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Candiani D, Drewe J, Forkman B, Herskin MS, Van Soom A, Aboagye G, Ashe S, Mountricha M, Van der Stede Y, Fabris C. Scientific and technical assistance on welfare aspects related to housing and health of cats and dogs in commercial breeding establishments. EFSA J 2023; 21:e08213. [PMID: 37719917 PMCID: PMC10500269 DOI: 10.2903/j.efsa.2023.8213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/19/2023] Open
Abstract
This Scientific Report addresses a mandate from the European Commission according to Article 31 of Regulation (EC) No 178/2002 on the welfare of cats and dogs in commercial breeding establishments kept for sport, hunting and companion purposes. The aim was to scrutinise recent recommendations made by the EU Platform on Animal Welfare Voluntary Initiative on measures to assist the preparation of policy options for the legal framework of commercial breeding of cats and dogs. Specifically, the main question addressed was if there is scientific evidence to support the measures for protection of cats and dogs in commercial breeding related to housing, health considerations and painful procedures. Three judgements were carried out based on scientific literature reviews and, where possible a review of national regulations. The first judgement addressed housing and included: type of accommodation, outdoor access, exercise, social behaviour, housing temperature and light requirements. The second judgement addressed health and included: age at first and last breeding, and breeding frequency. Judgement 3 addressed painful procedures (mutilations or convenience surgeries) and included: ear cropping, tail docking and vocal cord resections in dogs and declawing in cats. For each of these judgements, considerations were provided indicating where scientific literature is available to support recommendations on providing or avoiding specific housing, health or painful surgical interventions. Areas where evidence is lacking are indicated.
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Knauer WA, Barrell EA, Guedes AGP, Ventura BA. Effects of multimodal pain management strategies on acute physiological and behavioral response to cautery disbudding in neonatal goat kids. J Dairy Sci 2023; 106:2830-2845. [PMID: 36870841 DOI: 10.3168/jds.2022-22433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 11/02/2022] [Indexed: 03/06/2023]
Abstract
Dairy goat kids are commonly disbudded in the United States without pain relief. Our objective was to identify an efficient pain management strategy by monitoring changes in plasma biomarkers and behavior of disbudded goat kids. A total of 42 kids (5-18 d old at the time of disbudding) were randomly allocated to 1 of 7 treatments (n = 6/treatment): sham treatment; 0.05 mg/kg i.m. xylazine (X); 4 mg/kg subcutaneous buffered lidocaine (L); 1 mg/kg oral meloxicam (M); xylazine and lidocaine (XL); xylazine and meloxicam (XM); and xylazine, meloxicam, and lidocaine together (XML). Treatments were administered 20 min before disbudding. One trained individual, blinded to treatment, disbudded all kids; sham-treated kids were handled similarly except the iron was cold. Jugular blood samples (3 mL) were obtained before (-20, -10, and -1 min) and after (1, 15, and 30 min, and 1, 2, 4, 6, 12, 24, 36, 48 h) disbudding and analyzed for cortisol and prostaglandin E2 (PGE2). Mechanical nociceptive threshold (MNT) testing was performed at 4, 12, 24, and 48 h after disbudding, and kids were weighed daily until 2 d post-disbudding. Vocalizations, tail flicks, and struggle behavior during disbudding were recorded. Cameras were mounted over home pens; continuous and scan observations over 12 periods of 10 min each, in the 48 h after disbudding, captured frequency of locomotion and pain-specific behaviors. Repeated measures and linear mixed models assessed treatment effects on outcome measures during and after disbudding. Models accounted for sex, breed, and age as random effects, and Bonferroni adjustments accounted for multiple comparisons. At 15 min after disbudding, XML kids had lower plasma cortisol concentrations compared with L (50.0 ± 13.2 vs. 132.8 ± 13.6 mmol/L) and M kids (50.0 ± 13.2 vs. 145.4 ± 15.7 mmol/L). Cortisol was also lower in XML kids over the first hour after disbudding compared with L kids (43.4 ± 9 vs. 80.2 ± 9 mmol/L). Change from baseline PGE2 was not affected by treatment. Behaviors observed during disbudding did not differ by treatment group. Treatment affected MNT such that M kids were more sensitive overall compared with sham kids (0.93 ± 0.11 kgf vs. 1.35 ± 0.12 kgf). None of the recorded post-disbudding behaviors were affected by treatment, but study activities did influence behavior over time, with kid activity levels declining in the first day after disbudding but largely recovering thereafter. We conclude that none of the drug combinations investigated here appeared to fully attenuate pain indicators during or after disbudding, but triple modality seems to have offered partial relief compared with some of the single-modality treatments.
