Brammar, Sarah Grayland, Eleanor Pett, Tom Standley, Carly Webb, Manamohan Rangaiah, Laura Peltola, Leanne Darwin, Yvonne Grimes, Elizabeth Brodier, Scott Berwick, Adam Janeczko, Madeleine McKee, Katherine Davidson, Jan Woodward, Saurabh Mehotra, Tara Keogh, Kofi Mensah, Joyce Guy, James King, Matt Aldridge, Nicolas Price, Alaine Done, Teresa Jones, Julia Sampson, Smita Bapat, Lauren Perkins, Tamas Szelei, Ryan Kingan, Suleman Mulla, Celia Montgomery, Alex Belcher, Salma Kadiri, Bryan Singizi, Peter Chater-Lea, Jennifer Claire Taylor, Lauren Oswald, Stephanie L. Lee, Rhys Griffiths, Samuel Pestell, John Livesy, Sarah Ciechanowicz, Alexander Stephen Harrison, Richard Partridge, Alex Daniels, Beth Penhaligan, Lyndsay Bibb, Jonathan Little, Margaret Cullen, Anya Eijk, Charlotte Earnshaw, Elena Lynes, Nicholas Jenkins, Inthekab Mohammed Ali, Madhu Balasubramaniam, Vusumuzi Shabangu, Paul-Simon Whitney, Rebecca Denyer, Kathryn Potts, Andrew Ray, Jonny Guy, Mike (Stephen) Kinsella, Pearl Baker, Olga Fernandez, Julian Berry, Callum Forbes, Southcoast Peri-operative Audit, Rebecca Rice, Lisa Horner, Sally Pitts, Kirat Panesar, Joe Stevens, Timothy Molitor, Oon Chiu, Piers Murphy, Sudeshkumar Muniyappa, David George, Jonathan Veitch, Shifa Yaruk, Lynn O'Donohoe, Theresa Murray, Laura Tasker, Johanna Wales, Diane Mellers, Robert Sparrow, Olivia Ward, Emma Shacklock, Janet Middle, Sarah MacLennan, Martin Knight, Lindsay Dawson, Teodora Orasanu, Jo Fletcher, Sarah Martin, Pnt Laloë, Gregor Imrie, Harriet Pudge, Tamsin Gregory, Andrea Wood, Colin Christie, James Penketh, Mia Andrews, Nicky Ford, Ellie Fisher, Sophie Robin, Richard Stewart, Steve Williams, Harriet Gardiner, Alison Evans, Guanmei Luo, Urmila Ratnasabapathy, Ruth Joslyn, R. Sneyd, John Westwood, Naomi Cassells, Olivia Kay, Jordi Margalef, S Butler, Hari Nageswaran, Chloe Searles, Geoffrey Wright, Thomas Potter, Drew Norwood-Green, Jonathan Ramsden, Sarah Bean, Emma Sadler, Anaesthetic Trainees, Stephanie Lewis, Kevin E. Thorpe, Sarah MacLean, Paul Ogle, Mary O'Sullivan, Diane Whitehouse, Mandy Oakley, Rachel Coathup, Harisg Venkatesh, Lisa Burgess, Daniela Smith, Kimberley Plummer, Hilary Robb, Jeanette Grocott, Rebecca Mairs, Helen Gilfillan, Moira Morrison, Sharon Garner, and Tammy Towers

Subjects
Adult, medicine.medical_specialty, Adolescent, State Medicine, Cohort Studies, 03 medical and health sciences, Young Adult, 0302 clinical medicine, 030202 anesthesiology, Pregnancy, Risk Factors, Neoplasms, medicine, Humans, 030212 general & internal medicine, Prospective Studies, Young adult, Prospective cohort study, health care economics and organizations, Aged, Aged, 80 and over, Health Facility Size, Postoperative Care, Models, Statistical, business.industry, Incidence (epidemiology), Incidence, Health services research, Operating room management, Odds ratio, Middle Aged, Confidence interval, United Kingdom, Surgery, Obstetrics, Anesthesiology and Pain Medicine, Hospital Bed Capacity, General Surgery, Female, business, Emergency Service, Hospital, human activities, Cohort study
Abstract

