Chiropractic treatment of older adults with neck pain with or without headache or dizziness: analysis of 288 Australian chiropractors' self-reported views.
Identifieur interne : 000599 ( Main/Exploration ); précédent : 000598; suivant : 000600Chiropractic treatment of older adults with neck pain with or without headache or dizziness: analysis of 288 Australian chiropractors' self-reported views.
Auteurs : Dein Vindigni [Australie] ; Laura Zark [Australie] ; Tobias Sundberg [Suède, Australie] ; Matthew Leach [Australie] ; Jon Adams [Australie] ; Michael F. Azari [Australie]Source :
- Chiropractic & manual therapies [ 2045-709X ] ; 2019.
Descripteurs français
- KwdFr :
- Adulte (MeSH), Adulte d'âge moyen (MeSH), Australie (MeSH), Autorapport (MeSH), Cervicalgie (thérapie), Chiropraxie (MeSH), Céphalée (thérapie), Enquêtes et questionnaires (MeSH), Femelle (MeSH), Humains (MeSH), Manipulation vertébrale (MeSH), Mâle (MeSH), Personnel de santé (psychologie), Résultat thérapeutique (MeSH), Sensation vertigineuse (thérapie), Sujet âgé (MeSH), Sujet âgé de 80 ans ou plus (MeSH).
- MESH :
- Wicri :
- geographic : Australie.
English descriptors
- KwdEn :
- Adult (MeSH), Aged (MeSH), Aged, 80 and over (MeSH), Australia (MeSH), Chiropractic (MeSH), Dizziness (therapy), Female (MeSH), Headache (therapy), Health Personnel (psychology), Humans (MeSH), Male (MeSH), Manipulation, Spinal (MeSH), Middle Aged (MeSH), Neck Pain (therapy), Self Report (MeSH), Surveys and Questionnaires (MeSH), Treatment Outcome (MeSH).
- MESH :
- geographic : Australia.
- psychology : Health Personnel.
- therapy : Dizziness, Headache, Neck Pain.
- Adult, Aged, Aged, 80 and over, Chiropractic, Female, Humans, Male, Manipulation, Spinal, Middle Aged, Self Report, Surveys and Questionnaires, Treatment Outcome.
Abstract
Background
Neck pain is a leading cause of individual and societal burden worldwide, affecting an estimated 1 in 5 people aged 70 years and older. The nature and outcomes of chiropractic care for older adults with neck pain, particularly those with co-morbid headaches, remains poorly understood. Therefore, we sought to ascertain: What proportion of Australian chiropractors' caseload comprises older adults with neck pain (with or without headache); How are these conditions treated; What are the reported outcomes?
Methods
An online survey examining practitioner and practice characteristics, clinical patient presentations, chiropractic treatment methods and outcomes, and other health service use, was distributed to a random nationally representative sample of 800 Australian chiropractors. Quantitative methods were used to analyze the data.
Results
Two hundred eighty-eight chiropractors (response rate = 36%) completed the survey between August and November 2017. Approximately one-third (M 28.5%, SD 14.2) of the chiropractors' patients were older adults (i.e. aged ≥65 years), of which 45.5% (SD 20.6) presented with neck pain and 31.3% (SD 20.3) had co-morbid headache. Chiropractors reported to combine a range of physical and manual therapy treatments, exercises and self-management practices in their care of these patients particularly: manipulation of the thoracic spine (82.0%); activator adjustment of the neck (77.3%); and massage of the neck (76.5%). The average number of visits required to resolve headache symptoms was reported to be highest among those with migraine (M 11.2, SD 8.8). The majority of chiropractors (57.3%) reported a moderate response to treatment in reported dizziness amongst older adults with neck pain. Approximately 82% of older adult patients were estimated to use at least one other health service concurrently to chiropractic care to manage their neck pain.
