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23 results on '"Brangan A"'

1. Irish occupational therapists use of evidenced-based falls prevention programmes

Author

Kim Lombard, Ciara Phelan, Joan Brangan, and Laura Desmond

Subjects
Occupational therapy, 030506 rehabilitation, medicine.medical_specialty, Evidence-based practice, Descriptive statistics, business.industry, Qualitative property, language.human_language, 03 medical and health sciences, 0302 clinical medicine, Snowball sampling, Summative assessment, Irish, Content analysis, Family medicine, language, Medicine, 030212 general & internal medicine, 0305 other medical science, business
Abstract

Purpose As one ages, the risk of experiencing a fall increases and poses a number of serious consequences; 30 per cent of individuals over 65 years of age fall each year. Evidence-based falls prevention programmes demonstrate efficacy in reducing the rate and risk of falls among older adults, but their use in Irish occupational therapy practice is unknown. This study aims to investigate the implementation of falls prevention programmes by occupational therapists working with older adults in Ireland. Design/methodology/approach A cross-sectional survey was used to gather data on the use of falls prevention programmes among occupational therapists working with older adults in any clinical setting across Ireland. Purposeful, convenience and snowball sampling methods were used. The Association of Occupational Therapists of Ireland acted as a gatekeeper. Descriptive statistics and summative content analysis were used to analyse quantitative and qualitative data, respectively. Findings In all, 85 survey responses were analysed. Over 85 per cent of respondents reported “Never” using any of the evidence-based falls prevention programmes. The “OTAGO” Exercise Programme was the most “Frequently” used programme (9.5 per cent, n = 7); 29 respondents reported using “in-department” developed falls prevention programmes and 14 provided additional comments regarding current falls prevention practices in Ireland. Originality/value In the absence of Irish data on the subject, this study provides a benchmark to describe the use of evidence-based falls programmes by Irish occupational therapists with older adults.

Published
2019

2. Update

Author

Karen Jean Craig-Brangan and Mary Patricia Day

Subjects
Adult, medicine.medical_specialty, medicine.medical_treatment, Pediatric advanced life support, MEDLINE, Assessment and Diagnosis, Emergency Nursing, Advanced Cardiac Life Support, Critical Care Nursing, Pediatrics, medicine, Humans, Cardiopulmonary resuscitation, Child, Intensive care medicine, Advanced and Specialized Nursing, business.industry, Infant, Basic life support, American Heart Association, LPN and LVN, medicine.disease, Cardiopulmonary Resuscitation, United States, Heart Arrest, Life Support Care, Life support, Practice Guidelines as Topic, Medical emergency, business
Abstract

In November 2017, the American Heart Association published updates to its adult and pediatric Basic Life Support and Cardiopulmonary Resuscitation guidelines; one year later, it published updates to its Advanced Cardiovascular Life Support and Pediatric Advanced Life Support guidelines. This article reviews these updated guidelines and highlights the key changes and how to integrate them into practice.

Published
2019

3. The Genomics of Opioid Addiction Longitudinal Study (GOALS): study design for a prospective evaluation of genetic and non-genetic factors for development of and recovery from opioid use disorder

Author

Iris Jones, Michael Sabia, Kaitlan Baston, Emily Albertson, Alissa M. Resch, Wendy N Roberts, Russell J. Buono, Thomas N. Ferraro, Rachel Rafeq, Stefan Zajic, Rachel Haroz, Andrew Brangan, Matthew Salzman, Elliot Bodofsky, Laura B. Scheinfeldt, and Jessica Heil

Subjects
Adult, Male, Longitudinal study, medicine.medical_specialty, lcsh:Internal medicine, lcsh:QH426-470, media_common.quotation_subject, Psychological intervention, Addiction, Medication for opioid use disorder (MOUD), 03 medical and health sciences, Study Protocol, 0302 clinical medicine, medicine, Genetics, Humans, Longitudinal Studies, Psychiatry, lcsh:RC31-1245, Substance misuse, Genetics (clinical), media_common, business.industry, Medical record, Opioid use disorder, Genomics, medicine.disease, Opioid-Related Disorders, United States, 030227 psychiatry, Buprenorphine, lcsh:Genetics, Anxiety, Opioid use disorder (OUD), Observational study, medicine.symptom, business, 030217 neurology & neurosurgery, medicine.drug
Abstract

Background The opioid use disorder and overdose crisis in the United States affects public health as well as social and economic welfare. While several genetic and non-genetic risk factors for opioid use disorder have been identified, many of the genetic associations have not been independently replicated, and it is not well understood how these factors interact. This study is designed to evaluate relationships among these factors prospectively to develop future interventions to help prevent or treat opioid use disorder. Methods The Genomics of Opioid Addiction Longitudinal Study (GOALS) is a prospective observational study assessing the interplay of genetic and non-genetic by collecting comprehensive genetic and non-genetic information on 400 participants receiving medication for opioid use disorder. Participants will be assessed at four time points over 1 year. A saliva sample will be collected for large-scale genetic data analyses. Non-genetic assessments include validated surveys measuring addiction severity, depression, anxiety, and adverse childhood experiences, as well as treatment outcomes such as urine toxicology results, visit frequency, and number of pre and post-treatment overdoses extracted from electronic medical records. Discussion We will use these complex data to investigate the relative contributions of genetic and non-genetic risk factors to opioid use disorder and related treatment outcomes.

Published
2021

4. Abstract 13161: Acceptability and Feasibility of Novel Screening Models and Family Communication Methods for Familial Hypercholesterolemia

Author

Amy C. Sturm, Gemme Campbell Salome, Andrew Brangan, Alanna Kulchak Rahm, Nicole Walters, Catherine D. Ahmed, Mary P. McGowan, Laney K. Jones, and Amanda Sheldon

Subjects
Pediatrics, medicine.medical_specialty, business.industry, Physiology (medical), Genetic disorder, Medicine, Family communication, Familial hypercholesterolemia, Cardiology and Cardiovascular Medicine, business, medicine.disease
Abstract

Introduction: Despite familial hypercholesterolemia (FH) being a common cardiovascular genetic disorder, it is vastly underdiagnosed and undertreated. This is partly due to the lack of systematic screening methods to identify possible FH and little to no implementation of cascade screening approaches in the US. Screening models, such as machine learning algorithms, and family communication methods for cascade screening, such as chatbot technology and direct contact of at-risk relatives by a clinician, may help close the gap in FH identification. Methods: Focus groups were conducted with individuals with FH and clinicians. Focus groups were audio-recorded, transcribed, and coded for acceptability and feasibility of implementing screening models and family communication methods. Results: Individuals with FH and clinicians felt that models analyzing different data sources, including electronic health records, to screen for FH have the potential to activate patients and stimulate patient-clinician conversations about FH. While some expressed privacy and confidentiality concerns, individuals with FH found screening models acceptable, stating that these could have led to an earlier diagnosis and treatment and expressing their frustration with the status quo. Most had a strong desire to be notified of screening models’ outcomes at the same time as their clinician. Clinicians felt strongly that automated models would be helpful in identifying FH. Many with FH felt responsible for notifying their family about FH first; however, some indicated comfort with their clinician, healthcare system, or other professionals helping to communicate FH risk to their relatives via direct contact methods. Further, they indicated a strong willingness to use chatbots to share FH risk information with their relatives. Clinicians felt the need to support their patients and offer their services when sharing FH risk information with relatives, while individuals with FH expressed doubt that their clinicians would have time and resources to provide active support. Conclusions: Individuals with FH and clinicians agreed that FH screening models and enhanced family communication methods would be beneficial, acceptable, and feasible to implement in US healthcare systems.

