Feasibility, acceptability and diagnostic test accuracy of frailty screening instruments in community-dwelling older people within the Australian general practice setting: a study protocol for a cross-sectional study
Identifieur interne : 000C30 ( Main/Exploration ); précédent : 000C29; suivant : 000C31Feasibility, acceptability and diagnostic test accuracy of frailty screening instruments in community-dwelling older people within the Australian general practice setting: a study protocol for a cross-sectional study
Auteurs : Rachel Ambagtsheer [Australie] ; Renuka Visvanathan [Australie] ; Matteo Cesari [Australie, France] ; Solomon Yu [Australie] ; Mandy Archibald [Australie] ; Timothy Schultz [Australie] ; Jonathon Karnon [Australie] ; Alison Kitson [Australie] ; Justin Beilby [Australie]Source :
- BMJ Open [ 2044-6055 ] ; 2017.
Abstract
Frailty is one of the most challenging aspects of population ageing due to its association with increased risk of poor health outcomes and quality of life. General practice provides an ideal setting for the prevention and management of frailty via the implementation of preventive measures such as early identification through screening.
Our study will evaluate the feasibility, acceptability and diagnostic test accuracy of several screening instruments in diagnosing frailty among community-dwelling Australians aged 75+ years who have recently made an appointment to see their general practitioner (GP). We will recruit 240 participants across 2 general practice sites within South Australia. We will invite eligible patients to participate and consent to the study via mail. Consenting participants will attend a screening appointment to undertake the index tests: 2 self-reported (Reported Edmonton Frail Scale and Kihon Checklist) and 5 (Frail Scale, Groningen Frailty Index, Program on Research for Integrating Services for the Maintenance of Autonomy (PRISMA-7), Edmonton Frail Scale and Gait Speed Test) administered by a practice nurse (a Registered Nurse working in general practice). We will randomise test order to reduce bias. Psychosocial measures will also be collected via questionnaire at the appointment. A blinded researcher will then administer two reference standards (the Frailty Phenotype and Adelaide Frailty Index). We will determine frailty by a cut-point of 3 of 5 criteria for the Phenotype and 9 of 42 items for the AFI. We will determine accuracy by analysis of sensitivity, specificity, predictive values and likelihood ratios. We will assess feasibility and acceptability by: 1) collecting data about the instruments prior to collection; 2) interviewing screeners after data collection; 3) conducting a pilot survey with a 10% sample of participants.
The Torrens University Higher Research Ethics Committee has approved this study. We will disseminate findings via publication in peer-reviewed journals and presentation at relevant conferences.
Url:
DOI: 10.1136/bmjopen-2017-016663
PubMed: 28775191
PubMed Central: 5629644
Affiliations:
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content-type="city">Adelaide</addr-line>,<addr-line content-type="state">South Australia</addr-line>,<country>Australia</country></nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff2"><institution>Torrens University Australia</institution>,<addr-line content-type="city">Adelaide</addr-line>,<addr-line content-type="state">South Australia</addr-line>,<country>Australia</country></nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Visvanathan, Renuka" sort="Visvanathan, Renuka" uniqKey="Visvanathan R" first="Renuka" last="Visvanathan">Renuka Visvanathan</name><affiliation wicri:level="1"><nlm:aff id="aff1"><institution>National Health and Medical Research Council of Australia Centre of Research Excellence Frailty Transdisciplinary Research to Achieve Healthy Ageing</institution>,<addr-line content-type="city">Adelaide</addr-line>,<addr-line content-type="state">South Australia</addr-line>,<country>Australia</country></nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff3"><institution>Adelaide Medical