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Affiliation(s)
- W A Knauer
- Department of Veterinary Population Medicine, University of Minnesota, St. Paul 55108.
| | - E A Barrell
- Department of Veterinary Population Medicine, University of Minnesota, St. Paul 55108
| | - A G P Guedes
- Department of Veterinary Clinical Sciences, University of Minnesota, St. Paul 55108
| | - B A Ventura
- Department of Life Sciences, University of Lincoln, Lincoln LN6 7DL, UK
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Filippa M, Monaci MG, Spagnuolo C, Di Benedetto M, Serravalle P, Grandjean D. Oxytocin Levels Increase and Anxiety Decreases in Mothers Who Sing and Talk to Their Premature Infants during a Painful Procedure. Children (Basel) 2023; 10. [PMID: 36832462 DOI: 10.3390/children10020334] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 02/05/2023] [Accepted: 02/08/2023] [Indexed: 02/12/2023]
Abstract
(1) Background: Preterm infants spend their first weeks of life in the hospital partially separated from their parents and subjected to frequent potentially painful clinical procedures. Previous research has found that early vocal contact reduces infant pain perception while simultaneously increasing oxytocin (OXT) levels. The current study aims to assess the effect of maternal singing and speaking on mothers. (2) Methods: During a painful procedure over two days, twenty preterm infants were randomly exposed to their mother's live voice (speaking or singing). Maternal OXT levels were measured twice: before and after singing, as well as before and after speaking. The anxiety and resilience responses of mothers were studied before and after the two-day interventions, regardless of the speaking/singing condition. OXT levels in mothers increased in response to both singing and speech. Concurrently, anxiety levels decreased, but no significant effects on maternal resilience were found. (3) Conclusions: OXT could be identified as a key mechanism for anxiety regulation in parents, even in sensitive care situations, such as when their infant is in pain. Active involvement of parents in the care of their preterm infants can have a positive effect on their anxiety as well as potential benefits to their sensitivity and care abilities through OXT.
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Wang F, Zhang Q, Ni ZH, Lv HT. Effects of kangaroo care on pain relief in premature infants during painful procedures: A meta-analysis. J SPEC PEDIATR NURS 2022; 27:e12390. [PMID: 35859291 DOI: 10.1111/jspn.12390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 06/22/2022] [Accepted: 07/06/2022] [Indexed: 11/28/2022]
Abstract
AIM This study aimed to evaluate effects of kangaroo care on pain relief in premature infants during painful procedures. DESIGN A meta-analysis. METHODS Eight databases (Cochrane Library, PubMed, Embase, Web of Science, China Biology Medicine [CBM], China Science and Technology Journal Database [CSTJ], China National Knowledge Infrastructure [CNKI], and WanFang Data) were systematically reviewed from inception to November 2021 for randomized controlled and crossover trials. RESULTS Thirteen studies, including 2311 infants (kangaroo care: 1153, control: 1158) were analyzed. Kangaroo care had a moderate effect on pain relief during painful procedures in premature infants at a gestational age of 32-36 + 6 weeks but no effect at 28-31 + 6 weeks. Furthermore, 15 or 30 min of kangaroo care had a moderate effect and could markedly relieve pain at the instant of and 30/60 s after, had a small effect at 90 s after, and no effect at 120 s after the procedure. PRACTICE IMPLICATIONS Kangaroo care may be an effective nonpharmacologic alternative therapy to relieve procedural pain in premature infants born at a gestational age of 32-36 + 6 weeks.