Conclusion
This is the first known study to investigate chiropractic care of older adults living with neck pain. Chiropractors report using well-established conservative techniques to manage neck pain in older adults. Our findings also indicate that this target group of patients may frequently integrate chiropractic care with other health services in order to manage their neck pain. Further research should provide in-depth investigation of older patients' experience and other patient-reported outcomes of chiropractic treatment.
DOI: 10.1186/s12998-019-0288-1
PubMed: 31867101
PubMed Central: PMC6918629
Affiliations:
Links toward previous steps (curation, corpus...)
Le document en format XML
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Sciences, RMIT University, Melbourne, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>1Chiropractic Discipline, School of Health and Biomedical Sciences, RMIT University, Melbourne</wicri:regionArea><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName></affiliation></author><author><name sortKey="Zark, Laura" sort="Zark, Laura" uniqKey="Zark L" first="Laura" last="Zark">Laura Zark</name><affiliation wicri:level="3"><nlm:affiliation>1Chiropractic Discipline, School of Health and Biomedical Sciences, RMIT University, Melbourne, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>1Chiropractic Discipline, School of Health and Biomedical Sciences, RMIT University, Melbourne</wicri:regionArea><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName></affiliation><affiliation wicri:level="3"><nlm:affiliation>2School of Psychology, Faculty of Health, Deakin University, Burwood, Melbourne, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>2School of Psychology, Faculty of Health, Deakin University, Burwood, Melbourne</wicri:regionArea><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName></affiliation></author><author><name sortKey="Sundberg, Tobias" sort="Sundberg, Tobias" uniqKey="Sundberg T" first="Tobias" last="Sundberg">Tobias Sundberg</name><affiliation wicri:level="3"><nlm:affiliation>3Musculoskeletal & Sports Injury Epidemiology Center (MUSIC), Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden.</nlm:affiliation><country xml:lang="fr">Suède</country><wicri:regionArea>3Musculoskeletal & Sports Injury Epidemiology Center (MUSIC), Institute of Environmental Medicine, Karolinska Institute, Stockholm</wicri:regionArea><placeName><settlement type="city">Stockholm</settlement><region nuts="2">Svealand</region></placeName></affiliation><affiliation wicri:level="3"><nlm:affiliation>4Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>4Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney</wicri:regionArea><placeName><settlement type="city">Sydney</settlement><region type="état">Nouvelle-Galles du Sud</region></placeName></affiliation></author><author><name sortKey="Leach, Matthew" sort="Leach, Matthew" uniqKey="Leach M" first="Matthew" last="Leach">Matthew Leach</name><affiliation wicri:level="3"><nlm:affiliation>4Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>4Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney</wicri:regionArea><placeName><settlement type="city">Sydney</settlement><region type="état">Nouvelle-Galles du Sud</region></placeName></affiliation><affiliation wicri:level="1"><nlm:affiliation>5Department of Rural Health, University of South Australia, Adelaide, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>5Department of Rural Health, University of South Australia, Adelaide</wicri:regionArea><wicri:noRegion>Adelaide</wicri:noRegion></affiliation></author><author><name sortKey="Adams, Jon" sort="Adams, Jon" uniqKey="Adams J" first="Jon" last="Adams">Jon Adams</name><affiliation wicri:level="3"><nlm:affiliation>4Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>4Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney</wicri:regionArea><placeName><settlement type="city">Sydney</settlement><region type="état">Nouvelle-Galles du Sud</region></placeName></affiliation></author><author><name sortKey="Azari, Michael F" sort="Azari, Michael F" uniqKey="Azari M" first="Michael F" last="Azari">Michael F. Azari</name><affiliation wicri:level="3"><nlm:affiliation>1Chiropractic Discipline, School of Health and Biomedical Sciences, RMIT University, Melbourne, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>1Chiropractic Discipline, School of Health and Biomedical Sciences, RMIT University, Melbourne</wicri:regionArea><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName></affiliation><affiliation