School, University of Adelaide</institution>,<addr-line content-type="city">Adelaide</addr-line>,<addr-line content-type="state">South Australia</addr-line>,<country>Australia</country></nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Cesari, Matteo" sort="Cesari, Matteo" uniqKey="Cesari M" first="Matteo" last="Cesari">Matteo Cesari</name><affiliation wicri:level="1"><nlm:aff id="aff1"><institution>National Health and Medical Research Council of Australia Centre of Research Excellence Frailty Transdisciplinary Research to Achieve Healthy Ageing</institution>,<addr-line content-type="city">Adelaide</addr-line>,<addr-line content-type="state">South Australia</addr-line>,<country>Australia</country></nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff4"><institution>Centre Hospitalier Universitaire de Toulouse</institution>,<addr-line content-type="city">Toulouse</addr-line>,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Yu, Solomon" sort="Yu, Solomon" uniqKey="Yu S" first="Solomon" last="Yu">Solomon Yu</name><affiliation wicri:level="1"><nlm:aff id="aff1"><institution>National Health and Medical Research Council of Australia Centre of Research Excellence Frailty Transdisciplinary Research to Achieve Healthy Ageing</institution>,<addr-line content-type="city">Adelaide</addr-line>,<addr-line content-type="state">South Australia</addr-line>,<country>Australia</country></nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff3"><institution>Adelaide Medical School, University of Adelaide</institution>,<addr-line content-type="city">Adelaide</addr-line>,<addr-line content-type="state">South Australia</addr-line>,<country>Australia</country></nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Archibald, Mandy" sort="Archibald, Mandy" uniqKey="Archibald M" first="Mandy" last="Archibald">Mandy Archibald</name><affiliation wicri:level="1"><nlm:aff id="aff1"><institution>National Health and Medical Research Council of Australia Centre of Research Excellence Frailty Transdisciplinary Research to Achieve Healthy Ageing</institution>,<addr-line content-type="city">Adelaide</addr-line>,<addr-line content-type="state">South Australia</addr-line>,<country>Australia</country></nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff6"><institution>Adelaide Nursing School, University of Adelaide</institution>,<addr-line content-type="city">Adelaide</addr-line>,<addr-line content-type="state">South Australia</addr-line>,<country>Australia</country></nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Schultz, Timothy" sort="Schultz, Timothy" uniqKey="Schultz T" first="Timothy" last="Schultz">Timothy Schultz</name><affiliation wicri:level="1"><nlm:aff id="aff1"><institution>National Health and Medical Research Council of Australia Centre of Research Excellence Frailty Transdisciplinary Research to Achieve Healthy Ageing</institution>,<addr-line content-type="city">Adelaide</addr-line>,<addr-line content-type="state">South Australia</addr-line>,<country>Australia</country></nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff6"><institution>Adelaide Nursing School, University of Adelaide</institution>,<addr-line content-type="city">Adelaide</addr-line>,<addr-line content-type="state">South Australia</addr-line>,<country>Australia</country></nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Karnon, Jonathon" sort="Karnon, Jonathon" uniqKey="Karnon J" first="Jonathon" last="Karnon">Jonathon Karnon</name><affiliation wicri:level="1"><nlm:aff id="aff1"><institution>National Health and Medical Research Council of Australia Centre of Research Excellence Frailty Transdisciplinary Research to Achieve Healthy Ageing</institution>,<addr-line content-type="city">Adelaide</addr-line>,<addr-line content-type="state">South Australia</addr-line>,<country>Australia</country></nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff5"><institution>School of Population Health, University of Adelaide</institution>,<addr-line content-type="city">Adelaide</addr-line>,<addr-line content-type="state">South