Background: cancellation of planned surgery impacts substantially on patients and health systems. This study describes the incidence and reasons for cancellation of inpatient surgery in the UK NHS. Methods: we conducted a prospective observational cohort study over 7 consecutive days in March 2017 in 245 NHS hospitals. Occurrences and reasons for previous surgical cancellations were recorded. Using multilevel logistic regression, we identified patient- and hospital-level factors associated with cancellation due to inadequate bed capacity. Results: we analysed data from 14 936 patients undergoing planned surgery. A total of 1499 patients (10.0%) reported previous cancellation for the same procedure; contemporaneous hospital census data indicated that 13.9% patients attending inpatient operations were cancelled on the day of surgery. Non-clinical reasons, predominantly inadequate bed capacity, accounted for a large proportion of previous cancellations. Independent risk factors for cancellation due to inadequate bed capacity included requirement for postoperative critical care [odds ratio (OR)=2.92; 95% confidence interval (CI), 2.12–4.02; PConclusions: a significant proportion of patients presenting for surgery have experienced a previous cancellation for the same procedure. Cancer surgery is relatively protected, but bed capacity, including postoperative critical care requirements, are significant risk factors for previous cancellations.

Published
2018

26. Treatment of tobacco dependence in UK hospitals: an observational study

Author

John M. Hutchinson, Anna Lewis, Sanjay Agrawal, Laura Searle, and Zaheer Mangera

Subjects
Adult, Male, medicine.medical_specialty, Adolescent, medicine.medical_treatment, Population, Audit, 030204 cardiovascular system & hematology, Smoking prevalence, Logistic regression, 03 medical and health sciences, 0302 clinical medicine, Pharmacotherapy, Preventive Health Services, medicine, Prevalence, Humans, 030212 general & internal medicine, Staff Development, education, Original Research, Aged, 80 and over, education.field_of_study, business.industry, Smoking, General Medicine, Tobacco Use Disorder, United Kingdom, Hospitalization, Outcome and Process Assessment, Health Care, Family medicine, behavior and behavior mechanisms, Smoking cessation, Observational study, Female, Smoking Cessation, business, Pharmacy Service, Hospital, Hospital-Patient Relations, Needs Assessment, Staff training
Abstract

Over a million smokers are admitted to hospitals in the UK each year. The extent to which tobacco dependence is identified and addressed in this population is unclear. Data on 14,750 patients from 146 hospitals collected for the British Thoracic Society smoking cessation audit were analysed to determine smoking prevalence, attempts to ask smokers about quitting, and referrals to smoking cessation services. Associations with hospital organisational factors were assessed by logistic regression. Overall hospital smoking prevalence was 25%. Only 28% of smokers were asked whether they would like to quit, and only one in 13 smokers was referred for treatment of tobacco dependence. There was a higher chance of smokers being asked about quitting in organisations with smoke-free sites, dedicated smoking cessation practitioners, regular staff training, and availability of advanced pharmacotherapy. Treatment of tobacco dependence in smokers attending UK hospitals is poor and could be associated with organisational factors.

Published
2018

28. DECP Annual CPD Conference Individual Presentations and ReviewsEP role in raising literacy attainments in Medway’s schoolsExploring resilience in studentsExploring looked after children’s experiences of child and adolescent mental health services. Listening to looked after children: Best practice provision in mental health provisionDeveloping emotional resilience in ‘challenge averse’Risk and resilience factors in Europe: Siestas, girlfriends and families Dr Chris ArnoldFrom powerless to powerfulFoucauldian Iterative learning conversationsWhat does Dyslexia do for teachersA psychosocial study exploring the school experiences of adolescents who have self-harmedWhy well-being?Are synthetic phonics programmes and the phonics screen major causes of dyslexia?Life at a Residential Special School: Children’s views and perspectivesNurturing Me: An approach to gain the child’s perspective on well-beingThe role of the educational psychologist in further educationThe assessment of phonological awareness using PhAB2: Special studiesSupporting children affected by the imprisonment of a family member: An overview of Birmingham’s innovative champion modelWell-being in the Scottish context – how Edinburgh EPS ‘Gets it Right’Pastoral Adolescent Mental Health Strategy (PAMHS) for secondary schools – introduction to a practical psychological toolHidden victims of the justice and education systems: Giving children of prisoners a voiceThe well-being of children starting to learn to play musical instrumentsTanzanian teachers’ constructions and perceptions of ‘inclusive’ education for girls and girls with disabilities and the potential for improving well-beingThe Homunculi Approach: A how-to guide for those working on the autistic spectrum or with mental health difficultiesSchool-based applications of mindfulnessThe ‘Emotional-Warmth’ dimension of professional child-care: Empowering the carers of young people who have been rejected, neglected and abusedUsing the Holistic Politico-Psychological (HPP) model of mental health as a framework for the psychological formulation of mental distressEmotional Literacy Support Assistants (ELSAs) – developments and reflectionsOut of School: Exploring children’s experiences and adult understandings of extended non-attendance