wicri:level="3"><nlm:affiliation>Private practice, Azari Chiropractics, Mount Waverley, Melbourne, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Private practice, Azari Chiropractics, Mount Waverley, Melbourne</wicri:regionArea><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName></affiliation></author></analytic><series><title level="j">Chiropractic & manual therapies</title><idno type="eISSN">2045-709X</idno><imprint><date when="2019" type="published">2019</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult (MeSH)</term><term>Aged (MeSH)</term><term>Aged, 80 and over (MeSH)</term><term>Australia (MeSH)</term><term>Chiropractic (MeSH)</term><term>Dizziness (therapy)</term><term>Female (MeSH)</term><term>Headache (therapy)</term><term>Health Personnel (psychology)</term><term>Humans (MeSH)</term><term>Male (MeSH)</term><term>Manipulation, Spinal (MeSH)</term><term>Middle Aged (MeSH)</term><term>Neck Pain (therapy)</term><term>Self Report (MeSH)</term><term>Surveys and Questionnaires (MeSH)</term><term>Treatment Outcome (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte (MeSH)</term><term>Adulte d'âge moyen (MeSH)</term><term>Australie (MeSH)</term><term>Autorapport (MeSH)</term><term>Cervicalgie (thérapie)</term><term>Chiropraxie (MeSH)</term><term>Céphalée (thérapie)</term><term>Enquêtes et questionnaires (MeSH)</term><term>Femelle (MeSH)</term><term>Humains (MeSH)</term><term>Manipulation vertébrale (MeSH)</term><term>Mâle (MeSH)</term><term>Personnel de santé (psychologie)</term><term>Résultat thérapeutique (MeSH)</term><term>Sensation vertigineuse (thérapie)</term><term>Sujet âgé (MeSH)</term><term>Sujet âgé de 80 ans ou plus (MeSH)</term></keywords><keywords scheme="MESH" type="geographic" xml:lang="en"><term>Australia</term></keywords><keywords scheme="MESH" qualifier="psychologie" xml:lang="fr"><term>Personnel de santé</term></keywords><keywords scheme="MESH" qualifier="psychology" xml:lang="en"><term>Health Personnel</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Dizziness</term><term>Headache</term><term>Neck Pain</term></keywords><keywords scheme="MESH" qualifier="thérapie" xml:lang="fr"><term>Cervicalgie</term><term>Céphalée</term><term>Sensation vertigineuse</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Chiropractic</term><term>Female</term><term>Humans</term><term>Male</term><term>Manipulation, Spinal</term><term>Middle Aged</term><term>Self Report</term><term>Surveys and Questionnaires</term><term>Treatment Outcome</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Australie</term><term>Autorapport</term><term>Chiropraxie</term><term>Enquêtes et questionnaires</term><term>Femelle</term><term>Humains</term><term>Manipulation vertébrale</term><term>Mâle</term><term>Résultat thérapeutique</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Australie</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>Background</b></p><p>Neck pain is a leading cause of individual and societal burden worldwide, affecting an estimated 1 in 5 people aged 70 years and older. The nature and outcomes of chiropractic care for older adults with neck pain, particularly those with co-morbid headaches, remains poorly understood. Therefore, we sought to ascertain: What proportion of Australian chiropractors' caseload comprises older adults with neck pain (with or without headache); How are these conditions treated; What are the reported outcomes?</p></div><div type="abstract" xml:lang="en"><p><b>Methods</b></p><p>An online survey examining practitioner and practice characteristics, clinical patient presentations, chiropractic treatment methods and outcomes, and other health service use, was distributed to a random nationally representative sample of 800 Australian chiropractors. Quantitative methods were used to analyze the data.</p></div><div type="abstract" xml:lang="en"><p><b>Results</b></p><p>Two hundred eighty-eight chiropractors (response rate = 36%) completed the survey between August and November 2017. Approximately one-third (M 28.5%, SD 14.2) of the chiropractors' patients were older adults (i.e. aged ≥65 years), of which 45.5% (SD 20.6) presented with neck pain and 31.3% (SD 20.3) had co-morbid headache. Chiropractors reported to combine a range of physical and manual therapy treatments, exercises and self-management practices in their care of these patients particularly: manipulation of the thoracic spine (82.0%); activator adjustment of the neck (77.3%); and massage of the neck (76.5%). The average number of visits required to resolve headache symptoms was reported to be highest among those with migraine (M 11.2, SD 8.8). The majority of chiropractors (57.3%) reported a moderate response to treatment in reported dizziness amongst older adults with neck pain. Approximately 82% of older adult patients were estimated to use at least one other health service concurrently to chiropractic care to manage their neck pain.