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Cochrane Systematic Review: Traditional Chinese medicine for epilepsy
Li Q, Chen XY, He L, Zhou D
Li Q, Chen XY, He L, Zhou D
OBJECTIVES: To determine the effectiveness and safety of traditional Chinese medicine in people with epilepsy.
OBJECTIVES: To determine the effectiveness and safety of traditional Chinese medicine in people with epilepsy.
Cochrane Systematic Review: Chinese herbal medicine Huangqi type formulations for nephrotic syndrome
Feng M, Yuan W, Zhang R, Fu P, Wu T
Feng M, Yuan W, Zhang R, Fu P, Wu T
OBJECTIVES: To assess the benefits and harms of Huangqi and Huangqi type formulations in treating nephrotic syndrome in any age group, either as sole agents or in addition to other drug therapies.
OBJECTIVES: To assess the benefits and harms of Huangqi and Huangqi type formulations in treating nephrotic syndrome in any age group, either as sole agents or in addition to other drug therapies.
Cochrane Systematic Review: Chinese herbal medicine for atopic eczema
Zhang W, Leonard T, Bath-Hextall FJ, Chambers C, Lee C, Humphreys R, Williams HC
Zhang W, Leonard T, Bath-Hextall FJ, Chambers C, Lee C, Humphreys R, William...
OBJECTIVES: To assess the effects of Chinese herbal mixtures in the treatment of atopic eczema.
OBJECTIVES: To assess the effects of Chinese herbal mixtures in the treatment of atopic eczema.
Cochrane Systematic Review: Rapid viral diagnosis for acute febrile respiratory illness in children in the Emergency Department
Doan Q, Enarson P, Kissoon N, Klassen TP, Johnson DW.
Doan Q, Enarson P, Kissoon N, Klassen TP, Johnson DW.
Objectives: To determine the effect of rapid viral testing in the ED on the rate of precautionary testing, antibiotic use, and length of ED visit.
Objectives: To determine the effect of rapid viral testing in the ED on the rate of precautionary testing, antibiotic use, and length of ED visit.
Cochrane Systematic Review: Early emergency department treatment of acute asthma with systemic corticosteroids
Rowe BH, Spooner C, Ducharme FM, Bretzlaff JA, Bota GW.
Rowe BH, Spooner C, Ducharme FM, Bretzlaff JA, Bota GW.
Objectives: To determine the benefit of treating patients with acute asthma with systemic corticosteroids within an hour of presenting to the emergency department (ED).
Objectives: To determine the benefit of treating patients with acute asthma with systemic corticosteroids within an hour of presenting to the emergency department (ED).
Cochrane Systematic Review: Early use of inhaled corticosteroids in the emergency department treatment of acute asthma
Edmonds ML, Milan SJ, Camargo CA Jr, Pollack CV, Rowe BH.
Edmonds ML, Milan SJ, Camargo CA Jr, Pollack CV, Rowe BH.
Objectives: To determine the benefit of ICS for the treatment of patients with acute asthma managed in the emergency department (ED).
Objectives: To determine the benefit of ICS for the treatment of patients with acute asthma managed in the emergency department (ED).
Cochrane Systematic Review: Inhaled steroids for acute asthma following emergency department discharge
Edmonds ML, Milan SJ, Brenner BE, Camargo CA Jr, Rowe BH.
Edmonds ML, Milan SJ, Brenner BE, Camargo CA Jr, Rowe BH.
Objectives: To determine the effectiveness of ICS on outcomes in the treatment of acute asthma following discharge from the ED. To quantify the effectiveness of ICS therapy on acute asthma following ED discharge, when used in addition to, or as a substitute for, systemic corticosteroids.
Objectives: To determine the effectiveness of ICS on outcomes in the treatment of acute asthma following discharge from the ED. To quantify the effectiveness of ICS therapy on acute asthma following ED discharge, when used in addition to, or as a substitute for, systemic corticosteroids.
Cochrane Systematic Review: Interventions for educating children who are at risk of asthma-related emergency department attendance
Boyd M, Lasserson TJ, McKean MC, Gibson PG, Ducharme FM, Haby M.
Boyd M, Lasserson TJ, McKean MC, Gibson PG, Ducharme FM, Haby M.
Objectives: To conduct a systematic review of the literature and update the previous review as to whether asthma education leads to improved health outcomes in children who have attended the emergency room for asthma.
Objectives: To conduct a systematic review of the literature and update the previous review as to whether asthma education leads to improved health outcomes in children who have attended the emergency room for asthma.
Cochrane Systematic Review: Intravenous beta2-agonists for acute asthma in the emergency department
Travers A, Jones AP, Kelly K, Barker SJ, Camargo CA, Rowe BH.
Travers A, Jones AP, Kelly K, Barker SJ, Camargo CA, Rowe BH.