Author

Matt Baker, Sheila Burton, Dave Traxon, Sean Cameron, Jennifer Head, Anne Greig, Alexandra Sewel, Dawn Rose, Fiona Weidberg, Willem Van Royen, Kathryn Davidson, Melissa Jones, Simon Gibbs, Laura Merrel, Maura Kearney, Vivian Hill, Jonathan Solity, Sue Roffey, Jane Reichardt, Brian Apter, Jacqueline Batchelor, Chris Arnold, Vanessa Wood, Sidra Aslam, Simon Cassidy, Anna Lewis, Kelly-Marie Underdown, Alison Watson, Liz Pellicano, Rhiannon Yates, Paula Dudgeon, Heather Bell, Tommy Mackay, and Sarah Goalen

Published
2015
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29. 'Give the Reason for the Hope that you Have': Reginald Pecock’s Challenge to (Non)Disputing Lollards

Author

Anna Lewis

Subjects
Literature, business.industry, media_common.quotation_subject, Orthodoxy, General Medicine, False accusation, Church renewal, Heresy, Law, Isolation (psychology), Sociology, business, Lollardy, media_common
Abstract

Medieval scholars are in broad agreement about Lollardy’s academic roots and its familiarity with disputational techniques; contemporaries also recognized these characteristics of the movement. It is surprising, then, to find that Bishop Reginald Pecock, the most vocal and persistent of Lollardy’s fifteenth-century opponents, accused Lollards of resisting sincere, reasonable, and academically informed debate and of refusing to offer a clear defense of their own opinions. This article considers how and why Pecock made this unusual accusation. It examines Pecock’s view of the “processes” of reason and suggests that, by characterizing Lollards as those who reject these processes, Pecock was able to clearly distinguish his own theological project from theirs. Pecock’s project, outlined in his written works, encompasses education, Christian community, and church renewal, and places debate and discussion at its center. By emphasizing Lollard refusal to engage in true and earnest discussion, Pecock tapped into a tradition that identified a failure to clearly communicate as a mark of the heretic’s isolation from the wider Christian community. Pecock’s vision, by way of contrast, actively promotes an alternative communal model of lay learning that fosters orthodoxy and respect between clergy and laity.

Published
2015
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30. Smoking prevalence in UK hospital admissions from a national observational study

Author

John M. Hutchinson, Sanjay Agrawal, Zaheer Mangera, Laura Searle, and Anna Lewis

Subjects
medicine.medical_specialty, education.field_of_study, business.industry, Addiction, media_common.quotation_subject, Population, Smoking prevalence, Family medicine, Hospital admission, medicine, Case note, Observational study, Smoking status, National average, education, business, media_common
Abstract

Background: Hospital admission provides a special opportunity to identify smokers, and treatment of smoking in hospitalised patients is particularly effective. Objectives: We hypothesised that smoking prevalence is higher in people admitted to hospital compared to the general UK population, and higher in specific subgroups, such as emergency admissions. Methods: A British Thoracic Society online survey was used by hospitals, who randomly selected elective and emergency admissions under surgery and medicine, and retrospectively reviewed their case notes. Documentation of smoking status and treatment was recorded. Results: 146 institutions participated with 14,750 patient records submitted. Smoking status was recorded in 73% of cases. Smoking prevalence in UK hospital admissions was 25% (28% in males; 23% in females), significantly higher than the national average of 19% in Great Britain1 (p Conclusions: This is the first UK wide study to measure real time smoking prevalence in hospitals. Smoking prevalence is significantly higher in people admitted to hospital than the general UK population. It is especially high in younger adults and emergency admissions. With at least 1 in 4 patients being current smokers, hospitalisation represents a unique opportunity to treat tobacco addiction. 1 Office for national Statistics

Published
2017
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31. Weight in Parkinson's Disease: Phenotypical Significance

Author

Jagdish C, Sharma and Anna, Lewis

Subjects
Smell, Phenotype, Risk Factors, Deep Brain Stimulation, Body Weight, Weight Loss, Humans, Parkinson Disease, Overweight, Energy Intake, Hormones
Abstract

