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2. Pandemic Pandemonium and Primary Care Networks: Experiences of establishing primary care placements in a new medical school

Author

Neden, Catherine A., Popoola, Adetutu, and West, Jonty

Subjects
R729.5.G4
Abstract

Background: In 2018 five new medical schools were announced to support the expansion of the workforce. The Kent and Medway programme features early clinical placements in the community. These start in year one, structured as immersion weeks in Primary Care Networks. The KMMS school opened in September 2020 in the midst of the COVID-19 pandemic with all of its attendant challenges. We report on the challenges of selecting and establishing the placements in the newly established primary care networks (PCN). These offer a unique opportunity for medical students to learn about the provision of proactive personalised and co-ordinated multidisciplinary care at an early and formative stage in their careers. Over the course of the first year, multiple adjustments to the learning format were required including a move to blended learning. \ud Summary of Work Initial challenges included agreeing selection criteria for the PCNs before attending to the legal complexities of contracting and negotiating a service level agreement with the networks, addressing the needs of all stakeholders. Faculty development was conducted remotely. Challenges of the immersion weeks included compromises associated with lockdown restrictions, limited movement across organisations, social distancing and “shielding” students. Over the course of the immersion weeks, we moved to a blended format, navigating the challenges of recorded assessment presentations. \ud Summary of Results We will present a logic model evaluation of this first year of placements. This summarises the resources required, activities (aspects of implementation) as well as the outcomes. These are considered from the perspective of the school, the GP faculty and students. \ud Discussion and Conclusions Innovation in establishing a new medical school brings a unique set of challenges to negotiate. PCNs are contractual collaborations between practices (not legal entities), presenting a challenge for both contracting and quality evaluation. COVID-19 constraints compounded the complexities but offered a unique opportunity to observe multidisciplinary, cross organisation work at first hand in the delivery of the COVD vaccination programme. This balanced the change to a blended learning format. \ud Take Home Messages Flexibility is a key factor in the successful implementation of a new medical school programme involving a range of stakeholders, particularly during a pandemic.

Published
2021

3. Dilemmas and solutions- experiences of a national Family Medicine applied knowledge licensing test during a pandemic

Author

Elfes, Chris, Denney, Mei Ling, Blow, Carol, Cartwright-Terry, Roisin, and Neden, Catherine A.

Subjects
R729.5.G4, education
Abstract

Background: The unprecedented COVID-19 pandemic brought significant challenges to all of medicine, including primary care training and examinations. The MRCGP AKT is high-stakes licensing 200-item MCQ for UK trainee family physicians and is part of an assessment tripos that, up to the onset of the pandemic, included a Clinical Skills Assessment using Simulated Patients and workplace based assessment. The AKT is blueprinted onto a curriculum content specification and computer delivered three times a year at test centres across the UK. It tests the knowledge base underpinning independent general practice within the context of the UK National Health Service. We report on the challenges and dilemmas faced during the pandemic, decisions taken, and lessons learned. Rapid exam changes needed to be made, and communicated effectively to candidates, whilst maintaining standards and fairness to candidates. \ud Summary of Work: Challenges included lockdown travel restrictions, reduced capacity, social distancing and shielding candidates being unable to leave home. The April 2020 AKT was cancelled and prioritisation measures implemented to ensure candidates at the end of their training could enter the (stressed) workforce. We engaged with a wide range of stakeholders, carefully looked at remote testing, made contingency plans prioritised for those unable to sit exams and changed exam regulations to ensure fairness to candidates. In this emergency, we delivered a previously published exam which some candidates were unaware they had sat previously, and assessed how these candidates performed. We compared cohort performance before and during the pandemic. \ud Summary of Results: We summarise why we did not remote test, how we obtained key worker status, and adapted contingency plans. Analysis of candidates who had previously sat the same exam showed they performed less well. Despite wide-ranging changes in training and workplace experience, there was no significant difference in cohort performance overall pre-and peri-pandemic. \ud Discussion and Conclusions: COVID-19 constraints changed trainees clinical exposure, restricted training and supervisor support. However, exam preparedness did not appear adversely affected when measured by overall pass rates. Unexpectedly, candidates who sat an identical exam did not benefit from previous exposure. Take-home Messages: Involving stakeholders in key decisions and regular communications are essential. Test security and standards were not compromised.

Published
2021

4. Establishing Primary Care Network Placements in a new medical school

Author

Neden, Catherine A., Popoola, Adetutu, and West, Jonty

Subjects
R729.5.G4
Abstract

Establishing primary care network placements in a new medical school.\ud \ud Problem\ud Kent and Medway Medical School is one of five new medical schools established to support the expansion of the workforce. The programme features early clinical placements in the community, starting in year one and .structured as immersion weeks in Primary Care Networks. The KMMS school opened in September 2020 in the midst of the COVID-19 pandemic with all of its attendant challenges.\ud \ud We report on the challenges of establishing primary care placements for a new medical school in the newly established primary care networks (PCN). These offer a unique opportunity for medical students to learn about the provision of proactive personalised and co-ordinated multidisciplinary care at an early and formative stage in their careers.\ud \ud Approach\ud Initial challenges included agreeing selection criteria for the PCNs before attending to the legal complexities of negotiating a service level agreement with the networks, addressing the needs of all stakeholders. With the advent of the COVID 19 pandemic, faculty development was conducted remotely. Challenges of the immersion weeks included compromises associated with lockdown restrictions, limited movement across organisations, social distancing and “shielding” students.\ud \ud Findings\ud We will present a logic model evaluation of this first year of placements. This summarises the resources required, activities (aspects of implementation) as well as the outcomes. These are considered from the perspective of the school, the GP faculty and students.\ud \ud Consequences\ud With a move to place based learning across networks, learning about contracting and quality assurance models may be transferable to other settings.\ud \ud COVID-19 constraints compounded the challenges but offered a unique opportunity to observe multidisciplinary, cross organisation work at first hand in the delivery of the COVD vaccination programme. This balanced the change to a blended learning format

Published
2021

5. Home and Online Management and Evaluation of Blood Pressure (HOME BP) using a digital intervention in poorly controlled hypertension: randomised controlled trial

Author

McManus, Richard J., Little, Paul, Stuart, Beth, Morton, Katherine, Raftery, James, Kelly, Jo, Bradbury, Katherine, Zhang, Jin, Zhu, Shihua, Murray, Elizabeth, May, Carl R., Mair, Frances S., Michie, Susan, Smith, Peter, Band, Rebecca, Ogburn, Emma, Allen, Julie, Rice, Cathy, Nuttall, Jacqui, Williams, Bryan, Yardley, Lucy, HOME BP investigators, Jones, Adam, Hussain, Ajmal, McHardy, Alistair, Harrison, Anna, LaLonde, Anna, Malik, Asim, Hernandez-Diaz, Basilio, Cranfield, Ben, Nicholson, Brian, Anandan, Carl, Neden, Catherine, Bobrow, Cathy, Evans, Chloe, Keast, Christopher, Henderson, Clare, Sutherland, Corrine, Kyte, Craig, Henderson, Dan, Noble, Debbie, Capo-Bianco, Ed, Williams, Edward, Shaw, Elizabeth, Mohri, Fatima, Asal, Gaurav, Dougall, Greig, Bhupal, Hardeep, Luckhurst, Heidi, Dosanjh, Hergeven, Nowell, Hilary, Brown, Jan, Flett, Jennifer, Barber, Julian, Rutter, Heather, Thompson, Julian, Ramanan, Kanjhana, Madronal, Karen, Malone, Karen, Etherington, Katie, Tsoi, Kenney, Knox, Kyle, Amin, Laila, Hirst, Lisa, Allen, Lucy, Skellern, Luke, Flynn, Lynne, McEwan, Lorne, Pugsley, Mark, Frassen, Marloes, Gaw, Matthew, Prendergast, Matthew, Wallard, Matthew, Faisal, Muhammad, Wooding, Nick, Lees, Nienke, Wainman, Paul, Nanda, Nithya, Moore, Patrick, Conley, Paul, Johnson, Paul, Wilson, Penny, Jacobs, Phillip, Whitbred, Pippa, Zamir, Rebecca, Reed, Richard, Tribley, Richard, Woof, Richard, Danson, Ruth, Lawes, Ruth, Gallagher, Sarah, Wadsworth, Sarah, Macanovic, Serge, Cartwright, Simon, Pettitt, Simon, Tucker, Simon, Doggett, Stephen, Sevenoaks, Tamsin, Watson, Tara, Talbot, Tess, Imrie, Ruth, Herbert, Thomas, Crockett, Tony, Wright, Tony, Sharma, Vanshika, Telford, Vicki, Almashta, Zaid, Cheng, Zelda, Ali, Zishan, Grube, Alice, Claxton, Andy, Asante, Barbara, Weare, Becki, McKee, Eleanor, Werrett, Bertha, Barwell, Carmel, Mulvihill, Carole, Sherwood, Caroline, MacDonald, Clare, Tabor, Dadirayi, Denning, Dawn, Roberts, Debbie, Adshead, Diane, Clarke, Gemma, Huntley, Heather, Pinder, Heather, Qasim, Irene, Merrison, Jane, King, Jill, Allison, Julie, Johal, Kam, Terry, Karen, Wood, Karine, Balmford, Kathryn, Barnes, Katie, Post, Katie, Bowden, Kelly-Marie, Edmunds, Kirsty, Whittle, Klaire, Peniket, Lara, Carnegie, Leann, Neale, Linda, Davey, Lisa, Bartlett, Liz, Smith, Louise, Clack, Lucy, Brown, Martina, McKenna, Naomi, Kay, Pam, Jacobs, Polly, Cutts, Rebecca, Pearse, Robert, Atkinson, Ruth, Barter, Sally, Mackie, Sally, Norris, Sam, Cook, Sandra, Elderfield, Sarah, Nzante, Sarah, Cronin, Sharon, Maslen, Sophie, Marchant, Stephanie, Wright, Stephanie, Keene, Sue, Smith, Sue, Cimelli, Suzie, Stone, Tracy, Joyce, Tricia, Le Marechal, Trudie, Kettle, Vicky, Osborne, Victoria, Cubiss, Wendy, Marsden, Wendy, Kowalczyk-Williams, Wioletta, and Bailey, Zoe

Abstract

Objective: The HOME BP (Home and Online Management and Evaluation of Blood Pressure) trial aimed to test a digital intervention for hypertension management in primary care by combining self-monitoring of blood pressure with guided self-management. Design: Unmasked randomised controlled trial with automated ascertainment of primary endpoint. Setting: 76 general practices in the United Kingdom. Participants: 622 people with treated but poorly controlled hypertension (>140/90 mm Hg) and access to the internet. Interventions: Participants were randomised by using a minimisation algorithm to self-monitoring of blood pressure with a digital intervention (305 participants) or usual care (routine hypertension care, with appointments and drug changes made at the discretion of the general practitioner; 317 participants). The digital intervention provided feedback of blood pressure results to patients and professionals with optional lifestyle advice and motivational support. Target blood pressure for hypertension, diabetes, and people aged 80 or older followed UK national guidelines. Main outcome measures: The primary outcome was the difference in systolic blood pressure (mean of second and third readings) after one year, adjusted for baseline blood pressure, blood pressure target, age, and practice, with multiple imputation for missing values. Results: After one year, data were available from 552 participants (88.6%) with imputation for the remaining 70 participants (11.4%). Mean blood pressure dropped from 151.7/86.4 to 138.4/80.2 mm Hg in the intervention group and from 151.6/85.3 to 141.8/79.8 mm Hg in the usual care group, giving a mean difference in systolic blood pressure of −3.4 mm Hg (95% confidence interval −6.1 to −0.8 mm Hg) and a mean difference in diastolic blood pressure of −0.5 mm Hg (−1.9 to 0.9 mm Hg). Results were comparable in the complete case analysis and adverse effects were similar between groups. Within trial costs showed an incremental cost effectiveness ratio of £11 ($15, €12; 95% confidence interval £6 to £29) per mm Hg reduction. Conclusions: The HOME BP digital intervention for the management of hypertension by using self-monitored blood pressure led to better control of systolic blood pressure after one year than usual care, with low incremental costs. Implementation in primary care will require integration into clinical workflows and consideration of people who are digitally excluded. Trial registration: ISRCTN13790648.

Published
2021

6. Cardioversion in patients with newly diagnosed non-valvular atrial fibrillation: Observational study using prospectively collected registry data