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Affiliation(s)
- Fang Wang
- Neonatal Intensive Care Unit, Children's Hospital of Soochow University, Suzhou, China
| | - Qing Zhang
- Neonatal Intensive Care Unit, Children's Hospital of Soochow University, Suzhou, China
| | - Zhi Hong Ni
- Department of Nursing, Children's Hospital of Soochow University, Suzhou, China
| | - Hai Tao Lv
- Neonatal Intensive Care Unit, Children's Hospital of Soochow University, Suzhou, China
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Maslak K, Favara-Scacco C, Barchitta M, Agodi A, Astuto M, Scalisi R, Italia S, Bellia F, Bertuna G, D'Amico S, La Spina M, Licciardello M, Lo Nigro L, Samperi P, Miraglia V, Cannata E, Meli M, Puglisi F, Parisi GF, Russo G, Di Cataldo A. General anesthesia, conscious sedation, or nothing: Decision-making by children during painful procedures. Pediatr Blood Cancer 2019; 66:e27600. [PMID: 30604464 DOI: 10.1002/pbc.27600] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 12/10/2018] [Accepted: 12/13/2018] [Indexed: 11/06/2022]
Abstract
BACKGROUND Following diagnosis, children with cancer suddenly find themselves in an unknown world where unfamiliar adults make all the important decisions. Children typically experience increasing levels of anxiety with repeated invasive procedures and do not adapt to the discomfort. The aim of the present study is to explore the possibility of asking children directly about their medical support preferences during invasive procedures. PROCEDURE Each patient was offered a choice of medical support on the day of the procedure, specifically general anesthesia (GA), conscious sedation (CS), or nothing. An ad hoc assessment tool was prepared in order to measure child discomfort before, during, and after each procedure, and caregiver adequacy was measured. Both instruments were completed at each procedure by the attending psychologist. RESULTS We monitored 247 consecutive invasive procedures in 85 children and found that children in the 4 to 7 year age group showed significantly higher distress levels. GA was chosen 66 times (26.7%), CS was chosen 97 times (39.3%), and nothing was chosen 5 times and exclusively by adolescents. The child did not choose in 79 procedures (32%). The selection of medical support differed between age groups and distress level was reduced at succeeding procedures. CONCLUSIONS Offering children the choice of medical support during invasive procedures allows for tailored support based on individual needs and is an effective modality to return active control to young patients, limiting the emotional trauma of cancer and treatment.
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Affiliation(s)
- Karolina Maslak
- Pediatric Hemato-Oncology Unit, Azienda Policlinico Vittorio Emanuele, Catania, Italy
| | - Cinzia Favara-Scacco
- Pediatric Hemato-Oncology Unit, Azienda Policlinico Vittorio Emanuele, Catania, Italy
| | | | - Antonella Agodi
- Department "GF Ingrassia", University of Catania, Catania, Italy
| | - Marinella Astuto
- Intensive Care Unit, Azienda Policlinico Vittorio Emanuele, Catania, Italy
| | - Rita Scalisi
- Intensive Care Unit, Azienda Policlinico Vittorio Emanuele, Catania, Italy
| | - Simona Italia
- Pediatric Hemato-Oncology Unit, Azienda Policlinico Vittorio Emanuele, Catania, Italy
| | - Francesco Bellia
- Pediatric Hemato-Oncology Unit, Azienda Policlinico Vittorio Emanuele, Catania, Italy
| | - Gregoria Bertuna
- Pediatric Hemato-Oncology Unit, Azienda Policlinico Vittorio Emanuele, Catania, Italy
| | - Salvatore D'Amico
- Pediatric Hemato-Oncology Unit, Azienda Policlinico Vittorio Emanuele, Catania, Italy
| | - Milena La Spina
- Pediatric Hemato-Oncology Unit, Azienda Policlinico Vittorio Emanuele, Catania, Italy
| | - Maria Licciardello
- Pediatric Hemato-Oncology Unit, Azienda Policlinico Vittorio Emanuele, Catania, Italy
| | - Luca Lo Nigro
- Pediatric Hemato-Oncology Unit, Azienda Policlinico Vittorio Emanuele, Catania, Italy
| | - Piera Samperi
- Pediatric Hemato-Oncology Unit, Azienda Policlinico Vittorio Emanuele, Catania, Italy
| | - Vito Miraglia
- Pediatric Hemato-Oncology Unit, Azienda Policlinico Vittorio Emanuele, Catania, Italy
| | - Emanuela Cannata
- Pediatric Hemato-Oncology Unit, Azienda Policlinico Vittorio Emanuele, Catania, Italy
| | - Mariaclaudia Meli
- Pediatric Hemato-Oncology Unit, Azienda Policlinico Vittorio Emanuele, Catania, Italy.,Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Federica Puglisi
- Pediatric Hemato-Oncology Unit, Azienda Policlinico Vittorio Emanuele, Catania, Italy.,Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Giuseppe Fabio Parisi
- Pediatric Hemato-Oncology Unit, Azienda Policlinico Vittorio Emanuele, Catania, Italy.,Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Giovanna Russo
- Pediatric Hemato-Oncology Unit, Azienda Policlinico Vittorio Emanuele, Catania, Italy.,Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Andrea Di Cataldo
- Pediatric Hemato-Oncology Unit, Azienda Policlinico Vittorio Emanuele, Catania, Italy.,Clinical and Experimental Medicine, University of Catania, Catania, Italy
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Drayton NA, Waddups S, Walker T. Exploring distraction and the impact of a child life specialist: Perceptions from nurses in a pediatric setting. J SPEC PEDIATR NURS 2019; 24:e12242. [PMID: 30901151 DOI: 10.1111/jspn.12242] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 02/03/2019] [Accepted: 02/22/2019] [Indexed: 11/27/2022]