Body weight in Parkinson's disease (PD) is a significant nonmotor feature. Weight homeostasis is a complex physiological process and gets deranged in PD patients leading to changes in weight. While both the low and high body weight have been reported as risk factors for PD, the majority of PD patients have a lower weight and a subset of patients lose weight during the course of the disease, while a small proportion gain weight. A number of clinical parameters such as older age, impaired cognition, severity of disease, and an imbalance of food intake determined by satiety and hunger hormones have been reported to be associated with but not the cause of weight change. Low body weight and weight loss have a negative impact on disease severity, dyskinesia quality of life, and mortality indicative of disease progression. An early assessment of olfactory impairment seems to identify patients at risk of weight loss, the patients with more severe olfactory loss-anosmic group, lose weight as compared to the patients with some preservation of olfaction, the hyposmic group. Higher levodopa dose per kilogram body weight increases the risk of dyskinesia, higher body weight seems to be protective against this complication. The identification of PD patients according to the nonmotor phenotype of "Park-olfaction-weight-phenotype" and the "olfaction-weight-dyskinesia" triad should help to develop strategies to prevent weight reduction and improve general health and complications of PD patients. The phenotype seems to reflect a differential prodromal pathology and influence clinical disease. Higher body weight patients would benefit from life style changes to achieve a healthy profile. Weight monitoring and weight orientated approach to management of PD patients should help to improve their outcome. Body weight change might be a surrogate to disease progression and may be used to investigate neuroprotection strategies.

Published
2017

32. We Wait

Author

Anna Lewis and Dan Efergan

Subjects
Political science, Refugee crisis, Economic history
Abstract

This unforgettable VR experience transports you to the heart of the refugee crisis. Experience the hopes and fears of a terrified Syrian family as they make the perilous journey from Turkey to Greece on smugglers' boats.

Published
2017
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33. 173. NATIONAL AUDIT OF BIOSIMILARS USE IN RHEUMATOLOGY DEPARTMENTS IN THE UNITED KINGDOM: RESULTS FROM THE BIOSIMILARS OBSERVATORY

Author

Julia D. Flint, Alan Roach, Max Yates, Lesley Kay, Christopher Chan, Anna Lewis, Alex J. MacGregor, and Elaine M. Dennison

Subjects
medicine.medical_specialty, Biosimilar Pharmaceuticals, Rheumatology, Observatory, business.industry, Family medicine, medicine, Optometry, Pharmacology (medical), Biosimilar, business, National audit
Published
2017
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34. Science Educator Professional Development

Author

Anna Lewis and George I. Matsumoto

Subjects
Science educator, business.industry, Political science, Professional learning community, Professional development, Big data, Pedagogy, Mathematics education, business
Abstract

Scientific discovery, problem-solving, and hypothesis testing requires observation, data analysis and synthesis of new knowledge. In today's world, this process is highly dependent on computer-based data exploration of high volume, high velocity, and high variety data streams (3HV) However, though the power of 3HV surpasses the amount of information gathered from more familiar lab experiences, data-intensive science has not yet achieved the same impact or prominence in public education. This chapter provides an examination of the Education And Research: Testing Hypotheses (EARTH) Science Educator Professional Development (PD) which was developed to bridge this gap, bringing data-intensive science into the classroom while supporting inquiry learning practices.

Published
2017
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36. Weight in Parkinson's Disease: Phenotypical Significance

Author

Jagdish C. Sharma and Anna Lewis

Subjects
0301 basic medicine, Levodopa, medicine.medical_specialty, Parkinson's disease, Weight change, Disease, Overweight, medicine.disease, 03 medical and health sciences, 030104 developmental biology, 0302 clinical medicine, Dyskinesia, Weight loss, Internal medicine, medicine, Physical therapy, medicine.symptom, Psychology, Weight gain, 030217 neurology & neurosurgery, medicine.drug
Abstract