Author

Pope, Marita Knudsen, Hall, Trygve S, Schirripa, Valentina, Radic, Petra, Virdone, Saverio, Pieper, Karen S, Le Heuzey, Jean-Yves, Jansky, Petr, Fitzmaurice, David A, Cappato, Riccardo, Atar, Dan, Camm, A John, Kakkar, Ajay K, Bassand, Jean-Pierre, Fox, Keith A A, Gersh, Bernard J, Goldhaber, Samuel Z, Goto, Shinya, Haas, Sylvia, Hacke, Werner, Mantovani, Lorenzo G, Misselwitz, Frank, Turpie, Alexander G G, van Eickels, Martin, Verheugt, Freek W A, Luciardi, Hector Lucas, Gibbs, Harry, Brodmann, Marianne, Cools, Frank, Barretto, Antonio Carlos Pereira, Connolly, Stuart J, Eikelboom, John, Corbalan, Ramon, Jing, Zhi-Cheng, Nielsen, Jørn Dalsgaard, Ragy, Hany, Raatikainen, Pekka, Darius, Harald, Keltai, Matyas, Sawhney, Jitendra Pal Singh, Agnelli, Giancarlo, Ambrosio, Giuseppe, Koretsune, Yukihiro, Sánchez Díaz, Carlos Jerjes, Ten Cate, Hugo, Stepinska, Janina, Panchenko, Elizaveta, Lim, Toon Wei, Jacobson, Barry, Oh, Seil, Viñolas, Xavier, Rosenqvist, Marten, Steffel, Jan, Angchaisuksiri, Pantep, Oto, Ali, Parkhomenko, Alex, Al Mahmeed, Wael, Hu, Dayi, Chen, Kangning, Zhao, Yusheng, Zhang, Huaiqin, Chen, Jiyan, Cao, Shiping, Wang, Daowen, Yang, Yuejin, Li, Weihua, Li, Hui, Yin, Yuehui, Tao, Guizhou, Yang, Ping, Chen, Yingmin, He, Shenghu, Wang, Yong, Fu, Guosheng, Li, Xin, Wu, Tongguo, Cheng, Xiaoshu, Yan, Xiaowei, Zhao, Ruiping, Chen, Moshui, Xiong, Longgen, Chen, Ping, Jiao, Yang, Guo, Ying, Xue, Li, Yang, Zhiming, Jadhavm, Praveen, Sarma, Raghava, Kulkarni, Govind, Chandwani, Prakash, Pothiwala, Rasesh Atulbhai, Purayil, Mohanan Padinhare, Chawla, Kamaldeep, Kothiwale, Veerappa Annasaheb, Raghuraman, Bagirath, Vijan, Vinod Madan, Sawhney, Jitendra, Bantwal, Ganapathi, Khan, Aziz, Meena, Ramdhan, Chopada, Manojkumar, Abraham, Sunitha, Bisne, Vikas, Vijayaraghavan, Govindan, Roy, Debabrata, Durgaprasad, Rajashekhar, Shankar, A G Ravi, Kumar, Sunil, Jain, Dinesh, Bhargava, Kartikeya, Kumar, Vinay, Nagamalesh, Udigala Madappa, Rajput, Rajeeve Kumar, Kanamori, Seishu, Yamamoto, Kenichi, Kumagai, Koichiro, Katsuda, Yosuke, Yoshida, Keiki, Toyota, Fumitoshi, Mizuno, Yuji, Misumi, Ikuo, Noguchi, Hiroo, Ando, Shinichi, Suetsugu, Tetsuro, Minamoto, Masahiro, Oda, Hiroyuki, Adachi, Susumu, Chiba, Kei, Norita, Hiroaki, Tsuruta, Makoto, Koyanagi, Takeshi, Yamamoto, Kunihiko, Ando, Hiroshi, Higashi, Takayuki, Okada, Megumi, Azakami, Shiro, Komaki, Shinichiro, Kumeda, Kenshi, Murayama, Takashi, Matsumura, Jun, Oba, Yurika, Sonoda, Ryuji, Goto, Kazuo, Minoda, Kotaro, Haraguchi, Yoshikuni, Suefuji, Hisakazu, Miyagi, Hiroo, Kato, Hitoshi, Nakamura, Tsugihiro, Nakamura, Tadashi, Nandate, Hidekazu, Zaitsu, Ryuji, Fujiura, Yoshihisa, Yoshimura, Akira, Numata, Hiroyuki, Ogawa, Jun, Kamogawa, Yasuyuki, Murakami, Kinshiro, Wakasa, Yutaka, Yamasawa, Masanori, Maekawa, Hiromitsu, Abe, Sumihisa, Kihara, Hajime, Tsunoda, Satoru, Saito, Katsumi, Tachibana, Hiroki, Oba, Ichiro, Kuwahata, Takashi, Higa, Satoshi, Gushiken, Masamichi, Eto, Takuma, Chibana, Hidetoshi, Fujisawa, Kazuaki, Shiga, Yuhei, Sumi, Hirokuni, Nagatomo, Toshihisa, Atsuchi, Yoshihiko, Nagoshi, Toshiro, Sanno, Kazuhisa, Hoshino, Fumihiro, Yokota, Naoto, Kameko, Masahiro, Tabuchi, Toshifumi, Ishizawa, Munesumi, Fujiura, Yoshitake, Ikeda, Daisuke, Seto, Taku, Iwao, Tetsu, Ishioka, Norio, Oshiro, Koichi, Tsuchida, Keizo, Hatori, Yutaka, Takeuchi, Motoshi, Takezawa, Hiroto, Nagano, Shinjiro, Iwaki, Masaaki, Nakamura, Yuichiro, Miyamoto, Naomasa, Taguchi, Toshifumi, Ashida, Ko, Yoshizawa, Naoto, Agata, Jun, Matsukawa, Seishiro, Arasaki, Osamu, Fukuoka, Shuji, Murakami, Hirofumi, Mishima, Kazuya, Hata, Yoshiki, Sakuma, Ichiro, Obunai, Kotaro, Takamura, Ichiro, Akutsu, Mitsuyuki, Unoki, Toshihide, Go, Yoshinori, Ikemura, Makoto, Morii, Shoji, Marusaki, Shigeru, Doi, Hideo, Tanaka, Mitsuru, Kusumoto, Takaaki, Kakinoki, Shigeo, Ogurusu, Chiga, Murata, Kazuya, Shimoyama, Masaki, Nakatsuka, Masami, Kitami, Yutaka, Nakamura, Yoichi, Oda, Hiroshi, Oyama, Rikimaru, Ageta, Masato, Mita, Teruaki, Nagao, Kazuhiko, Mito, Takafumi, Minami, Junichi, Abe, Mitsunori, Fujii, Masako, Okawa, Makoto, Fujito, Tsuneo, Taniguchi, Toshiya, Ko, Tenei, Kubo, Hiroshi, Imamaki, Mizuho, Akiyama, Masahiro, Ueda, Takashi, Odakura, Hironori, Inagaki, Masahiko, Katsube, Yoshiki, Nakata, Atsuyuki, Tomimoto, Shinobu, Shibuya, Mitsuhiro, Nakano, Masayuki, Ito, Kenichiro, Matsuta, Masahiro, Ishiguro, Motoyuki, Minagawa, Taro, Wada, Masamichi, Mukawa, Hiroaki, Mizuguchi, Masato, Okuda, Fumio, Kimura, Teruaki, Taga, Kuniaki, Techigawara, Masaaki, Igarashi, Morio, Watanabe, Hiroshi, Seo, Toshihiko, Hiramitsu, Shinya, Hosokawa, Hiroaki, Hoshiai, Mitsumoto, Hibino, Michitaka, Miyagawa, Koichi, Horie, Hideki, Sugishita, Nobuyoshi, Shiga, Yukio, Soma, Akira, Neya, Kazuo, Yoshida, Tetsuro, Akahane, Kunio, Adachi, Sen, Takanaka, Chiei, Matsui, Saori, Kanda, Hirofumi, Kaneko, Masanori, Nagasaka, Shiro, Taguchi, Atsushi, Toru, Shuta, Saito, Kazuyuki, Miyashita, Akiko, Sasaguri, Hiroki, Nariyama, Jin, Hatsuno, Taketo, Iwase, Takash, Sato, Kazuki, Kawai, Kazuya, Kotani, Tomobumi, Tsuji, Tsuyoshi, Sakai, Hirosumi, Nishino, Kiyoshi, Ikeda, Kenichi, Maeda, Kazuo, Shinozuka, Tomohiro, Inoue, Takeshi, Kawakami, Koichi, Kitazumi, Hiromichi, Takagi, Tsutomu, Hamaoka, Mamoru, Kojima, Jisho, Sasaki, Akitoshi, Tsuchiya, Yoshihiro, Betsuyaku, Tetsuo, Higuchi, Koji, Honda, Masaaki, Hasegawa, Koichi, Baba, Takao, Mineoi, Kazuaki, Koeda, Toshihiko, Hirasawa, Kunihiko, Kumazaki, Toshihide, Nakagomi, Akira, Otaki, Eiji, Shindo, Takashi, Hirayama, Hiroyoshi, Sugimoto, Chikako, Yamagishi, Takashi, Mizuguchi, Ichiro, Sezaki, Kazunori, Niwa, Isamu, Takenaka, Ken, Iiji, Osamu, Taya, Koichi, Kitazawa, Hitoshi, Ueda, Samu, Kakuda, Hirokazu, Ono, Takuya, Oriso, Seizo, Kamata, Junya, Nanke, Toshihiko, Maeda, Itaru, Matsuura, Yoshifusa, Teragawa, Hiroki, Maruyama, Yasuyuki, Takei, Kazuo, Horie, Hajime, Kito, Tetsutaro, Asano, Hiroshi, Matsushita, Koji, Nakamura, Masaichi, Washizuka, Takashi, Yoshida, Tomoki, Sawano, Masato, Arima, Shinichi, Arai, Hidekazu, Shinohara, Hisanori, Takai, Hiroyuki, Furukawa, Nobufusa, Ota, Akira, Yamamoto, Kentaro, Aoki, Kenji, Yamamoto, Taku, Kasai, Takeaki, Suzuki, Shunji, Suzuki, Shu, Shibata, Nitaro, Watanabe, Masayuki, Nishihata, Yosuke, Arino, Toru, Okuyama, Masaki, Wakiyama, Tetsushi, Kato, Tomoko, Sasagawa, Yasuo, Tana, Takeshi, Hayashi, Yoshihito, Hirota, Shinichi, Abe, Yukihiko, Saito, Yoshihiro, Uchiyama, Hirohide, Takeda, Hiroshi, Ono, Hiroshi, Tohyo, Shuichi, Hanazono, Naoto, Miyajima, Seiichi, Shimono, Hisashi, Aoyama, Takuma, Shozawa, Yasunobu, Niijima, Yawara, Murai, Osamu, Inaba, Hideko, Nomura, Katsumasa, Nozoe, Masatsugu, Suzuki, Kazuo, Furukawa, Toshiyuki, Shiraiwa, Toshihiko, Ito, Nobuhisa, Nagai, Shunichi, Sato, Kiyoharu, Nakahara, Shiro, Shimoyama, Yujin, Ohara, Naoko, Kozuka, Teruhiko, Okita, Hideaki, Endo, Masato, Goto, Tsutomu, Hirose, Makoto, Nagata, Emiko, Nakanishi, Noriyuki, Mori, Toshizumi, Seki, Shuichi, Okamoto, Katsuhiro, Moriai, Osamu, Emura, Yoko, Fukuda, Tsuyoshi, Date, Haruhiko, Kawakami, Shuichi, Nagai, Sho, Ueyama, Yuya, Fudo, Tetsuro, Imaizumi, Mitsuru, Ogawa, Takuo, Take, Shunsuke, Ikeda, Hideo, Nishioka, Hiroaki, Sakamoto, Norihiko, Ikeoka, Kiyomitsu, Wakaki, Nobuo, Abe, Masatake, Doiuchi, Junji, Kira, Tetsuya, Tada, Masato, Tsuzaki, Ken, Miura, Naoya, Fujisawa, Yasuaki, Furumoto, Wataru, Suzuki, Susumu, Fujisawa, Akinori, Nakamura, Ryosai, Komatsu, Hiroyasu, Fujiki, Rei, Kawano, Shuichi, Nishizawa, Keijiro, Kato, Yoji, Azuma, Junya, Yasui, Kiyoshi, Amano, Toshio, Sekine, Yasuhiro, Honzawa, Tatsuo, Koshibu, Yuichiro, Sakamoto, Yasuhide, Seta, Yukihiro, Miyaguchi, Shingo, Morishita, Kojuro, Samejima, Yasuko, Sasaki, Toyoshi, Iseki, Fumiko, Kobayashi, Toshiyuki, Kano, Hiroshi, Kim, Jaeyoung, Yamaguchi, Hiroshi, Takagi, Yoichi, Pearce, Yoko Onuki, Suzuki, Yasuyuki, Fukui, Takayuki, Nakayama, Toru, Kanai, Hideaki, Kawano, Yoshiyuki, Ino, Tetsuji, Miyoshi, Hironori, Miyamoto, Yasufumi, Shigekiyo, Masahito, Ono, Shimato, Okamoto, Yutaka, Ubukata, Satoshi, Kodera, Kojiro, Oriuchi, Tatsuo, Matsumoto, Naoki, Inagaki, Koichi, Iseki, Atsushi, Yoshida, Tomohiro, Goda, Toshihiro, Katsuki, Tsukasa, Sato, Atsushi, Mori, Etsuo, Tsubokura, Toshio, Shudo, Hiroshi, Fujimoto, Shunichi, Katsuya, Tomohiro, Furukawa, Yoshiyuki, Hosokawa, Hiroshi, Narumi, Jun, Yamamoto, Kiichiro, Owari, Masaki, Inakura, Takuya, Anno, Takafumi, Shirakawa, Kazuyuki, Ching, Chi Keong, Foo, David, Wong, Kelvin, Yuyang, Tan, Park, Hui Nam, Kim, Woo-Shik, Lee, HyeYoung, Jang, Sung-Won, Kim, Dae Hyeok, Kim, Jun, Ryu, DongRyeol, Shim, Jaemin, Kim, Dae-Kyeong, Choi, Dong Ju, Oh, Yong Seog, Cho, Myeong-Chan, Kim, Hack-Lyoung, Jeon, Hui-Kyung, Shin, Dong-Gu, Park, Sang Weon, Park, Hoon Ki, Han, Sang-Jin, Sung, Jung Hoon, Park, Hyung-Wook, Nam, Gi-Byoung, On, Young Keun, Lim, Hong Euy, Kwak, JaeJin, Cha, Tae-Joon, Hong, Taek Jong, Park, Seong Hoon, Yoon, Jung Han, Kim, Nam-Ho, Kim, Kee-Sik, Jung, Byung Chun, Hwang, Gyo-Seung, Kim, Chong-Jin, Rungaramsin, Sakda, Katekangplu, Peerapat, Khunrong, Porames, Bunyapipat, Thanita, Wongcharoen, Wanwarang, Kaewsuwanna, Pinij, Siriwattana, Khanchai, Tiyanon, Waraporn, Pattanaprichakul, Supalerk, Likittanasombat, Khanchit, Cholsaringkarl, Doungrat, Boonyapisit, Warangkana, Cheewatanakornkul, Sirichai, Silaruks, Songkwan, Hutayanon, Pisit, Chawanadelert, Seksan, Chattranukulchai, Pairoj, Chatlaong, Boonsert, Santanakorn, Yingsak, Kanokphatcharakun, Khompiya, Mongkolwongroj, Piya, Jai-Aue, Sasivimon, Komson, Ongkarn, Altun, Armagan, Aydinlar, Ali, Topsakal, Ramazan, Ongen, Zeki, Acikel, Sadik, Sahin, Durmus Yildiray, Yilmaz, Ozcan, Yilmaz, Mehmet Birhan, Pekdemir, Hasan, Demir, Mesut, Sucu, Murat, Sahiner, Levent, Ersanli, Murat, Okuyan, Ertugrul, Aras, Dursun, Rolandi, Florencia, Ingaramo, Adrian Cesar, Sambadaro, Gustavo Alberto, Caputi, Vanina Fernandez, Luciardi, Hector, Berman, Sofia Graciela, Dragotto, Pablo, Kleiban, Andres Javier, Centurion, Nestor, Guerrero, Rodolfo Andres Ahuad, Di Paola, Leonel Adalberto, Dran, Ricardo Dario, Egido, Javier, Fosco, Matias Jose, Sinisi, Victor Alfredo, Cartasegna, Luis Rodolfo, Vilamajo, Oscar Gomez, Ramos, Jose Luis, Sassone, Sonia, Zapata, Gerardo, Conde, Diego, Giacomi, Guillermo, Fernandez, Alberto Alfredo, Berli, Mario Alberto, Ferroni, Fabian, Filho, Dário Celestino Sobral, Jaber, Jefferson, Armaganijan, Luciana Vidal, Costantini, Costantino Roberto Frack, Steffens, André, de Souzaem, Weimar Kunz Sebba Barroso, de Souza Neto, João David, Ribeiro, José Márcio, Teixeira, Marcelo Silveira, Rossi, Paulo, Pires, Leonardo, Moreira, Daniel, Jorge, José Carlos Moura, Filho, Adalberto Menezes Lorga, Bodanese, Luiz, Montera, Marcelo Westerlund, Del Carlo, Carlos Henrique, Saad, Jamil Abdalla, Alves da Costa, Fernando Augusto, Lopes, Renato, de Araújo, Gilson Roberto, Manenti, Euler Roberto, Saraiva, Jose Francisco Kerr, Braga, João Carlos Ferreira, Negri, Alexandre, Moncada, Carlos, Precoma, Dalton, Roquette, Fernando, Reis, Gilmar, Ramos Filho, Roberto Álvaro, Figueiredo, Estêvão Lanna, Botelho, Roberto Vieira, da Fontoura Tavares, Cláudio Munhoz, Finimundi, Helius Carlos, Kochi, Adriano, França, César Cássio Broilo, Alban, Fábio, Rosito, Guido Bernardo Aranha, Junior, João Batista de Moura Xavier Moraes, Tumelero, Rogério Tadeu, Maia, Lilia, de Almeida, Roberto Simões, do Carmo Borges, Ney Carter, Gomes Ferreira, Luís Gustavo, Corbalán, Ramón, Fernandez, Benjamin Aleck Joseh Stockins, Montecinos, Humberto, Lanas, Fernando, Gómez, Martín Larico, Astudillo, Carlos, Conejeros, Carlos, Cuevas, Patricio Marin, Forero, Alejandro, Gutiérrez, Claudio Bugueño, Aguilar, Juan, Cardenas, Sergio Potthoff, Eggers, German, Houzvic, Cesar, Rey, Carlos, Arriagada, Germán, Vilches, Gustavo Charme, Illescas Diaz, Jesus Jaime, Cantu, Raul Leal, Ramos Zavala, Maria Guadalupe, Jardines, Ricardo Cabrera, Zavaleta, Nilda Espinola, Rosas, Enrique Lopez, Llamas Esperón, Guillermo Antonio, Pozas, Gerardo, Muñoz, Ernesto Cardona, Hernandez, Norberto Matadamas, Rendon, Adolfo Leyva, Hernandez, Norberto Garcia, de los Rios Ibarra, Manuel, Carrillo, Luis Ramon Virgen, Villezca, David Lopez, Herrera, Carlos Hernandez, Lopez Prieto, Juan Jose, Rodriguez, Rodolfo Gaona, Espinosa, Efrain Villeda, Martinez, David Flores, Barcena, Jose Velasco, Fierro, Omar Fierro, Briones, Ignacio Rodriguez, Leiva Pons, Jose Luis, Lopez, Humberto Alvarez, Ruiz, Rafael Olvera, Brito, Carlos Gerardo Cantu, Valenzuela, Eduardo Julian Jose Roberto Chuquiure, Sanchez, Roxana Reyes, Bazzoni Ruiz, Alberto Esteban, Lopez Ruiz, Oscar Martin, Nava, Roberto Arriaga, Morales Cerda, Jesus David, Campos, Pedro Fajardo, Gonzalez, Mario Benavides, Lenz, Kurt, Hagn, Claus, Foechterle, Johannes, Drexel, Heinz, Huber, Kurt, Podczeck-Schweighofer, Andrea, Winkler, Michael, Schneeweiss, Bruno, Gegenhuber, Alfons, Lang, Wilfried, Eichinger-Hasenauer, Sabine, Kaserer, Peter, Sykora, Josef, Rasch, Heribert, Strohmer, Bernhard, Capiau, Luc, Vervoort, Geert, Wollaert, Bart, Hollanders, Geert, Vercammen, Jan, Faes, Dirk, Balthazar, Yohan, Delforge, Marc, Xhaet, Olivier, Striekwold, Harry, Thoeng, John, Hermans, Kurt, Mairesse, Georges, Anné, Wim, Blankoff, Ivan, Beutels, Michel, Verstraete, Stefan, Vandergoten, Peter, Purnode, Philippe, Godart, Pascal, Boussy, Tim, Desfontaines, Philippe, Heyse, Alex, Voet, Joeri, De