Published
2020

5. Management of chlamydia and gonorrhoea infections diagnosed in primary care using a centralised nurse-led telephone-based service: mixed methods evaluation

Author

Petra Manley, John Macleod, Emer Brangan, Paddy Horner, Peter Muir, Jeremy Horwood, and Paul North

Subjects
medicine.medical_specialty, Sexual health, partner notification, urologic and male genital diseases, Nurse's Role, 03 medical and health sciences, Gonorrhea, 0302 clinical medicine, Intervention (counseling), Qualitative research, Health care, medicine, Humans, Sex organ, 030212 general & internal medicine, Chlamydia, Reproductive health, general practice, lcsh:R5-920, Primary Health Care, business.industry, 030503 health policy & services, Partner notification, Workload, CAPC, Chlamydia Infections, medicine.disease, Telephone, Gonorrhoea, Family medicine, Female, 0305 other medical science, Family Practice, business, lcsh:Medicine (General), General practice, qualitative research, psychological phenomena and processes, Research Article
Abstract

Background Up to 18% of genital Chlamydia infections and 9% of Gonorrhoea infections in England are diagnosed in Primary Care. Evidence suggests that a substantial proportion of these cases are not managed appropriately in line with national guidelines. With the increase in sexually transmitted infections and the emergence of antimicrobial resistance, their timely and appropriate treatment is a priority. We investigated feasibility and acceptability of extending the National Chlamydia Screening Programme’s centralised, nurse-led, telephone management (NLTM) as an option for management of all cases of chlamydia and gonorrhoea diagnosed in Primary Care. Methods Randomised feasibility trial in 11 practices in Bristol with nested qualitative study. In intervention practices patients and health care providers (HCPs) had the option of choosing NLTM or usual care for all patients tested for Chlamydia and Gonorrhoea. In control practices patients received usual care. Results One thousand one hundred fifty-four Chlamydia/gonorrhoea tests took place during the 6-month study, with a chlamydia positivity rate of 2.6% and gonorrhoea positivity rate of 0.8%. The NLTM managed 335 patients. Interviews were conducted with sixteen HCPs (11 GPs, 5 nurses) and 12 patients (8 female). HCPs were positive about the NLTM, welcomed the partner notification service, though requested more timely feedback on the management of their patients. Explaining the NLTM to patients didn’t negatively impact on consultations. Patients found the NLTM acceptable, more convenient and provided greater anonymity than usual care. Patients appreciated getting a text message regarding a negative result and valued talking to a sexual health specialist about positive results. Conclusion Extension of this established NLTM intervention to a greater proportion of patients was both feasible and acceptable to both patients and HCP, could provide a better service for patients, whilst decreasing primacy care workload. The study provides evidence to support the wider implementation of this NLTM approach to managing chlamydia and gonorrhoea diagnosed in primary care.

Published
2020

6. Acceptability, Appropriateness, and Feasibility of Automated Screening Approaches and Family Communication Methods for Identification of Familial Hypercholesterolemia: Stakeholder Engagement Results from the IMPACT-FH Study

Author

Mary P. McGowan, Andrew Brangan, Gemme Campbell-Salome, Michael Gatusky, Laney K. Jones, Nicole Walters, Ilene G. Ladd, Amanda Sheldon, Alanna Kulchak Rahm, Samuel S. Gidding, Catherine D. Ahmed, and Amy C. Sturm

Subjects
medicine.medical_specialty, cascade screening, Medicine (miscellaneous), Stakeholder engagement, chatbots, Familial hypercholesterolemia, Family communication, Cascade screening, 030204 cardiovascular system & hematology, Article, 03 medical and health sciences, 0302 clinical medicine, Medicine, 030212 general & internal medicine, familial hypercholesterolemia, business.industry, allergology, Conceptual model (computer science), cascade testing, medicine.disease, Focus group, Identification (information), implementation outcomes, Family medicine, identification, Implementation research, direct contact, business
Abstract

Guided by the Conceptual Model of Implementation Research, we explored the acceptability, appropriateness, and feasibility of: (1) automated screening approaches utilizing existing health data to identify those who require subsequent diagnostic evaluation for familial hypercholesterolemia (FH) and (2) family communication methods including chatbots and direct contact to communicate information about inherited risk for FH. Focus groups were conducted with 22 individuals with FH (2 groups) and 20 clinicians (3 groups). These were recorded, transcribed, and analyzed using deductive (coded to implementation outcomes) and inductive (themes based on focus group discussions) methods. All stakeholders described these initiatives as: (1) acceptable and appropriate to identify individuals with FH and communicate risk with at-risk relatives, and (2) feasible to implement in current practice. Stakeholders cited current initiatives, outside of FH (e.g., pneumonia protocols, colon cancer and breast cancer screenings), that gave them confidence for successful implementation. Stakeholders described perceived obstacles, such as nonfamiliarity with FH, that could hinder implementation and potential solutions to improve systematic uptake of these initiatives. Automated health data screening, chatbots, and direct contact approaches may be useful for patients and clinicians to improve FH diagnosis and cascade screening.

Published
2021

7. Exploring the relationship between general practice characteristics, and attendance at walk-in centres, minor injuries units and EDs in England 2012/2013: a cross-sectional study

Author

Peter Tammes, Sarah Purdy, Emer Brangan, Lesley Wye, Kath Checkland, Daniel Lasserson, Alyson L Huntley, Fiona MacKichan, Richard W Morris, Helen England, and Chris Salisbury

Subjects
Male, medicine.medical_specialty, Cross-sectional study, General Practice, Population, Poison control, Critical Care and Intensive Care Medicine, Ambulatory Care Facilities, Suicide prevention, Health Services Accessibility, State Medicine, Occupational safety and health, 03 medical and health sciences, 0302 clinical medicine, Injury prevention, medicine, Humans, 030212 general & internal medicine, education, education.field_of_study, business.industry, 030503 health policy & services, Attendance, General Medicine, Cross-Sectional Studies, England, Emergency medicine, Emergency Medicine, Life expectancy, Female, Health Services Research, Emergency Service, Hospital, 0305 other medical science, business, Demography
Abstract

Background For several years, EDs in the UK NHS have faced considerable increases in attendance rates. Walk-in centres (WiCs) and minor injuries units (MIUs) have been suggested as solutions. We aimed to investigate the associations between practice and practice population characteristics with ED attendance rates or combined ED/WiC/MIU attendance, and the associations between WiC/MIU and ED attendance. Methods We used general practice-level data including 7462 English practices in 2012/2013 and present adjusted regression coefficients from linear multivariable analysis for relationships between patients9 emergency attendance rates and practice characteristics. Results Every percentage-point increase in patients reporting inability to make an appointment was associated with an increase in emergency attendance by 0.36 (95% CI 0.06 to 0.66) per 1000 population. Percentage-point increases in patients unable to speak to a general practitioner (GP)/nurse within two workdays and patients able to speak often to their preferred GP were associated with increased emergency attendance/1000 population by 0.23 (95% CI 0.05 to 0.42) and 0.10 (95% CI 0.00 to 0.19), respectively. Practices in areas encompassing several towns (conurbations) had higher attendance than rural practices, as did practices with more non-UK-qualified GPs. Practice population characteristics associated with increased emergency attendance included higher unemployment rates, higher percentage of UK whites and lower male life expectancy, which showed stronger associations than practice characteristics. Furthermore, higher MIU or WiC attendance rates were associated with lower ED attendance rates. Conclusions Improving availability of appointments and opportunities to speak a GP/nurse at short notice might reduce ED attendance. Establishing MIUs and WiCs might also reduce ED attendance.

Published
2016

8. Using the National Early Warning Score (NEWS) outside acute hospital settings: a qualitative study of staff experiences in the West of England

Author

Hein le Roux, Anne Pullyblank, Jonathan Banks, Heather Brant, Sabi Redwood, and Emer Brangan

Subjects
medicine.medical_specialty, Emergency Medical Services, Referral, Attitude of Health Personnel, Acute care, Interviews as Topic, 03 medical and health sciences, primary care, 0302 clinical medicine, Community care, Nursing, Track and Trigger, Qualitative research, Health care, medicine, Humans, 030212 general & internal medicine, Primary Care, Qualitative Research, Warning system, Clinical Deterioration, business.industry, Research, 030208 emergency & critical care medicine, General Medicine, Early warning score, Mental health, England, Early Warning Score, Emergency Medicine, Thematic analysis, business, Emergency Service, Hospital, Delivery of Health Care, mental health
Abstract

ObjectivesEarly warning scores were developed to improve recognition of clinical deterioration in acute hospital settings. In England, the National Early Warning Score (NEWS) is increasingly being recommended at a national level for use outside such settings. In 2015, the West of England Academic Health Science Network supported the roll-out of NEWS across a range of non-acute-hospital healthcare sectors. Research on the use of NEWS outside acute hospitals is limited. The objective of this study was to explore staff experiences of using NEWS in these new settings.DesignThematic analysis of qualitative semi-structured interviews with purposefully sampled healthcare staff.SettingWest of England healthcare settings where NEWS was being used outside acute hospitals—primary care, ambulance, referral management, community and mental health services.ParticipantsTwenty-five healthcare staff interviewed from primary care (9), ambulance (3), referral management/acute interface (5), community (4) and mental health services (3), and service commissioning (1).ResultsParticipants reported that NEWS could support clinical decision-making around escalation of care, and provide a clear means of communicating clinical acuity between clinicians and across different healthcare organisations. Challenges with implementing NEWS varied—in primary care, clinicians had to select patients for NEWS and adopt different methods of clinical assessment, whereas for paramedics it fitted well with usual clinical practice and was used for all patients. In community services and mental health, modifications were ‘needed’ to make the tool relevant to some patient populations.ConclusionsThis study demonstrated that while NEWS can work for staff outside acute hospital settings, the potential for routine clinical practice to accommodate NEWS in such settings varied. A tailored approach to implementation in different settings, incorporating guidance supported by further research on the use of NEWS with specific patient groups in community settings, may be beneficial, and enhance staff confidence in the tool.