Australia</addr-line>,<country>Australia</country></nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Kitson, Alison" sort="Kitson, Alison" uniqKey="Kitson A" first="Alison" last="Kitson">Alison Kitson</name><affiliation wicri:level="1"><nlm:aff id="aff1"><institution>National Health and Medical Research Council of Australia Centre of Research Excellence Frailty Transdisciplinary Research to Achieve Healthy Ageing</institution>,<addr-line content-type="city">Adelaide</addr-line>,<addr-line content-type="state">South Australia</addr-line>,<country>Australia</country></nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff6"><institution>Adelaide Nursing School, University of Adelaide</institution>,<addr-line content-type="city">Adelaide</addr-line>,<addr-line content-type="state">South Australia</addr-line>,<country>Australia</country></nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Beilby, Justin" sort="Beilby, Justin" uniqKey="Beilby J" first="Justin" last="Beilby">Justin Beilby</name><affiliation wicri:level="1"><nlm:aff id="aff1"><institution>National Health and Medical Research Council of Australia Centre of Research Excellence Frailty Transdisciplinary Research to Achieve Healthy Ageing</institution>,<addr-line content-type="city">Adelaide</addr-line>,<addr-line content-type="state">South Australia</addr-line>,<country>Australia</country></nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff2"><institution>Torrens University Australia</institution>,<addr-line content-type="city">Adelaide</addr-line>,<addr-line content-type="state">South Australia</addr-line>,<country>Australia</country></nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author></analytic><series><title level="j">BMJ Open</title><idno type="eISSN">2044-6055</idno><imprint><date when="2017">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Introduction</title><p>Frailty is one of the most challenging aspects of population ageing due to its association with increased risk of poor health outcomes and quality of life. General practice provides an ideal setting for the prevention and management of frailty via the implementation of preventive measures such as early identification through screening.</p></sec><sec><title>Methods and analysis</title><p>Our study will evaluate the feasibility, acceptability and diagnostic test accuracy of several screening instruments in diagnosing frailty among community-dwelling Australians aged 75+ years who have recently made an appointment to see their general practitioner (GP). We will recruit 240 participants across 2 general practice sites within South Australia. We will invite eligible patients to participate and consent to the study via mail. Consenting participants will attend a screening appointment to undertake the index tests: 2 self-reported (Reported Edmonton Frail Scale and Kihon Checklist) and 5 (Frail Scale, Groningen Frailty Index, Program on Research for Integrating Services for the Maintenance of Autonomy (PRISMA-7), Edmonton Frail Scale and Gait Speed Test) administered by a practice nurse (a Registered Nurse working in general practice). We will randomise test order to reduce bias. Psychosocial measures will also be collected via questionnaire at the appointment. A blinded researcher will then administer two reference standards (the Frailty Phenotype and Adelaide Frailty Index). We will determine frailty by a cut-point of 3 of 5 criteria for the Phenotype and 9 of 42 items for the AFI. We will determine accuracy by analysis of sensitivity, specificity, predictive values and likelihood ratios. We will assess feasibility and acceptability by: 1) collecting data about the instruments prior to collection; 2) interviewing screeners after data collection; 3) conducting a pilot survey with a 10% sample of participants.</p></sec><sec><title>Ethics and dissemination</title><p>The Torrens University Higher Research Ethics Committee has approved this study. We will disseminate findings via publication in peer-reviewed journals and presentation at relevant conferences.