Wolf, Axel, Zidkova, Eva, Spacek, Rudolf, Machova, Vilma, Ludka, Ondrej, Olsr, Josef, Kotik, Lubos, Racz, Blazej, Ferkl, Richard, Hubac, Jan, Kotik, Ilja, Monhart, Zdenek, Burianova, Hana, Jerabek, Ondrej, Pisova, Jana, Petrova, Iveta, Dedek, Vratislav, Honkova, Michaela, Podrazil, Petr, Reichert, Petr, Spinar, Jindrich, Novak, Miroslav, Durdil, Vaclav, Plocova, Katarina, Lastuvka, Jiri, Nielsen, Jørn, Husted, Steen, Dominguez, Helena, Hintze, Ulrik, Rasmussen, Søren, Sygehus, Næstved, Bremmelgaard, Arne, Markenvard, John, Børger, Jan, Solgaard, Jorgen, Eriksen, Ebbe, Løkkegaard, Thomas, Bruun, Michael, Mertz, Jacob, Schou, Morten, Olsen, Michael, Airaksinen, K E Juhani, Paganelli, Franck, Ohayon, Joël, Casassus, Frédéric, Galinier, Michel, Gottwalles, Yannick, Loiselet, Philippe, Muller, Jean-Joseph, Koujan, Mohamed Bassel, Marquand, André, Destrac, Sylvain, Piot, Olivier, Delarche, Nicolas, Cebron, Jean-Pierre, Guenoun, Maxime, Guedj-Meynier, Dominique, Lokesh, A G, Zuber, Mathieu, Amarenco, Pierre, Ellie, Emmanuel, Kadouch, James, Fournier, Pierre-Yves, Huberman, Jean-Pierre, Lemaire, Nestor, Rodier, Gilles, Vandamme, Xavier, Sibon, Igor, Neau, Jean-Philippe, Mahagne, Marie Hélène, Mielot, Antoine, Bonnefoy, Marc, Churet, Jean-Baptiste, Navarre, Vincent, Sellem, Frederic, Monniot, Gilles, Boyes, Jean-Paul, Doucet, Bernard, Martelet, Michel, Obadia, Désiré, Crousillat, Bernard, Mouallem, Joseph, Bearez, Etienne, Brugnaux, Jean Philippe, Fedorowsky, Alain, Nazeyrollas, Pierre, Berneau, Jean-Baptiste, Chemin, Frédéric, Schellong, Sebastien, Koeniger, Georg, Kopf, Andreas, Gerbaulet, Uwe, Kellner, Bernd-Thomas, Schaefer, Thomas, Purr, Jan, Eißfeller, Enno, Zauzig, Heinz-Dieter, Riegel, Peter, Axthelm, Christoph, Heinz, Gerd-Ulrich, Menke, Holger, Pustelnik, Andreas, Zutz, Stefan, Eder, Wolfgang, Rehling, Guenter, Glatzel, Dirk, Ludwig, Norbert, Sandow, Petra, Wiswedel, Henning, Wildenauer, Cosmas, Schoen, Steffen, Schwarz, Toralf, Babyesiza, Adyeri, Kropp, Maximilian, Zimny, Hans-Hermann, Kahl, Friedhelm, Caspar, Andreas, Omankowsky, Sabine, Laessig, Torsten, Hartmann, Hermann-Josef, Lehmann, Gunter, Bindig, Hans-Walter, Hergdt, Gunter, Reimer, Dietrich, Hauk, Joachim, Michel, Holger, Dres, Praxis, Erdle, Werner, Dorsch, Wilfried, Dshabrailov, Janna, Rapp, Karl-Albrecht, Vormann, Reinhold, Mueller, Thomas, Mayer, Peter, Horstmeier, Uwe, Eissing, Volker, Hey, Heinz, Leuchtgens, Heinz, Lilienweiss, Volker, Mueller, Heiner, Schubert, Christian, Lauer, Herrmann, Buchner, Thomas, Brauer, Gunter, Kamin, Susanne, Mueller, Karsten, Baumbach, Sylvia, Abdel-Qader, Muwafeg, Ebert, Hans-Holger, Schwencke, Carsten, Bernhardt, Peter, Karolyi, Laszlo, Sievers, Britta, Haverkamp, Wilhelm, Roehnisch, Jens-Uwe, Vertes, Andras, Szantai, Gabor, Matoltsy, Andras, Kanakaridisz, Nikosz, Boda, Zoltan, Kis, Erno, Gaszner, Balazs, Juhasz, Ferenc, Juhasz, Gizella, Kancz, Sandor, Laszlo, Zoltan, May, Zsolt, Merkely, Bela, Noori, Ebrahim, Habon, Tamas, Polgar, Peter, Szalai, Gabriella, Vangel, Sandor, Nagy, Andras, Engelthaler, Gabriella, Ferenczi, Judit, Egyutt, Mihaly, Martini, Giuliana, Cristina, Leone Maria, Tiraferri, Eros, Santoro, Rita, Testa, Sophie, Di Minno, Giovanni, Moia, Marco, Caimi, Teresa Maria, Tessitori, Maria, Cappelli, Roberto, Poli, Daniela, Quintavalla, Roberto, Cosmi, Franco, Fanelli, Raffaele, Oriana, Vincenzo, Reggio, Raffaele, Santi, Roberto, Pancaldi, Leonardo, De Cristofaro, Raimondo, Guazzaloca, Giuliana, De Blasio, Angelo, Uriate, Jorge Salerno, Lillo, Flavia, Pogliani, Enrico Maria, Bilo, Grzegorz, Accogli, Michele, Mariani, Antonio, Feola, Mauro, Raisaro, Arturo, Fattore, Luciano, Mauric, Andrea, Germini, Fabrizio, Tedeschi, Luca, Settimi, Maria, Nicoli, Sergio, Ricciarini, Paolo, Argena, Antonio, Ronchini, Paolo, Bulla, Claudio, Tradati, Filippo, Volpe, Massimo, D’Avino, Maria, Bongiorni, Maria Grazia, Severi, Silva, Capucci, Alessandro, Lodigiani, Corrado, Salomone, Enrico, Serviddio, Gaetano, Tondo, Claudio, Golino, Paolo, Mazzone, Carmine, Iacopino, Saverio, ten Cate, Hugo, Ruiter, J H, Lucassen, Andreas, Adriaansen, Henk, Bongaerts, Maarten, Pieterse, Mathijs, van Guldener, Coen, Herrman, Johannes, Nierop, S H K P R, Hoogslag, Pieter, Hermans, Walter, Groenemeijer, B E, Terpstra, W, Buiks, Cees, Boersma, L V A, Berge, Eivind, Sirnes, Per Anton, Gjertsen, Erik, Hole, Torstein, Erga, Knut, Hallaråker, Arne, Skjelvan, Gunnar, Østrem, Anders, Ghezai, Beraki, Svilaas, Arne, Christersson, Peter, Øien, Torbjørn, Henrichsen, Svein Høegh, Otterstad, Jan Erik, Berg-Johansen, Jan, Gieroba, Andrzej, Biedrzycka, Malgorzata, Ogorek, Michal, Wozakowska-Kaplon, Beata, Loboz-Grudzien, Krystyna, Supinski, Wieslaw, Kuzniar, Jerzy, Zaluska, Roman, Hiczkiewicz, Jaroslaw, Swiatkowska-Byczynska, Lucyna, Kucharski, Lech, Gruchala, Marcin, Minc, Piotr, Olszewski, Maciej, Kania, Grzegorz, Krzciuk, Malgorzata, Lajkowski, Zbigniew, Ostrowska-Pomian, Bozenna, Lewczuk, Jerzy, Zinka, Elzbieta, Karczmarczyk, Agnieszka, Chmielnicka-Pruszczynska, Malgorzata, Wozniak-Skowerska, Iwona, Opolski, Grzegorz, Bronisz, Marek, Ogorek, Marcin, Glanowska, Grazyna, Ruszkowski, Piotr, Skonieczny, Grzegorz, Sciborski, Ryszard, Okopien, Boguslaw, Kukla, Piotr, Galbas, Krzysztof, Cymerman, Krzysztof, Jurowiecki, Jaroslaw, Miekus, Pawel, Myszka, Waldemar, Mazur, Stanislaw, Lysek, Roman, Baszak, Jacek, Rusicka-Piekarz, Teresa, Raczak, Grzegorz, Domanska, Ewa, Nessler, Jadwiga, Lesnik, Jozef, Eltishcheva, Vera, Libis, Roman, Kamalov, Gadel, Belenky, Dmitry, Egorova, Liudmila, Khokhlov, Alexander, Yakupov, Eduard, Zateyshchikov, Dmitry, Barbarash, Olga, Miller, Olga, Mazur, Evgeniy, Zrazhevskiy, Konstantin, Novikova, Tatyana, Moiseeva, Yulia, Polkanova, Elena, Sobolev, Konstantin, Rossovskaya, Maria, Shapovalova, Yulia, Kolesnikova, Alla, Nikolaev, Konstantin, Zemlianskaia, Oksana, Zateyshchikova, Anna, Kostenko, Victor, Popov, Sergey, Poltavskaya, Maria, Edin, Anton, Aleksandrova, Elena, Drapkina, Oksana, Vishnevsky, Alexander, Nagibovich, Oleg, Chizhov, Petr, Rachkova, Svetlana, Sergeev, Mikhail, Kurylo, Borys, Ushakov, Alexey, Vinolas, Xavier, Garcia, Pere Alvarez, Lopez Fernandez, Maria Fernanda, Sanchez, Luis Tercedor, Iparraguirre, Salvador Tranche, Monserrat, Pere Toran, Contreras, Emilio Marquez, Rafecas, Jordi Isart, Carrasco, Juan Motero, Pavia, Pablo Garcia, Pajuelo, Casimiro Gomez, Rincon Diaz, Luis Miguel, Iglesias Alonso, Luis Fernando, Ruiz, Angel Grande, Klein, Jordi Merce, Gonzalez Juanatey, Jose Ramon, Collado, Ines Monte, Piquero, Herminia Palacin, Cuixart, Carles Brotons, Escobar, Esther Fernandez, Bayo i Llibre, Joan, Vicente, Cecilia Corros, Gutierrez, Manuel Vida, Gonzalo, Francisco Epelde, Almeida Fernandez, Carlos Alexandre, Navarro, Encarnacion Martinez, Alia, Juan Jose Montero, Gonzalez, Maria Barreda, Oliva, Maria Angels Moleiro, Sanmartin, Jose Iglesias, Gonzalez, Mercedes Jimenez, Alvarez, Maria del Mar Rodriguez, Melenchon, Juan Herreros, Vera, Tomas Ripoll, Navarro, Manuel Jimenez, Caamano, Maria Vazquez, Arcocha Torres, Maria Fe, Gomez, Gonzalo Marcos, Romo, Andres Iniguez, Prieto Diaz, Miguel Angel, Rosenqvist, Mårten, Wirdby, Alexander, Lindén, Jan, Henriksson, Kerstin, Elmersson, Micael, Egilsson, Arnor, Börjesson, Ulf, Svärd, Gunnar, Liu, Bo, Lindh, Anders, Olsson, Lars-Bertil, Gustavsson, Mikael, Andersson, Lars, Benson, Lars, Bothin, Claes, Hajimirsadeghi, Ali, Martinsson, Björn, Ericsson, Marianne, Ohlsson, Åke, Lindvall, Håkan, Svensson, Peter, Thörne, Katarina, Händel, Hans, Platonov, Pyotr, Bernsten, Fredrik, Timberg, Ingar, Crisby, Milita, Karlsson, Jan-Erik, Andersson, Agneta, Malmqvist, Lennart, Engdahl, Johan, Thulin, Jörgen, Hot-Bjelak, Aida, Jensen, Steen, Stalby, Per, Debrunner, Johann, Beer, Juerg H, Shah, Dipen, Rudyk, Iurii, Tseluyko, Vira, Karpenko, Oleksandr, Zhurba, Svitlana, Kraiz, Igor, Parkhomenko, Oleksandr, Kupnovytska, Iryna, Seredyuk, Nestor, Mostovoy, Yuriy, Ushakov, Oleksiy, Koval, Olena, Kovalskiy, Igor, Svyshchenko, Yevgeniya, Sychov, Oleg, Stanislavchuk, Mykola, Yagensky, Andriy, Tykhonova, Susanna, Fushtey, Ivan, Murdoch, Will, Chauhan, Naresh, Goodwin, Daryl, Lumley, Louise, Patel, Ramila, Saunders, Philip, Wong, Bennett, Cameron, Alex, Patel, Niranjan, Jhittay, P, Ross, Andrew, Kainth, M S, Ladha, Karim, Douglas, Kevin, Pickavance, Gill, McDonnell, Joanna, Handscombe, Laura, Gooding, Trevor, Wagner, Helga, Bradshaw, Colin, Bromham, Catherine, Jones, Kevin, Suryani, Shoeb, Coates, Richard, Sarai, Bhupinder, Willcock, W, Sircar, S, Cairns, John, Gilliand, A, Bilas, Roman, Strieder, E, Hutchinson, Peter, Wakeman, Anne, Stokes, Michael, Kirby, Graham, Vishwanathan, Bhaskhar, Bird, Nigel, Evans, Paul, Clark, M, Bisatt, John, Litchfield, Jennifer, Fisher, E, Fooks, Tim, Kelsall, Richard, Paul, Neil, Alborough, Elizabeth, Aziz, Michael, Ramesh, C, Wilson, Pete, Franklin, Simon, Fairhead, Sue, Thompson, Julian, Chowan, Hasan, Taylor, Gary, Tragen, Dawn, Parfitt, Matt, Seamark, Claire, Paul, Carolyn, Richardson, Mark, Jefferies, Angus, Sharp, Helen, Jones, Hywel, Giles, Claire, Bramley, Matthew, Williams, Philip, Aldegather, Jehad, Wetherell, Simon, Lumb, William, Evans, Phil, Scouller, Frances, Macey, Neil, Rogers, Stephen, Stipp, Yvette, West, Richard, Pinney, Philip, Wadeson, Paul, Matthews, John, Pandya, Preeti, Gallagher, Andrew, Railton, T, Davies, Emyr, McClure, Jonathan, Jacobs, Marc, Hutton, Claire, Thompson, R, Sinha, Bijoy, Butter, Keith, Barrow, Susan, Little, Helen, Russell, David, Choudhary, Ulka, Haq, Ikram, Ainsworth, Paul, Jones, Claire, Weeks, Phil, Eden, Jane, Gibbons, Lisa, Glencross, Janet, MacLeod, Alison, Poland, K, Mulolland, Conor, Warke, A, Conn, Paul, Burns, D, Smith, R, Kamath, R, Webster, Jonathan, Hodgins, Ian, Vercoe, Stephen, Roome, Paul, Pinnock, Hilary, Patel, Jayesh, Ali, Amar, Hart, Nigel, Davies, Richard, De-Sousa, Nigel, Neden, Catherine, Danielsen, Mark, Sharma, Purnima, Galloway, Sophia, Hawkins, Charlotte, Oliver, Raife, Aylward, Martin, Pattni, Mira, Irvine, Gordon, Ahmad, Shahid, Rothwell, Catherine, Choudhary, Fiaz, Khalaque, Sabrina, Short, Stephanie, Peters, Sharon, Coulson, Warwick, Roberts, Neil, Butler, Amy, Coates, Steven, Ward, Ben, Jackson, Daniel, Walton, Steve, Shepherd, Diane, Wong, Toh, Boon, Mark, Deacon, Melanie, Cornelius, David, Davies, Sarah, Frankel, Ben, Hargreaves, Nick, Choi, Henry, Sumner, Jon, Myhill, Tim, Estifanos, Salah, Geatch, Diane, Wilkinson, Justin, Veale, Richard, Forshaw, Karen, Hirst, Rob, Zaman, Kashif, Liley, Catherine, Wastling, Rebecca, McEleny, Paul, Beattie, Andre, Cooke, Philip, Wong, Mike, Pugsley, Mark, Dooldeniya, Chaminda, Rogers, Greg, Bennett, James, Jacobs, Polly, Muvva, Rajesh, Adam, Matthew, Fox, Robin, Thomas, Nicolas, Cartwright, Simon, Reed, Rory, Randfield, Simon, A’Court, Christine, Flynn, Ann, Halpin, Andrew, Dobson, Simon, Lomax, Louise, Nadaph, Minnal, Munro, Iain, Goram, Jane, Stoddart, Helen, Simmons, Phil, Shewring, John, Bowen-Simpkins, Emma, Rickenbach, Mark, Blenkhorn, Adam, Singh, Bhuwanendu, Astridge, Penny, van Gaal, William, Abhayaratna, Walter, Thomson, Philip, Lehman, Ron, Kilian, Jens, Coulshed, David, Catanchin, Andrei, Colquhoun, David, Kiat, Hosen, Eccleston, David, French, John, Ayres, Bronte, Blombery, Peter, Phan, Thanh, Rogers, James, O’Donnell, David, Bae, Sang Cheol, Carroll, Patrick, Starmer, Greg, Arstall, Margaret, Binnekamp, Maurits, Lee, Astin, Luton, Robert, Gupta, Milan, Pandey, Amritanshu Shekhar, Cheung, Stephen, Leader, Rolland, Beaudry, Philippe, Ayala-Paredes, Félix, Berlingieri, Joseph, Heath, John, Poirier, Germain, du Preez, Miranda, Schweitzer, Bradley, Nadeau, Reginald, Dhillon, Ripple, Hruczkowski, Tomasz, Lavoie, Andrea, Parkash, Ratika, Cha, James, Coutu, Benoit, MacDonald, Paul, Ramjattan, Brian, Bonet, Jorge, Vizel, Saul, Angaran, Paul, Fikry, Sameh, Mowafy, Ahmed, Katta, Azza, Tawfik, Mazen, Nawar, Moustafa, Sobhy, Mohamed, Abou Seif, Seif Kamal, Khairy, Tarek, El-Aziz, Ahmed Abd, Taha, Nasser, Reda, Ashraf, Elbahry, Atef, Setiha, Mohamed, El Din, Mohamed Gamal, Elkhadem, Magdi, El-Etreby, Adel, Kettles, David, Bayat, Junaid, Siebert, Heidi, Horak, Adrian, Kelfkens, Ynez, Garda, Riaz, Pillay, Thayabran, Guerra, Michele, van Zyl, Louis, Theron, Hendrik, Murray, Andrew, Louw, Rikus, Greyling, Deon, Mntla, Pindile, Ismail, Siddique, Ahmed, Fayzal, Engelbrecht, Johannes, Maharajh, Shambu, Oosthuysen, Wessel, Loghdey, Rehana, Ueckermann, Veronica, Al Naeemi, Abdullah, Yousef, Ghazi, Bazargani, Nooshin, AlOmairi, Munther, Maruthanayagam, Rajan, Singh, Rupesh, Naguib, Ahmed, Ibrahim, Mohamed, Agrawal, Amrish, Nathani, Mukesh, Esheiba, Ehab M, Wassef, Adel, Gupta, Rajeev, Cox, Michael, Beach, Scott, Duffy, Peter, Falkowski, Stephen, Ferrick, Kevin, Franco, Miguel, Kutayli, W Michael, Quick, Annette, Sharma, Niraj, Wilson, Vance, Miller, Stephen, Alberts, Mark, Blumberg, Edwin, Canosa, Roddy, Gutowski, Ted, Ison, Rodney, Garcia, Jorge, Mullen, Paul, Noveck, Howard, Rama, Pamela, Reddy, Rajneesh, Williams, Marcus, Nishijima, Daniel, Ferdinand, Keith, Haque, Ihsan, Mendelson, Robert, Pitta, Sridevi, Theodoro, Daniel, Treasure, Charles, Moustafa, Moustafa, Cader, Cas, Pharr, Walter, Oropallo, Alisha, Platt, George, Gujral, Jaspal, Welker, James, and Koura, Firas