Published
2018

9. Exploring the relationship between general practice characteristics and attendance at Walk-in Centres, Minor Injuries Units and Emergency Departments in England 2009/10–2012/2013: a longitudinal study

Author

Daniel Lasserson, Lesley Wye, Emer Brangan, Katherine Checkland, Alyson L Huntley, Sarah Purdy, Richard W Morris, Fiona MacKichan, Chris Salisbury, Peter Tammes, and Helen England

Subjects
Male, Emergency Medical Services, Longitudinal study, General Practice, Alternative health care service, Ambulatory Care Facilities, alternative health care service, Health administration, 0302 clinical medicine, Outcome Assessment, Health Care, Health care, Emergency medical services, Population Characteristics, Medicine, Longitudinal Studies, hospital’, 030212 general & internal medicine, Primary health care, education.field_of_study, lcsh:Public aspects of medicine, Health Policy, Nursing research, Attendance, Multilevel Modelling, Population characteristics, England, Patient Satisfaction, Centre for Surgical Research, Multilevel Analysis, Female, emergency service hospital, Emergency Service, Hospital, Research Article, Adult, medicine.medical_specialty, Population, 03 medical and health sciences, continuity of care, Patient satisfaction, ‘Emergency service, Humans, contintuity of care, education, Aged, business.industry, lcsh:RA1-1270, 030208 emergency & critical care medicine, ‘emergency service, hospital’, primary health care, Family medicine, Continuity of care, Multilevel modelling, business
Abstract

Background The UK National Health Service Emergency Departments (ED) have recently faced increasing attendance rates. This study investigated associations of general practice and practice population characteristics with emergency care service attendance rates. Methods A longitudinal design with practice-level measures of access and continuity of care, patient population demographics and use of emergency care for the financial years 2009/10 to 2012/13. The main outcome measures were self-referred discharged ED attendance rate, and combined self-referred discharged ED, self-referred Walk-in Centre (WiC) and self-referred Minor Injuries Unit (MIU) attendance rate per 1000 patients. Multilevel models estimated adjusted regression coefficients for relationships between patients’ emergency attendance rates and patients’ reported satisfaction with opening hours and waiting time at the practice, proportion of patients having a preferred GP, and use of WiC and MIU, both between practices, and within practices over time. Results Practice characteristics associated with higher ED attendance rates included lower percentage of patients satisfied with waiting time (0.22 per 1% decrease, 95%CI 0.02 to 0.43) and lower percentage having a preferred GP (0.12 per 1% decrease, 95%CI 0.02 to 0.21). Population influences on higher attendance included more elderly, more female and more unemployed patients, and lower male life-expectancy and urban conurbation location. Net reductions in ED attendance were only seen for practices whose WiC or MIU attendance was high, above the 60th centile for MIU and above the 75th centile for WiC. Combined emergency care attendance fell over time if more patients within a practice were satisfied with opening hours (−0.26 per 1% increase, 95%CI −0.45 to −0.08). Conclusion Practices with more patients satisfied with waiting time, having a preferred GP, and using MIU and WIC services, had lower ED attendance. Increases over time in attendance at MIUs, and patient satisfaction with opening hours was associated with reductions in service use. Electronic supplementary material The online version of this article (doi:10.1186/s12913-017-2483-x) contains supplementary material, which is available to authorized users.

Published
2017

10. ARTICULATING GLOBAL PRESCRIPTIONS FOR HEALTH WITH LOCAL CONCEPTIONS OF WELL-BEING AND RISK: THE CASE OF PHYSICAL ACTIVITY AND THE WORLD HEALTH ORGANISATION

Author

Emer Brangan

Subjects
Economic growth, medicine.medical_specialty, Public health, Geography, Planning and Development, Development, Health promotion, Well-being, Global health, medicine, Health education, Sociology, Medical prescription, Health policy, Qualitative research
Abstract

If there is one thing that policy makers at the World Health Organisation and residents of the South African township of Langa are likely to agree on, it is that ‘just sitting’ is not good for you. The positions from which they approach this conclusion however differ profoundly. This research uses qualitative methods to investigate different conceptualisations of physical activity, health and well-being, and the implications of these differences for policy on the prevention of non-communicable diseases in low-income and middle-income countries, taking South Africa as a case study. Copyright © 2013 John Wiley & Sons, Ltd.

Published
2013

11. Staying Well in a South African Township: Stories from Public Health and Sociology

Author

Emer Brangan

Subjects
medicine.medical_specialty, business.industry, Public health, Gender studies, Public relations, Order (exchange), medicine, Normative, Sociology, business, Construct (philosophy), Discipline, Biomedicine, Public health policy, Qualitative research
Abstract

The current approach to preventing noncommunicable diseases1 (NCDs) in low— and middle-income countries draws heavily on the disciplines of public health and biomedicine, which unsurprisingly construct health as a dominant normative goal and a central component of wellbeing. The research which this chapter draws on was driven by my sense that something important was missing from much policy on NCD prevention: a broader understanding of how health and the so-called health behaviours2 implicated in causing NCDs were related to wellbeing, particularly in very challenging environments such as a South African township. It seemed to me that one of the reasons that such an understanding was lacking was the approach to knowledge which was being taken: the discourse around public health policy on prevention was ‘expert’ driven; the vast majority of the research on which policy was based was quantitative and had been carried out in high-income countries; and the ‘public’ were often cast as a group to be manipulated in order to change their behaviour, rather than as stakeholders with knowledge, values and reasons which warranted respectful attention. In order to explore this, I carried out qualitative research alongside a quantitative epidemiological study which was already underway in a township in South Africa. This chapter presents some of the stories which the combined data told and considers the implications of the different disciplinary approaches for the ideas about health and wellbeing which emerged.

Published
2016

12. Update: 2015 AHA BLS and ACLS guidelines

Author

Mary Patricia Day and Karen Jean Craig-Brangan

Subjects
Adult, 030506 rehabilitation, medicine.medical_specialty, medicine.medical_treatment, Assessment and Diagnosis, Emergency Nursing, Critical Care Nursing, Advanced Cardiac Life Support, Life Support Care, 03 medical and health sciences, Pregnancy, medicine, Humans, 0501 psychology and cognitive sciences, Cardiopulmonary resuscitation, Intensive care medicine, 050107 human factors, Advanced and Specialized Nursing, business.industry, 05 social sciences, Advanced cardiac life support, American Heart Association, LPN and LVN, medicine.disease, Cardiopulmonary Resuscitation, United States, Heart Arrest, Practice Guidelines as Topic, Female, 0305 other medical science, business
Published
2015

