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Basnet R, Jensen MP, Pathak A, Gurung G, Thagunna NS, Elisa Maharjan, Hansford H, Riju Maharjan, Nicholas M, Sharma S. Self-Efficacy in Nepali Adults With Musculoskeletal Pain: Measurement Properties of Hard-Copy and Online Versions of the Pain Self-Efficacy Questionnaire. THE JOURNAL OF PAIN 2024; 25:918-933. [PMID: 37871683 DOI: 10.1016/j.jpain.2023.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 10/11/2023] [Accepted: 10/13/2023] [Indexed: 10/25/2023]
Abstract
The Pain Self-Efficacy Questionnaire (PSEQ) is commonly used in pain self-efficacy research. Yet its Nepali translation is unavailable, limiting the ability to conduct cross-cultural research on the role of self-efficacy in musculoskeletal pain and its management. This study aimed to 1) translate and culturally adapt the 10-item (PSEQ-10) and 2-item (PSEQ-2) versions of the PSEQ into Nepali, 2) evaluate their measurement properties in Nepali adults with musculoskeletal pain, and 3) evaluate whether the type of administration (ie, hard-copy vs online) affected their measurement properties. The measurement properties of different administrations of the Nepali PSEQ-10 and PSEQ-2 were evaluated in 180 Nepali adults (120 hard-copy and 60 online administrations) with musculoskeletal pain. We conducted confirmatory factor analyses and estimated the measures' internal consistencies, test-retest reliabilities, and smallest detectable changes using standard error of measurement. We planned to conclude that the measures were valid if ≥ 75% of the validity hypotheses were supported. The results supported unidimensionality for the Nepali PSEQ-10. The Nepali PSEQ-2 and PSEQ-10 evidenced excellent internal consistencies (Cronbach alphas = .90-.95) and good to excellent test-retest reliabilities (intraclass correlation coefficient = .61-.85) for both administrations. Construct validity (r's ≥ .20) and concurrent validity (r's ≥ .83) were supported, as hypothesized. Both hard-copy and online administrations of the Nepali PSEQ-2 and PSEQ-10 are similar, reliable, and valid ways to assess self-efficacy in Nepali adults with musculoskeletal pain. The findings should facilitate telehealth and cross-cultural research on pain self-efficacy in Nepal. PERSPECTIVE: This is the first Nepali adaptation of a self-efficacy scale with testing of measurement properties for hard-copy and online administrations. It will facilitate the assessment of pain self-efficacy in clinical practice and research and facilitate a deeper cross-cultural understanding of the role of self-efficacy in musculoskeletal pain.
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Affiliation(s)
- Ritu Basnet
- Department of Psychology, K and K International College, Tribhuvan University, Kathmandu, Nepal; Department of Physiotherapy, Scheer Memorial Hospital, Banepa, Bagmati, Nepal; Department of Psychiatry and Mental Health, Maharajgunj Medical Campus, T.U. Institute of Medicine, Kathmandu, Nepal
| | - Mark P Jensen
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA
| | - Anupa Pathak
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Gagan Gurung
- Department of General Practice and Rural Health, University of Otago, Dunedin, New Zealand; Te Whatu Ora, National Public Health Service, Southern, Dunedin, New Zealand
| | - Narendra Singh Thagunna
- Department of Psychology, K and K International College, Tribhuvan University, Kathmandu, Nepal; Department of Psychology, Padma Kanya Multiple Campus, Tribhuvan University, Kathmandu, Nepal
| | - Elisa Maharjan
- Department of Physical Medicine and Rehabilitation, Star Hospital, Lalitpur, Bagmati, Nepal
| | - Harrison Hansford
- School of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia; Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, New South Wales, Australia
| | - Riju Maharjan
- Department of Physiotherapy, Upendra Devkota Memorial Hospital, Bansbari, Kathmandu, Nepal
| | - Michael Nicholas
- Pain Management Research Institute, The Kolling Institute, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Saurab Sharma
- School of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia; Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, New South Wales, Australia
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Thapa P, Kc B, Gyawali S, Leong SL, Mohamed Ibrahim MI, Lee SWH. Effectiveness of community pharmacist-led interventions in osteoarthritis pain management: A cluster-randomized trial. Res Social Adm Pharm 2024; 20:149-156. [PMID: 37945419 DOI: 10.1016/j.sapharm.2023.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 09/04/2023] [Accepted: 10/26/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND Community pharmacists contribute in osteoarthritis management via evidence-based pain management services. However, their roles and impacts on osteoarthritis management in low- and middle-income countries have yet to be explored. OBJECTIVE This study aims to evaluate the effectiveness of community pharmacist-led educational intervention and medication review among osteoarthritis patients. METHODS A 6-month cluster-randomized controlled study was conducted in 22 community pharmacies of Nepal. Patients clinically diagnosed with osteoarthritis, aged 18 years and above, with a poor knowledge level of osteoarthritis and pain management were enrolled in the study. The intervention groups were educated on osteoarthritis and pain management, and had their medications reviewed while control group received usual care. Primary outcomes evaluated for the study were the change in pain levels, knowledge, and physical functional scores at 3 and 6 months. Repeated analyses of covariance were performed to examine the outcomes. RESULTS A total of 158 participants were recruited for the study. The intervention group reported improvements in pain score (mean difference 0.473, 95 % CI 0.047 to 0.900) at 3 months and the end of the study (mean difference 0.469, 95 % CI 0.047 to 0.891) as compared to control. Similarly, improvement in knowledge scores were observed in the intervention group at 3 months (mean difference 5.320, 95 % CI 4.982 to 5.658) and 6 months (mean difference 5.411, 95 % CI 5.086 to 5.735). No differences were observed in other outcomes, including physical functional score, depression, and quality of life. CONCLUSION Community pharmacist-led intervention improved patients' knowledge of osteoarthritis and pain management. While pain scores improved, physical functional score, depression, and quality of life score remained unchanged. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT05337709.