Subjects
Male, medicine.medical_specialty, medicine.drug_class, medicine.medical_treatment, Electric Countershock, Therapeutics, Cardioversion, Lower risk, Cause of Death, Internal medicine, Atrial Fibrillation, medicine, Humans, Prospective Studies, Registries, Propensity Score, Stroke, Aged, Proportional Hazards Models, business.industry, Proportional hazards model, Research, Anticoagulant, Hazard ratio, Atrial fibrillation, General Medicine, Middle Aged, medicine.disease, Propensity score matching, Cardiology, Female, business, RC
Abstract

OBJECTIVE To investigate the clinical outcomes of patients who underwent cardioversion compared with those who did not have cardioverson in a large dataset of patients with recent onset non-valvular atrial fibrillation. DESIGN Observational study using prospectively collected registry data (Global Anticoagulant Registry in the FIELD-AF-GARFIELD-AF). SETTING 1317 participating sites in 35 countries. PARTICIPANTS 52 057 patients aged 18 years and older with newly diagnosed atrial fibrillation (up to six weeks' duration) and at least one investigator determined stroke risk factor. MAIN OUTCOME MEASURES Comparisons were made between patients who received cardioversion and those who had no cardioversion at baseline, and between patients who received direct current cardioversion and those who had pharmacological cardioversion. Overlap propensity weighting with Cox proportional hazards models was used to evaluate the effect of cardioversion on clinical endpoints (all cause mortality, non-haemorrhagic stroke or systemic embolism, and major bleeding), adjusting for baseline risk and patient selection. RESULTS 44 201 patients were included in the analysis comparing cardioversion and no cardioversion, and of these, 6595 (14.9%) underwent cardioversion at baseline. The propensity score weighted hazard ratio for all cause mortality in the cardioversion group was 0.74 (95% confidence interval 0.63 to 0.86) from baseline to one year follow-up and 0.77 (0.64 to 0.93) from one year to two year follow-up. Of the 6595 patients who had cardioversion at baseline, 299 had a follow-up cardioversion more than 48 days after enrolment. 7175 patients were assessed in the analysis comparing type of cardioversion: 2427 (33.8%) received pharmacological cardioversion and 4748 (66.2%) had direct current cardioversion. During one year follow-up, event rates (per 100 patient years) for all cause mortality in patients who received direct current and pharmacological cardioversion were 1.36 (1.13 to 1.64) and 1.70 (1.35 to 2.14), respectively. OBJECTIVE To investigate the clinical outcomes of patients who underwent cardioversion compared with those who did not have cardioverson in a large dataset of patients with recent onset non-valvular atrial fibrillation. DESIGN Observational study using prospectively collected registry data (Global Anticoagulant Registry in the FIELD-AF-GARFIELD-AF). SETTING 1317 participating sites in 35 countries. PARTICIPANTS 52 057 patients aged 18 years and older with newly diagnosed atrial fibrillation (up to six weeks' duration) and at least one investigator determined stroke risk factor. MAIN OUTCOME MEASURES Comparisons were made between patients who received cardioversion and those who had no cardioversion at baseline, and between patients who received direct current cardioversion and those who had pharmacological cardioversion. Overlap propensity weighting with Cox proportional hazards models was used to evaluate the effect of cardioversion on clinical endpoints (all cause mortality, non-haemorrhagic stroke or systemic embolism, and major bleeding), adjusting for baseline risk and patient selection. RESULTS 44 201 patients were included in the analysis comparing cardioversion and no cardioversion, and of these, 6595 (14.9%) underwent cardioversion at baseline. The propensity score weighted hazard ratio for all cause mortality in the cardioversion group was 0.74 (95% confidence interval 0.63 to 0.86) from baseline to one year follow-up and 0.77 (0.64 to 0.93) from one year to two year follow-up. Of the 6595 patients who had cardioversion at baseline, 299 had a follow-up cardioversion more than 48 days after enrolment. 7175 patients were assessed in the analysis comparing type of cardioversion: 2427 (33.8%) received pharmacological cardioversion and 4748 (66.2%) had direct current cardioversion. During one year follow-up, event rates (per 100 patient years) for all cause mortality in patients who received direct current and pharmacological cardioversion were 1.36 (1.13 to 1.64) and 1.70 (1.35 to 2.14), respectively. CONCLUSION In this large dataset of patients with recent onset non-valvular atrial fibrillation, a small proportion were treated with cardioversion. Direct current cardioversion was performed twice as often as pharmacological cardioversion, and there appeared to be no major difference in outcome events for these two cardioversion modalities. For the overall cardioversion group, after adjustments for confounders, a significantly lower risk of mortality was found in patients who received early cardioversion compared with those who did not receive early cardioversion. STUDY REGISTRATION ClinicalTrials.gov NCT01090362.

Published
2021

7. Home and Online Management and Evaluation of Blood Pressure (HOME BP) using a digital intervention in poorly controlled hypertension: randomised controlled trial

Author

McManus, Richard J, Little, Paul, Stuart, Beth, Morton, Katherine, Raftery, James, Kelly, Jo, Bradbury, Katherine, Zhang, Jin, Zhu, Shihua, Murray, Elizabeth, May, Carl R, Mair, Frances S, Michie, Susan, Smith, Peter, Band, Rebecca, Ogburn, Emma, Allen, Julie, Rice, Cathy, Nuttall, Jacqui, Williams, Bryan, Yardley, Lucy, Jones, Adam, Hussain, Ajmal, McHardy, Alistair, Harrison, Anna, LaLonde, Anna, Malik, Asim, Hernandez-Diaz, Basilio, Cranfield, Ben, Nicholson, Brian, Anandan, Carl, Neden, Catherine, Bobrow, Cathy, Evans, Chloe, Keast, Christopher, Henderson, Clare, Sutherland, Corrine, Kyte, Craig, Henderson, Dan, Noble, Debbie, Capo-Bianco, Ed, Williams, Edward, Shaw, Elizabeth, Mohri, Fatima, Asal, Gaurav, Dougall, Greig, Bhupal, Hardeep, Luckhurst, Heidi, Dosanjh, Hergeven, Nowell, Hilary, Brown, Jan, Flett, Jennifer, Barber, Julian, Rutter, Heather, Thompson, Julian, Ramanan, Kanjhana, Madronal, Karen, Malone, Karen, Etherington, Katie, Tsoi, Kenney, Knox, Kyle, Amin, Laila, Hirst, Lisa, Allen, Lucy, Skellern, Luke, Flynn, Lynne, McEwan, Lorne, Pugsley, Mark, Frassen, Marloes, Gaw, Matthew, Prendergast, Matthew, Wallard, Matthew, Faisal, Muhammad, Wooding, Nick, Lees, Nienke, Wainman, Paul, Nanda, Nithya, Moore, Patrick, Conley, Paul, Johnson, Paul, Wilson, Penny, Jacobs, Phillip, Whitbred, Pippa, Zamir, Rebecca, Reed, Richard, Tribley, Richard, Woof, Richard, Danson, Ruth, Lawes, Ruth, Gallagher, Sarah, Wadsworth, Sarah, Macanovic, Serge, Cartwright, Simon, Pettitt, Simon, Tucker, Simon, Doggett, Stephen, Sevenoaks, Tamsin, Watson, Tara, Talbot, Tess, Imrie, Ruth, Herbert, Thomas, Crockett, Tony, Wright, Tony, Sharma, Vanshika, Telford, Vicki, Almashta, Zaid, Cheng, Zelda, Ali, Zishan, Grube, Alice, Claxton, Andy, Asante, Barbara, Weare, Becki, McKee, Eleanor, Werrett, Bertha, Barwell, Carmel, Mulvihill, Carole, Sherwood, Caroline, MacDonald, Clare, Tabor, Dadirayi, Denning, Dawn, Roberts, Debbie, Adshead, Diane, Clarke, Gemma, Huntley, Heather, Pinder, Heather, Qasim, Irene, Merrison, Jane, King, Jill, Allison, Julie, Johal, Kam, Terry, Karen, Wood, Karine, Balmford, Kathryn, Barnes, Katie, Post, Katie, Bowden, Kelly-Marie, Edmunds, Kirsty, Whittle, Klaire, Peniket, Lara, Carnegie, Leann, Neale, Linda, Davey, Lisa, Bartlett, Liz, Smith, Louise, Clack, Lucy, Brown, Martina, McKenna, Naomi, Kay, Pam, Jacobs, Polly, Cutts, Rebecca, Pearse, Robert, Atkinson, Ruth, Barter, Sally, Mackie, Sally, Norris, Sam, Cook, Sandra, Elderfield, Sarah, Nzante, Sarah, Cronin, Sharon, Maslen, Sophie, Marchant, Stephanie, Wright, Stephanie, Keene, Sue, Smith, Sue, Cimelli, Suzie, Stone, Tracy, Joyce, Tricia, Le Marechal, Trudie, Kettle, Vicky, Osborne, Victoria, Cubiss, Wendy, Marsden, Wendy, Kowalczyk-Williams, Wioletta, and Bailey, Zoe