13. The National Lung Screening Trial: Overview and Study Design

Author

Natalie Cunningham, Michael Khalili, John Waltz, Ralph Weiben, Deb Gurtner, Linda DeAlmeida, Sanjay Gupta, Sharon Maxfield, Crissy Kibic, Kathleen DeWitt, David DeMets, Walter Allen Bowman, Robert Epstein, Mia Burkhard, Stephen J. Swensen, Hattie Cromwell, Kianoush Rezai, Steadman Sankey, Lisa Scott Wasson, Rita Musanti, Tamim Malbari, Joy Ferola, Qimei He, Patty Trapnell, Melba Francis, Sam Quattlebaum, Joanice Thompson, Ana Birofka, Robin Griggs, Elizabeth Johnson, Margaret R. Spitz, Nicole Richardson, Yuting Liang, Lawrence G. Hutchins, Mirjana Tecmire, Lila Camara, James J. Navin, Eileen Frost, Diane Romano, Carrie Petkus, Eric J. Berns, Pei Jan P Lin, Steve D. Uttecht, Marian Acerra, Lawrence R. Ragard, Leo P. Lawler, Christopher M. Rogers, Alan Lee Goodwin, L. Ellen Martinusen, Melissa Ford, Michael T. Fisher, Beverly Powell, Cindy Lin, Jamie Downs, Brent Fodera, Bonita Wohlers, Michael Brangan, Peggy Bradley, Todd B. Burt, Susan Allen, Shiva Borgheian, Mingying Zeng, Thomas Riley, Danielle Gherardini, Steven Shiff, Olivia Campa, Wahied Gendi, Fang F. Xu, Ivana K. Kazda, Anne Chung, Briar Doi, Helen Price, Maria Vlachou, Alan Morgan, Simone Vuong, Pierre P. Massion, Darcy Watson, Debbie William, Esther Nakano, Karen Broski, David Creed, Melanie Bvorak, Lakisha Hawkins, Gladys Hino, Raymond Dauphinais, Michele Sallas, Helene Shiratori, Venus Brown, Denise Brooks, Heather Porter, Ilana F. Gareen, Tracy Lee, Melissa Cates, Kyle Turner, Tiffanie Hammond, Margaret Paquette, Lorraine Kerchum, Barbara Lewis, Douglas J. Reding, Thomas E. Hartman, Cathy Longden, Melissa Laron, Reza Abaya, Beborah Robertson, J W Semenkovich, Christine Holland, Hugh McGinley, Chani Montalbo, Karen Zubena, Vanessa Ralda, Adam C. Stein, Jennifer Ott, Lawrence M. Kotner, Jing Lee, Arnold Ssali, Michael Young, Quinn A. DeMordaunt, Linda V. White, Steve Dubinett, Pearl Chan, Roxana Phillips, Mallory Kolich, Brent B. Nelson, Phi Do, Jill Spivak, Angele LaFleur, Kesha Smith, Elayne Weslowsky, Patricia Nieters, Maurice LeBlanc, Satinder Singh, Lonna Matthews, Quentin McMullen, Karen Lappe, Sharon Longacre, Cindy Cobb, Jane A. Zehner, Michael Teepe, Pamela M. Marcus, Kathleen Bow, Wendy Francis, Mary Gemmel, Robert S. Fontana, Linda Jurjans, Barbara Ginther, Jonathan B. Clapp, Monica Richel, Scott F. Pickering, Brenda Edwards, Kendrick Looney, Randy Marshall, Roni Atkins, Danielle Wicks, Julie Peterson, Dcanna Cape, Albert J. Cook, Jerry Brekke, Louisa Turner, Larry Stoller, Mark B. Salerno, Bavid E. Midthun, Mark Delano, Minnetta Belyea, Deborah Greene, Jonathan Goldin, Terry Lewis, Virginia Fischer, Andrea Chapman, Shari Jordan, Deb Warren, Demetria Johnson, Rekha Khatri, Lisa Sirianni, Guillermo Geisse, Michael A. Fuchs, Kanya Kumbalasiri, Jeremy J. Erasmus, Vicki Shambaugh, Denise Boyles, Sarah Hallsky, Anna Nanovski, Jill Heinz, Mollie King, Kay Vydareny, Olga Soukhanova, Patricia Rueweler, Perry G. Pernicano, Regina Rendas-Baum, Phyllis Pirotte, Russell Harris, Neil Argyle, Miyoung Kim, June Krebsbach, Audrey Gallego, Sheila Wein, Mukesh F. Karwat, Karla Myra-Bloom, Pamela Byrnes, Mitchell D. Schnall, Hector Ahumada, Eric Sanchez, Donna DesMarais, Julie Maderitz, Cindy Lavergne, Lori Kirchoff, Patricia C. Sanders, Elizabeth Thielke, Michael Sullivan, Jennifer Gaegler, Janet Manual, Jennifer R. Heinz, Ray Zisumbo, Diane C. Strollo, Candace Mueller, Irene Mahon, Brenda Delfosse, Carolyn M. Johnson, William E. Grizzle, Merideth Stanley, Sylvan Green, Pamela Harvey, Lindsay Richardson, Brenda K. Brewer, Philip Costello, Deanna Zapolski, John Worrell, Jeffrey G. Schragin, David S. Alberts, Edward L. Korn, Tamara Owens, Hank Brastater, Kay Mathiesen-Viergutz, Mark Broschinsky, Paul W. Spirn, Grace Isaacs, John S. Waltz, Mitch Goodsitt, Christi Newton-Foster, Sharlene Snowden, Barbara Voight, Gail Bizer, Kathy McDonough, William Huynh, Eduard Van Stam, Robert A. Carlson, Mike Florzyk, Paula M. Jacobs, Joan Fuller, Mauren Grunenwald, Ann Bangerter, Jacksonville, Adriane Andersen, Tess Thompson, Kenneth Nowers, Stephanie Helwi, Martin J. Edelman, Emmanuel Omoba, Rubenia Flores, Kevin T. White, Patrick W. Wolfe, Michael Milacek, Sharon Gard, Brandon B. Bigby, Cynthia H. McCollough, Andrew Burnside, Sheryl L. Ogden, Maisha Pollard, Thomas K. Pilgram, Sydney Laster, Claudia J. Kasales, Bruce W. Turnbull, Cheri Haselhuhn, Laura N. Myers, Jean Jacobsen, Melissa Love, Gavin D. Watt, Cheryl Love, Gerald F. Abbott, Susanne Kozakowski, Jerry L. Montague, Cynthia Hill, Neil F. O'Donnell, Anna Sear, Thomas M. Beck, Jean Wegner, Chrispina Wray, Edward M. Brown, Louise Ledbetter, Karen Bellware, Julie Moody, Noel Bahr, Matthew T. Freedman, Thomas Hensley, John E. Madewell, Leanne Hadfield, David R. Maffitt, Lisa Cottrell, John J. Warner, Deborah Graham, Krystal Arnold, Alejandra Reyes, Kristin Lieberman, Derek Omori, Donna Garland, Mike Burek, Mel Johnson, Judith Harkins, Martha Fronheiser, M. Y. M. Chen, Dawn Simmons, Kathleen Voight, Aaron O. Bungum, Marianne Rice, Lakeshia Murray, Tami Krpata, Donna Sammons, Leslie Kmetty, Catherine Duda, Carissa Krzeczkowski, Anne Nguyen, Richard H. Lane, Cynthia Mack, Loren C. Macey, Eddy Wicklander, Kelly McDaniel, Sue Zahradka, Hassan Bourija, Cristina Farkas, Jincy George, Renae Kiffmeyer, Wendell Christie, Catherine Engartner, John Crump, Mimi Kim, Carol Steinberg, Reginald F. Munden, Deb Kirby, Jo Ann Stetz, Barbara O'Brien, Sally Tenorio, Laura Multerer, Carlotta McCalister-Cross, Jessica Silva-Gietzen, Tamara Saunders, Harvey Glazer, Cam Vashel, Maria Oh, Rodkise Estell, Steven M. Moore, Tara Riley, Grant Izmirlian, D. Claire Anderson, James Burner, Steven Peace, Phil Hoffman, Angela Del Pino, Brian Irons, Carlos Jamis-Dow, John K. Lawlor, Edward F. Patz, Jay Afiat, Amber Barrow, Bawn M. Beno, Melissa S. Fritz, Lynn Coppage, Scott J. Sheltra, Tim Swan, Jerry Bergen, Charlie Fenton, Eric Deaton, Marilyn J. Siegel, Korinna Vigeant, Kerry Engber, Sarah Merrill, Buddy Williams, Kimberly Stryker, Bradley S. Snyder, Christina Romo, Andrea Hugill, Michael J. O'Shea, Linda White, Gail Fellows, Yasmeen Hafeez, Joe Woodside, Shauna Dave Scholl, Philip C. Prorok, Sharon Carmen, Kelly Hatton, Steven V. Marx, Sooah Kim, Robert Kobistek, Dawn Thomas, Lea Momongan, Chris Steward, Kari Bohman, Holly Bradford, Bradley S. Sabloff, Phillip Peterson, William C. Black, Lisa Pineda, James G. Ravenel, Karen Taylor, Beverly Trombley, Mona N. Fouad, Amber McDonald, Lauren J. Ramsay, Lisa Harmon, Jeffrey Geiger, David L. Spizarny, Jeffrey S. Klein, Xizeng Wu, Heather Tumberlinson, Joy Espiritu, Gina Varner, Dawn Fuehrer, Eric A. Hoffman, Sheila Moesinger, Nina Wadhwa, Steve King, Patricia Lavernick, Paola Spicker, Timothy R. Church, Cheryl Whistle, Sheila Greenup, Patricia Fantuz, Stephanie Levi, Peter Balkin, Mary E. Johnson, Johanna Ziegler, Susan Hoffman, Kathy L. Clingan, Craig Kuhlka, Maria Marchese, Lawrence F Cohen, Cylen Javidan-Nejad, Wilbur A. Franklin, Kevin J. Leonard, Tim A. Parritt, Jade Quijano, Kathleen Poler, Jennifer Rosenbaum, Xiuli Zhang, Christine