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Concept of older person autonomy: phenomenological study of the opinion of specialist nurses. Porto Biomed J 2022; 7:e178. [PMID: 37152078 PMCID: PMC10158865 DOI: 10.1097/j.pbj.0000000000000178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Accepted: 01/04/2022] [Indexed: 12/23/2022] Open
Abstract
Background: The concept of autonomy is composed of several components, making it a multidimensional concept. This includes cognitive ability, intellectual ability, emotional intelligence, social situation, and physical ability skills. This study aimed to describe the experiences attributed to the meaning of the concept of autonomy, by specialist nurses. Methods: A descriptive phenomenological study was carried out, according to the Giorgi method. Eighteen nurses were recruited at a hospital in Portugal. Data were collected through individual interviews. Results: The 18 specialist nurses work on average as nurses for 16years and are specialist nurses; for an average of 5.9years, most are specialist nurses in rehabilitation nursing. From the data analysis, six themes emerged: ability to do, ability to resolve, decision ability, cognitive ability, social integration, and emotional intelligence. Conclusions: Most professionals perceive the concept as the ability to perform activities of daily living and the ability to make decisions, especially concerning informed consent. It is necessary to raise awareness of the breadth of this concept since the quality of life and dignity of the elderly person depends on autonomy.
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Lima AMN, Martins MMFDS, Ferreira MSM, Coelho ARN, Schoeller SD, Parola VSO. Nursing focuses and interventions that promote the autonomy of the elderly. Rev Gaucha Enferm 2022; 43:e20220018. [PMID: 35613235 DOI: 10.1590/1983-1447.2022.20210018.en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 09/01/2021] [Indexed: 05/31/2023] Open
Abstract
OBJECTIVES To describe the meaning attributed to the experiences of the clinical experience of specialist nurses in the implementation of nursing care focuses and respective interventions that promote the autonomy of the elderly. METHOD Qualitative study based on Giorgi's method. Eighteen specialist nurses were interviewed, recruited for convenience in two hospitals in the northern region of Portugal, between March and December 2018. RESULTS In the clinical experience of specialist nurses, regarding the nursing process, three themes emerged: focuses of nursing care; implementation of nursing interventions and hindering factors. CONCLUSIONS The specialist nurses, most of whom are rehabilitation specialists, essentially promote the physical capacity of the elderly, within the scope of autonomy, revealing that working conditions, such as lack of time and information systems, are the limiting factor of their promotion.
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Affiliation(s)
- Andreia Maria Novo Lima
- Universidade do Porto (U.Porto), Instituto de Ciências Biomédicas Abel Salazar. Porto, Portugal.,Universidade Fernando Pessoa - Escola Superior de Saúde (UFP). Porto, Portugal.,Universidade do Porto (U.Porto), Faculdade de Ciências, Centro de Investigação em Tecnologias e Serviços de Saúde. Porto, Portugal
| | - Maria Manuela Ferreira da Silva Martins
- Universidade do Porto (U.Porto), Faculdade de Ciências, Centro de Investigação em Tecnologias e Serviços de Saúde. Porto, Portugal.,Escola Superior de Enfermagem do Porto (ESEP). Porto, Portugal
| | - Maria Salomé Martins Ferreira
- Escola Superior de Enfermagem de Coimbra (ESEnfC). Instituto Politécnico de Viana do Castelo. Viana do Castelo, Portugal.,Escola Superior de Enfermagem de Coimbra (ESEnfC). Instituto Politécnico de Viana do Castelo Unidade de Investigação em Ciências da Saúde: Enfermagem - Núcleo de Viana do Castelo. Viana do Castelo, Portugal
| | - Adriana Raquel Neves Coelho
- Escola Superior de Enfermagem de Coimbra (ESEnfC). Coimbra, Portugal.,Escola Superior de Enfermagem de Coimbra (ESEnfC). Unidade de Investigação em Ciências da Saúde: Enfermagem. Coimbra, Portugal
| | | | - Vítor Sérgio Oliveira Parola
- Escola Superior de Enfermagem de Coimbra (ESEnfC). Coimbra, Portugal.,Escola Superior de Enfermagem de Coimbra (ESEnfC). Unidade de Investigação em Ciências da Saúde: Enfermagem. Coimbra, Portugal
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Lima AMN, Martins MMFDS, Ferreira MSM, Coelho ARN, Schoeller SD, Parola VSO. Focos e intervenções de Enfermagem promotoras da autonomia dos idosos. Rev Gaucha Enferm 2022. [DOI: 10.1590/1983-1447.2022.20210018.pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivos: Descrever o significado atribuído às vivências da experiência clínica dos enfermeiros especialistas na implementação de focos do cuidado de enfermagem e respetivas intervenções promotoras da autonomia dos idosos. Método: Estudo qualitativo com base no método de Giorgi. Foram entrevistados 18 enfermeiros especialistas, recrutados por conveniência em dois hospitais da região a norte de Portugal, entre março e dezembro de 2018. Resultados: Na experiência clínica dos enfermeiros especialistas, quanto ao processo de enfermagem, emergiram três temas: focos do cuidado de enfermagem; implementação de intervenções de enfermagem e fatores dificultadores. Conclusões: Os enfermeiros especialistas, em sua maioria em reabilitação, promovem essencialmente a capacidade física dos idosos, no âmbito da autonomia, revelando que as condições de trabalho, como a falta de tempo e os sistemas de informação, constituem o fator limitador da sua promoção.