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Affiliation(s)
- Parbati Thapa
- School of Pharmacy, Monash University Malaysia, Subang Jaya, Selangor, Malaysia
| | - Bhuvan Kc
- School of Clinical Sciences, Queensland University of Technology, Brisbane, Australia; College of Public Health, Medical, and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
| | - Sudesh Gyawali
- Department of Pharmacology, Manipal College of Medical Sciences, Pokhara, Nepal
| | - Siew Lian Leong
- School of Pharmacy, Monash University Malaysia, Subang Jaya, Selangor, Malaysia
| | | | - Shaun Wen Huey Lee
- School of Pharmacy, Monash University Malaysia, Subang Jaya, Selangor, Malaysia; School of Pharmacy, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Selangor, Malaysia; Asian Centre for Evidence Synthesis in Population, Implementation and Clinical Outcomes (PICO), Health and Well Being Cluster, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia; Global Asia in the 21st Century (GA21) Platform, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia.
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Mlunde LB, Hirschhorn LR, Nyblade L, Rothrock NE, Mbugi EV, Moskowitz JT, Kaaya S, Hawkins C, Leyna G, Mbwambo JK. Translation and cultural adaptation of drug use stigma and HIV stigma measures among people who use drugs in Tanzania. PLoS One 2023; 18:e0292642. [PMID: 37856437 PMCID: PMC10586607 DOI: 10.1371/journal.pone.0292642] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 09/26/2023] [Indexed: 10/21/2023] Open
Abstract
INTRODUCTION People who use drugs (PWUD) experience stigma from multiple sources due to their drug use. HIV seroprevalence for PWUD in Tanzania is estimated to range from 18 to 25%. So, many PWUD will also experience HIV stigma. Both HIV and drug use stigma have negative health and social outcomes, it is therefore important to measure their magnitude and impact. However, no contextually and linguistically adapted measures are available to assess either HIV or drug use stigma among PWUD in Tanzania. In response, we translated and culturally adapted HIV and drug use stigma measures among Tanzanian PWUD and described that process in this study. METHODS This was a cross-sectional study. We translated and adapted existing validated stigma measures by following a modified version of Wild's ten steps for translation and adaptation. We also added new items on stigmatizing actions that were not included in the original measures. Following translation and back translation, we conducted 40 cognitive debriefs among 19 PWUD living with and 21 PWUD not living with HIV in Dar es Salaam to assess comprehension of the original and new items. For challenging items, we made adaptations and repeated cognitive debriefs among ten new PWUD participants where half of them were living with HIV. RESULTS Most of the original items (42/54, 78%), response options and all items with new 12 stigmatizing actions were understood by participants. Challenges included response options for a few items; translation to Swahili; and differences in participants' interpretation of Swahili words. We made changes to these items and the final versions were understood by PWUD participants. CONCLUSION Drug use and HIV stigma measures can successfully be translated and culturally adapted among Tanzanian PWUD living with and without HIV. We are currently conducting research to determine the stigma measures' psychometric properties and we will report the results separately.