Brown, Terri David-Schlegel, Susan M. Peterson, James R. Jett, Kenneth W. Clark, Edward P. Gelmann, Arthur Migo, Patricia Fox, Lori Hamm, Janie McMahon, Darlene Guillette, Robert C. Young, Patty Beckmann, Jerome Jones, Nikki Jablonsky, Roberta Yoffie, Heather L. Bradley, Darlene Higgins, Francine L. Jacobson, Christine B. Berg, Mark Bramwitt, Constantine N. Petrochko, Karen Stokes, Jennifer Rowe, Kathy McKeeta-Frobeck, Brenda Sleasman, Courtney Bell, Dave Tripp, Saundra S. Buys, Susan Walsh, Jo Rean D. Sicks, Richard G. Barr, Kirk Midkiff, Tom Caldwell, Elisabeth A. Grady, Subbarao Inampudi, Marilyn Calulot, Paul A. Kvale, Alice DuChateau, Kathy Berreth, Ruth Holdener, Katie Kuenhold, Thomas E. Warfel, David P. Naidich, Mandie Leming, Fraser Wilton, Leanne Franceshelli, Kathleen McMurtrie, Elaine Bowman, Donald F. Bittner, Helen Kaemmerer, Merri Mullennix, Adelheid Lowery, Andrew Karellas, Jenny Hirschy, Kate Naughton, Ashley B. Long, Kristin M. Gerndt, Kathleen Young, Richard M. Schwartzstein, Wendy Smith, Joseph Aisner, Shane Ball, Kathleen Krach, Cathy Mueller, Virginia May, Christopher Blue, Marsha Lawrence, Ronald S. Kuzo, Colleen McGuire, Alisha Moore, Sara Cantrell, Christie Leary, Pamela Allen, Maryann Trotta, Clifford Caughman, Peggy J. Gocala, Brian Mullen, Janan Alkilidar, Maryann Duggan, Lin Mueller, Alesis Nieves, Fenghai Duan, Frederick Olson, Edwin G. Williams, Jo Ann Hall Sky, Grant Izmirilian, Peggy Joyce, Judy Preston, Cristine Juul, Julianne Falcone, Bruce Neilson, Fla Lisa Beagle, Beth Evans, Jamie Mood, Janet Bishop, Jean Tsukamoto, Vivien Gardner, Gillian Devereux, Minesh Patel, Sally Fraki, Celia Stolin, Ami Lyn Taplin, Stephenie Johnson, Saeed Matinkhah, Jenna Bradford, Sanjeev Bhalla, Charles Jackson, Julie Haglage, Darlene R. Fleming, Allie M. Bell, Paul A. Bunn, Gail Orvis, Andrew J. Bierhals, Julie Ngo, Belores K. Prudoehl, Elaine N. Daniel, Peggy Olson, Paul F. Pinsky, Glenna M. Fehrmann, Aras Acemgil, Andrea Hamilton-Foss, Leeta Grayson, Smita Patel, Scott Emerson, Carl J. Zylak, James R. Maxwell, Jennifer Fleischer, Suzanne Smith, Jacqueline R. Sheeran, Alan Williams, Scott Gaerte, John Fletcher, Sonya Clark, Nancy Gankiewicz, Stuart S. Sagel, Jason Spaulding, Nancy E. Hanson, Nicole Fields, Richard D. Nawfel, Dinakar Gopalakrishnan, Margaret Oechsli, Susan Wenmoth, Isabelle Forter, Elizabeth Morrell, Jessica Rider, Letitia Clark, Michael Woo, Cynthia A. Brown, Camille Mueller, Mark T. Dransfield, Lois M. Roberts, Anne Randall, Eduard J. Gamito, Carrie O'Brien, Carolyn Palazzolo, Julie Schach, Robert Falk, Melissa Hudson, Jennifer Garcia Livingston, Cynthia L. Andrist, Tammy Fox, Elliott Drake, Tanya Zeiger, Renee Metz, Kevin Thomas, Neha Kumar, Elizabeth Couch, Beborah Bay, Mei Hsiu Chen, Jason Bronfman, Philip Dennis, Deb Engelhard, Pamela McBride, Daniel Kimball, Amy Haas, Pamela M. Mazuerk, Marlea Osterhout, Venetia Cooke, Tina Taylor, Amy St.Claire, Joe Hughes, Becky McElsain, Beverly Brittain, Michele Adkinson, Paige Beck, Martha Maineiro, Paula R. Beerman, Jackie Seivert, Mary M. Pollock, Donald Corle, Tina Herron, Marcella Petruzzi, Natalie F. Scully, Kenneth A. Coleman, Jennifer Yang, Debra Loria, Wendy Moss, Alan Brisendine, Cheryl M. Lewis, Dalphany Blalock, Lonni Schultz, Douglas Bashford, Nora Szabo, David Shea, Amanda Devore, Karen Schleip, Judy Netzer, Barry Clot, Gerald M. Mulligan, Nancy E. Krieger Black, David Schultz, Jim Pool, Craig E. Leymaster, Kathryn Rabanal, Kay Bohn, Tara Berg, Marisol Furlong, Stacey Mitchell, Donna Biracree, Laura Jones, Cassie Olson, Robin Stewart, Jeremy Pierce, Marilyn Bruger, Valene Kennedy, Stephanie Davis, Colin O'Donnell, Glenn A. Tung, Shannon Wright, William Lake, Sharon Jones, Vincent Girardi, Brad Benjamin, Veenu Harjani, Drew A. Torigian, Kevin Edelman, Sue Frederickson, Paul E. Smart, Michelle Wann Haynes, D S Gierada, Glenn Fletcher, Rosalie Ronan, Patricia Ann Street, Eleace Eldridge-Smith, Lynly Wilcox, Cindy Lewis-Burke, La Tonja Davis, Rachel Black Thomas, Dawn Shone, Evangeline Griesemer, Tim Budd, Lindsey Dymond, Marlene Semansky, Amy Rueth, Constantine Gatsonis, Kay H. Vydareny, Usha Singh, Amy Lita Evangelista, Angelica C. Barrett, Bethany Pitino, Shirley Wachholz, Angela M. Williams, Sandra Fiarman, Karen Luttrop, David Chellini, Michael Bradley, Helen Fink, Aaron Zirbes, Roger Inatomi, Joon K. Lee, Heather Bishop Blake, Lisa Woodard, Craig Hritz, Sarah Neff, Aine Marie Kelly, Deborah Harbison, Baigalmaa Yondonsambuu, Amy Lloyd, Christine Gjertson, Erin Cunningham, Angelee Mean, June Morfit, Ping Hu, William Thomas, Jazman Brooke, Paul Marcus, Jeremy Gorelick, Erin Lange, William Stanford, Denise R. Aberle, Lena Glick, Annabelle Lee, Ian Malcomb, Deanna L. Miller, Mary Mesnard, Jacqueline Jackson, Jhenny Hernandez, Desiree E. Morgan, Howard I. Jolies, Jacquie Marietta, Teresa Lanning, Debra Rempinski, Amanda C. Davis, Karen Mathews Batton, Mahadevappa Mahesh, Erik Wilson, Deana Nelson, Sharan L. Campleman, William Manor, Julie Sears, Howard Mann, E. David Crawford, Carl Krinopol, Greg Gambill, Margo Cousins, Rex C. Yung, Sangeeta Tekchandani, Thomas Vahey, Ann D. McGinnis, Kimberly Nolan, Kaylene Crawford, Kelli P. Rockwell, Dana Roeshe, Fred W. Prior, Kari Ranae Kramer, Heidi Nordstrom, Frank Stahan, Shawn Sams, Cherie Baiton, Joy Tani, Thomas J. Watson, Angela Cosas, Diane Kowalik, Pritha Dalal, Ann Jolly, Jeanine Wade, Laura Bailey, Julie Varner, Glen K. Nyborg, Christopher Toyn, David Gemmel, Susanna N. Dyer, Laurie Amendolare, Mary Ellen Frebes, Judy Ho, Adele Perryman, John Keller, D. Sullivan, George Mahoney, Scott Cupp, Linda L. Welch, Peter Greenwald, Robert Sole, Marcello Grigolo, Caroline Chiles, Patricia Sheridan, Deborah M. Chewar, Vijayasri Narayanaswami, Susan Blackwell, Suzanne B. Lenz, Alphonso Dial, Melvin Tockman, Carolyn Hill, John Stubblefield, Catherine E. Smith, Judith Lobaugh, Rosa M. Medina, Jackie Meier, Nandita Bhattacharjee, Robert Tokarz, Lisa Clement, Nancy Caird, Cindy Masiejczyk, Patricia Shwarts, Laura Springhetti, Sandra Schornak-Curtis, Edwin F. Donnelly, Patricia Tesch, Laurie Rathmell, Pamela K. Woodard, Edward A. Sausville, David R. Pickens, Kylee Hansen, Paulette Williams, Barbara Ferris, Rachel L. McCall, Nicole M. Carmichael, Dawn Whistler, Ramachandra Chanapatna, Glynis Marsh, Mary Wiseman, Tony DeAngelis, L. Heather, Vicki Prayer, Robin Laura, Priscilla Bland, Gregory W. Gladish, Amy Garrett, Kelly McNulty, Daniel J. Pluta, Mylene T. Truong, Serelda Young, Crista Cimis, Gordon Jacob Sen, Rhonda Rosario, Anthony B. Miller, Edward Hunt, Juanita Helms, Jill K. Bronson, Jeff Yates, Ginette D. Turgeon, Bo Lu, Nancy Fredericks, Pam Senn, Ryan Pena, Hakan Sahin, Mary Lynn Steele, Jill E. Cordes, Noel Maddy, R. Adam DeBaugh, Hope Hooks, Zipporah Lewis, Robert L. Berger, Shani Harris, Natalie Gray, Jennifer Kasecamp, Elizabeth King, Jacinta Mattingly, Hrudaya Nath, Kathy Torrence, Christine Cole Johnson, Sara Mc Clellan, Kalin Albertsen, Kim Sprenger, Ryan Norton, Jody Wietharn Kristopher, Linda Warren, Byung Choi, Casey O'Quinn, Mark K. Haron, Chris J. Jennings, Karen Robinson, Joan