Body weight in Parkinson's disease (PD) is a significant nonmotor feature. Weight homeostasis is a complex physiological process and gets deranged in PD patients leading to changes in weight. While both the low and high body weight have been reported as risk factors for PD, the majority of PD patients have a lower weight and a subset of patients lose weight during the course of the disease, while a small proportion gain weight. A number of clinical parameters such as older age, impaired cognition, severity of disease, and an imbalance of food intake determined by satiety and hunger hormones have been reported to be associated with but not the cause of weight change. Low body weight and weight loss have a negative impact on disease severity, dyskinesia quality of life, and mortality indicative of disease progression. An early assessment of olfactory impairment seems to identify patients at risk of weight loss, the patients with more severe olfactory loss-anosmic group, lose weight as compared to the patients with some preservation of olfaction, the hyposmic group. Higher levodopa dose per kilogram body weight increases the risk of dyskinesia, higher body weight seems to be protective against this complication. The identification of PD patients according to the nonmotor phenotype of "Park-olfaction-weight-phenotype" and the "olfaction-weight-dyskinesia" triad should help to develop strategies to prevent weight reduction and improve general health and complications of PD patients. The phenotype seems to reflect a differential prodromal pathology and influence clinical disease. Higher body weight patients would benefit from life style changes to achieve a healthy profile. Weight monitoring and weight orientated approach to management of PD patients should help to improve their outcome. Body weight change might be a surrogate to disease progression and may be used to investigate neuroprotection strategies.

Published
2017
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37. Survey on Teaching Science to K-12 Students with Disabilities: Teacher Preparedness and Attitudes

Author

Anna Lewis and Sami Kahn

Subjects
030506 rehabilitation, business.industry, Multimethodology, 05 social sciences, 050301 education, Standardized test, Science teachers, Science education, Teacher education, Education, 03 medical and health sciences, Teaching science, Preparedness, Mathematics education, 0305 other medical science, business, Psychology, 0503 education, Inclusion (education)
Abstract

Students with disabilities are increasingly included in general education science classrooms and are expected to demonstrate academic proficiency on standardized assessments. Teacher preparation and attitudes have been cited as major factors contributing to either the success or failure of students with disabilities in science. In order to assess the current state of what could be facilitative or inhibitory influences, a national online survey to which 1,088 K-12 science teachers responded was conducted. Mixed methods’ analyses suggest that science teachers receive little formal training and feel underprepared to teach students with disabilities. Results identify specific gaps in science teachers’ education, as well as attitudinal and institutional barriers that may inhibit students with disabilities’ success. However, science teachers remain highly receptive to training and collaboration. Implications for science teacher education are discussed.

Published
2014
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38. Global Oil Spills and Oiled Wildlife Response Effort: Implications for Oil Spill Contingency Planning

Author

Kellie Pendoley, Ian Bellingham, Anna Lewis, Mitch Pearce, Andrew David Morgan, and Katherine Shaw-Brown

Subjects
Contingency plan, Environmental protection, business.industry, Oil spill, Fossil fuel, Wildlife, Environmental engineering, Environmental science, business
Abstract

Over the last century there has been a significant increase in the number and size of oil spills to the marine environment due to the global proliferation of oil and gas extraction as well as the number of tankers and other maritime transport infrastructure associated with increased production. Efforts have traditionally been focussed on containment and deflection of oil rather than responding to wildlife. The present study examines total oiled wildlife effort in response to maritime spills for 286 recorded globally. Between 1910 and 1961 there was an average of 1.23 ± 0.43 incidents per year, spilling an average of 114,062 ± 352,512 tonnes of oil per year. These averages increased to 3.83 ± 2.65 events with 123,277 ± 166,735 tonnes of oil spilt per year from 1962 to 1990, and again, from 1991 to 2012 to 6.50 ± 5.17 events with 164,299 ± 290,655 tonnes of oil spilt per year. Offshore platform and tanker spills have accounted for 37% and 27% of this total, respectively. Of the 104 recorded instances where wildlife interactions occurred (40%), spill volume was not related to the total number of animals caught, oiled or pre-emptively; however, it was related to the number of carcasses collected. A lack of planning for Oiled Wildlife Response (OWR) was identified as a contributing factor exacerbating the impact of a spill on wildlife and for resourcing a response. Inadequacies within operator and government contingency planning, to prepare for and sustain a wildlife response for extended periods, can be overcome by using a mobilisation model that integrates wildlife carer networks, government regulatory agencies and operator resourcing via an independent coordinating organisation consisting of a small group of personnel highly experienced and trained in maritime operations and marine science with access to a network of persons with experience in responding to wildlife and their handling, treatment and rehabilitation.