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Clegg, A" uniqKey="Clegg A">A Clegg</name></author><author><name sortKey="Bates, C" uniqKey="Bates C">C Bates</name></author><author><name sortKey="Young, J" uniqKey="Young J">J Young</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="De Vries, Nm" uniqKey="De Vries N">NM de Vries</name></author><author><name sortKey="Staal, Jb" uniqKey="Staal J">JB Staal</name></author><author><name sortKey="Van Ravensberg, Cd" uniqKey="Van Ravensberg C">CD van Ravensberg</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Gobbens, Rj" uniqKey="Gobbens R">RJ Gobbens</name></author><author><name sortKey="Van Assen, Ma" uniqKey="Van Assen M">MA van Assen</name></author><author><name 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sortKey="Rocca, Wa" uniqKey="Rocca W">WA Rocca</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Archibald, Mm" uniqKey="Archibald M">MM Archibald</name></author><author><name sortKey="Ambagtsheer, R" uniqKey="Ambagtsheer R">R Ambagtsheer</name></author><author><name sortKey="Beilby, J" uniqKey="Beilby J">J Beilby</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Andrew, Mk" uniqKey="Andrew M">MK Andrew</name></author><author><name sortKey="Fisk, Jd" uniqKey="Fisk J">JD Fisk</name></author><author><name sortKey="Rockwood, K" uniqKey="Rockwood K">K Rockwood</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Sanchez Garcia, S" uniqKey="Sanchez Garcia S">S Sánchez-García</name></author><author><name sortKey="Sanchez Arenas, R" uniqKey="Sanchez Arenas R">R Sánchez-Arenas</name></author><author><name sortKey="Garcia Pe A, C" uniqKey="Garcia Pe A C">C García-Peña</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Dent, E" uniqKey="Dent E">E Dent</name></author><author><name sortKey="Hoogendijk, Eo" uniqKey="Hoogendijk E">EO Hoogendijk</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Martin, Fc" uniqKey="Martin F">FC Martin</name></author><author><name sortKey="Brighton, P" uniqKey="Brighton P">P Brighton</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Buigues, C" uniqKey="Buigues C">C Buigues</name></author><author><name sortKey="Padilla Sanchez, C" uniqKey="Padilla Sanchez C">C Padilla-Sánchez</name></author><author><name sortKey="Garrido, Jf" uniqKey="Garrido J">JF Garrido</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mooney, Cj" uniqKey="Mooney C">CJ Mooney</name></author><author><name sortKey="Elliot, Aj" uniqKey="Elliot A">AJ Elliot</name></author><author><name sortKey="Douthit, Kz" uniqKey="Douthit K">KZ Douthit</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mulasso, A" uniqKey="Mulasso A">A Mulasso</name></author><author><name sortKey="Roppolo, M" uniqKey="Roppolo M">M Roppolo</name></author><author><name sortKey="Giannotta, F" uniqKey="Giannotta F">F Giannotta</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Morley, Je" uniqKey="Morley J">JE Morley</name></author><author><name sortKey="Malmstrom, Tk" uniqKey="Malmstrom T">TK Malmstrom</name></author><author><name sortKey="Miller, Dk" uniqKey="Miller D">DK Miller</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Bielderman, A" uniqKey="Bielderman A">A Bielderman</name></author><author><name sortKey="Van Der Schans, Cp" uniqKey="Van Der Schans C">CP van der Schans</name></author><author><name sortKey="Van Lieshout, Mr" uniqKey="Van Lieshout M">MR van Lieshout</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Schuurmans, H" uniqKey="Schuurmans H">H Schuurmans</name></author><author><name sortKey="Steverink, N" uniqKey="Steverink N">N Steverink</name></author><author><name sortKey="Lindenberg, S" uniqKey="Lindenberg S">S Lindenberg</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Raiche, M" uniqKey="Raiche M">M Raîche</name></author><author><name sortKey="Hebert, R" uniqKey="Hebert R">R Hébert</name></author><author><name sortKey="Dubois, Mf" uniqKey="Dubois M">MF Dubois</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Clegg, A" uniqKey="Clegg A">A Clegg</name></author><author><name sortKey="Rogers, L" uniqKey="Rogers L">L Rogers</name></author><author><name sortKey="Young, J" uniqKey="Young J">J