Molton, Dorothy Hastings, Robert I. Garver, Christopher J. Cangelosi, Jeannette Lynch, Peter Ohan, Angela Campbell, Dawn Mead, Miriam Galbraith, Divine Hartwell, Natalya Portnov, Gene L. Colice, Andetta R. Hunsaker, Analisa Somoza, Todd Risa, Daniel C. Sullivan, Karthikeyan Meganathan, Tammy DeCoste, Peter Zamora, Richard M. Fagerstrom, Iiana Gareen, Phyllis J. Walters, Barbara L. Carter, Alem Mulugeta, Rob Bowman, Kavita Garg, Andrea Franco, Mary Adams Zafar Awan, Edward Reed Smith, Rachel Phillips, Michelle Aganon-Acheta, Fred R. Hirsch, Peter Jenkins, Pamela Taybus, Joy Knowles, Karen M. Horton, Cheryl Spoutz-Ryan, Sarah Landes, William G. Hocking, Laura B. Schroeder, Erini Makariou, Jered Sieren, Kaylene Evans, Erin Nekervis, Brenda Polding, Tonda Robinson, Joel L. Weissfeld, Terry J. Sackett, Michael F. McNitt-Gray, Leslie Dobson, Raymond Weatherby, Randell Kruger, Revathy B. Iyer, Mary Krisk, Anthony Levering, Susan Collins, Alison Schmidt, William M. Hanson, Patricia Schuler, Karen Glanz, Morgan Ford, Beatrice Trotman-Bickenson, Richard Guzman, Paul Koppel, Judith K. Amorosa, Meredith Slear, Dayna Love, Carol Vaughn, Kellyn Adams, Celeste Monje, Garry Morrison, Sherri Mesquita, Paul Cronin, Tony Blake, Constance Elbon-Copp, Robert A. Clark, Felix Mestas, Erich Allman, Armen Markarian, Cheryl Souza, Karen O’Toole, Elliot K. Fishman, Karen Augustine, Jane Hill, Bonnie Kwit, Ralph Drosten, Susan Foley, Stacy E. Smith, Angie Bailey, Jennifer Bishop Kaufmann, Shelly Meese, Phillip M. Boiselle, Howard Morrow, Thomas D. Hinke, Barry Edelstein, Erin Schuler, William C. Bailey, Donna Letizia, David S. Gierada, Frederick J. Larke, Robin Haverman, Sarah Baum, Sally Hurst, Richard L. Morin, Ben Dickstein, William Russell, J. Anthony Seibert, Sophia Sabina, Mary Alyce Riley, Michael A. Taylor, Katherine BeAngelis, Robert A. Hawkins, Fernando R. Gutierrez, Amie Welch, Heather Lancor, George Armah, James Blaine, Eric Henricks, Joel Dunnington, Carole Walker, Laura Motley, Melody Kolich, Bruce J. Hillman, David W. Sturges, Mindy Lofthouse, Amy Warren, Michael Black, Mark Kolich, Lisa A. Holloway, Shannon M. Pretzel, Susan Shannon, Yassminda Harts, Dallas Sorrel, Lance A. Yokochi, Diana Wisler, Arthur Sandy, Roberta Clune, Shirley Terrian, Shalonda Manning, Bradley Willcox, Thomas J. Payne, James L. Tatum, Dale Brawner, Sandy Morales, Rodolfo C. Morice, Amy Vieth, Emily Jewitt, Chelsea O'Carroll, Theresa C. McLoud, John E. Langenfeld, Chris H. Cagnon, Lisa B. Hinshaw, Gena Kucera, Helena R. Richter, Drew Torigian, June McSwain, Courtney Eysmans, Vinis Salazar, David Spizarny, Mary Kelly-Truran, Mark Whitty, Henry Albano, Connie L. Sathre, William R. Geiser, Barnett S. Kramer, Marianna Gustitis, Gordon C. Jones, Neil E. Caporaso, Timothy Welsh, Roger Tischner, Ana Maria Mendez, Dominick A. Antico, Cathy L. Bornhorst, Carla Chadwell, Stephanie Pawlak, Kelli M. West, Joe V. Selby, Randall Kruger, Jodi Hildestad, Elaine Freesmeier, Nicole Rivas, Andrew Goodman, Naima Vera-Gonzalez, Stuart Lutzker, Eric M. Hart, Melanie Yeh, Shane Sorrell, Deb Multerer, Sharon Jacoby, Debbie Gembala, Elizabeth Fleming, Myrle Johnson, Michael J. Flynn, Frank Tabrah, Martin L. Schwartz, Deanna Mandley, Brad Siga, Guillermo Marquez, Jeffrey Koford, Victoria Jenkins, Janice Pitts, Constantine A. Gatsonis, Natalie Baptiste, Edith M. Marom, Gina Sammons, Anne Burrough, Martha Ramirez, Jack Cahill, Carl Jaffe, Linda Heinrichs, Aura Cole, Paul Rust, Alon Coppens, Gregg Hamm, Lisa Conklin, Kathleen A. Robbins, Carleaner Williams, Gwen Chalom, Winston Sterling, Colleen Hudak, Lea Matous, Ella A. Kazerooni, Denise Kriescher, David A. Lynch, Liz Bolan, Jacob Wolf, Jonathan G. Goldin, Roberta Quinn, L. A. Schneider, Kathleen A. Murray, Erica Sturgeon, Jennifer Avrin, Michelle T. Biringer, Mark Hinson, Cynthia Reiners, Brian Chin, Amy Brunst, Ann M. Lambrecht, Katherine Lohmann, Jennifer Bacon, Ulander Giles, Diane Shepherd, William T. Corey, Timothy Cosgrove, Lana C. Walters, Nancy Kadish, Hilary C. Nosker, Christine D. Berg, Thomas Payne, Jackie Becker, Kanistha Sookpisal, Lyn Seguin, Todd R. Hazelton, Roy Adaniya, James Fisher, Annmarie Walsh, Shirleen Hyun, Laura Stark, Kenneth Hansen, Carolyn Nelson, Martin Tammemagi, Mary A. Wolfsberger, Barry H. Gross, Valentina Ortico, Marge Watry, Jeff Childs, Gabe Herron, Loretta Thorpe, Lisa Damon, Evanthia Papadopoulos, Denise Moline, Voula E. Christopoulos, John D. Minna, Tony Jones, Mitchell Machtay, Michael Plunkett, Melissa Laughren, Luis Zagarra, Adam Leming, Eda Ordonez, Chris Howell, Marissa Peters, Wendy Mosiman, Joanne Gerber, Alfonso Lorenzo, Barbara L. McComb, Laura Hill, Gale Christensen, Hanna Comer, Carmen Guzman, Kathy Taylor, Misty Oviatt, Malcolm King, Lily Stone, Rex Welsh, Bernadette Pennetta, Cristina Raver, Jan E. Hyder, Stephanie Clabo, Peggy Lau, Jacqueline Fearon, Patricia Pangburn, Pamela Dow, William K. Evans, Victor De Caravalho, Mike Wirth, Brooke Johnson, Meridith Blevins, Lisa H. Gren, Sharon L. Kurjan, James P. Evans, Kirk E. Smith, Donna King, John A. Worrell, Mindy S. Geisser, Philip F. Judy, Richard Barr, Sue Misko, Stanley R. Phillips, Jillian Nickel, Christine M. McKey, Joe Austin, Donna Hartfeil, Laura Young, Shovonna White, Alexis K. Potemkin, Anthony Boulos, Tawny Martin, Karen Kofka, Heather McLaughlin, Matthew K. Siemionko, Melissa Houston, Angela Lee Rowley, Adys Fernandez, Murray Backer, Jagdish Singh, Mary Weston, Nancy Payte, Charles Apgar, John K. Gohagan, Jeff Fairbanks, Wylie Burke, David Chi, Michael Nahill, Kevin DeMarco, Karen Patella, Beverly Rozanok, Carol M. Moser, Nicole Matetic Mac, Karen Boyle, Dinah Lorenzo, Elanor Adkins, Phyllis Olsson, Amanda M. Adams, Sujaya Rao, K.E. Jones, Polly Kay, D. Lynn Werner, John B. Weaver, Sally Anne Kopesec, Jennifer Frye, Victoria Chun, Cathy Francow, Cheri Whiton, Jo Ann Nevilles, Andrew Bodd, Barbara Galen, Sabrina Chen, Cindy Cyphert, Stephen M. Moore, Petra J. Lewis, Shanna Nichols, Mareie Walters, Thea Palmer Zimmerman, Warren B. Gefter, Peter Dubbs, Ann Reinert, Holly Washburn, Renee MacDonald, Boleyn R. Andrist, Dianalyn M. Evans, Marvin Flores, Tricia Adrales-Bentz, Claudine Isaacs, Regina C. MacDougall, Greg M. Silverman, Nichoie Cadez, Lynne Bradford, Rochelle Williams, Angela M. McLaughlin, Ellen Sandberg, Cheryl Crozier, Robert Mayer, Richard P. Remitz, Sheron Bube, Leroy Riley, Vish Iyer, Sophie Breer, Stephen Baylin, Anna Boyle, Shannon Williams, Kristen Keating, Martin M. Oken, Gerald L. Andriole, Bruce E. Hubler, Eric T. Goodman, David Engelhart, Bonna Au, Brianne Whittaker, Tricia Hoffa, Eng Brown, Tammy Wolfsohn, Denise L. Foster, Barry H. Cohen, Linda Galocy, Matthew T. Bee, Jacqueline Matuza, Leslie Henry, Katherine Meagher, Mona Fouad, Beth McLellan, Troy Cook, John Sheflin, Lilian Villaruz, Marcella Moore, Brandy Mack-Pipkin, Vanessa Graves, Ryan Weyls, William T. Herbick, Geoffrey McLennan, Lynn Hoese, Janise Webb, Terrie Kitchner, Michele Lee, Robert T. Greenlee, Charles C. Matthews, Nicole Spiese, Jeffrey Heffernon, Dianna D. Cody, Patricia Blair, Kathy Garrett, Michael A. Sullivan, and Loretta Granger