Published
2014
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39. Children as researchers: An Appreciative Inquiry with primary-aged children to improve ‘Talking and Listening’ activities in their class

Author

Oonagh Davies and Anna Lewis

Subjects
Developmental and Educational Psychology
Abstract

Appreciative Inquiry (AI) is a process that strives to create a better future by inquiring into, identifying and further developing the best of an organisation (Coghlan et al., 2003). As part of the authors’ systemic work in schools, AI was used as a framework for children to investigate how ‘talking and listening’ in a primary mixed Year 2 and 3 class could be improved. Whilst the broad focus of ‘talking and listening’ was donated by the teacher, this pilot project involved the children, class teacher, teaching assistant (TA) and educational psychologists collaborating in a genuine inquiry regarding the children’s best experiences of talking and listening. The goal was to develop the children’s ideas and ‘dreams’ into new ways of functioning in the classroom. Participants gave feedback regarding the AI process generally, and how they could improve ‘talking and listening’ specifically.

Published
2013
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40. Using Appreciative Inquiry to facilitate organisational change and develop professional practice within an Educational Psychology Service

Author

Caroline Doggett and Anna Lewis

Subjects
Developmental and Educational Psychology
Abstract

Appreciative Inquiry (AI) is a strengths-based, organisational change model (Cooperrider et al., 2008). The primary aim of this project was to explore the potential of AI as a means of developing professional practice in the context of a local authority (LA) educational psychology service (EPS). AI is a type of participative action research (PAR) rooted in social constructionist epistemology. The 4-D AI cycle (Discovery, Dream, Design and Destiny) was undertaken over the course of 16 months. Educational Psychologists’ (EPs) reflections on their AI experience were collated via self-report questionnaires. Positive outcomes of AI were evident from EPs’ responses, most especially in terms of: developing personal and collective practice; enabling effective communication with managers; strengthening relationships between colleagues; and enhancing feelings of agency and control. Limiting factors related to the timing of, and time for AI, within the context of LA budget cuts and potential job insecurity. Critical reflections on the AI process and suggestions for future applications of AI are discussed.

Published
2013
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41. Divine Horsemen

Author

Anna Lewis

Subjects
Chariot, media_common.quotation_subject, Art, Ancient history, media_common
Published
2016
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43. Contextualizing Nature of Science Instruction in Socioscientific Issues

Author

Leila Amiri, Anna Lewis, Jennifer L. Eastwood, Dana L. Zeidler, Troy D. Sadler, and Scott Applebaum

Subjects
Science instruction, Qualitative analysis, Scientific literacy, Teaching method, Mathematics education, Nature of Science, Statistical analysis, Science curriculum, Psychology, Education, Qualitative research
Abstract

The purpose of this study was to investigate the effects of two learning contexts for explicit-reflective nature of science (NOS) instruction, socioscientific issues (SSI) driven and content driven, on student NOS conceptions. Four classes of 11th and 12th grade anatomy and physiology students participated. Two classes experienced a curricular sequence organized around SSI (the SSI group), and two classes experienced a content-based sequence (the Content group). An open-ended NOS questionnaire was administered to both groups at the beginning and end of the school year and analyzed to generate student profiles. Quantitative analyses were performed to compare pre-instruction NOS conceptions between groups as well as pre to post changes within groups and between groups. Both SSI and Content groups showed significant gains in most NOS themes, but between-group gains were not significantly different. Qualitative analysis of post-instruction responses, however, revealed that students in the SSI group tended to ...

Published
2012
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44. DECP Annual CPD Conference WorkshopsSupporting children from Forces families through therapeutic story writingPsychologists as expert witnesses: Extending the role and experience of educational psychologistsSession 1: Children as researchers: An Appreciative Inquiry with primaryaged children to improve ‘Talking and Listening’ activities in their classHelping the customer to buy the exotics as well as the standards

Author

Aoife McNally, Anna Lewis, Mike Hymans, Jacqueline Batchelor, Jemma Murray, Oonagh Davies, Caroline Doggett, and Simon Claridge

Published
2014
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45. Validation of a software-based clinical trial matching platform for oncology using comprehensive clinical information

Author

Anna Lewis, Petros Giannikopoulos, Sameer Soi, James L. Gulley, Denise Mitchell, and Andrew Schaer

Subjects
Oncology, Cancer Research, medicine.medical_specialty, Matching (statistics), business.industry, Cancer, medicine.disease, Clinical trial, Software, Internal medicine, Clinical information, Medicine, business
Abstract

e18589Background: Despite the critical need for cancer patients to participate in clinical trials, only 3% of US cancer patients actually do so, and 40-60% of oncology clinical trials fail to recru...