Objectives: To determine the benefit of intravenous (IV) beta2-agonists for severe acute asthma treated in the emergency department.
Objectives: To determine the benefit of intravenous (IV) beta2-agonists for severe acute asthma treated in the emergency department.
Cochrane Systematic Review: Magnesium sulfate for treating exacerbations of acute asthma in the emergency department
Rowe BH, Bretzlaff JA, Bourdon C, Bota GW, Camargo CA Jr.
Rowe BH, Bretzlaff JA, Bourdon C, Bota GW, Camargo CA Jr.
Objectives: To examine the effect of additional intravenous magnesium sulfate in patients with acute asthma managed in the emergency department.
Objectives: To examine the effect of additional intravenous magnesium sulfate in patients with acute asthma managed in the emergency department.
Cochrane Systematic Review: Emergency intubation for acutely ill and injured patients
Lecky F, Bryden D, Little R, Tong N, Moulton C
Lecky F, Bryden D, Little R, Tong N, Moulton C
OBJECTIVES: To determine in acutely ill and injured patients who have real or anticipated problems in maintaining an adequate airway whether emergency endotracheal intubation, as opposed to other airway management techniques, improves the outcome in terms of survival, degree of disability at discharge or length of stay and complications occurring in hospital.
OBJECTIVES: To determine in acutely ill and injured patients who have real or anticipated problems in maintaining an adequate airway whether emergency endotracheal intubation, as opposed to other airway management techniques, improves the outcome in terms of survival, degree of disability at discharge or length of stay and complications occurring in hospital.
Cochrane Systematic Review: Tranexamic acid for reducing mortality in emergency and urgent surgery
Perel P, Ker K, Morales Uribe CH, Roberts I
Perel P, Ker K, Morales Uribe CH, Roberts I
OBJECTIVES: To assess the effects of tranexamic acid on mortality, blood transfusion and thromboembolic events in adults undergoing emergency or urgent surgery.
OBJECTIVES: To assess the effects of tranexamic acid on mortality, blood transfusion and thromboembolic events in adults undergoing emergency or urgent surgery.
Cochrane Systematic Review: Emergency interventions for hyperkalaemia
Mahoney BA, Smith WA, Lo DS, Tsoi K, Tonelli M, Clase CM
Mahoney BA, Smith WA, Lo DS, Tsoi K, Tonelli M, Clase CM
OBJECTIVES: To review randomised evidence informing the emergency (i.e. acute, rather than chronic) management of hyperkalaemia
OBJECTIVES: To review randomised evidence informing the emergency (i.e. acute, rather than chronic) management of hyperkalaemia
Review: Pediatric orthopedic injuries: evidence-based management in the emergency department
Lien J
Lien J
This issue reviews the etiology and pathophysiology of child-specific fractures, as well as common injuries of the upper and lower extremities.
This issue reviews the etiology and pathophysiology of child-specific fractures, as well as common injuries of the upper and lower extremities.
Key Study: Outcome of Pediatric Forearm Fracture Reductions Performed by Pediatric Emergency Medicine Providers Compared With Reductions Performed by Orthopedic Surgeons: A Retrospective Cohort Study
Milner, D, Krause, E, Hamre, K and Flood, A
Milner, D, Krause, E, Hamre, K and Flood, A
The aim of this study was to describe the outcome differences between board-certified orthopedists and pediatric emergency medicine (PEM) physicians conducting forearm fracture reductions.
The aim of this study was to describe the outcome differences between board-certified orthopedists and pediatric emergency medicine (PEM) physicians conducting forearm fracture reductions.
Key Study: Cost Consequence Analysis of Implementing the Low Risk Ankle Rule in Emergency Departments
Boutis, K, von Keyserlingk, C, Willan, A, Narayanan, UG, Brison, R, Grootendorst, P, Plint AC, Parker, M & Goeree, R
Boutis, K, von Keyserlingk, C, Willan, A, Narayanan, UG, Brison, R, Grootendo...
Objective: To examine the costs and consequences of implementing the Low Risk Ankle Rule.
Objective: To examine the costs and consequences of implementing the Low Risk Ankle Rule.
Overview of studies: Emergency presentation of congenital heart disease in children
EB Medicine
EB Medicine
Objective: To address the evaluation and management of pediatric patients with congenital heart defects in the context of the evidence available from the medical literature.
Objective: To address the evaluation and management of pediatric patients with congenital heart defects in the context of the evidence available from the medical literature.
Overview of studies: Congenital Heart Disease In Pediatric Patients: Recognizing The Undiagnosed And Managing Complications In The Emergency Department
Judge P, Meckler G
Judge P, Meckler G
Objective: This review focuses on the recognition and initial management of patients with undiagnosed congenital heart disease presenting to the ED and touches on considerations for postoperative infants and children with complex congenital heart disease.