Subjects
Male, medicine.medical_specialty, General Practice, Psychological intervention, Blood Pressure, law.invention, Randomized controlled trial, law, Diabetes mellitus, Clinical endpoint, Humans, Medicine, Antihypertensive Agents, Aged, business.industry, Research, Self-Management, General Medicine, Blood Pressure Monitoring, Ambulatory, Middle Aged, medicine.disease, Telemedicine, United Kingdom, Confidence interval, Mean blood pressure, Blood pressure, Hypertension, Physical therapy, Female, Physical and Mental Health, business, Incremental cost-effectiveness ratio
Abstract

Objective The HOME BP (Home and Online Management and Evaluation of Blood Pressure) trial aimed to test a digital intervention for hypertension management in primary care by combining self-monitoring of blood pressure with guided self-management. Design Unmasked randomised controlled trial with automated ascertainment of primary endpoint. Setting 76 general practices in the United Kingdom. Participants 622 people with treated but poorly controlled hypertension (>140/90 mm Hg) and access to the internet. Interventions Participants were randomised by using a minimisation algorithm to self-monitoring of blood pressure with a digital intervention (305 participants) or usual care (routine hypertension care, with appointments and drug changes made at the discretion of the general practitioner; 317 participants). The digital intervention provided feedback of blood pressure results to patients and professionals with optional lifestyle advice and motivational support. Target blood pressure for hypertension, diabetes, and people aged 80 or older followed UK national guidelines. Main outcome measures The primary outcome was the difference in systolic blood pressure (mean of second and third readings) after one year, adjusted for baseline blood pressure, blood pressure target, age, and practice, with multiple imputation for missing values. Results After one year, data were available from 552 participants (88.6%) with imputation for the remaining 70 participants (11.4%). Mean blood pressure dropped from 151.7/86.4 to 138.4/80.2 mm Hg in the intervention group and from 151.6/85.3 to 141.8/79.8 mm Hg in the usual care group, giving a mean difference in systolic blood pressure of −3.4 mm Hg (95% confidence interval −6.1 to −0.8 mm Hg) and a mean difference in diastolic blood pressure of −0.5 mm Hg (−1.9 to 0.9 mm Hg). Results were comparable in the complete case analysis and adverse effects were similar between groups. Within trial costs showed an incremental cost effectiveness ratio of £11 ($15, €12; 95% confidence interval £6 to £29) per mm Hg reduction. Conclusions The HOME BP digital intervention for the management of hypertension by using self-monitored blood pressure led to better control of systolic blood pressure after one year than usual care, with low incremental costs. Implementation in primary care will require integration into clinical workflows and consideration of people who are digitally excluded. Trial registration ISRCTN13790648 .

Published
2020

9. What is the General Practitioner’s understanding of multi-professional teamwork?

Author

Neden, John Wilfred, Parkin, Claire, and Neden, Catherine

Abstract

Background There has been a move to increase multidisciplinary working in primary care, driven both by policy changes and by workforce challenges. The perspectives of the General Practitioners have not been widely investigated. Aim The aim of this project was to explore what general practitioners (GPs) understand by ‘multi-disciplinary, primary healthcare team working’ in the current climate. Design, Setting and Methods A descriptive qualitative study, using semi-structured interviews was undertaken to explore the views of six GPs. Transcribed interviews were thematically analysed. Results Analysis of the interviews identified six broad themes. These were: practice team structure and function, GPs’ perceptions of their own role within the team, others’ roles within the team, communication issues, constraints impacting upon change and lastly, relationships with external organisations. Conclusions General practice multidisciplinary teams are at present in a considerable state of flux due to changes in the workforce, with the introduction of new members, notably paramedic practitioners, extended nursing team roles and physician associates. The extension of the team has implications for increasing the supervisory and leadership role of the GP, without GPs necessarily feeling that they have the skill set for extending that role. The transition from providing physician-only care to team care provision, is seen as inevitable, given the work force strictures on general practice, but this study suggests it is not universally welcomed., Advanced Journal of Professional Practice, Vol 2 No 1 (2019)

Published
2019
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10. Coping with General Practice: An exploratory study of the working lives of General Practitioners in 2017

Author

Neden, Catherine A., Hamilton-West, Kate E., and Wilson, Patricia M.

Subjects
R729.5.G4
Abstract

Problem Whilst it is recognised that health policy is changing the shape and direction of primary care, an expert generalist role is still required in the system to help meet the breadth of clinical challenges posed. At the same time, the NHS is finding it difficult to recruit and retain sufficient General Practitioners (GPs) who wish to do patient facing work This was a study of GPs working in England in 2017. It aimed to explore both nature of the demands of their role as well as the support mechanisms available and how these GP s managed the demands of their work. Approach As the researcher is a GP, participants were recruited using a Snowball/ Respondent driven sampling strategy. Data was gathered using a series of semi-structured telephone interviews which were transcribed. Semistructured interviews were chosen to allow the respondents to provide depth of information about attitudes and experiences as well as to permit expression of feelings and opinions.A critical realist approach informed the approach to this study. Framework analysis was used for data management and analysis. A matrix of five overarching themes was identified. Findings Interviews with 12 Drs were completed. This sample included salaried Drs and partners practising across England. Five worked full-time and the others part-time. Their primary medical qualifications had been gained (between 1970 and 2012) in the UK, India, Europe and South Africa, mirroring the range seen in GMC workforce data. The five major themes identified were: Health Policy impacts, Changes in the external environment, Dealing with Complexity, Uncertainty in a changing system, Impact on the individual doctor's stress and coping mechanisms (including moderating and mediating factors). Consequences This group of doctors was acutely aware of the service re-organisation taking place around them. For the majority, promised increased resources had not materialised and workload was rising inexorably.The interview findings are discussed in the context of stress and coping. The final theme operates in a similar fashion to that described in the Job Demands-Resources model (Schaufeli and Bakker).An overarching consideration is ‘eudaemonic’ well-being, several were experiencing anhedonia and feeling of being ‘chronically sub-burnout’. There appeared to be significant deficits in core dimensions of well-being as well as a sense of ‘moral distress’. Jameton warns that failure to recognise this or acknowledge these experiences had devastating effects on both the individual and the services they provide. The findings of this study will be used to inform a questionnaire study of stress and coping in a larger sample of GPs in England, considering whether particular characteristics of the doctor or their working environment are related to burnout. These finding may inform workplace changes aimed at ameliorating the current workforce crisis

Published
2019

11. What is the General Practitioner’s understanding of multidisciplinary teamwork?

Author

Neden, John, Neden, Catherine A., and Parkin, Claire

Subjects
R729.5.G4
Abstract

Background: The size and composition of multidisciplinary teams working in primary care has increased over the last twenty years. The views of General Practitioners about these changes have not been widely investigated. The aim of this project was to explore what general practitioners (GPs) understand by ‘multidisciplinary, primary healthcare team working’ in the current climate. \ud Methods: A descriptive qualitative case study, using semi-structured interviews was undertaken to explore the views of six GPs. Transcribed interviews were thematically analysed. Results: Analysis of the interviews identified six broad themes. These were: practice team structure and function, GPs’ perceptions of their own role within the team, others’ roles within the team, communication issues, constraints impacting upon change and lastly, relationships with external organisations.\ud Conclusions: Movement to multidisciplinary teams has meant that true personal continuity of care between individual patients and individual doctors is no longer possible, however, enabling the GP to let go of this idealised historical model of general practice is difficult. The extension of the team has implications for increasing the supervisory and leadership role of the GP, without GPs necessarily feeling that they have the skill set for extending that role. The transition from providing physician-only care to team care provision, is seen as inevitable, given the work force strictures on general practice, but this study suggests it is not universally welcomed.