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Affiliation(s)
- Andreia Maria Novo Lima
- Universidade do Porto, Portugal; Universidade Fernando Pessoa, Portugal; Universidade do Porto, Portugal
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Lima AMN, Martins MMFDS, Ferreira MSM, Coelho ARN, Schoeller SD, Parola VSO. Nursing practice in the promotion of the elderly's autonomy. Rev Esc Enferm USP 2021; 55:e20210029. [PMID: 34515725 DOI: 10.1590/1980-220x-reeusp-2021-0029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 05/27/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To describe the meaning attributed by specialist nurses to the promotion of the elderly's autonomy. METHOD This is a phenomenological study, according to Giorgi's method, which uses semi-structured interviews. Eighteen specialist nurses participated, recruited using convenience sampling, in two hospitals in the northern region of Portugal, between March and December 2018. RESULTS Five themes emerged: use of instruments; use of theoretical framework; nursing diagnoses; prescription of interventions; nursing records. CONCLUSION Specialist nurses use instruments that essentially promote the elderly's physical capacity, within the scope of autonomy. The information systems used to record the diagnoses and prescriptions for interventions do not reflect the intervention for the person's autonomy. Autonomy in a multidimensional way is not very well developed, despite the recognition of its importance for the elderly's quality of life and dignity.
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Affiliation(s)
- Andreia Maria Novo Lima
- Instituto de Ciências Biomédicas Abel Salazar, Porto, Portugal, Escola Superior de Saúde da Universidade Fernando Pessoa, Porto, Portugal
| | | | - Maria Salomé Martins Ferreira
- Instituto Politécnico de Viana do Castelo, Escola Superior de Saúde - Viana do Castelo, Unidade de Investigação em Ciências da Saúde: Enfermagem, Núcleo da Escola Superior de Saúde, Instituto Politécnico de Viana do Castelo, Viana do Castelo, Portugal
| | - Adriana Raquel Neves Coelho
- Escola Superior de Enfermagem de Coimbra, Coimbra, Portugal, Unidade de Investigação em Ciências da Saúde: Enfermagem, Coimbra, Portugal.,Centro de Prática Baseada em Evidencias: Um Centro de Excelência do Instituto Joanna Briggs, Coimbra, Portugal
| | | | - Vítor Sérgio Oliveira Parola
- Escola Superior de Enfermagem de Coimbra, Coimbra, Portugal, Unidade de Investigação em Ciências da Saúde: Enfermagem, Coimbra, Portugal.,Centro de Prática Baseada em Evidencias: Um Centro de Excelência do Instituto Joanna Briggs, Coimbra, Portugal
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Bennett L, Bergin M, Wells JSG. Exploring Dimensions of Empowerment from the Patients' Perspective in One Specialist Epilepsy Service in Ireland. J Patient Exp 2020; 7:1189-1196. [PMID: 33457564 PMCID: PMC7786655 DOI: 10.1177/2374373520948405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Empowerment is integral to patient-centered practice, particularly as this relates to people with chronic conditions, though operationally it is poorly understood in this context. Empowerment, therefore, as experienced by patients with a chronic condition needs exploration. This article reports the experience of empowerment by patients in one specialist epilepsy service in Ireland as an exemplar of broader issues affecting empowerment of patients with chronic conditions. A Frameworks Approach was used to analyze in-depth interviews with patients (n = 10) in one Irish epilepsy service. Analysis was further informed by nonparticipatory observation of service delivery. Results indicate that patients' negative experiences of empowerment appear to be derived from traditional social norms relating to clinician patient power dimensions and social stigma internalized by clinicians at an unconscious level. With this in mind, educational approaches based upon critical social theory may provide a framework and guide to enable services to engage with these issues and embrace empowerment of patients with chronic conditions within therapeutic engagement.