Young</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Rolfson, Db" uniqKey="Rolfson D">DB Rolfson</name></author><author><name sortKey="Majumdar, Sr" uniqKey="Majumdar S">SR Majumdar</name></author><author><name sortKey="Tsuyuki, Rt" uniqKey="Tsuyuki R">RT Tsuyuki</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Theou, O" uniqKey="Theou O">O Theou</name></author><author><name sortKey="Brothers, Td" uniqKey="Brothers T">TD Brothers</name></author><author><name sortKey="Mitnitski, A" uniqKey="Mitnitski A">A Mitnitski</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hilmer, Sn" uniqKey="Hilmer S">SN Hilmer</name></author><author><name sortKey="Perera, V" uniqKey="Perera V">V Perera</name></author><author><name sortKey="Mitchell, S" uniqKey="Mitchell S">S Mitchell</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Fritz, S" uniqKey="Fritz S">S Fritz</name></author><author><name sortKey="Lusardi, M" uniqKey="Lusardi M">M 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uniqKey="Rockwood K">K Rockwood</name></author><author><name sortKey="Song, X" uniqKey="Song X">X Song</name></author><author><name sortKey="Macknight, C" uniqKey="Macknight C">C MacKnight</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hamaker, Me" uniqKey="Hamaker M">ME Hamaker</name></author><author><name sortKey="Jonker, Jm" uniqKey="Jonker J">JM Jonker</name></author><author><name sortKey="De Rooij, Se" uniqKey="De Rooij S">SE de Rooij</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Cesari, M" uniqKey="Cesari M">M Cesari</name></author><author><name sortKey="Gambassi, G" uniqKey="Gambassi G">G Gambassi</name></author><author><name sortKey="Van Kan, Ga" uniqKey="Van Kan G">GA van Kan</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="De Groot, Ja" uniqKey="De Groot J">JA de Groot</name></author><author><name sortKey="Dendukuri, N" uniqKey="Dendukuri N">N Dendukuri</name></author><author><name sortKey="Janssen, Kj" uniqKey="Janssen K">KJ Janssen</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Theou, O" uniqKey="Theou O">O Theou</name></author><author><name sortKey="Cann, L" uniqKey="Cann L">L Cann</name></author><author><name sortKey="Blodgett, J" uniqKey="Blodgett J">J Blodgett</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Cesari, M" uniqKey="Cesari M">M Cesari</name></author><author><name sortKey="Demougeot, L" uniqKey="Demougeot L">L Demougeot</name></author><author><name sortKey="Boccalon, H" uniqKey="Boccalon H">H Boccalon</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Radloff, Ls" uniqKey="Radloff L">LS Radloff</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Taylor, Hl" uniqKey="Taylor H">HL Taylor</name></author><author><name sortKey="Jacobs, Dr" uniqKey="Jacobs D">DR Jacobs</name></author><author><name sortKey="Schucker, B" uniqKey="Schucker B">B Schucker</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Searle, Sd" uniqKey="Searle S">SD Searle</name></author><author><name sortKey="Mitnitski, A" uniqKey="Mitnitski A">A Mitnitski</name></author><author><name sortKey="Gahbauer, Ea" uniqKey="Gahbauer E">EA Gahbauer</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Thompson, Mq" uniqKey="Thompson M">MQ Thompson</name></author><author><name sortKey="Yu, S" uniqKey="Yu S">S Yu</name></author><author><name sortKey="Theou, O" uniqKey="Theou O">O Theou</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Fried, Lp" uniqKey="Fried L">LP Fried</name></author><author><name sortKey="Ferrucci, L" uniqKey="Ferrucci L">L Ferrucci</name></author><author><name sortKey="Darer, J" uniqKey="Darer J">J 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Weaver</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Robertson, Da" uniqKey="Robertson D">DA Robertson</name></author><author><name sortKey="Kenny, Ra" uniqKey="Kenny R">RA Kenny</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Sexton, E" uniqKey="Sexton E">E Sexton</name></author><author><name sortKey="King Kallimanis, Bl" uniqKey="King Kallimanis B">BL King-Kallimanis</name></author><author><name sortKey="Morgan, K" uniqKey="Morgan K">K