Published
2019

12. Outcomes in Newly Diagnosed Atrial Fibrillation and History of Acute Coronary Syndromes: Insights from GARFIELD-AF

Author

Butler, Amy, Elmersson, Micael, Egilsson, Arnor, Borjesson, Ulf, Svard, Gunnar, Liu, Bo, Lindh, Anders, Olsson, Lars-Bertil, Gustaysson, Mikael, Andersson, Lars, Benson, Lars, Bothin, Claes, Hajimirsadeghi, Ali, Martinsson, Bjorn, Ericsson, Marianne, Ohlsson, Ake, Lindvall, Hakan, Svensson, Peter, Thorne, Katarina, Handel, Hans, Platonov, Pyotr, Bernsten, Fredrik, Timberg, Ingar, Crisby, Milita, Karlsson, Jan-Erik, Andersson, Agneta, Malmqvist, Lennart, Engdahl, Johan, Thulin, Jorgen, Hot-Bjelak, Aida, Jensen, Steen, Debrunner, Johann, Beer, Juerg H., Shah, Dipen, Rudyk, Iurii, Tseluyko, Vira, Karpenko, Oleksandr, Zhurba, Svitlana, Kraiz, Igor, Parkhomenko, Oleksandr, Kupnovytska, Iryna, Seredyuk, Nestor, Mostovoy, Yuriy, Ushakov, Oleksiy, Koval, Olena, Kovalskiy, Igor, Svyshchenko, Yevgeniya, Sychov, Oleg, Stanislavchuk, Mykola, Tykhonova, Susanna, Fushtey, Ivan, Murdoch, Will, Chauhan, Naresh, Goodwin, Daryl, Lumley, Louise, Patel, Ramila, Saunders, Philip, Wong, Bennett, Patel, Niranjan, Jhittay, P., Ross, Andrew, Kainth, M. S., Ladha, Karim, Douglas, Kevin, Pickavance, Gill, McDonnell, Joanna, Handscombe, Laura, Gooding, Trevor, Wagner, Helga, Bradshaw, Colin, Bromham, Catherine, Jones, Kevin, Suryani, Shoeb, Coates, Richard, Sarai, Bhupinder, Willcock, W., Sircar, S., Cairns, John, Gilliand, A., Bilas, Roman, Strieder, E., Hutchinson, Peter, Wakeman, Anne, Stokes, Michael, Kirby, Graham, Vishwanathan, Bhaskhar, Vormann, Reinhold, Mueller, Thomas, Mayer, Peter, Horstmeier, Uwe, Eissing, Volker, Hey, Heinz, Leuchtgens, Heinz, Lilienweiss, Volker, Mueller, Heiner, Schubert, Christian, Lauer, Hellmann, Buchner, Thomas, Brauer, Gunter, Kamin, Susanne, Mueller, Karsten, Baumbach, Sylvia, Abdel-Qader, Muwafeg, Ebert, Hans-Holger, Schwencke, Carsten, Bernhardt, Peter, Karolyi, Laszlo, Sievers, Britta, Haverkamp, Wilhelm, Roehnisch, Jens-Uwe, Vertes, Andras, Szantai, Gabor, Menke, Holger, Matoltsy, Andras, Kanakaridisz, Nikosz, Boda, Zoltan, Kis, Erno, Gaszner, Balazs, Juhasz, Ferenc, Kamogawa, Yasuyuki, Fournier, Pierre-Yves, Muller, Jean-Joseph, Marquand, Andre, Delarche, Nicolas, Bantwal, Ganapathi, Faes, Dirk, Verstraete, Stefan, Dominguez, Helena, Topsakal, Ramazan, Centurion, Nestor, Alfredo Sinisi, Victor, Minc, Piotr, Nagy, Andras, Bilo, Grzegorz, Bongiorni, Maria Grazia, Bird, Nigel, Paul, Carolyn, Wadeson, Paul, Hargreaves, Nick, Kostenko, Victor, Tercedor Sanchez, Luis, Tranche Iparraguirre, Salvador, Jimenez Gonzalez, Mercedes, Herreros Melenchon, Juan, Stalby, Per, Yagensky, Andriy, Cameron, Alex, Jacobs, Polly, Juhasz, Gizella, Kancz, Sandor, Laszlo, Zoltan, May, Zsolt, Astridge, Penny, Loghdey, Rehana, Quick, Annette, Yang, Ping, Chen, Yingmin, He, Shenghu, Wang, Yong, Fu, Guosheng, Li, Xin, Wu, Tongguo, Cheng, Xiaoshu, Yan, Xiaowei, Zhao, Ruiping, Chen, Moshui, Xiong, Longgen, Chen, Ping, Jiao, Yang, Guo, Ying, Xue, Li, Yang, Zhiming, Jadhavm, Praveen, Merkely, Bela, Noon, Ebrahim, Habon, Tamas, Polgar, Peter, Szalai, Gabriella, Vangel, Sandor, Sarma, Raghava, Kulkarni, Govind, Engelthaler, Gabriella, Ferenczi, Judit, Chandwani, Prakash, Pothiwala, Rasesh Atulbhai, Purayil, Mohanan Padinhare, Chawla, Kamaldeep, Verheugt, Freek W. A., Ambrosio, Giuseppe, Atar, Dan, Bassand, Jean-Pierre, Costabel, Juan Pablo, Goldhaber, Samuel Z., Goto, Shinya, Egyutt, Mihaly, Martini, Giuliana, Cristina, Leone Maria, Tirafern, Eros, Santoro, Rita, Testa, Sophie, Di Minno, Giovanni, Moia, Marco, Caimi, Teresa Maria, Tessitori, Maria, Cappelli, Roberto, Accogli, Michele, Mariani, Antonio, Feola, Mauro, Raisaro, Arturo, Fattore, Luciano, Mauric, Andrea, Germini, Fabrizio, Tedeschi, Luca, Settimi, Maria, Nicoli, Sergio, Ricciarini, Paolo, Argena, Antonio, Ronchini, Paolo, Bulla, Claudio, Tradati, Filippo, Volpe, Massimo, Avino, Maria D., Seven, Silva, Capucci, Alessandro, Lodigiani, Corrado, Salomone, Enrico, Serviddio, Gaetano, Tondo, Claudio, Golino, Paolo, Mazzone, Carmine, Iacopino, Saverio, Ruiter, J. H., Lucassen, Andreas, Adriaansen, Henk, Bongaerts, Maarten, Pieterse, Mathijs, van Guldener, Coen, Herrman, Johannes, Nierop, S. H. K. P. R., Hoogslag, Pieter, Hermans, Walter, Groenemeijer, B. E., Terpstra, W., Buiks, Cees, Boersma, L. V. A., Berge, Eivind, Sirnes, Per Anton, Gjertsen, Erik, Hole, Torstein, Erga, Knut, Hallaraker, Arne, Skjelvan, Gunnar, Ostrem, Anders, Ghezai, Beraki, Svilaas, Arne, Christersson, Peter, Oien, Torbjorn, Henrichsen, Svein Hoegh, Otterstad, Jan Erik, Berg-Johansen, Jan, Gieroba, Andrzej, Biedrzycka, Malgorzata, Ogorek, Michal, Wozakowska-Kaplon, Beata, Loboz-Grudzien, Krystyna, Jaroslaw, Jaroslaw, Supinski, Wieslaw, Kuzniar, Jerzy, Zaluska, Roman, Hiczkiewicz, Jaroslaw, Swiatkowska-Byczynska, Lucyna, Kucharski, Lech, Gruchala, Marcin, Olszewski, Maciej, Kania, Grzegorz, Krzciuk, Malgorzata, Lajkowski, Zbigniew, Ostrowska-Pomian, Bozenna, Lewczuk, Jerzy, Zinka, Elzbieta, Karczmarczyk, Agnieszka, Chmielnicka-Pruszczynska, Malgorzata, Wozniak-Skowerska, Iwona, Opolski, Grzegorz, Bronisz, Marek, Ogorek, Marcin, Glanowska, Grazyna, Ruszkowski, Piotr, Skonieczny, Grzegorz, Sciborski, Ryszard, Okopien, Boguslaw, Kukla, Piotr, Galbas, Krzysztof, Cymerman, Krzysztof, Jurowiecki, Jaroslaw, Miekus, Pawel, Myszka, Waldemar, Mazur, Stanislaw, Lysek, Roman, Baszak, Jacek, Rusicka-Piekarz, Teresa, Raczak, Grzegorz, Domanska, Ewa, Nessler, Jadwiga, Catanchin, Andrei, Colquhoun, David, Kiat, Hosen, Eccleston, David, French, John, Ayres, Bronte, Blombery, Peter, Phan, Thanh, Rogers, James, O'Donnell, David, Cheol, Sang, Carroll, Patrick, Starmer, Greg, Arstall, Margaret, Binnekamp, Maurits, Lee, Astin, Luton, Robert, Gupta, Milan, Pandey, Amritanshu Shekhar, Cheung, Stephen, Leader, Rolland, Beaudry, Philippe, Ayala-Paredes, Felix, Berlingieri, Joseph, Heath, John, Poirier, Germain, du Preez, Miranda, Schweitzer, Bradley, Nadeau, Reginald, Dhillon, Ripple, Hruczkowski, Tomasz, Lavoie, Andrea, Parkash, Ratika, Cha, James, Coutu, Benoit, MacDonald, Paul, Ramjattan, Brian, Bonet, Jorge, Vizel, Saul, Angaran, Paul, Fikry, Sameh, Mowafy, Ahmed, Katta, Azza, Tawfik, Mazen, Nawar, Moustafa, Sobhy, Mohamed, Abou Seif, Seif Kamal, Khairy, Tarek, Abd El-Aziz, Ahmed, Taha, Nasser, Reda, Ashraf, Elbahry, Atef, Setiha, Mohamed, El Din, Mohamed Gamal, Elkhadem, Magdi, El-Etreby, Adel, Kettles, David, Bayat, Junaid, Siebert, Heidi, Horak, Adrian, Kelfkens, Ynez, Garda, Riaz, Pillay, Thayabran, Guerra, Michele, van Zyl, Louis, Theron, Hendrik, Murray, Andrew, Louw, Rikus, Greyling, Deon, Mntla, Pindile, Ismail, Siddique, Ahmed, Fayzal, Engelbrecht, Johannes, Maharajh, Shambu, Oosthuysen, Wessel, Ueckermann, Veronica, Al Naeemi, Abdullah, Yousef, Ghazi, Bazargani, Nooshin, Alomairi, Munther, Maruthanayagam, Rajan, Singh, Rupesh, Naguib, Ahmed, Ibrahim, Mohamed, Agrawal, Amrish, Nathani, Mukesh, Esheiba, Ehab M., Wassef, Adel, Gupta, Rajeev, Cox, Michael, Beach, Scott, Duffy, Peter, Falkowski, Stephen, Ferrick, Kevin, Franco, Miguel, Kutayli, W. Michael, Sharma, Niraj, Wilson, Vance, Miller, Stephen, Alberts, Mark, Blumberg, Edwin, Canosa, Roddy, Gutowski, Ted, Ison, Rodney, Garcia, Jorge, Mullen, Paul, Noveck, Howard, Rama, Pamela, Reddy, Rajneesh, Williams, Marcus, Nishijima, Daniel, Ferdinand, Keith, Hague, Ihsan, Mendelson, Robert, Pitta, Sridevi, Theodoro, Daniel, Treasure, Charles, Moustafa, Moustafa, Cader, Cas, Pharr, Walter, Oropallo, Alisha, Platt, George, Gujral, Jaspal, Welker, James, Koura, Firas, Lesnik, Jozef, Eltishcheva, Vera, Libis, Roman, Kamalov, Gadel, Belenky, Dmitry, Egorova, Liudmila, Khokhlov, Alexander, Yakupov, Eduard, Zateyshchikov, Dmitry, Barbarash, Olga, Miller, Olga, Mazur, Evgeniy, Zrazhevskiy, Konstantin, Novikova, Tatyana, Moiseeva, Yulia, Polkanova, Elena, Sobolev, Konstantin, Rossovskaya, Maria, Shapovalova, Yulia, Kolesnikova, Alla, Nikolaev, Konstantin, Zemlianskaia, Oksana, Zateyshchikova, Anna, Popov, Sergey, Poltayskaya, Maria, Edin, Anton, Aleksandrova, Elena, Drapkina, Oksana, Vishnevsky, Alexander, Nagibovich, Oleg, Chizhov, Petr, Rachkova, Svetlana, Sergeev, Mikhail, Kurylo, Borys, Ushakov, Alexey, Alvarez Garcia, Pere, Lopez Fernandez, Maria Fernanda, Toran Monserrat, Pere, Marquez Contreras, Emilio, Isart Rafecas, Jordi, Motero Carrasco, Juan, Garcia Pavia, Pablo, Gomez Pajuelo, Casimiro, Rincon Diaz, Luis Miguel, Iglesias Alonso, Luis Fernando, Grande Ruiz, Angel, Merce Klein, Jordi, Gonzalez Juanatey, Jose Ramon, Monte Collado, Ines, Palacin Piquero, Herminia, Brotons Cuixart, Carles, Fernandez Escobar, Esther, Bayo i Llibre, Joan, Corros Vicente, Cecilia, Vida Gutierrez, Manuel, Evans, Paul, Clark, M., Bisatt, John, Litchfield, Jennifer, Fisher, E., Fooks, Tim, Kelsall, Richard, Paul, Neil, Alborough, Elizabeth, Aziz, Michael, Ramesh, C., Wilson, Pete, Franklin, Simon, Fairhead, Sue, Thompson, Julian, Chowan, Hasan, Taylor, Gary, Tragen, Dawn, Parfitt, Matt, Seamark, Claire, Richardson, Mark, Jefferies, Angus, Sharp, Helen, Jones, Hywel, Giles, Claire, Bramley, Matthew, Williams, Philip, Aldegather, Jehad, Wetherell, Simon, Lumb, William, Evans, Phil, Scouller, Frances, Macey, Neil, Rogers, Stephen, Stipp, Yvette, West, Richard, Pinney, Philip, Matthews, John, Pandya, Preeti, Gallagher, Andrew, Railton, T., Davies, Emyr, McClure, Jonathan, Jacobs, Marc, Hutton, Claire, Thompson, R., Sinha, Bijoy, Butter, Keith, Barrow, Susan, Little, Helen, Russell, David, Choudhary, Ulka, Haq, Ikram, Ainsworth, Paul, Jones, Claire, Weeks, Phil, Eden, Jane, Gibbons, Lisa, Glencross, Janet, MacLeod, Alison, Poland, K., Mulolland, Conor, Warke, A., Conn, Paul, Burns, D., Smith, R., Kamath, R., Webster, Jonathan, Hodgins, Ian, Vercoe, Stephen, Roome, Paul, Pinnock, Hilary, Patel, Jayesh, Ali, Amar, Hart, Nigel, Davies, Richard, De-Sousa, Nigel, Neden, Catherine, Danielsen, Mark, Sharma, Purnima, Galloway, Sophia, Hawkins, Charlotte, Oliver, Raife, Aylward, Martin, Pattni, Mira, Irvine, Gordon, Ahmad, Shahid, Rothwell, Catherine, Choudhary, Fiaz, Khalaque, Sabrina, Short, Stephanie, Peters, Sharon, Coulson, Warwick, Roberts, Neil, Coates, Steven, Ward, Ben, Jackson, Daniel, Walton, Steve, Shepherd, Diane, Wong, Toh, Boon, Mark, Deacon, Melanie, Cornelius, David, Davies, Sarah, Ben Frankel, Ben Frankel, Choi, Henry, Sumner, Jon, Myhill, Tim, Estifanos, Salah, Geatch, Diane, Wilkinson, Justin, Veale, Richard, Forshaw, Karen, Hirst, Rob, Zaman, Kashif, Liley, Catherine, Wastling, Rebecca, McEleny, Paul, Beattie, Andre, Cooke, Philip, Wong, Mike, Pugsley, Mark, Dooldeniya, Chaminda, Rogers, Greg, Bennett, James, Muvva, Rajesh, Adam, Matthew, Fox, Robin, Thomas, Nicolas, Cartwright, Simon, Reed, Rory, Randfield, Simon, ACourt, Christine, Flynn, Ann, Halpin, Andrew, Dobson, Simon, Lomax, Louise, Nadaph, Minnal, Goram, Jane, Stoddart, Helen, Simmons, Phil, Shewring, John, Bowen-Simpkins, Emma, Rickenbach, Mark, Munro, Iain, Blenkhorn, Adam, Singh, Bhuwanendu, van Gaal, William, Abhayaratna, Walter, Thomson, Philip, Lehman, Ron, Kilian, Jens, Coulshed, David, Camm, A. John, Fitzmaurice, David A., Illingworth, Laura, Kayani, Gloria, Kakkar, Ajay K., YILMAZ, MEHMET BİRHAN, Taga, Kuniaki, Techigawara, Masaaki, Igarashi, Mono, Watanabe, Hiroshi, Seo, Toshihiko, Hiramitsu, Shinya, Hosokawa, Hiroaki, Hoshiai, Mitsumoto, Hibino, Michitaka, Miyagawa, Koichi, Horie, Hideki, Turpie, Alexander G. G., van Eickels, Martin, Hacke, Werner, Mantovani, Lorenzo G., Misselwitz, Frank, Pieper, Karen S., Kayani, Glo-ria, Fox, Keith A. A., Gersh, Bernard J., Lucas Luciardi, Hector, Gibbs, Harry, Brodmann, Marianne, Cools, Frank, Pereira Barrett, Antonio Carlos, Connolly, Stuart J., Spyropoulos, Alex, Eikelboom, John, Corbalan, Ramon, Hu, Dayi, Nielsen, JOrn Dalsgaard, Ragy, Hany, Raatikainen, Pekka, Le Heuzey, Jean-Yves, Darius, Harald, Keltai, Matyas, Kakkar, Sanjay, Sawhney, Jitendra Pal Singh, Agnelli, Giancarlo, Koretsune, Yukihiro, Sanchez Diaz, Carlos Jerjes, Ten Cate, Hugo, Panchenko, Elizaveta, Lim, Toon Wei, Jacobson, Barry, Oh, Seil, Vinolas, Xavier, Rosenqvist, Marten, Steffel, Jan, Angchaisuksiri, Pantep, Oto, Ali, Parkhomenko, Alex, Al Mahmeed, Wael, Fitzmaurice, David, Chen, Kangning, Zhao, Yusheng, Zhang, Huaiqin, Chen, Jiyan, Cao, Shiping, Wang, Daowen, Yang, Yuejin, Li, Weihua, Li, Hui, Yin, Yuehui, Tao, Guizhou, Kothiwale, Veerappa Annasaheb, Kimura, Teruaki, Raghuraman, Bagirath, Vijan, Vinod Madan, Sawhney, Jitendra, Khan, Aziz, Meena, Ramdhan, Okuda, Fumio, Mizuguchi, Masato, Mukawa, Hiroaki, Chopada, Manojkumar, Abraham, Sunitha, Bisne, Vikas, Vijayaraghavan, Govindan, Roy, Debabrata, Durgaprasad, Rajashekhar, Shankar, A. G. Ravi, Kumar, Sunil, Jain, Dinesh, Bhargava, Kartikeya, Kumar, Vinay, Nagamalesh, Udigala Madappa, Rajput, Rajeeve