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Affiliation(s)
- Louise Bennett
- Department of Nursing, School of Health Sciences, Cork Road, Waterford Institute of Technology, Waterford, Ireland
| | - Michael Bergin
- Department of Applied Arts, School of Humanities, Waterford Institute of Technology, Waterford, Ireland
| | - John S G Wells
- School of Health Sciences, Waterford Institute of Technology, Cork Road, Waterford, Ireland
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Halvorsen K, Dihle A, Hansen C, Nordhaug M, Jerpseth H, Tveiten S, Joranger P, Ruud Knutsen I. Empowerment in healthcare: A thematic synthesis and critical discussion of concept analyses of empowerment. PATIENT EDUCATION AND COUNSELING 2020; 103:1263-1271. [PMID: 32164960 DOI: 10.1016/j.pec.2020.02.017] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 02/05/2020] [Accepted: 02/12/2020] [Indexed: 05/11/2023]
Abstract
OBJECTIVE The objective of this study is to shed light on common characteristics revealed in concept analyses of empowerment to contribute to further understanding. A further objective is to discuss how the perspective of healthcare service users appeared in the concept analyses. METHODS The review was performed by systematically searching Medline, CINAHL, EMBASE, PsycINFO and ERIC. The search yielded 255 abstracts, which were reduced by relevance and critical appraisal to the 12 concept analyses included. The analysis process involved thematic synthesis as described by Thomas and Harden. RESULTS The synthesis led to 13 descriptive themes structured according to antecedents, attributes and consequences of empowerment. The synthesis revealed how sparsely the question of equality and power in the relation between health professionals and healthcare service users is addressed. DISCUSSION To a great extent empowerment is viewed as a helping process of making patients act differently, rather than redistribution of power. For groups that are particularly vulnerable to oppression, questions of power are of severe importance. PRACTICE IMPLICATIONS As user participation is a growing discourse in health policy, health professionals need education to develop and address dimensions of power and reciprocity in empowering relations between users and themselves.
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Affiliation(s)
- Kristin Halvorsen
- Faculty of Health Sciences, Institute of Nursing and health Promotion, Oslo Metropolitan University, Postbox 4, St. Olavs Plass, N-0130 Oslo, Norway.
| | - Alfhild Dihle
- Faculty of Health Sciences, Institute of Nursing and health Promotion, Oslo Metropolitan University, Postbox 4, St. Olavs Plass, N-0130 Oslo, Norway.
| | - Camilla Hansen
- Faculty of Health Sciences, Institute of Nursing and health Promotion, Oslo Metropolitan University, Postbox 4, St. Olavs Plass, N-0130 Oslo, Norway.
| | - Marita Nordhaug
- Faculty of Health Sciences, Institute of Nursing and health Promotion, Oslo Metropolitan University, Postbox 4, St. Olavs Plass, N-0130 Oslo, Norway.
| | - Heidi Jerpseth
- Faculty of Health Sciences, Institute of Nursing and health Promotion, Oslo Metropolitan University, Postbox 4, St. Olavs Plass, N-0130 Oslo, Norway.
| | - Sidsel Tveiten
- Faculty of Health Sciences, Institute of Nursing and health Promotion, Oslo Metropolitan University, Postbox 4, St. Olavs Plass, N-0130 Oslo, Norway.
| | - Pål Joranger
- Faculty of Health Sciences, Institute of Nursing and health Promotion, Oslo Metropolitan University, Postbox 4, St. Olavs Plass, N-0130 Oslo, Norway.
| | - Ingrid Ruud Knutsen
- Faculty of Health Sciences, Institute of Nursing and health Promotion, Oslo Metropolitan University, Postbox 4, St. Olavs Plass, N-0130 Oslo, Norway.