Subjects
Oncology, medicine.medical_specialty, business.industry, Mortality rate, medicine.disease, law.invention, Quality-adjusted life year, Randomized controlled trial, law, Internal medicine, medicine, Radiology, Nuclear Medicine and imaging, National Lung Screening Trial, Radiology, Overdiagnosis, business, Lung cancer, Lung cancer screening, Mass screening
Abstract

The National Lung Screening Trial (NLST) is a randomized multicenter study comparing low-dose helical computed tomography (CT) with chest radiography in the screening of older current and former heavy smokers for early detection of lung cancer, which is the leading cause of cancer-related death in the United States. Five-year survival rates approach 70% with surgical resection of stage IA disease; however, more than 75% of individuals have incurable locally advanced or metastatic disease, the latter having a 5-year survival of less than 5%. It is plausible that treatment should be more effective and the likelihood of death decreased if asymptomatic lung cancer is detected through screening early enough in its preclinical phase. For these reasons, there is intense interest and intuitive appeal in lung cancer screening with low-dose CT. The use of survival as the determinant of screening effectiveness is, however, confounded by the well-described biases of lead time, length, and overdiagnosis. Despite previous attempts, no test has been shown to reduce lung cancer mortality, an endpoint that circumvents screening biases and provides a definitive measure of benefit when assessed in a randomized controlled trial that enables comparison of mortality rates between screened individuals and a control group that does not undergo the screening intervention of interest. The NLST is such a trial. The rationale for and design of the NLST are presented.

Published
2011

14. Health literacy of hospital patients using a linguistically validated Croatian version of the Newest Vital Sign screening test (NVS-HR)

Author

Goranka Rafaj, Martina Ivanišić, Sanja Brangan, and Gill Rowlands

Subjects
Male, European People, Psychometrics, Health Care Providers, lcsh:Medicine, Social Sciences, Nurses, Linguistic validation, 0302 clinical medicine, Sociology, Surveys and Questionnaires, Medicine and Health Sciences, Ethnicities, Medical Personnel, 030212 general & internal medicine, lcsh:Science, education.field_of_study, Schools, Multidisciplinary, healthcare communication, health literacy, Newest Vital Sign (NVS test), Middle Aged, Cognitive Linguistics, Professions, Health Education and Awareness, language, Female, 0305 other medical science, Research Article, Adult, medicine.medical_specialty, Adolescent, Patients, Croatia, Population, MEDLINE, Health literacy, Education, Young Adult, 03 medical and health sciences, medicine, Humans, Translations, Cognitive interview, education, Educational Attainment, Aged, Nutrition, Croatian, Inpatients, 030505 public health, business.industry, lcsh:R, Primary care physician, Reproducibility of Results, Biology and Life Sciences, Linguistics, language.human_language, Health Literacy, Health Care, Family medicine, People and Places, lcsh:Q, Population Groupings, business, Croatian People, Slavic People
Abstract

The Newest Vital Sign (NVS) is a simple, quick and accurate screening test for health literacy (HL). It has been validated for different languages but, to date, not for the Croatian language. The aim of this study was to develop a linguistically validated Croatian version of the NVS and to use it at a later stage in a pilot study of health literacy assessment of hospital patients in Croatia. A full linguistic validation procedure was applied, including forward and backward translation, expert panel review, cognitive interview with 10 respondents from general population, and full involvement in the procedure of one of the screening test developers, the lead author of the NVS-UK version. HL testing on 100 hospital patients (55% women, median age 63.5 years) revealed 58% of patients had less than adequate HL level (scores less than 4), and mean NVS total score was 3.34. A positive significant association was observed between HL and educational level (p = 0.002). A high percentage of patients (92%) did not object to being tested for HL by their primary care physician or in hospital, and 99% of patients would recommend HL testing among patients in general. The respondents' positive views on HL testing and mean completion time of 4 minutes indicate that the Croatian version of the NVS (NVS-HR) could be recommended for use in both clinical and research settings in Croatia.

Published
2018

15. Development and evaluation of a new occupational therapy service in a mental health facility in Ireland

Author

Joan Brangan and Siobhan MacCobb

Subjects
Occupational therapy, Service (business), medicine.medical_specialty, Nursing, business.industry, medicine, Psychiatric hospital, Service user, Commission, Audit, business, Mental health, Service development
Abstract

This paper describes the development and evaluation of a six month pilot occupational therapy service, established in 2007 in St. Brigid’s Hospital, Ardee Co. Louth, a rural psychiatric hospital in Ireland. The lead up to the development of the service, following an inspection at the hospital by the Mental Health Commission, Ireland, is explained. The article describes the involvement of faculty staff from the Division of Occupational Therapy, University of Dublin, Trinity College, in developing a proposal for the service which included a research audit. A description of the service and audit result is given. The audit provides a summary of the views of both service users and staff involved with occupational therapy. It describes the extent to which the occupational therapy service met its target objectives and provided a service which was highly valued by service users and staff. This article provides an example of how a similar service might be reviewed to demonstrate evidence for it’s effective...