Published
2018
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46. A Picture of Christendom: The Creation of an Interpretive Community in Julian of Norwich's A Revelation of Love

Author

Anna Lewis

Subjects
Microbiology (medical), Law, Immunology, Opposition (politics), Immunology and Allergy, Middle Ages, Sociology, Religious studies, Revelation, Legitimacy
Abstract

In order to avoid suspicion, opposition, and even inquisition, visionaries of the late Middle Ages did well to deny their capacities as either readers or writers. In A Revelation of Love , Julian of Norwich nullifies her role in uncovering the meaning of the divine 'text' she receives by demonstrating that the interpretation, and the processes by which it was achieved, are the responsibility of an interpretive community. The legitimacy of the interpretation is established by the authority of this community which, as a union between God, Church, and Christian souls, is a picture of Christendom itself.

Published
2009
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47. Are physiotherapy exercises effective in reducing chronic low back pain?

Author

Meg E. Morris, Clare Walsh, and Anna Lewis

Subjects
medicine.medical_specialty, business.industry, medicine.medical_treatment, Rehabilitation, Alternative medicine, Psychological intervention, Physical Therapy, Sports Therapy and Rehabilitation, Placebo, Low back pain, humanities, Chronic low back pain, Physical medicine and rehabilitation, medicine, Physical therapy, Aerobic exercise, Orthopedics and Sports Medicine, medicine.symptom, Hydrotherapy, business, human activities, General fitness training
Abstract

The purpose of this systematic review was to evaluate the literature on the effectiveness of physiotherapy exercises in reducing chronic low back pain (CLBP). A systematic search of the medical databases was performed, with 64 articles retrieved. After the exclusion criteria were applied, 15 randomised controlled trials (RCTs) evaluating physiotherapy delivered exercise programmes to patients with CLBP remained. A methodological quality assessment was performed, showing the included studies to have medium to high quality. Prescribed physiotherapy exercises included general fitness and aerobic exercises, flexibility regimes, stretches, muscle strengthening and spinal stabilising exercises. These interventions were compared with each other as well as surgical stabilisation, yoga, hydrotherapy, back care education booklets and placebo groups. Overall, physiotherapy prescribed exercise programmes were found to be effective in reducing pain in patients with CLBP. However, there was no consensus on a sp...

Published
2008
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48. Impacts and risks associated with developing, but unsupervised, stingray tourism at Hamelin Bay, Western Australia

Author

Daryl Moncrieff, Anna Lewis, and David Newsome

Subjects
Ecology, Visitor pattern, Geography, Planning and Development, Foraging, Fishing, Transportation, Provisioning, Geography, Tourism, Leisure and Hospitality Management, Stingray, Wildlife management, Bay, Tourism, Nature and Landscape Conservation
Abstract

Interacting with stingrays at Hamelin Bay, in the south-west of Western Australia, appears to be substantially growing in popularity. Promotion of the rays is increasing through websites and brochures and larger tourism productions, such as the ‘Getaway’ television programme, have shown interest in the Hamelin Bay site. Yet there is still very little known about the impacts on rays (both behavioural and physical), risks to humans, or indeed the issues that provisioning stingrays can present. Although Shackley (1998) conducted an impact study of stingray provisioning in the Cayman Islands, provisioning activities at Hamelin Bay, and other areas in the southwest are unique because they are shore-based. As part of developing a profile of conditions at the Hamelin Bay provisioning site we investigated stingray numbers and their distribution in the area. We also collected data on the type and amount of provisioned food, investigated stingray behaviour and observed how tourists interacted with stingrays. It was shown through site profile data that rays are attracted to the site principally by food provisioning and secondarily by boats due to learned association with food. They are most common at the provisioning site in the middle of the day, as are peak visitor numbers. Behavioural impacts on rays were found to be attraction to humans, resulting in aggression and hierarchy towards one another. Attraction to humans at the provisioning site reflected that the rays may be partially habituated. However, rays were also seen foraging naturally for food, indicating that they are not yet dependent on humans. Other potential impacts to rays include boat damage from pleasure craft, overfeeding, being fed the wrong food, damage from fishing hooks and risk of disease from foul water. Lesions on skin and permanent shoaling behaviour, as witnessed at other stingray provisioning sites, were not observed at Hamelin Bay. Management actions are recommended to reduce impacts on the rays, eliminate risks to visitors and increase visitor satisfaction.