Abstract
PURPOSE The purpose of this study is to explore perceptions held by nurses on the use of distraction and the role of a child life specialist in caring for children undergoing painful procedures. DESIGN AND METHODS A qualitative focus-group design was conducted with 18 nurses from a 24-bed pediatric unit in New South Wales, Australia; this represented 51% of the staff from the unit. Three focus groups were conducted and transcribed verbatim followed by thematic analysis. RESULTS Findings revealed five main themes that reflected the perceptions of the nurses' use of distraction and the impact of the child life specialist. The theme "Distraction as part of everyday nursing practice" was viewed by nurses as an integral component of nursing practice. The theme "Influence of child life specialist" revealed that the child life specialist created a feeling of ease during procedures. Differences were acknowledged between the two roles, "Contrast of roles" the child life specialist was seen as positive for children and families, whereas nurses viewed themselves as mean and unkind due to the nature of their work. The theme "The value of collaboration for positive healthcare experiences" acknowledged distraction as a contributing factor in ensuring the child and their family had a positive healthcare experience. The types of "nurses perception of the child's experience with distraction" shared in each of the focus groups identified nurses felt their techniques for distraction were much more simplified than the child life specialist; nurses felt disadvantaged at times in not having access to the same tools. PRACTICE IMPLICATIONS The findings indicate the positive impact that a child life specialist has on a nurse's role while caring for children undergoing painful procedures. Nurses felt they were able to focus on the procedure, therefore ensuring the physician received the right amount of assistance. This reassured the nurses in knowing the child and their families emotional needs were being taken care of. The child life specialist was viewed as being able to provide a positive healthcare experience for the child and families, nurses felt this added to the value of care provided in the pediatric unit. Recommendations include further exploration of the child life specialist role in the pediatric inpatient setting.
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Affiliation(s)
- Nicola A Drayton
- Department of Nursing and Midwifery, Nepean Blue Mountains Local Health District, Penrith, New South Wales, Australia
| | - Shannan Waddups
- Department of Women's and Children's Health, Nepean Blue Mountains Local Health District, Penrith, New South Wales, Australia
| | - Tanya Walker
- Department of Women's and Children's Health, Nepean Blue Mountains Local Health District, Penrith, New South Wales, Australia
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Guedj R, Danan C, Daoud P, Zupan V, Renolleau S, Zana E, Aizenfisz S, Lapillonne A, de Saint Blanquat L, Granier M, Durand P, Castela F, Coursol A, Hubert P, Cimerman P, Anand KJS, Khoshnood B, Carbajal R. Does neonatal pain management in intensive care units differ between night and day? An observational study. BMJ Open 2014; 4:e004086. [PMID: 24556241 PMCID: PMC3931991 DOI: 10.1136/bmjopen-2013-004086] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE To determine whether analgesic use for painful procedures performed in neonates in the neonatal intensive care unit (NICU) differs during nights and days and during each of the 6 h period of the day. DESIGN Conducted as part of the prospective observational Epidemiology of Painful Procedures in Neonates study which was designed to collect in real time and around-the-clock bedside data on all painful or stressful procedures. SETTING 13 NICUs and paediatric intensive care units in the Paris Region, France. PARTICIPANTS All 430 neonates admitted to the participating units during a 6-week period between September 2005 and January 2006. DATA COLLECTION During the first 14 days of admission, data were collected on all painful procedures and analgesic therapy. The five most frequent procedures representing 38 012 of all 42 413 (90%) painful procedures were analysed. INTERVENTION Observational study. MAIN OUTCOME ASSESSMENT We compared the use of specific analgesic for procedures performed during each of the 6 h period of a day: morning (7:00 to 12:59), afternoon, early night and late night and during daytime (morning+afternoon) and night-time (early night+late night). RESULTS 7724 of 38 012 (20.3%) painful procedures were carried out with a specific analgesic treatment. For morning, afternoon, early night and late night, respectively, the use of analgesic was 25.8%, 18.9%, 18.3% and 18%. The relative reduction of analgesia was 18.3%, p<0.01, between daytime and night-time and 28.8%, p<0.001, between morning and the rest of the day. Parental presence, nurses on 8 h shifts and written protocols for analgesia were associated with a decrease in this difference. CONCLUSIONS The substantial differences in the use of analgesics around-the-clock may be questioned on quality of care grounds.