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Briggs FBS, Wilson BK, Pyatka N, Colón-Zimmermann K, Sajatovic MM. Effects of a remotely delivered group-format epilepsy self-management program on adverse health outcomes in vulnerable people with epilepsy: A causal mediation analysis. Epilepsy Res 2020; 162:106303. [PMID: 32151965 PMCID: PMC8019153 DOI: 10.1016/j.eplepsyres.2020.106303] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 01/31/2020] [Accepted: 02/22/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND People with epilepsy frequently experience negative health events (NHEs), such as emergency room visits or hospitalizations for epilepsy-related complications despite significant advances in care. We developed a novel remotely delivered group-format epilepsy self-management program ("Self-management for people with epilepsy and a history of negative health events"; SMART). In a 6-month randomized controlled trial (RCT), SMART participants had significant decreases in NHEs, as well changes in attitudes and behaviors compared to a wait-list (Sajatovic et al., 2018). This secondary analysis from the RCT characterizes the indirect causal effects of SMART on NHE improvements that may be mediated by specific improvements in self-management, self-efficacy, social support, quality of life, and depression symptom severity. METHODS Participants were adults with epilepsy and a NHE in the prior 6 months. There were 60 participants in each RCT arm (SMART versus wait-list) and assessments were conducted at baseline, 10 weeks and 24 weeks. The outcome was a binary variable measuring NHE improvement at week 24. A counterfactual-based mediation framework was used to determine whether improvements or changes in attitudes and behaviors at specific time points or across the study period, mediated the impact of SMART on NHE improvements. RESULTS At week 24, SMART contributed to significant improvements in NHEs compared to those in wait-list (odds ratio = 3.2, p = 0.015). SMART was significantly associated with improvements and changes in aspects of self-management, self-efficacy, quality of life, and depression symptom severity at week 10, and significant improvements between baseline and week 24 in overall self-management and quality of life. Mediation analyses demonstrated that a portion of the effect (∼20-30 %; p < 0.05) of SMART on NHE improvement was also indirectly mediated by early improvements in depression symptom severity and quality of life. CONCLUSIONS This mediation analysis of the SMART intervention demonstrates that in addition to its direct effect on improving NHEs in people with epilepsy, early improvements in depression symptom severity and quality of life indirectly mediated ∼20-30 % of the intervention's effect. These results demonstrate the promise of self-management approaches as a key component of an optimal healthcare model for people with epilepsy, particularly those with a recent history of NHEs.
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Affiliation(s)
- Farren B S Briggs
- Department of Population and Quantitative Health Sciences, School of Medicine, Case Western Reserve University, Cleveland, Ohio, United States
| | - Betsy K Wilson
- Department of Neurology, School of Medicine, Case Western Reserve University, Cleveland, Ohio, United States
| | - Nataliya Pyatka
- University Hospitals Cleveland Medical Center Neurological Institute, Cleveland, Ohio, United States; Louis Stokes Veterans Affairs Cleveland Medical Center, Cleveland, Ohio, United States
| | - Kari Colón-Zimmermann
- Department of Neurology, School of Medicine, Case Western Reserve University, Cleveland, Ohio, United States
| | - Martha M Sajatovic
- Department of Population and Quantitative Health Sciences, School of Medicine, Case Western Reserve University, Cleveland, Ohio, United States; Department of Neurology, School of Medicine, Case Western Reserve University, Cleveland, Ohio, United States; University Hospitals Cleveland Medical Center Neurological Institute, Cleveland, Ohio, United States; Department of Psychiatry, School of Medicine, Case Western Reserve University, Cleveland, Ohio, United States.
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Higgins A, Downes C, Varley J, Doherty CP, Begley C, Elliott N. Supporting and empowering people with epilepsy: Contribution of the Epilepsy Specialist Nurses (SENsE study). Seizure 2019; 71:42-49. [DOI: 10.1016/j.seizure.2019.06.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 05/28/2019] [Accepted: 06/08/2019] [Indexed: 11/25/2022] Open
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Oppenheimer J, Leviton A, Chiujdea M, Antonetty A, Ojo OW, Garcia S, Weas S, Fleegler EW, Chan E, Loddenkemper T. Caring electronically for young outpatients who have epilepsy. Epilepsy Behav 2018; 87:226-232. [PMID: 30197227 DOI: 10.1016/j.yebeh.2018.06.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 06/08/2018] [Accepted: 06/11/2018] [Indexed: 01/17/2023]
Abstract
PURPOSE The purpose of this study was to review electronic tools that might improve the delivery of epilepsy care, reduce medical care costs, and empower families to improve self-management capability. METHOD We reviewed the epilepsy-specific literature about self-management, electronic patient-reported or provider-reported outcomes, on-going remote surveillance, and alerting/warning systems. CONCLUSIONS The improved care delivery system that we envision includes self-management, electronic patient (or provider)-reported outcomes, on-going remote surveillance, and alerting/warning systems. This system and variants have the potential to reduce seizure burden through improved management, keep children out of the emergency department and hospital, and even reduce the number of outpatient visits.