Published
2004
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49. Planning for stingray tourism at Hamelin Bay, Western Australia: the importance of stakeholder perspectives

Author

David Newsome and Anna Lewis

Subjects
biology, Ecology, Visitor pattern, Geography, Planning and Development, Transportation, biology.organism_classification, Dasyatis brevicaudata, Fishery, Geography, Signage, Tourism, Leisure and Hospitality Management, Stingray, Bay, Recreation, Tourism, Nature and Landscape Conservation, Dasyatis thetidis
Abstract

Stingray tourism continues to be developed at various locations around the world with the concept being marketed on television travel programmes, documentaries, internet sites and travel brochures. Food provisioned stingray tourism, for example, now attracts some 100 000 visitors a year to ‘tingray city’ in the Caymen Islands. At Hamelin Bay in southwest Western Australia, up to 16 large stingrays (Dasyatis brevicaudata and Dasyatis thetidis) and numerous eaglerays (Myliobatis australis) are fed by visitors from the waters edge. This study reports on stakeholder perspectives relating to tourism development and potential management of the Hamelin Bay site. From the results of this study it is clear that there is sufficient interest in stingray tourism (by all the stakeholders surveyed) to develop Hamelin Bay as a permanent feeding site. Visitors on average gave their experience with the rays a satisfaction value of 8.9 out of 10. Twenty-five per cent of visitors surveyed did not want commercialisation, tour groups or excessive visitor numbers. Their main concern was that the health and safety of the rays may deteriorate with an increase of visitors if the situation is not managed correctly. Visitors desire to be educated about the rays, and how to best interact with them safely. Visitors also acknowledged that the site needs management through more signs, information and a management plan. Management for the site is therefore likely to be best implemented through the application of signage, development of guidelines/codes of conduct, protection of the rays and zoning the beach according to specific recreational purposes. Management regimes should also use various indicators to monitor the impacts of stingray tourism at Hamelin Bay.

Published
2003
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50. Development of Oiled Wildlife Preparedness and Response Management Systems and Their Integration with oil Spill Contingency Planning and oil Spill Response

Author

Mitch Pearce, Kellie Pendoley, Anna Lewis, Ian Bellingham, and Andrew David Morgan

Subjects
Contingency plan, Preparedness, Management system, Oil spill, Wildlife, Environmental science, Environmental planning
Abstract

Commercial and social media is accessible globally and is always fixated on the impact an oil spill has on marine animals and the environment. Combined with the cost of cleanup and recovery, public perception and a lack of preparedness and operational response structure arrangements by the operator can impact severely on the financial viability of an oil and gas business. This paper outlines how to set up and implement an Oiled Wildlife Response (OWR) and how preparedness is integrated into oil spill planning and response. Traditionally, OWR relied on ‘not for profit’ organisations funded through donations. The development of wildlife carer networks and their links to industry, government and non-government organisations (NGOs) has evolved from this. More recently, coordinating organisations have taken on the further development of OWR. A good OWR management system requires reliable information on the environment and ecosystems at risk and integration of key wildlife response personnel and resources across the spill response command structure. This is demonstrated in recent Australian regulatory changes, which now require operators to prove they have the capacity to respond to an oil spill through valid contracts with service providers. A good OWR plan should meet industry standards for risk assessment, management, and emergency response. The plan must demonstrate that risk to fauna during hazing and deterrence and recovery and handling is As Low As Reasonably Practicable (ALARP). Appropriately qualified wildlife handling personnel should always be identified and available for deployment during an emergency response. The plan should be underpinned by detailed Standard Operating Procedures (SOPs) for use of equipment and should integrate the biological aspects of the response with Health and Safety requirements, a Hazard Register inclusive of Major Accident Events, Safety Critical Equipment and the associated performance standards. Response equipment availability should align with immediate ‘first strike’ requirements together with expected escalation of response scenarios developed around best practice in marine wildlife interactions and use of equipment. Activation of oiled wildlife teams must be scalable and commensurate with the size of the spill, development of spill containment and deflection strategies by industry, and fauna at risk. A reduction in reactive OWR response and subsequent recovery times and an increase in positive public perception of oil spill response will limit the impact of the cost of an oil spill on the financial viability of an oil and gas business.

Published
2014
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