</p></div><div type="abstract" xml:lang="en"><p><b>Conclusion</b></p><p>This is the first known study to investigate chiropractic care of older adults living with neck pain. Chiropractors report using well-established conservative techniques to manage neck pain in older adults. Our findings also indicate that this target group of patients may frequently integrate chiropractic care with other health services in order to manage their neck pain. Further research should provide in-depth investigation of older patients' experience and other patient-reported outcomes of chiropractic treatment.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">31867101</PMID><DateCompleted><Year>2020</Year><Month>02</Month><Day>12</Day></DateCompleted><DateRevised><Year>2020</Year><Month>02</Month><Day>12</Day></DateRevised><Article PubModel="Electronic-eCollection"><Journal><ISSN IssnType="Electronic">2045-709X</ISSN><JournalIssue CitedMedium="Internet"><Volume>27</Volume><PubDate><Year>2019</Year></PubDate></JournalIssue><Title>Chiropractic & manual therapies</Title><ISOAbbreviation>Chiropr Man Therap</ISOAbbreviation></Journal><ArticleTitle>Chiropractic treatment of older adults with neck pain with or without headache or dizziness: analysis of 288 Australian chiropractors' self-reported views.</ArticleTitle><Pagination><MedlinePgn>65</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1186/s12998-019-0288-1</ELocationID><Abstract><AbstractText Label="Background">Neck pain is a leading cause of individual and societal burden worldwide, affecting an estimated 1 in 5 people aged 70 years and older. The nature and outcomes of chiropractic care for older adults with neck pain, particularly those with co-morbid headaches, remains poorly understood. Therefore, we sought to ascertain: What proportion of Australian chiropractors' caseload comprises older adults with neck pain (with or without headache); How are these conditions treated; What are the reported outcomes?</AbstractText><AbstractText Label="Methods">An online survey examining practitioner and practice characteristics, clinical patient presentations, chiropractic treatment methods and outcomes, and other health service use, was distributed to a random nationally representative sample of 800 Australian chiropractors. Quantitative methods were used to analyze the data.</AbstractText><AbstractText Label="Results">Two hundred eighty-eight chiropractors (response rate = 36%) completed the survey between August and November 2017. Approximately one-third (M 28.5%, SD 14.2) of the chiropractors' patients were older adults (i.e. aged ≥65 years), of which 45.5% (SD 20.6) presented with neck pain and 31.3% (SD 20.3) had co-morbid headache. Chiropractors reported to combine a range of physical and manual therapy treatments, exercises and self-management practices in their care of these patients particularly: manipulation of the thoracic spine (82.0%); activator adjustment of the neck (77.3%); and massage of the neck (76.5%). The average number of visits required to resolve headache symptoms was reported to be highest among those with migraine (M 11.2, SD 8.8). The majority of chiropractors (57.3%) reported a moderate response to treatment in reported dizziness amongst older adults with neck pain. Approximately 82% of older adult patients were estimated to use at least one other health service concurrently to chiropractic care to manage their neck pain.</AbstractText><AbstractText Label="Conclusion">This is the first known study to investigate chiropractic care of older adults living with neck pain. Chiropractors report using well-established conservative techniques to manage neck pain in older adults. Our findings also indicate that this target group of patients may frequently integrate chiropractic care with other health services in order to manage their neck pain. Further research should provide in-depth investigation of older patients' experience and other patient-reported outcomes of chiropractic treatment.</AbstractText><CopyrightInformation>© The Author(s). 2019.