Objective: This review focuses on the recognition and initial management of patients with undiagnosed congenital heart disease presenting to the ED and touches on considerations for postoperative infants and children with complex congenital heart disease.
Key Study: Intravenous regional anaesthesia (Bier's block) for pediatric forearm fractures in a pediatric emergency department-Experience from 2003 to 2014
Chua ISY, Chong SL, Ong GYK
Chua ISY, Chong SL, Ong GYK
The objective of the study was to evaluate the efficacy (length of stay in the emergency department and failure rate of Bier's block) and safety profile (death and major complications) of Bier's block in its use for manipulation and reduction of paediatric forearm fractures.
The objective of the study was to evaluate the efficacy (length of stay in the emergency department and failure rate of Bier's block) and safety profile (death and major complications) of Bier's block in its use for manipulation and reduction of paediatric forearm fractures.
Key Study: The utility of clinical ultrasonography in identifying distal forearm fractures inthe pediatric emergency department
Galletebeitia Laka I, Samson F, Gorostiza I, Gonzalez A, Gonzalez C
Galletebeitia Laka I, Samson F, Gorostiza I, Gonzalez A, Gonzalez C
The aim of this study is to evaluate the utility of point-of-care ultrasound for diagnosing distal forearm fractures in pediatric emergency departments.
The aim of this study is to evaluate the utility of point-of-care ultrasound for diagnosing distal forearm fractures in pediatric emergency departments.
Key Study: Reduced Length of Stay and Adverse Events Using Bier Block for Forearm Fracture Reduction in the Pediatric Emergency Department
Fauteux-Lamarre E, Burstein B, Cheng A, Bretholz A
Fauteux-Lamarre E, Burstein B, Cheng A, Bretholz A
This study sought to compare Bier block and procedural sedation for forearm fracture reduction.
This study sought to compare Bier block and procedural sedation for forearm fracture reduction.
Key Study: Manipulation and reduction of paediatric fractures of the distal radius and forearm using intranasal diamorphine and 50% oxygen and nitrous oxide in the emergency department: a 2.5-year study
Kurien T, Price KR, Pearson RG, Dieppe C, Hunter JB
Kurien T, Price KR, Pearson RG, Dieppe C, Hunter JB
This study presents the results of managing children's fracture of the distal forearm in the ED using intranasal diamorphine and Entonox to allow manipulation and discharge on the same day.
This study presents the results of managing children's fracture of the distal forearm in the ED using intranasal diamorphine and Entonox to allow manipulation and discharge on the same day.
Key Study: Effect of a Computerized Reminder on Splinting of Pediatric Upper Limb Fractures in the Emergency Department
Mills E, Craig S, Oakley E
Mills E, Craig S, Oakley E
The primary objective was to assess if a computerized pop-up reminder increased splint application before X-ray in pediatric emergency department patients with deformed upper limb fractures.
The primary objective was to assess if a computerized pop-up reminder increased splint application before X-ray in pediatric emergency department patients with deformed upper limb fractures.
Key Study: Using softcast to treat torus fractures in a paediatric emergency department
Callender O, Koe S
Callender O, Koe S
Wrist torus fractures in children are a frequent reason for Emergency Department (ED) visits. Torus fractures traditionally were treated with a backslab cast in the Children's ED and then referred to the Fracture Clinic. Guidelines were developed in order to standardise the care for children who attended the ED with a torus fracture. All patients who were seen & treated by the Advanced Nurse Practitioner (ANP) over a one year period with a diagnosis of a torus fracture were treated with immobilisation in a softcast. 119 patients met the criteria for inclusion. There were no adverse events recorded and no patient required subsequent visits to the Fracture Clinic. There was a cost savings of 18,596 as compared with the normal referral pathway to the Fracture Clinic.
Wrist torus fractures in children are a frequent reason for Emergency Department (ED) visits. Torus fractures traditionally were treated with a backslab cast in the Children's ED and then referred to the Fracture Clinic. Guidelines were developed in order to standardise the care for children who attended the ED with a torus fracture. All patients who were seen & treated by the Advanced Nurse Practitioner (ANP) over a one year period with a diagnosis of a torus fracture were treated with immobilisation in a softcast. 119 patients met the criteria for inclusion. There were no adverse events recorded and no patient required subsequent visits to the Fracture Clinic. There was a cost savings of 18,596 as compared with the normal referral pathway to the Fracture Clinic.
Key Study: Feasibility of a reduction protocol in the emergency department for diaphyseal forearm fractures in children
Pesenti S, Litzelmann E, Kahil M, Mallet C, Jehanno P, Mercier JC, Ilharreborde B, Mazda K
Pesenti S, Litzelmann E, Kahil M, