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Caskie GIL, Bashian HM, Voelkner AR. Effects of Alzheimer's Diagnosis and Gender on Ageist Attitudes, Aging Anxiety, and Emotional Reactions to Older Adults. THE GERONTOLOGIST 2024; 64:gnad093. [PMID: 37436158 DOI: 10.1093/geront/gnad093] [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: 01/16/2023] [Indexed: 07/13/2023] Open
Abstract
BACKGROUND AND OBJECTIVES We investigated whether ageist attitudes, aging anxiety, and emotional reactions to older adults differ based on Alzheimer's disease (AD) diagnosis, older adult gender, and participant gender, as well as their interactions. RESEARCH DESIGN AND METHODS Using an experimental design, 291 participants (176 men, 115 women; 19-55 years) were randomly assigned to read 1 of 4 descriptions of an older adult that varied cognitive health and gender. Measures of ageist attitudes, aging anxiety, and emotional reactions to the older adult were completed online. RESULTS Relative to a cognitively intact older adult, an older adult with AD evoked less ageist attitudes, less aging anxiety, more compassion, and less emotional distance. A significant interaction between older adult gender and participant gender indicated women felt greater emotional distance from an older adult man than an older adult woman, while men showed no significant difference. DISCUSSION AND IMPLICATIONS The more positive emotions and less ageist responses to an older adult with AD could present as paternalistic and diminish older adults' agency. Women may prioritize shared gender identity over age, which has implications for caregivers and health professionals working with older adults.
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Affiliation(s)
- Grace I L Caskie
- Department of Education & Human Services, Lehigh University, Bethlehem, Pennsylvania, USA
| | - Hannah M Bashian
- Department of Education & Human Services, Lehigh University, Bethlehem, Pennsylvania, USA
- VA Boston Health Care System, Boston, Massachusetts, USA
| | - Abigail R Voelkner
- Department of Education & Human Services, Lehigh University, Bethlehem, Pennsylvania, USA
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Harkin B, Davies LE, Yates A. Contamination-Focussed Vignettes as an Analogue of Infectious Pandemics: An Experimental Validation using the State Disgust and Anxiety Responses in OCD. Psychol Rep 2024:332941241238208. [PMID: 38462961 DOI: 10.1177/00332941241238208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
Despite infectious pandemics proving particularly detrimental to those with Obsessive-Compulsive Disorder (OCD), the investigation of analogous experimental paradigms is lacking. To address this gap, we conducted two studies employing vignettes that depicted contamination-related situations commonly experienced during a pandemic (e.g., Coughing into hands and failing to use hand sanitizer). We manipulated the salience of these vignettes across three levels: high contamination, low contamination, and a neutral control condition. Our examination of state anxiety and disgust responses in all participants revealed the successful manipulation of the vignettes' impact. Specifically, individuals with more severe OCD symptoms reported significantly higher levels of state disgust and anxiety for both high and low contamination vignettes, in contrast to the group with lower symptom severity. No significant differences were observed in the neutral vignette condition between the high- and low-scoring groups. Interestingly, for those with higher OCD symptoms, high salience contamination-focused vignettes resulted in similarly elevated state disgust and anxiety, regardless of whether the vignettes were situated in public (Study 1) or domestic (Study 2) settings. This suggests that the heightened sensitivity to contamination-related scenarios observed in individuals with OCD symptoms in the present study is not confined to a specific context. These findings support the use of contamination-focused vignettes as analogues for studying infectious pandemics and provide valuable insights into OCD models, interventions, and future research.
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Affiliation(s)
- Ben Harkin
- Department of Psychology, Manchester Metropolitan University, Manchester, UK
| | - Lucy E Davies
- Department of Psychology, Manchester Metropolitan University, Manchester, UK
| | - Alan Yates
- Department of Psychology, Manchester Metropolitan University, Manchester, UK
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Błaszkiewicz M, Szcześniak D, Ciułkowicz M, Kowalski K, Rymaszewska JE, Bartosz B, Bulińska K, Karczewski M, Brodaty H, Rymaszewska J. Biomedical knowledge of dementia is not enough to counteract its stigma - quantitative research among future medical and social care staff in Poland. Aging Ment Health 2024:1-9. [PMID: 38407168 DOI: 10.1080/13607863.2024.2320139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 02/12/2024] [Indexed: 02/27/2024]
Abstract
OBJECTIVES The aim is to assess the level of stigmatization and knowledge of dementia among university students of medical, rehabilitation and social faculties in Poland. Possible correlates of these concepts and group differences are also investigated. METHODS We applied quantitative methods using an online questionnaire comprising sociodemographics, the Alzheimer's Disease Knowledge Scale, a vignette of a person with dementia and the modified Family Stigma in Alzheimer's Disease Scale. RESULTS Students had low levels of dementia knowledge and moderate levels of stigma. Medical science students had significantly better knowledge than the other groups but did not differ in their level of stigma. Relationships between the main variables were complex. Emotional and cognitive stigmatizing attributions were negatively correlated with knowledge about communication and behaviors of people with dementia. Better knowledge on causes and characteristics, as well as on risks and health promotion of the disease also triggered fewer negative attributions toward people with dementia. CONCLUSIONS If health-related programs are to be effective, they should provide opportunities for the acquisition of relevant knowledge and skills that also address the stigmatization of people living with dementia. Well-established biomedical knowledge on dementia must be supplemented with a person-centered approach and proper communication skills.
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Affiliation(s)
| | - Dorota Szcześniak
- Department of Psychiatry, Wroclaw Medical University, Wrocław, Poland
| | - Marta Ciułkowicz
- Department of Psychiatry, Wroclaw Medical University, Wrocław, Poland
| | | | - Julia E Rymaszewska
- Department and Clinic of Dermatology, Allergology and Venerology, Wrocław Medical University, Wrocław, Poland
| | - Bogna Bartosz
- Institute of Psychology, University of Wroclaw, Wrocław, Poland
| | - Katarzyna Bulińska
- Department of Physiotherapy, Wrocław University of Health and Sport Sciences, Wrocław, Poland
| | - Maciej Karczewski
- Department of Applied Mathematics, University of Environmental and Life Sciences, Wroclaw, Poland
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, NSW, Australia
| | - Joanna Rymaszewska
- Department of Biomedical Engineering, Wroclaw University of Science and Technology, Wrocław, Poland
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Auvin S, Damera V, Martin M, Holland R, Simontacchi K, Saich A. The impact of seizure frequency on quality of life in patients with Lennox-Gastaut syndrome or Dravet syndrome. Epilepsy Behav 2021; 123:108239. [PMID: 34375802 DOI: 10.1016/j.yebeh.2021.108239] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 05/30/2021] [Accepted: 07/25/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Lennox-Gastaut syndrome (LGS) and Dravet syndrome (DS) are rare treatment-resistant epileptic encephalopathies with limited data describing the relationship between seizures and quality of life (QoL). The objective of this cross-sectional pilot study was to assess the impact on QoL of seizures and seizure-free days for the generation of utility values. METHODS Surveys were conducted in the UK and France, whereby patients and/or caregivers of patients with LGS, DS, or other epilepsies were asked to score health state vignettes for a hypothetical patient with LGS or DS. Respondents evaluated QoL for health states based on the number of seizures and seizure-free days per month, using a visual analog scale (VAS). Visual analog scale scores were converted to the 0-1 scale as a proxy estimate for utility values. Surveys were pilot tested and respondents were recruited from October 2018 to August 2019. RESULTS Patient respondents were mainly treatment-responsive (n = 43/55) whereas caregiver respondents mainly cared for patients with treatment-resistant epilepsy (n = 38/43). Most respondents and patients were aged ≥18 years. Results from LGS and DS surveys in the UK (n = 58) and France (n = 40) suggested that health states with fewer seizures and more seizure-free days had higher QoL scores for hypothetical patients. For DS, QoL scores for patient health states ranged from 0.20 (32 convulsive seizures and 4 seizure-free days/month, UK) to 0.92 (seizure-free, France). For LGS, scores ranged from 0.14 (130 drop seizures and 1 seizure-free day/month, France) to 0.83 (seizure-free, UK). In all surveys, seizure-free days had a greater impact on QoL than seizure frequency (P < 0.001). CONCLUSIONS Fewer seizures and additional seizure-free days improved QoL in patients with LGS or DS; seizure-free days had the greatest impact on QoL.
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Affiliation(s)
- Stéphane Auvin
- Université de Paris, Service de Neurologie Pédiatrique, Hôpital Robert-Debré, APHP, 48 Bd Sérurier, 75019 Paris, France.
| | - Vidya Damera
- Syneos Health Consulting, 10 Bloomsbury Way, 4th Floor, London WC1A 2SL, UK
| | - Monique Martin
- Syneos Health Consulting, 10 Bloomsbury Way, 4th Floor, London WC1A 2SL, UK
| | - Rowena Holland
- GW Pharma Ltd, 1 Cavendish Pl, Marylebone, London W1G 0QF, UK
| | | | - Andrew Saich
- Greenwich Biosciences, Inc., 5750 Fleet St, Carlsbad, CA 92008, USA
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St Marie B, Jimmerson A, Perkhounkova Y, Herr K. Developing and Establishing Content Validity of Vignettes for Health Care Education and Research. West J Nurs Res 2020; 43:677-685. [PMID: 33150841 DOI: 10.1177/0193945920969693] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The use of vignettes in research and education is well documented. Documentation of how vignettes are developed and content validity is established, however, are rare. The purpose of this paper is to describe a method for development and establishing content validity of vignettes that can be used to assess student performance and research participant outcomes. This three-phase method was designed to validate seven vignettes for a future research project. Content validity index survey and expert panel interviews were used to inform improvements in validity. Findings showed that clinical vignettes were improved with respect to content relevance (from 0.93 to 0.96) and importance (from 0.68 to 0.93). Developing validated vignettes is essential when used to measure outcomes in education and in research. This three-phase method of vignette development and validation is feasible and effective in improving content validity of vignettes and can be used in other education and research projects.
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Affiliation(s)
| | | | | | - Keela Herr
- College of Nursing, University of Iowa, Iowa City, IA, USA
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Bortoluzzi CF, Pontello E, Pintani E, de Winter-de Groot KM, D'Orazio C, Assael BM, Hunink MM, Tiddens HA, Caudri D, Belessis Y, Bremont F, Bui S, Casciaro R, Cavicchi M, Cox D, Da Dalt L, De Gregorio F, Dubus J, Gartner S, Geerdink M, Hansen C, Honková L, Jenkins L, Jung A, Karpati F, Mainguy C, Möller A, Neri A, Pressler T, Proesmans M, Raia V, Reid A, Rietschel E, Robinson P, Robinson P, Rossi P, Rovira S, Schultz A, Sepe O, Skalická V, Stick S, Švabe V, Tai A, Tosco A, Vazquez C. The impact of chest computed tomography and chest radiography on clinical management of cystic fibrosis lung disease. J Cyst Fibros 2020; 19:641-646. [DOI: 10.1016/j.jcf.2019.08.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 08/08/2019] [Accepted: 08/10/2019] [Indexed: 01/19/2023]
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Chishti S, Jaggi KR, Saini A, Agarwal G, Ranjan A. Artificial Intelligence-Based Differential Diagnosis: Development and Validation of a Probabilistic Model to Address Lack of Large-Scale Clinical Datasets. J Med Internet Res 2020; 22:e17550. [PMID: 32343256 PMCID: PMC7218591 DOI: 10.2196/17550] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 01/30/2020] [Accepted: 02/01/2020] [Indexed: 12/19/2022] Open
Abstract
Background Machine-learning or deep-learning algorithms for clinical diagnosis are inherently dependent on the availability of large-scale clinical datasets. Lack of such datasets and inherent problems such as overfitting often necessitate the development of innovative solutions. Probabilistic modeling closely mimics the rationale behind clinical diagnosis and represents a unique solution. Objective The aim of this study was to develop and validate a probabilistic model for differential diagnosis in different medical domains. Methods Numerical values of symptom-disease associations were utilized to mathematically represent medical domain knowledge. These values served as the core engine for the probabilistic model. For the given set of symptoms, the model was utilized to produce a ranked list of differential diagnoses, which was compared to the differential diagnosis constructed by a physician in a consult. Practicing medical specialists were integral in the development and validation of this model. Clinical vignettes (patient case studies) were utilized to compare the accuracy of doctors and the model against the assumed gold standard. The accuracy analysis was carried out over the following metrics: top 3 accuracy, precision, and recall. Results The model demonstrated a statistically significant improvement (P=.002) in diagnostic accuracy (85%) as compared to the doctors’ performance (67%). This advantage was retained across all three categories of clinical vignettes: 100% vs 82% (P<.001) for highly specific disease presentation, 83% vs 65% for moderately specific disease presentation (P=.005), and 72% vs 49% (P<.001) for nonspecific disease presentation. The model performed slightly better than the doctors’ average in precision (62% vs 60%, P=.43) but there was no improvement with respect to recall (53% vs 56%, P=.27). However, neither difference was statistically significant. Conclusions The present study demonstrates a drastic improvement over previously reported results that can be attributed to the development of a stable probabilistic framework utilizing symptom-disease associations to mathematically represent medical domain knowledge. The current iteration relies on static, manually curated values for calculating the degree of association. Shifting to real-world data–derived values represents the next step in model development.
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Affiliation(s)
| | | | - Anuj Saini
- 1mg Technologies Pvt Ltd, Gurgaon, India
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Attitudes, knowledge and beliefs about dementia: focus group discussions with Pakistani adults in Karachi and Lahore. AGEING & SOCIETY 2019. [DOI: 10.1017/s0144686x19000862] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractPakistan is a lower middle-income country, which to date has had very little research and policy making to address the challenge of dementia. This study aims to explore the perceptions of dementia in a group of Pakistani adults. A series of focus group discussions were completed during 2017 with men and women in two metropolitan centres in Pakistan (Lahore and Karachi) (N = 40). Two vignettes, depicting someone with mild dementia and someone with severe dementia, were used to facilitate discussions. An induction-led thematic analysis was completed. Five themes were identified, reflecting (a) dementia awareness, (b) responsibility, (c) barriers to health care, (d) identified support needs, and (e) religion. Most participants had little awareness and knowledge about dementia, commonly understood to be a disease of forgetting or just normal ageing. Thus, there is an urgent need of a nation-wide campaign to raise dementia awareness in Pakistan, though this needs to be accompanied by improved, accessible health and social care services.
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Abstract
The authors of this paper discuss the use of participatory and visual research methods with older adults with daily care needs in the United Kingdom. The comments made by older adults and their caregivers in focus groups provided the narrative for this paper. The authors also discuss how to engage older adults in participatory research. Nursing research and practice both involve evaluating processes to gain a holistic understanding of patients through multiple means of data collection. In other words, how do nurses give voice to otherwise silent older adults, even in cases when their strength and recall is failing?
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Affiliation(s)
- Kari Velzke
- Postgraduate Research Candidate, Dementia and Social Gerontology Research Group, School of Applied Social Science, University of Stirling, Stirling, Scotland
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Oremus M, Xie F, Gaebel K. Development of Clinical Vignettes to Describe Alzheimer's Disease Health States: A Qualitative Study. PLoS One 2016; 11:e0162422. [PMID: 27589604 PMCID: PMC5010212 DOI: 10.1371/journal.pone.0162422] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Accepted: 07/26/2016] [Indexed: 12/02/2022] Open
Abstract
Aims To develop clinical descriptions (vignettes) of life with Alzheimer’s disease (AD), we conducted focus groups of persons with AD (n = 14), family caregivers of persons with AD (n = 20), and clinicians who see persons with AD in their practices (n = 5). Methods Group participants read existing descriptions of AD and commented on the realism and comprehensibility of the descriptions. We used thematic framework analysis to code the comments into themes and develop three new vignettes to describe mild, moderate, and severe AD. Results Themes included the types of symptoms to mention in the new vignettes, plus the manner in which the vignettes should be written. Since the vignette descriptions were based on focus group participants’ first-hand knowledge of AD, the descriptions can be said to demonstrate content validity. Conclusion Members of the general public can read the vignettes and estimate their health-related quality-of-life (HRQoL) as if they had AD based on the vignette descriptions. This is especially important for economic evaluations of new AD medications, which require HRQoL to be assessed in a manner that persons with AD often find difficult to undertake. The vignettes will allow the general public to serve as a proxy and provide HRQoL estimates in place of persons with AD.
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Affiliation(s)
- Mark Oremus
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
- * E-mail:
| | - Feng Xie
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
- Program for Health Economics and Outcome Measures (PHENOM), Hamilton, Ontario, Canada
- Centre for Evaluation of Medicines of St. Joseph’s Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Kathryn Gaebel
- Centre for Evaluation of Medicines of St. Joseph’s Healthcare Hamilton, Hamilton, Ontario, Canada
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Flores G, Flores-Gómez GD, de Jesús Gomez-Villalobos M. Neuronal changes after chronic high blood pressure in animal models and its implication for vascular dementia. Synapse 2016; 70:198-205. [DOI: 10.1002/syn.21887] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 01/08/2016] [Accepted: 01/15/2016] [Indexed: 12/11/2022]
Affiliation(s)
- Gonzalo Flores
- Instituto de Fisiología, Benemérita Universidad Autónoma de Puebla. 14 Sur 6301; Puebla 72570 México
| | - Gabriel D. Flores-Gómez
- Departamento de Ciencias de la Salud; Licenciatura en Medicina. Universidad de las Américas Puebla; Puebla Cholula México
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Oremus M, Xie F, Pullenayegum E, Gaebel K. Can the general public use vignettes to discriminate between Alzheimer's disease health states? BMC Geriatr 2016; 16:36. [PMID: 26842500 PMCID: PMC4738787 DOI: 10.1186/s12877-016-0207-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 01/26/2016] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Valid estimates of health-related quality-of-life (HRQoL) are often difficult to obtain from persons with Alzheimer's disease (AD) and family caregiver proxies. To help assess whether the general public can serve as an alternate source of proxy HRQoL estimates in AD, we examined whether the general public can use vignettes to discriminate between AD health states. METHODS We administered a telephone survey to randomly recruited participants from the general public who were aged 18 years or older. Interviewers read vignettes describing the mild, moderate, and severe AD health states to the participants, who answered the EQ-5D-5L and Quality of Life-Alzheimer's Disease (QoL-AD) scales as if they had AD based on the vignette descriptions. Participants also answered the EQ-5D-5L for their current health states. We converted EQ-5D-5L responses into health utility scores using Canadian preference weights. We employed the Wilcoxon signed rank test to examine whether mean health utility scores and mean QoL-AD scores differed between health states. We used Pearson's r to assess correlations between health utility and QoL-AD scores. RESULTS Forty-eight participants (median age = 53 years; 25 female) completed the telephone interview; health utility and QoL-AD scores decreased as AD severity increased (p <0.0001). Mean health utility scores were 0.65 (mild), 0.51 (moderate), and 0.25 (severe). Mean QoL-AD scores were 26.7 (mild), 23.0 (moderate), and 17.4 (severe). The correlations between health utility and QoL-AD scores were moderate to strong (r ≥ 0.62). CONCLUSIONS Using the vignettes, the general public provided HRQoL estimates that discriminated between the three AD health states. This finding suggests the general public may be a promising source of proxy HRQoL estimates in place of persons with AD.
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Affiliation(s)
- Mark Oremus
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON, Canada.
| | - Feng Xie
- Department of Clinical Epidemiology and Biostatistics, McMaster University, 1280 Main Street West, Hamilton, ON, Canada. .,Program for Health Economics and Outcome Measures (PHENOM), 50 Charlton Avenue East, Hamilton, ON, Canada. .,Centre for Evaluation of Medicines, St. Joseph's Healthcare Hamilton, 25 Main Street West, Hamilton, ON, Canada.
| | - Eleanor Pullenayegum
- Child Health Evaluative Sciences, Hospital for Sick Children, 555 University Avenue, Toronto, ON, Canada.
| | - Kathryn Gaebel
- Centre for Evaluation of Medicines, St. Joseph's Healthcare Hamilton, 25 Main Street West, Hamilton, ON, Canada.
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