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Affiliation(s)
- Julia Oppenheimer
- Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
| | - Alan Leviton
- Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA.
| | - Madeline Chiujdea
- Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
| | - Annalee Antonetty
- Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
| | - Oluwafemi William Ojo
- Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
| | - Stephanie Garcia
- Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
| | - Sarah Weas
- Division of Developmental Medicine, Department of Medicine, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
| | - Eric W Fleegler
- Division of Emergency Medicine, Department of Medicine, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
| | - Eugenia Chan
- Division of Developmental Medicine, Department of Medicine, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
| | - Tobias Loddenkemper
- Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
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Fishman J, Cohen G, Josephson C, Collier AM, Bharatham S, Zhang Y, Wild I. Patient emotions and perceptions of antiepileptic drug changes and titration during treatment for epilepsy. Epilepsy Behav 2017; 69:44-52. [PMID: 28222341 DOI: 10.1016/j.yebeh.2017.01.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Revised: 01/30/2017] [Accepted: 01/31/2017] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To investigate the impact of antiepileptic drug (AED) change and dose titration on the emotional well-being of patients with epilepsy. METHODS Members of an online epilepsy community were invited to voluntarily participate in an online survey. The cross-sectional anonymous survey consisted of 31 multiple choice questions balanced in terms of variety and positivity/negativity of emotions concerning participants' most recent AED change. To substantiate survey results, spontaneous comments from epilepsy-related online forums and social media websites that mentioned participants' experiences with AED medication changes (termed passive listening statements) were analyzed and categorized by theme. RESULTS All 345 survey participants (270 [78.3%] female; 172 [49.9%] were 26-45years old) self-reported an epilepsy/seizure diagnosis and were currently taking seizure medication; 263 (76.2%) were taking ≥2 AEDs and 301 (87.2%) had ≥1 seizure in the previous 18months. All participants reported a medication change within the previous 12months (dose increased [153 participants (44.3%)], medication added [105 (30.4%)], dose decreased [49 (14.2%)], medication removed [38 (11.0%)]). Improving seizure control (247 [71.6%]) and adverse events (109 [31.6%]) were the most common reasons for medication change. Primary emotions most associated (≥10% of participants) with an AED regimen change were (before medication change; during/after medication change) hopefulness (50 [14.5%]; 43 [12.5%]), uncertainty (50 [14.5%]; 69 [20.0%]), and anxiety (35 [10.1%]; 45 [13.0%]), and were largely due to concerns whether the change would work (212/345 [61.4%]; 180/345 [52.2%]). In the text analysis segment aimed at validating the survey, 230 participants' passive listening statements about medication titration were analyzed; additional seizure activity during dose titration (93 [40.4%]), adverse events during titration (71 [30.9%]), higher medication dosages (33 [14.3%]), and drug costs (25 [10.9%]) were the most commonly noted concerns. CONCLUSION Although the emotional well-being of patients with epilepsy is complex, our study results suggest that participants report their emotional well-being as negatively affected by changes in AED regimen, with most patients reporting uncertainty regarding the outcome of such a change. Future research is warranted to explore approaches to alleviate patient concerns associated with AED medication changes.
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Affiliation(s)
- Jesse Fishman
- UCB Pharma, 1950 Lake Park Drive SE, Smyrna, GA 30080, USA.
| | - Greg Cohen
- UCB Pharma, 1950 Lake Park Drive SE, Smyrna, GA 30080, USA.
| | - Colin Josephson
- Department of Clinical Neurosciences, University of Calgary, Cummings School of Medicine, Foothills Medical Center, 1403 29th St NW, Calgary, Alberta T2N 2T9, Canada.
| | - Ann Marie Collier
- St Mary's Hospital, 750 Wellington Ave, Grand Junction, CO 81501, USA.
| | | | - Ying Zhang
- UCB Pharma, 1950 Lake Park Drive SE, Smyrna, GA 30080, USA.
| | - Imane Wild
- UCB Pharma, 1950 Lake Park Drive SE, Smyrna, GA 30080, USA.
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