Morgan</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Grewal, I" uniqKey="Grewal I">I Grewal</name></author><author><name sortKey="Lewis, J" uniqKey="Lewis J">J Lewis</name></author><author><name sortKey="Flynn, T" uniqKey="Flynn T">T Flynn</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Nouri, Fm" uniqKey="Nouri F">FM Nouri</name></author><author><name sortKey="Lincoln, Nb" uniqKey="Lincoln N">NB Lincoln</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Yohannes, Am" uniqKey="Yohannes A">AM Yohannes</name></author><author><name sortKey="Roomi, J" uniqKey="Roomi J">J Roomi</name></author><author><name sortKey="Waters, K" uniqKey="Waters K">K Waters</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Buderer, Nm" uniqKey="Buderer N">NM Buderer</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ghasemi, A" uniqKey="Ghasemi A">A Ghasemi</name></author><author><name sortKey="Zahediasl, S" uniqKey="Zahediasl S">S Zahediasl</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Johnson, Rb" uniqKey="Johnson R">RB Johnson</name></author><author><name sortKey="Onwuegbuzie, Aj" uniqKey="Onwuegbuzie A">AJ Onwuegbuzie</name></author><author><name sortKey="Turner, La" uniqKey="Turner L">LA Turner</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Guetterman, Tc" uniqKey="Guetterman T">TC Guetterman</name></author><author><name sortKey="Fetters, Md" uniqKey="Fetters M">MD Fetters</name></author><author><name sortKey="Creswell, Jw" uniqKey="Creswell J">JW Creswell</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hertzog, Ma" uniqKey="Hertzog M">MA Hertzog</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Australie</li><li>France</li></country></list><tree><country name="Australie"><noRegion><name sortKey="Ambagtsheer, Rachel" sort="Ambagtsheer, Rachel" uniqKey="Ambagtsheer R" first="Rachel" last="Ambagtsheer">Rachel Ambagtsheer</name></noRegion><name sortKey="Ambagtsheer, Rachel" sort="Ambagtsheer, Rachel" uniqKey="Ambagtsheer R" first="Rachel" last="Ambagtsheer">Rachel Ambagtsheer</name><name sortKey="Archibald, Mandy" sort="Archibald, Mandy" uniqKey="Archibald M" first="Mandy" last="Archibald">Mandy Archibald</name><name sortKey="Archibald, Mandy" sort="Archibald, Mandy" uniqKey="Archibald M" first="Mandy" last="Archibald">Mandy Archibald</name><name sortKey="Beilby, Justin" sort="Beilby, Justin" uniqKey="Beilby J" first="Justin" last="Beilby">Justin Beilby</name><name sortKey="Beilby, Justin" sort="Beilby, Justin" uniqKey="Beilby J" first="Justin" last="Beilby">Justin Beilby</name><name sortKey="Cesari, Matteo" sort="Cesari, Matteo" uniqKey="Cesari M" first="Matteo" last="Cesari">Matteo Cesari</name><name sortKey="Karnon, Jonathon" sort="Karnon, Jonathon" uniqKey="Karnon J" first="Jonathon" last="Karnon">Jonathon Karnon</name><name sortKey="Karnon, Jonathon" sort="Karnon, Jonathon" uniqKey="Karnon J" first="Jonathon" last="Karnon">Jonathon Karnon</name><name sortKey="Kitson, Alison" sort="Kitson, Alison" uniqKey="Kitson A" first="Alison" last="Kitson">Alison Kitson</name><name sortKey="Kitson, Alison" sort="Kitson, Alison" uniqKey="Kitson A" first="Alison" last="Kitson">Alison Kitson</name><name sortKey="Schultz, Timothy" sort="Schultz, Timothy" uniqKey="Schultz T" first="Timothy" last="Schultz">Timothy Schultz</name><name sortKey="Schultz, Timothy" sort="Schultz, Timothy" uniqKey="Schultz T" first="Timothy" last="Schultz">Timothy Schultz</name><name sortKey="Visvanathan, Renuka" sort="Visvanathan, Renuka" uniqKey="Visvanathan R" first="Renuka" last="Visvanathan">Renuka Visvanathan</name><name sortKey="Visvanathan, Renuka" sort="Visvanathan, Renuka" uniqKey="Visvanathan R" first="Renuka" last="Visvanathan">Renuka Visvanathan</name><name sortKey="Yu, Solomon" sort="Yu, Solomon" uniqKey="Yu S" first="Solomon" last="Yu">Solomon Yu</name><name sortKey="Yu, Solomon" sort="Yu, Solomon" uniqKey="Yu S" first="Solomon" last="Yu">Solomon Yu</name></country><country name="France"><noRegion><name sortKey="Cesari, Matteo" sort="Cesari, Matteo" uniqKey="Cesari M" first="Matteo" last="Cesari">Matteo 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