Kumar, Kanamori, Seishu, Wada, Masamichi, Minagawa, Taro, Ishiguro, Motoyuki, Yamamoto, Kenichi, Kumagai, Koichiro, Katsuda, Yosuke, Yoshida, Keiki, Toyota, Fumitoshi, Mizuno, Yuji, Misumi, Ikuo, Noguchi, Hiroo, Ando, Shinichi, Suetsugu, Tetsuro, Minamoto, Masahiro, Oda, Hiroyuki, Adachi, Susumu, Chiba, Kei, Norita, Hiroaki, Tsuruta, Makoto, Koyanagi, Takeshi, Matsuta, Masahiro, Ito, Kenichiro, Nakano, Masayuki, Shibuya, Mitsuhiro, Stepinska, Janina, Jansky, Petr, Yamamoto, Kunihiko, Haas, Sylvia, Ando, Hiroshi, Higashi, Takayuki, Okada, Megumi, Azakami, Shiro, Komaki, Shinichiro, Kumeda, Kenshi, Murayama, Takashi, Matsumura, Jun, Oba, Yurika, Sonoda, Ryuji, Goto, Kazuo, Minoda, Kotaro, Haraguchi, Yoshikuni, Suefuji, Hisakazu, Miyagi, Hiroo, Kato, Hitoshi, Nakamura, Tsugihiro, Nakamura, Tadashi, Nandate, Hidekazu, Zaitsu, Ryuji, Fujiura, Yoshihisa, Yoshimura, Akira, Numata, Hiroyuki, Ogawa, Jun, Murakami, Kinshiro, Wakasa, Yutaka, Yamasawa, Masanori, Maekawa, Hiromitsu, Abe, Sumihisa, Kihara, Hajime, Tsunoda, Satoru, Saito, Katsumi, Tachibana, Hiroki, Oba, Ichiro, Kuwahata, Takashi, Higa, Satoshi, Gushiken, Masamichi, Eto, Takuma, Chibana, Hidetoshi, Fujisawa, Kazuaki, Shiga, Yuhei, Sumi, Hirokuni, Nagatomo, Toshihisa, Atsuchi, Yoshihiko, Nagoshi, Toshiro, Sanno, Kazuhisa, Hoshino, Fumihiro, Yokota, Naoto, Kameko, Masahiro, Tabuchi, Toshifumi, Ishizawa, Munesumi, Fujiura, Yoshitake, Ikeda, Daisuke, Seto, Taku, Iwao, Tetsu, Ishioka, Norio, Oshiro, Koichi, Tsuchida, Keizo, Hatori, Yutaka, Takeuchi, Motoshi, Takezawa, Hiroto, Kira, Tetsuya, Tada, Masato, Tsuzaki, Ken, Miura, Naoya, Fujisawa, Yasuaki, Furumoto, Wataru, Suzuki, Susumu, Fujisawa, Akinori, Nakamura, Ryosai, Komatsu, Hiroyasu, Fujiki, Rei, Kawano, Shuichi, Nishizawa, Keijiro, Kato, Yoji, Azuma, Junya, Yasui, Kiyoshi, Amano, Toshio, Sekine, Yasuhiro, Honzawa, Tatsuo, Koshibu, Yuichiro, Sakamoto, Yasuhide, Seta, Yukihiro, Miyaguchi, Shingo, Morishita, Kojuro, Samejima, Yasuko, Sasaki, Toyoshi, Iseki, Fumiko, Kobayashi, Toshiyuki, Kano, Hiroshi, Kim, Jaeyoung, Yamaguchi, Hiroshi, Takagi, Yoichi, Pearce, Yoko Onuki, Suzuki, Yasuyuki, Fukui, Takayuki, Nakayama, Toni, Kanai, Hideaki, Kawano, Yoshiyuki, Ino, Tetsuji, Miyoshi, Hironori, Miyamoto, Yasufumi, Shigekiyo, Masahito, Ono, Shimato, Okamoto, Yutaka, Ubukata, Satoshi, Kodera, Kojiro, Oriuchi, Tatsuo, Matsumoto, Naoki, Nagano, Shinjiro, Iwaki, Masaaki, Nakamura, Yuichiro, Miyamoto, Naomasa, Taguchi, Toshifumi, Ashida, Ko, Yoshizawa, Naoto, Agata, Jun, Matsukawa, Seishiro, Arasaki, Osamu, Fukuoka, Shuji, Murakami, Hirofumi, Mishima, Kazuya, Hata, Yoshiki, Sakuma, Ichiro, Obunai, Kotaro, Takamura, Ichiro, Akutsu, Mitsuyuki, Unoki, Toshihide, Go, Yoshinori, Ikemura, Makoto, Morii, Shoji, Marusaki, Shigem, Doi, Hideo, Tanaka, Mitsuru, Kusu-moto, Takaaki, Kakinoki, Shigeo, Ogurusu, Chiga, Murata, Kazuya, Shimoyama, Masaki, Nakatsuka, Masami, Kitami, Yutaka, Nakamura, Yoichi, Oda, Hiroshi, Oyama, Rikimaru, Ageta, Masato, Mita, Teruaki, Nagao, Kazuhiko, Mito, Takafumi, Minami, Junichi, Abe, Mitsunori, Fujii, Masako, Okawa, Makoto, Fujito, Tsuneo, Taniguchi, Toshiya, Ko, Tenei, Kubo, Hiroshi, Imamaki, Mizuho, Akiyama, Masahiro, Ueda, Takashi, Odakura, Hironori, Inagaki, Masahiko, Katsube, Yoshiki, Nakata, Atsuyuki, Tomimoto, Shinobu, Sugishita, Nobuyoshi, Shiga, Yukio, Soma, Akira, Neya, Kazuo, Yoshida, Tetsuro, Akahane, Kunio, Adachi, Sen, Takanaka, Chiei, Matsui, Saori, Kanda, Hirofumi, Kaneko, Masanori, Nagasaka, Shiro, Taguchi, Atsushi, Toru, Shuta, Saito, Kazuyuki, Miyashita, Akiko, Sasaguri, Hiroki, Nariyama, Jin, Hatsuno, Taketo, Iwase, Takash, Sato, Kazuki, Kawai, Kazuya, Kotani, Tomobumi, Tsuji, Tsuyoshi, Sakai, Hirosumi, Nishino, Kiyoshi, Ikeda, Kenichi, Maeda, Kazuo, Shinozuka, Tomohiro, Inoue, Takeshi, Kawakami, Koichi, Kitazumi, Hiromichi, Takagi, Tsutomu, Hamaoka, Mamoru, Kojima, Jisho, Sasaki, Akitoshi, Tsuchiya, Yoshihiro, Bet-suyaku, Tetsuo, Higuchi, Koji, Honda, Masaaki, Hasegawa, Koichi, Baba, Takao, Mineoi, Kazuaki, Koeda, Toshihiko, Hirasawa, Kunihiko, Kumazaki, Toshihide, Nakagomi, Akira, Otaki, Eiji, Shindo, Takashi, Hirayama, Hiroyoshi, Sugimoto, Chikako, Yamagishi, Takashi, Mizuguchi, Ichiro, Sezaki, Kazunori, Niwa, Isamu, Takenaka, Ken, Iiji, Osamu, Taya, Koichi, Kitazawa, Hitoshi, Ueda, Samu, Kakuda, Hirokazu, Ono, Takuya, Oriso, Seizo, Kamata, Junya, Nanke, Toshihiko, Maeda, Itaru, Matsuura, Yoshifusa, Teragawa, Hiroki, Maruyama, Yasuyuki, Takei, Kazuo, Hone, Hajime, Kito, Tetsu-taro, Asano, Hiroshi, Matsushita, Koji, Nakamura, Masaichi, Washizuka, Takashi, Yoshida, Tomoki, Sawano, Masato, Arima, Shinichi, Arai, Hidekazu, Shinohara, Hisanori, Takai, Hiroyuki, Furukawa, Nobufusa, Ota, Akira, Yamamoto, Kentaro, Aoki, Kenji, Yamamoto, Taku, Kasai, Takeaki, Suzuki, Shunji, Suzuki, Shu, Shibata, Nitaro, Watanabe, Masayuki, Nishihata, Yosuke, Arino, Torn, Okuyama, Masaki, Wakiyama, Tetsushi, Kato, Tomoko, Sasagawa, Yasuo, Tana, Takeshi, Tumelero, Rogerio Tadeu, Maia, Lilia, de Almeida, Roberto Simoes, Carmo Borges, Ney Carter, Gomes Ferreira, Luis Gustavo, Stockins Fernandez, Benjamin Aleck Joseh, Montecinos, Humberto, Lanas, Fernando, Larico Gomez, Martin, Astudillo, Carlos, Conejeros, Carlos, Marin Cuevas, Patricio, Forero, Alejandro, Bugueno Gutierrez, Claudio, Aguilar, Juan, Potthoff Cardenas, Sergio, Eggers, German, Houzvic, Cesar, Rey, Carlos, Arriagada, German, Charme Vilches, Gustavo, Illescas Diaz, Jesus Jaime, Leal Cantu, Raul, Ramos Zavala, Maria Guadalupe, Cabrera Jardines, Ricardo, Espinola Zavaleta, Nilda, Lopez Rosas, Enrique, Llamas Esperon, Guillermo Antonio, Pozas, Gerardo, Cardona Munoz, Ernesto, Her-nandez, Norberto Matadamas, Leyva Rendon, Adolfo, Garcia Hernandez, Norberto, de los Rios Ibarra, Manuel, Virgen Carrillo, Luis Ramon, Lopez Villezca, David, Hernandez Herrera, Carlos, Lopez Prieto, Juan Jose, Gaona Rodriguez, Rodolfo, Villeda Espinosa, Efrain, Flores Martinez, David, Velasco Barcena, Jose, Fierro Fierro, Omar, Rodriguez Briones, Ignacio, Leiva Pons, Jose Luis, Alvarez Lopez, Humberto, Olvera Ruiz, Rafael, Cantu Brito, Carlos Gerardo, Chuquiure Valenzuela, Eduardo Julian Jose Roberto, Reyes Sanchez, Roxana, Bazzoni Ruiz, Alberto Esteban, Lopez Ruiz, Oscar Martin, Arriaga Nava, Roberto, Morales Cerda, Jesus David, Fajardo Campos, Pedro, Benavides Gonzalez, Mario, Lenz, Kurt, Hagn, Claus, Foechterle, Johannes, Drexel, Heinz, Huber, Kurt, Podczeck-Schweighofer, Andrea, Winkler, Michael, Schneeweiss, Bruno, Gegenhuber, Alfons, Lang, Wilfried, Eichinger-Hasenauer, Sabine, Kaserer, Peter, Sykora, Josef, Rasch, Heribert, Strohmer, Bernhard, Capiau, Luc, Vervoort, Geert, Wollaert, Bart, Hollanders, Geert, Vercammen, Jan, Balthazar, Yohan, Delforge, Marc, Xhaet, Olivier, Striekwold, Harry, Thoeng, John, Hermans, Kurt, Mairesse, Georges, Anne, Wim, Blankoff, Ivan, Beutels, Michel, Vandergoten, Peter, Purnode, Philippe, Godart, Pascal, Boussy, Tim, Desfontaines, Philippe, Heyse, Alex, Voet, Joeri, De Wolf, Axel, Zidkova, Eva, Spacek, Rudolf, Machova, Vilma, Ludka, Ondrej, Olsr, Josef, Kotik, Lubos, Racz, Blazej, Ferkl, Richard, Hubac, Jan, Kotik, Ilja, Monhart, Zdenek, Burianova, Hana, Jerabek, Ondrej, Pisova, Jana, Petrova, Iveta, Dedek, Vratislav, Honkova, Michaela, Podrazil, Petr, Reichert, Petr, Spinar, Jindrich, Novak, Miroslav, Durdil, Vaclav, Plocova, Katarina, Lastuvka, Jiri, Nielsen, Jorn, Hayashi, Yoshihito, Hirota, Shinichi, Abe, Yukihiko, Saito, Yoshihiro, Uchiyama, Hirohide, Takeda, Hiroshi, Ono, Hiroshi, Tohyo, Shuichi, Hanazono, Naoto, Miyajima, Seiichi, Shimono, Hisashi, Aoyama, Takuma, Shozawa, Yasunobu, Niijima, Yawara, Murai, Osamu, Inaba, Hideko, Nomura, Katsumasa, Nozoe, Masatsugu, Suzuki, Kazuo, Furukawa, Toshiyuki, Shiraiwa, Toshihiko, Ito, Nobuhisa, Nagai, Shunichi, Sato, Kiyoharu, Nakahara, Shiro, Shimoyama, Yujin, Ohara, Naoko, Kozuka, Teruhiko, Okita, Hideaki, Endo, Masato, Goto, Tsutomu, Hirose, Makoto, Nagata, Emiko, Nakanishi, Noriyuki, Mori, Toshizumi, Seki, Shuichi, Okamoto, Katsuhiro, Moriai, Osamu, Emura, Yoko, Fukuda, Tsuyoshi, Date, Haruhiko, Kawakami, Shuichi, Nagai, Sho, Ueyama, Yuya, Fudo, Tetsuro, Imaizumi, Mitsuru, Ogawa, Takuo, Take, Shunsuke, Ikeda, Hideo, Nishioka, Hiroaki, Sakamoto, Norihiko, Ikeoka, Kiyomitsu, Wakaki, Nobuo, Abe, Masatake, Doiuchi, Junji, Inagaki, Koichi, Iseki, Atsushi, Yoshida, Tomohiro, Goda, Toshihiro, Katsuki, Tsukasa, Sato, Atsushi, Mori, Etsuo, Tsubokura, Toshio, Shudo, Hiroshi, Fujimoto, Shunichi, Katsuya, Tomohiro, Furukawa, Yoshiyuki, Hosokawa, Hiroshi, Narumi, Jun, Yamamoto, Kiichiro, Owari, Masaki, Inakura, Takuya, Anno, Takafumi, Shirakawa, Kazuyuki, Ching, Chi Keong, Foo, David, Wong, Kelvin, Yuyang, Tan, Park, Hui Nam, Kim, Woo-Shik, Lee, HyeYoung, Jang, Sung-Won, Kim, Dae Hyeok, Kim, Jun, Ryu, DongRyeol, Shim, Jaemin, Kim, Dae-Kyeong, Choi, Dong Ju, Oh, Yong Seog, Cho, Myeong-Chan, Kim, Hack-Lyoung, Jeon, Hui-Kyung, Shin, Dong-Gu, Park, Sang Weon, Park, Hoon Ki, Han, Sang-Jin, Sung, Jung Hoon, Park, Hyung-Wook, Nam, Gi-Byoung, On, Young Keun, Lim, Hong Euy, Kwak, JaeJin, Cha, Tae-Joon, Hong, Taek Jong, Park, Seong Hoon, Yoon, Jung Han, Kim, Nam-Ho, Kim, Kee-Sik, Jung, Byung Chun, Hwang, Gyo-Seung, Kim, Chong-Jin, Rungaramsin, Sakda, Katekangplu, Peerapat, Khunrong, Porames, Bunyapipat, Thanita, Wongcharoen, Wanwarang, Kaewsuwanna, Pinij, Siriwattana, Khanchai, Tiyanon, Waraporn, Pattanaprichakul, Supalerk, Likittanasombat, Khanchit, Cholsaringkarl, Doungrat, Boonyapisit, Warangkana, Cheewatanakornkul, Sirichai, Silaruks, Songkwan, Hutayanon, Pisit, Chawanadelert, Seksan, Chattranukulchai, Pairoj, Chatlaong, Boonsert, Santanakorn, Yingsak, Kanokphatcharakun, Khompiya, Mongkolwongroj, Piya, Jai-Aue, Sasivimon, Komson, Ongkarn, Altun, Armagan, Aydinlar, Ali, Ongen, Zeki, Acikel, Sadik, Sahin, Durmus Yildiray, Yilmaz, Ozcan, Pekdemir, Hasan, Demir, Mesut, Sucu, Murat, Sahiner, Levent, Ersanli, Murat, Okuyan, Ertugrul, Aras, Dursun, Rolandi, Florencia, Cesar Ingaramo, Adrian, Alberto Sambadaro, Gustavo, Fernandez Caputi, Vanina, Luciardi, Hector, Graciela Berman, Sofia, Dragotto, Pablo, Poli, Daniela, Quintavalla, Roberto, Cosmi, Franco, Fanelli, Raffaele, Oriana, Vincenzo, Reggio, Raffaele, Anti, Roberto S., Pancaldi, Leonardo, De Cristofaro, Raimondo, Guazzaloca, Giuliana, De Blasio, Angelo, Uriate, Jorge Salerno, Lillo, Flavia, Pogliani, Enrico Maria, Javier Kleiban, Andres, Ahuad Guerrero, Rodolfo Andres, Adalberto Di Paola, Leonel, Dario Dran, Ricardo, Egido, Javier, Jose Fosco, Matias, Rodolfo Cartasegna, Luis, Gomez Vilamajo, Oscar, Luis Ramos, Jose, Sassone, Sonia, Zapata, Gerardo, Conde, Diego, Giacomi, Guillermo, Alfredo Fernandez, Alberto, Alberto Berli, Mario, Ferroni, Fabian, Sobral Filho, Dario Celestino, Jaber, Jefferson, Armaganijan, Luciana Vidal, Frack Costantini, Costantino Roberto, Steffens, Andre, Sebba Barroso de Souzaem, Weimar Kunz, de Souza Neto, Joao David, Ribeiro, Jose Marcio, Teixeira, Marcelo Silveira, Rossi, Paulo, Pires, Leonardo, Moreira, Daniel, Moura Jorge, Jose Carlos, Lorga Filho, Adalberto Menezes, Bodanese, Luiz, Montera, Marcelo Westerlund, Del Carlo, Carlos Henrique, Saad, Jamil Abdalla, Alves Costa, Fernando Augusto, Lopes, Renato, de Aranjo, Gilson Roberto, Manenti, Euler Roberto, Kerr Saraiva, Jose Francisco, Ferreira Braga, Joao Carlos, Negri, Alexandre, Moncada, Carlos, Precoma, Dalton, Roquette, Fernando, Reis, Gilmar, Ramos Filho, Roberto Alvaro, Figueiredo, Estevao Lanna, Botelho, Roberto Vieira, Fontoura Tavares, Claudio Munhoz, Finimundi, Helius Carlos, Kochi, Adriano, Broilo Franca, Cesar Cassio, Alban, Fabio, Aranha Rosito, Guido Bernardo, de Moura Xavier Moraes Junior, Joao Batista, Husted, Steen, Hintze, Ulrik, Rasmussen, Soren, Sygehus, Nwstved, Bremmelgaard, Arne, Markenvard, John, Borger, Jan, Solgaard, Jorgen, Eriksen, Ebbe, Lokkegaard, Thomas, Bruun, Michael, Mertz, Jacob, Schou, Morten, Olsen, Michael, Viitanen, Carmela, Paganelli, Franck, Ohayon, Joel, Casassus, Frederic, Galinier, Michel, Gottwalles, Yannick, Loiselet, Philippe, Koujan, Mohamed Bassel, Destrac, Sylvain, Piot, Olivier, Cebron, Jean-Pierre, Guenoun, Maxime, Guedj-Meynier, Dominique, Lokesh, A. G., Zuber, Mathieu, Amarenco, Pierre, Ellie, Emmanuel, Kadouch, James, Huberman, Jean-Pierre, Lemaire, Nestor, Rodier, Gilles, Vandamme, Xavier, Sibon, Igor, Neau, Jean-Philippe, Mahagne, Marie Helene, Mielot, Antoine, Bonnefoy, Marc, Churet, Jean-Baptiste, Navarre, Vincent, Sellem, Frederic, Monniot, Gilles, Boyes, Jean-Paul, Doucet, Bernard, Martelet, Michel, Obadia, Desire, Crousillat, Bernard, Mouallem, Joseph, Bearez, Etienne, Brugnaux, Jean Philippe, Fedorowsky, Alain, Nazeyrollas, Pierre, Berneau, Jean-Baptiste, Chemin, Frederic, Schellong, Sebastien, Koeniger, Georg, Kopf, Andreas, Gerbaulet, Uwe, Kellner, Bernd-Thomas, Schaefer, Thomas, Purr, Jan, Eissfeller, Enno, Zauzig, Heinz-Dieter, Riegel, Peter, Axthelm, Christoph, Heinz, Gerd-Ulrich, Pustelnik, Andreas, Zutz, Stefan, Eder, Wolfgang, Rehling, Guenter, Glatzel, Dirk, Ludwig, Norbert, Sandow, Petra, Wiswedel, Henning, Wildenauer, Cosmas, Schoen, Steffen, Schwarz, Toralf, Babyesiza, Adyeri, Kropp, Maximilian, Zimny, Hans-Hermann, Kahl, Friedhelm, Caspar, Andreas, Omankowsky, Sabine, Laessig, Torsten, Hartmann, Hermann-Josef, Lehmann, Gunter, Bindig, Hans-Walter, Hergdt, Gunter, Reimer, Dietrich, Hauk, Joachim, Michel, Holger, Dres, Praxis, Erdle, Werner, Dorsch, Wilfried, Dshabrailov, Janna, Rapp, Karl-Albrecht, Epelde Gonzalo, Francisco, Almeida Fernandez, Carlos Alexandre, Martinez Navarro, Encarnacion, Montero Alia, Juan Jose, Barreda Gonzalez, Maria, Moleiro Oliva, Maria Angels, Iglesias Sanmartin, Jose, Rodriguez Alvarez, Maria del Mar, Ripoll Vera, Tomas, Jimenez Navarro, Manuel, Vazquez Caamano, Maria, Arcocha Tones, Maria Fe, Marcos Gomez, Gonzalo, Iniguez Romo, Andres, Prieto Diaz, Miguel Angel, Wirdby, Alexander, Linden, Jan, and Henriksson, Kerstin