Published
2009

16. An outbreak of equine infectious anaemia in Ireland during 2006: Investigation methodology, initial source of infection, diagnosis and clinical presentation, modes of transmission and spread in the Meath cluster

Author

P. Brangan, P. Lenihan, B. Flaherty, J. F. Larkin, Ursula Fogarty, D. P. Leadon, I. Aznar, D. C. Bailey, and Simon J. More

Subjects
Male, medicine.medical_specialty, Time Factors, Enzyme-Linked Immunosorbent Assay, Antibodies, Viral, Disease cluster, Disease Outbreaks, Equine infectious anaemia, Diagnosis, Differential, Equine infectious anemia, Epidemiology, medicine, Animals, Cluster Analysis, Horses, Intensive care medicine, biology, Clinical pathology, Reverse Transcriptase Polymerase Chain Reaction, Transmission (medicine), business.industry, Outbreak, General Medicine, biology.organism_classification, Virology, Equine Infectious Anemia, Female, Presentation (obstetrics), business, Ireland, human activities, Infectious Anemia Virus, Equine
Abstract

Keywords: horse; equine infectious anaemia; EIA; Ireland; epidemiology; source; transmission; spread, outbreak investigation; diagnosis, clinical pathology; clinical presentation

Published
2008

17. Management of the national programme to eradicate equine infectious anaemia from Ireland during 2006: A review

Author

P. Brangan, J. F. Larkin, T. Myers, Simon J. More, and D. C. Bailey

Subjects
Government, medicine.medical_specialty, business.industry, MEDLINE, Disease Management, macromolecular substances, General Medicine, Disease Outbreaks, Equine infectious anaemia, Equine Infectious Anemia, hemic and lymphatic diseases, Family medicine, Communicable Disease Control, medicine, Animals, Optometry, Horses, Disease management (health), business, Ireland, human activities
Abstract

Keywords: horse; equine infectious anaemia; EIA; Ireland; eradication; surveillance; resources; government; industry

Published
2008

18. Transfusion therapy in elective total hip arthroplasty

Author

C. P. Kelly, G. P. Joshi, Joan Brangan, and S. M. McCarroll

Subjects
Male, medicine.medical_specialty, Total hip replacement, Audit, Hematocrit, Sex Factors, Sex factors, health services administration, Medicine, Humans, Blood Transfusion, Aged, Retrospective Studies, Postoperative Care, Intraoperative Care, medicine.diagnostic_test, business.industry, Retrospective cohort study, General Medicine, Middle Aged, humanities, Surgery, Transfusion therapy, Female, Hip Prosthesis, business, Total hip arthroplasty
Abstract

A retrospective audit of transfusion practice in 150 consecutive elective primary total hip arthroplasties was undertaken, to examine blood usage and to determine the potential for reduction in its use. Predetermined criteria were used to measure unnecessary transfusions. Transfusion was considered unnecessary if the discharge haematocrit exceeded 36%, or if patients who lost less than 30% of their estimated blood volume, were transfused. Using these criteria, overtransfusion occurred in 42-45% patients. The intra-operative blood transfused correlated well with intra-operative blood lost. All other variables showed no significant correlation with both intra-operative and post-operative blood transfused. Females lost less and were transfused significantly more than males. The study corroborates previous reports of blood overuse. These results suggest that adopting standards of practice to measure and to monitor transfusion practice (quality assurance programmes) would be a worthwhile objective.

Published
1992

19. Royal Academy of Medicine in Ireland section of Epidemiology and Preventive Medicine

Author

M. O’Mahony, J. Garcia, L. Thornton, M. Gregg, M. O’Connor, A. Gallagher, Joan Brangan, and M. Reilly

Subjects
Cervical cancer, medicine.medical_specialty, business.industry, Section (typography), Alternative medicine, Public health nurse, General Medicine, medicine.disease, Respite care, Family medicine, Internal medicine, Child sexual abuse, Epidemiology, medicine, business, Preventive healthcare
Published
1992

20. Irish Cardiac Society Annual General Meeting and Scientific Sessions held on Friday, 6th December and Saturday, 7th December, 1985

Author

M. B. Buchalter, P. J. Quigley, J. E. Erwin, B. J. Maurer, M. J. Walsh, G. F. Gearty, B. Griffin, A. Timmis, J. C. P. Crick, E. Sowton, E. McGovern, A. E. Wood, K. M. Shaw, Peter A. Crean, David D. Waters, Pierre Theroux, N. Armstrong, E. Chadwick, T. Nugent, Paula Toner, M. P. S. Varma, S. G. Richardson, Patricia Morton, J. G. Murtagh, M. E. Scott, D. B. O’Keeffe, D. C. Allen, M. Walsh, D. P. Murray, E. Rafiqi, R. G. Murray, W. A. Littler, J. P. Branagan, D. McCafferty, A. Kelleher, M. D. I. Donnelly, W. F. Mcllwaine, D. Duff, A. Hussain, S. Devane, M. St. J. Hickey, M. C. Neligan, H. C. Mulholland, M. D. Shields, Ian P. Clements, Martin A. Nelson, Raymond J. Gibbon, Manuel L. Brown, L. Daly, R. Conroy, N. Hickey, R. Mulcahy, J. E. Lee, J. A. Knight, N. P. S. Campbell, A. A. J. Adgey, M. J. O’Hara, R. I. Jones, A. Lahira, E. B-Raftery, K. P. Walsh, A. Ingram, R. A. Kenny, P. E. Vardas, R. Sutton, J. Erwin, E. McWilliams, G. Gearty, B. Maurer, P. Holt, E. Boyd, T. H. Pringle, T. Aherne, E. S. Yee, D. Tcholakoff, W. Finkbeiner, C. B. Higgins, R. Conray, K. Robinson, M. Salih, L. B. Tan, S. Derry, A. J. Moriarty, S. D. Nelson, K. Balnave, I. Graham, S. Bourke, G. Hurley, D. Nunes, F. Stafford, I. Al-Khawaja, M. Caruana, A. Lahiri, E. B. Raftery, F. W. McCullough, S. W. McNair, J. J. Horgan, D. O’Callaghan, Hilary Webb, P. Kelly, J. P. Brangan, W. C. Collins, B. Madden, H. A. Jamidar, S. W. Crooks, J. Crick, A. Halligan, K. Harkin, W. C. J. Collins, M. J. Cullen, J. Feely, John L. McCans, R. S. Kohli, M. M. Kardash, E. A. Rodrigues, N. S. Khurmi, E. B. RafteryKhurmi, P. A. Sullivan, Bertie Daly, Raymond O’Connor, Ml. Freyne, Mary Dineen, D. A. Mulcahy, L. M. Shapiro, Caroline Westgate, D. N. Ross, R. Donaldson, E. M. Ohman, K. K. Teo, A. Johnson, P. Collins, J. H. Horgan, C. M. Jack, E. Hunter, T. Wilson, J. Anderson, G. Brigden, P. Cashman, D. Mulcahy, P. Colins, Tariq M. Sherani, Eilis McGovern, Habib-Al Tarief, Maurice C. Neligan, B. Reardon, T. Mitsuoka, K. Walsh, J. Bourke, R. G. Gold, S. Jameson, and Heather Steen

Subjects
medicine.medical_specialty, Irish, business.industry, Ophthalmology, Family medicine, medicine, language, General Medicine, business, language.human_language
Published
1987

23. Assessment practices of Irish occupational therapists: A study

Author

Geraldine O'Neill and Joan Brangan

Subjects
Occupational therapy, Economics and Econometrics, medicine.medical_specialty, business.industry, Forestry, Standardized test, Key issues, Care giver, language.human_language, Irish, Nursing, Materials Chemistry, Media Technology, medicine, language, Objectivity (science), business
Abstract

Assessment is a key component of the occupational therapy intervention process. Standardized assessments provide objectivity to this process. It is important that, in addition, these assessments reflect the client-centred philosophy of the profession. This article addresses key issues regarding the use of standardized assessments, and reports on the results of a study investigating the assessment practices of a group of Irish occupational therapists. The purpose of this article is to identify the attributes of standardized assessments and to question their place within the practice of occupational therapy. Occupational therapy philosophy stresses the importance of a client-centred approach to intervention, where the client's problems, needs and priorities are determined by the client or by the therapist in collaboration with the client or care giver. Many of the current standardized tests lack this client-centred approach. This article looks at current assessment practices among a group of Irish occupational therapists and suggests some future directions worth considering to optimize the use of standardized assessments.

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