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Affiliation(s)
- Romain Guedj
- INSERM U1153 – Equipe Epopé, Paris Cedex, France
- AP-HP, Hôpital Armand-Trousseau, Service d'urgences pédiatriques, Paris, France
| | - Claude Danan
- Centre Hospitalier Intercommunal de Créteil, Unité de Réanimation Néonatale et Soins Intensifs, Créteil, France
| | - Patrick Daoud
- Centre HospitaIier André Grégoire, Réanimation Infantile, Montreuil-sous-Bois, France
| | - Véronique Zupan
- AP-HP, Hôpital Antoine Béclère, Pédiatrie et Réanimation Néonatale, Clamart, France
| | - Sylvain Renolleau
- AP-HP, Hôpital Armand-Trousseau, Réanimation Néonatale et Pédiatrique, Paris, France
| | - Elodie Zana
- Maternité Port-Royal, Réanimation néonatale, Paris, France
| | - Sophie Aizenfisz
- AP-HP, Hôpital Robert Debré, Réanimation et Surveillance Continue Pédiatrique, Paris, France
| | - Alexandre Lapillonne
- Université Paris Descartes, AP-HP, Hôpital Necker-Enfants Malades, Réanimation Néonatale, Paris, France
| | | | - Michèle Granier
- Centre Hospitalier Sud Francilien, Médecine Néonatale, Corbeil, France
| | - Philippe Durand
- AP-HP, Hôpital Bicêtre, Réanimation Néonatale et Pédiatrique, Kremlin-Bicêtre, France
| | - Florence Castela
- Centre Hospitalier Intercommunal de Poissy Unité de Réanimation Néonatale, Poissy, France
| | - Anne Coursol
- Centre Hospitalier René Dubos, Médecine Néonatale et Réanimation Pédiatrique, Pontoise, France
| | - Philippe Hubert
- AP-HP, Hôpital Necker-Enfants Malades, Réanimation Polyvalent Pédiatrique, Paris, France
| | - Patricia Cimerman
- AP-HP, Hôpital Armand-Trousseau, Centre Nationale de Ressources de Lutte Contre la Douleur, Paris, France
| | - K J S Anand
- University of Tennessee Health Science Center & Le Bonheur Children's Hospital, Memphis, Tennessee, USA
| | | | - Ricardo Carbajal
- INSERM U1153 – Equipe Epopé, Paris Cedex, France
- AP-HP, Hôpital Armand-Trousseau, Service d'urgences pédiatriques, Paris, France
- Université Pierre et Marie Curie, Paris VI, France
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Abstract
PURPOSE This article provides an overview of literature relevant to the prevention and relief of pain and distress during physiotherapy procedures, with guidance for physiotherapists treating children. SUMMARY OF KEY POINTS Physiotherapists are generally well trained in assessing and managing pain as a symptom of injury or disease, but there is a need to improve the identification and management of pain produced by physiotherapy procedures such as stretching and splinting. In contrast to physiotherapy, other health care disciplines, such as dentistry, nursing, paediatrics, emergency medicine, and paediatric psychology, produce extensive literature on painful procedures. Procedural pain in children is particularly important because it can lead to later fear and avoidance of necessary medical care. RECOMMENDATIONS We emphasize the need for physiotherapists to recognize procedural pain and fear in the course of treatment using verbal, nonverbal, and contextual cues. We present many methods that physiotherapists can use to prevent or relieve procedural pain and fear in paediatric patients and provide an example of a simple, integrated plan for prevention and relief of distress induced by painful procedures.
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Affiliation(s)
- Carl L von Baeyer
- Susan M. Tupper, BScPT: PhD Candidate in Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan
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