Subjects
Male, medicine.medical_specialty, Acute coronary syndrome, Vascular damage Radboud Institute for Health Sciences [Radboudumc 16], Hemorrhage, 030204 cardiovascular system & hematology, antiplatelet therapy, Coronary artery disease, Anticoagulation, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Cause of Death, Internal medicine, Atrial Fibrillation, medicine, Humans, 030212 general & internal medicine, Acute Coronary Syndrome, bleeding, mortality, stroke, Stroke, Aged, Proportional Hazards Models, business.industry, Hazard ratio, Anticoagulants, Atrial fibrillation, General Medicine, Prognosis, medicine.disease, Blood pressure, Cardiovascular Diseases, Heart failure, Cardiology, Female, Liver function, business, Platelet Aggregation Inhibitors, Follow-Up Studies
Abstract

Item does not contain fulltext BACKGROUND: Many patients with atrial fibrillation have concomitant coronary artery disease with or without acute coronary syndromes and are in need of additional antithrombotic therapy. There are few data on the long-term clinical outcome of atrial fibrillation patients with a history of acute coronary syndrome. This is a 2-year study of atrial fibrillation patients with or without a history of acute coronary syndromes. METHODS: Adults with newly diagnosed atrial fibrillation and >/=1 investigator-defined stroke risk factor were enrolled in GARFIELD-AF between March 2010 and September 2015. The association between prior acute coronary syndromes and long-term outcomes was determined using a Cox proportional hazards model, adjusting for baseline risk factors, oral anticoagulation (OAC) +/- antiplatelet (AP) therapy, and usual care. RESULTS: Of 39,679 patients, 10.5% had a history of acute coronary syndromes. At 2-year follow-up, patients with prior acute coronary syndromes had higher adjusted risks of stroke/systemic embolism (hazard ratio [HR] 1.39; 95% confidence interval [CI], 1.08-1.78), major bleeding (HR 1.30; 95% CI, 0.95 -1.79), all-cause mortality (HR 1.34; 95% CI, 1.21 -1.49), cardiovascular mortality (HR 1.85; 95% CI, 1.51-2.26), and new acute coronary syndromes (HR 3.42; 95% CI, 2.62-4.45). Comparing antithrombotic therapy in the acute coronary syndromes vs no acute coronary syndromes groups, most patients received OAC +/- AP: 60.8% vs 66.1%, but AP therapy was more likely in the acute coronary syndromes group (68.1% vs 32.9%), either alone (34.9% vs 20.8%) or with OAC (33.2% vs 12.1%). Overall, 17.8% in the acute coronary syndromes group received dual AP therapy with (5.3%) or without OAC (12.5%). Among patients with moderate/high risk for stroke/systemic embolism, fewer in the acute coronary syndromes group received OAC with or without AP therapy (Congestive heart failure, Hypertension, Age 75 years, Diabetes mellitus, prior Stroke, TIA, or thromboembolism, Vascular disease, Age 65-74 years, Sex category [CHA2DS2-VASc] 2: 52.1% vs 64.6%; CHA2DS2-VASc >/=3: 62.0% vs 70.7%), and the majority with a Hypertension (uncontrolled systolic blood pressure >160 mm Hg), Abnormal renal or liver function, previous Stroke, Bleeding history or predisposition, Labile international normalized ratios, Elderly, and concomitant Drugs or alcohol excess (HAS-BLED) score >/=3 were on AP therapy (83.8% vs 65.5%). CONCLUSIONS: In GARFIELD-AF, previous acute coronary syndromes are associated with worse 2-year outcomes and a greater likelihood of under-treatment with OAC, while two-thirds of patients receive AP therapy. Major bleeding was more common with previous acute coronary syndromes, even after adjusting for all risk factors.

Published
2019

13. Has there been a change in the knowledge of GP registrars between 2011 and 2016 as measured by performance on common items in the Applied\ud Knowledge Test?

Author

Neden, Catherine A., Parkin, Claire, Siriwardena, A Niroshan, and Blow, Carol

Subjects
R729.5.G4, sense organs
Abstract

The aim of this study was to assess whether the absolute standard of candidates sitting the MRCGP Applied Knowledge Test (AKT) between 2011 and 2016 had changed. It is a descriptive study comparing the performance on marker questions of a reference group of UK graduates taking the AKT for the first time between 2011 and 2016. Using aggregated examination data, the performance of individual ‘marker’ questions was compared using Pearson’s chi-squared tests and trend-line analysis. Binary logistic regression was used to analyse changes in performance over the study period. Changes in performance of individual marker questions using Pearson’s chi-squared test showed statistically significant differences in 32 of the 49 questions included in the study. Trend line analysis showed a positive trend in 29 questions and a negative trend in the remaining 23. The magnitude of change was small. Logistic regression did not demonstrate any evidence for a change in the performance of the question set over the study period. However, candidates were more likely to get items on administration wrong compared with clinical medicine or research. There was no evidence of a change in performance of the question set as a whole.

Published
2018

14. Initiating conversations about end of life care: COPD

Author

Faull, Christina, Neden, Catherine A., Neden, John W.D., Faull, Christina, Neden, Catherine A., and Neden, John W.D.

Abstract

This is an e-learning for health module considering the key features of end-stage chronic obstructive pulmonary disease, how to recognise where the patient is on the disease trajectory and how to assess the impact of the disease on the patient and his or her family.

Published
2010

15. Palliative Care in patients with cancer, Chapter 27

Author

Khot, Alex, Polmear, Andrew, Neden, Catherine A., Neden, John W.D., Khot, Alex, Polmear, Andrew, Neden, Catherine A., and Neden, John W.D.

Abstract

A chapter in a text book for General Practitioners on symptom control in patients with cancer during the palliative phase of their illness

Published
2006

17. Chapter 25 Pain, palliative care and bereavement

Author

Khot, Alex, Polmear, Andrew, Neden, Catherine A., Neden, John W.D., Khot, Alex, Polmear, Andrew, Neden, Catherine A., and Neden, John W.D.

Abstract

Chapter in a text book (for General Practitioners) summarising guidance for the management of pain, for symptoms control in patients at the end of life and the management of bereavement.

Published
2003

18. Has there been a change in the knowledge of GP registrars between 2011 and 2016 as measured by performance on common items in the Applied Knowledge Test?

Author

Neden, Catherine A., Parkin, Claire, Blow, Carol, Siriwardena, A. Niroshan, Neden, Catherine A., Parkin, Claire, Blow, Carol, and Siriwardena, A. Niroshan

Abstract

The aim of this study was to assess whether the absolute standard of candidates sitting the MRCGP Applied Knowledge Test (AKT) between 2011 and 2016 had changed. It is a descriptive study comparing the performance on marker questions of a reference group of UK graduates taking the AKT for the first time between 2011 and 2016. Using aggregated examination data, the performance of individual ‘marker’ questions was compared using Pearson’s chi-squared tests and trend-line analysis. Binary logistic regression was used to analyse changes in performance over the study period. Changes in performance of individual marker questions using Pearson’s chi-squared test showed statistically significant differences in 32 of the 49 questions included in the study. Trend line analysis showed a positive trend in 29 questions and a negative trend in the remaining 23. The magnitude of change was small. Logistic regression did not demonstrate any evidence for a change in the performance of the question set over the study period. However, candidates were more likely to get items on administration wrong compared with clinical medicine or research. There was no evidence of a change in performance of the question set as a whole.

19. Comparing performance among male and female candidates in sex- specific clinical knowledge in the MRCGP

Author

Siriwardena, A. Niroshan, Irish, Bill, Asghar, Zahid, Milne, Paul, Dixon, Hilton, Neden, Catherine, Richardson, Jo, Blow, Carol, Siriwardena, A. Niroshan, Irish, Bill, Asghar, Zahid, Milne, Paul, Dixon, Hilton, Neden, Catherine, Richardson, Jo, and Blow, Carol

Abstract

Background Patients often seek doctors of the same sex, particularly for sex-specific complaints and also because of a perception that doctors have greater knowledge of complaints relating to their own sex. Few studies have investigated differences in knowledge by sex of candidate on sex-specific questions inmedical examinations. Aim The aim was to compare the performance of males and females in sex-specific questions in a 200-item computer-based applied knowledge test for licensing UK GPs. Design and setting A cross-sectional design using routinely collected performance and demographic data from the first three versions of the Applied Knowledge Test, MRCGP, UK. Method Questions were classified as female specific,male specific, or sex neutral. The performance of males and females was analysed using multiple analysis of covariance after adjusting for sex-neutral score and demographic confounders. Results Data were included from 3627 candidates. After adjusting for sex-neutral score, age, time since qualification, year of speciality training, ethnicity, and country of primarymedical qualification, there were differences in performance in sex specific questions. Males performed worse than females on female-specific questions (–4.2%, 95%confidence interval [CI] = –5.7 to –2.6) but did not perform significantly better than females on male-specific questions (0.3%, 95%CI = –2.6 to 3.2%). Conclusion There was evidence of better performance by females in female-specific questions but this was small relative to the size of the test. Differential performance of males and females in sex specific questions in a licensing examination may have implications for vocational and post qualification general practice training.

20. Has there been a change in the knowledge of GP registrars between 2011 and 2016 as measured by performance on common items in the Applied Knowledge Test?

Author

Neden CA, Parkin C, Blow C, and Siriwardena AN

Subjects
Humans, Knowledge, Logistic Models, Longitudinal Studies, United Kingdom, Education, Medical, Graduate standards, Education, Medical, Graduate statistics & numerical data, Educational Measurement standards, Educational Measurement statistics & numerical data
Abstract

The aim of this study was to assess whether the absolute standard of candidates sitting the MRCGP Applied Knowledge Test (AKT) between 2011 and 2016 had changed. It is a descriptive study comparing the performance on marker questions of a reference group of UK graduates taking the AKT for the first time between 2011 and 2016. Using aggregated examination data, the performance of individual 'marker' questions was compared using Pearson's chi-squared tests and trend-line analysis. Binary logistic regression was used to analyse changes in performance over the study period. Changes in performance of individual marker questions using Pearson's chi-squared test showed statistically significant differences in 32 of the 49 questions included in the study. Trend line analysis showed a positive trend in 29 questions and a negative trend in the remaining 23. The magnitude of change was small. Logistic regression did not demonstrate any evidence for a change in the performance of the question set over the study period. However, candidates were more likely to get items on administration wrong compared with clinical medicine or research. There was no evidence of a change in performance of the question set as a whole.

Published
2018
Full Text
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