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Affiliation(s)
- Linda B. Mlunde
- Department of Community Health, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Lisa R. Hirschhorn
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States of America
| | - Laura Nyblade
- Health Practice, RTI, International, Washington, DC, United States of America
| | - Nan E. Rothrock
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States of America
| | - Erasto V. Mbugi
- Department of Biochemistry, School of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Judith T. Moskowitz
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States of America
| | - Sylvia Kaaya
- Department of Psychiatry and Mental Health, School of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Claudia Hawkins
- Department of Medicine, Feinberg School of Medicine Northwestern University, Chicago, Illinois, United States of America
| | - Germana Leyna
- Department of Epidemiology and Biostatistics, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Jessie K. Mbwambo
- Department of Psychiatry and Mental Health, Muhimbili National Hospital, Dar es Salaam, Tanzania
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Higgins C, Sharma S, Bimali I, Hales TG, Cameron PA, Smith BH, Colvin LA. Cross-sectional study examining the epidemiology of chronic pain in Nepal. Pain Rep 2023; 8:e1067. [PMID: 36818647 PMCID: PMC9928837 DOI: 10.1097/pr9.0000000000001067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 12/07/2022] [Accepted: 12/23/2022] [Indexed: 02/12/2023] Open
Abstract
Introduction The World Health Organization recognizes chronic pain as a global public health concern; however, there is a bias towards research conducted in relatively affluent nations. There is a dearth of large-scale epidemiological studies in Nepal using rigorously validated, cross-culturally adapted instruments. Objectives The aim of this study was to examine the prevalence of both chronic pain and chronic pain of predominantly neuropathic origin and their associations with a range of sociodemographic and psychosocial characteristics. Methods We conducted a cross-sectional study of adults (≥18 years) in all households in Ranipani, Baluwa Village Development Committee, Nepal. All adults (n = 887) were approached, and those consenting, who met the inclusion criteria (n = 520, 58.6%), participated. Questionnaires validated in Nepali were used to examine several constructs: demographics; chronic pain; neuropathic pain; pain catastrophizing; resilience, pain intensity; pain interference; sleep disturbance; and depression. Results The point prevalence of chronic pain was 53.3% (n = 277). The point prevalence of chronic pain of predominantly neuropathic origin was 12.7% (n = 66). Chronic pain was associated with female gender, older age, and manual labour occupations. Using standardized scoring techniques, compared with available population estimates from other countries, those with chronic pain were associated with lower pain intensity and resilience scores and higher pain catastrophizing, pain interference, and depression scores. Conclusion These findings are broadly comparable to epidemiological studies from other countries, and these indicate areas for targeting interventions (eg, occupational and mental health). For comparison, more data are needed, from larger population samples in this region.
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Affiliation(s)
- Cassie Higgins
- Division of Population Health and Genomics, School of Medicine, Ninewells Hospital, University of Dundee, Dundee, Scotland
| | - Saurab Sharma
- School of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, Australia
| | - Inosha Bimali
- Department of Physiotherapy, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
| | - Tim G. Hales
- Division of Systems Medicine, School of Medicine, Ninewells Hospital, University of Dundee, Dundee, Scotland
| | - Paul A. Cameron
- Division of Population Health and Genomics, School of Medicine, Ninewells Hospital, University of Dundee, Dundee, Scotland
| | - Blair H. Smith
- Division of Population Health and Genomics, School of Medicine, Ninewells Hospital, University of Dundee, Dundee, Scotland
| | - Lesley A. Colvin
- Division of Population Health and Genomics, School of Medicine, Ninewells Hospital, University of Dundee, Dundee, Scotland
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Devine J, Kaman A, Seum TL, Zoellner F, Dabs M, Ottova-Jordan V, Schlepper LK, Haller AC, Topf S, Boecker M, Schuchard J, Forrest CB, Ravens-Sieberer U. German translation of the PROMIS ® pediatric anxiety, anger, depressive symptoms, fatigue, pain interference and peer relationships item banks. J Patient Rep Outcomes 2023; 7:16. [PMID: 36810699 PMCID: PMC9943801 DOI: 10.1186/s41687-023-00548-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 01/14/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND The present study aimed at the translation and cross-cultural adaptation of six PROMIS® pediatric self- and proxy- item banks and short forms to universal German: anxiety (ANX), anger (ANG), depressive symptoms (DEP), Fatigue (FAT), pain interference (P) and peer relationships (PR). METHODS Using standardized methodology approved by the PROMIS Statistical Center and in line with recommendations of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) PRO Translation Task Force, two translators for each German-speaking country (Germany, Austria, and Switzerland) commented on and rated the translation difficulty and provided forward translations, followed by a review and reconciliation phase. An independent translator performed back translations, which were reviewed and harmonized. The items were tested in cognitive interviews with 58 children and adolescents from Germany (16), Austria (22), and Switzerland (20) for the self-report and 42 parents and other caregivers (Germany (12), Austria (17), and Switzerland (13)) for the proxy-report. RESULTS Translators rated the translation difficulty of most items (95%) as easy or feasible. Pretesting showed that items of the universal German version were understood as they were intended, as only 14 out of 82 items of the self-report and 15 out of 82 items of the proxy-report versions required minor rewording. However, on average German translators rated the items more difficult to translate (M = 1.5, SD = 0.20) than the Austrian (M = 1.3, SD = 0.16) and the Swiss translators (M = 1.2, SD = 0.14) on a three-point Likert scale. CONCLUSIONS The translated German short forms are ready for use by researchers and clinicians ( https://www.healthmeasures.net/search-view-measures ).