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y" EqualContrib="Y"><LastName>Vindigni</LastName><ForeName>Dein</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>1Chiropractic Discipline, School of Health and Biomedical Sciences, RMIT University, Melbourne, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y" EqualContrib="Y"><LastName>Zark</LastName><ForeName>Laura</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>1Chiropractic Discipline, School of Health and Biomedical Sciences, RMIT University, Melbourne, Australia.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>2School of Psychology, Faculty of Health, Deakin University, Burwood, Melbourne, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sundberg</LastName><ForeName>Tobias</ForeName><Initials>T</Initials><AffiliationInfo><Affiliation>3Musculoskeletal & Sports Injury Epidemiology Center (MUSIC), Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>4Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Leach</LastName><ForeName>Matthew</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>4Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, Australia.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>5Department of Rural Health, University of South Australia, Adelaide, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Adams</LastName><ForeName>Jon</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>4Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Azari</LastName><ForeName>Michael F</ForeName><Initials>MF</Initials><AffiliationInfo><Affiliation>1Chiropractic Discipline, School of Health and Biomedical Sciences, RMIT University, Melbourne, Australia.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Private practice, Azari Chiropractics, Mount Waverley, Melbourne, Australia.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2019</Year><Month>12</Month><Day>18</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Chiropr Man Therap</MedlineTA><NlmUniqueID>101551481</NlmUniqueID><ISSNLinking>2045-709X</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000369" MajorTopicYN="N">Aged, 80 and over</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D001315" MajorTopicYN="N" Type="Geographic">Australia</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D002684" MajorTopicYN="Y">Chiropractic</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D004244" MajorTopicYN="N">Dizziness</DescriptorName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006261" MajorTopicYN="N">Headache</DescriptorName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006282" MajorTopicYN="N">Health Personnel</DescriptorName><QualifierName UI="Q000523" MajorTopicYN="N">psychology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D020393" MajorTopicYN="Y">Manipulation, Spinal</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D019547" MajorTopicYN="N">Neck Pain</DescriptorName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D057566" MajorTopicYN="N">Self Report</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011795" MajorTopicYN="N">Surveys and Questionnaires</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016896" MajorTopicYN="N">Treatment Outcome</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="Y">Chiropractic</Keyword><Keyword MajorTopicYN="Y">Headache</Keyword><Keyword MajorTopicYN="Y">Neck pain</Keyword><Keyword MajorTopicYN="Y">Older adults</Keyword><Keyword MajorTopicYN="Y">Survey</Keyword></KeywordList><CoiStatement>Competing interestsNone of the authors have any competing interests.</CoiStatement></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2019</Year><Month>07</Month><Day>30</Day></PubMedPubDate><PubMedPubDate 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Azari</name><name sortKey="Leach, Matthew" sort="Leach, Matthew" uniqKey="Leach M" first="Matthew" last="Leach">Matthew Leach</name><name sortKey="Leach, Matthew" sort="Leach, Matthew" uniqKey="Leach M" first="Matthew" last="Leach">Matthew Leach</name><name sortKey="Sundberg, Tobias" sort="Sundberg, Tobias" uniqKey="Sundberg T" first="Tobias" last="Sundberg">Tobias Sundberg</name><name sortKey="Zark, Laura" sort="Zark, Laura" uniqKey="Zark L" first="Laura" last="Zark">Laura Zark</name><name sortKey="Zark, Laura" sort="Zark, Laura" uniqKey="Zark L" first="Laura" last="Zark">Laura Zark</name></country><country name="Suède"><region name="Svealand"><name sortKey="Sundberg, Tobias" sort="Sundberg, Tobias" uniqKey="Sundberg T" first="Tobias" last="Sundberg">Tobias Sundberg</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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