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Affiliation(s)
- J. Devine
- grid.13648.380000 0001 2180 3484Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - A. Kaman
- grid.13648.380000 0001 2180 3484Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - T. L. Seum
- grid.13648.380000 0001 2180 3484Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - F. Zoellner
- grid.13648.380000 0001 2180 3484Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - M. Dabs
- grid.13648.380000 0001 2180 3484Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - V. Ottova-Jordan
- grid.13648.380000 0001 2180 3484Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - L. K. Schlepper
- grid.13648.380000 0001 2180 3484Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - A.-C. Haller
- grid.13648.380000 0001 2180 3484Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - S. Topf
- grid.13648.380000 0001 2180 3484Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - M. Boecker
- grid.13648.380000 0001 2180 3484Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany ,grid.412301.50000 0000 8653 1507Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, University Hospital Aachen, Aachen, Germany
| | - J. Schuchard
- grid.239552.a0000 0001 0680 8770Applied Clinical Research Center, Children’s Hospital of Philadelphia, Roberts Center for Pediatric Research, 2716 South Street, Philadelphia, PA 19146 USA
| | - C. B. Forrest
- grid.239552.a0000 0001 0680 8770Applied Clinical Research Center, Children’s Hospital of Philadelphia, Roberts Center for Pediatric Research, 2716 South Street, Philadelphia, PA 19146 USA
| | - Ulrike Ravens-Sieberer
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
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Sharma S, Higgins C, Cameron P, Bimali I, Hales TG, Bennett MI, Colvin L, Smith BH. Validation of the Nepali Version of the Self-reported Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) in Adults With Chronic Pain and Predominantly Low-literacy Levels. THE JOURNAL OF PAIN 2021; 23:424-433. [PMID: 34583020 DOI: 10.1016/j.jpain.2021.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 07/27/2021] [Accepted: 09/02/2021] [Indexed: 11/24/2022]
Abstract
Neuropathic pain research and clinical care is limited in low- and middle-income countries with high prevalence of chronic pain such as Nepal. We translated and cross-culturally adapted the Self-report version of the Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS)-a commonly used, reliable and valid instrument to screen for pain of predominantly neuropathic origin (POPNO)-into Nepali (S-LANSS-NP) and validated it using recommended guidelines. We recruited 30 patients with chronic pain in an outpatient setting for cognitive debriefing and recruited 287 individuals with chronic pain via door-to-door interviews for validation. For known-group validity, we hypothesized that the POPNO group would report significantly more pain intensity and pain interference than the chronic pain group without POPNO using a cut-off score of ≥10/24. The S-LANSS-NP was comprehensible based on the ease of understanding the questionnaire and lack of missing responses. The validation sample consisted of predominantly low-levels of literacy (81% had 5 years or less education); 23% were classified as having POPNO. Internal consistency was good (alpha = .80). Known-group validity was supported (chronic pain with POPNO reported significantly greater pain intensity than those without). The S-LANSS-NP is a comprehensible, unidimensional, internally consistent, and valid instrument to screen POPNO in individuals with chronic pain with predominantly low-levels of literacy for clinical and research use. PERSPECTIVE: This paper shows that the Nepali version of the S-LANSS is comprehensible, reliable and valid in adults with chronic pain and predominantly low-levels of literacy in rural Nepal. The study could potentially develop research and clinical care of neuropathic pain in this resource-limited setting where chronic pain is a significant problem.
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Affiliation(s)
- Saurab Sharma
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, Australia; Centre for Musculoskeletal Outcomes Research, University of Otago, Dunedin, New Zealand; Department of Physiotherapy, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal.
| | - Cassie Higgins
- Division of Population Health and Genomics, School of Medicine, University of Dundee, Dundee, UK
| | - Paul Cameron
- Division of Population Health and Genomics, School of Medicine, University of Dundee, Dundee, UK; NHS Fife, Dunfermline, Scotland, UK; School of Medicine, Cardiff University, Cardiff, UK
| | - Inosha Bimali
- Department of Physiotherapy, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
| | - Tim G Hales
- Division of Systems Medicine, School of Medicine, University of Dundee, Dundee, UK
| | - Michael I Bennett
- Academic Unit of Palliative Care, School of Medicine, University of Leeds, Leeds, UK
| | - Lesley Colvin
- Division of Population Health and Genomics, School of Medicine, University of Dundee, Dundee, UK
| | - Blair H Smith
- Division of Population Health and Genomics, School of Medicine, University of Dundee, Dundee, UK
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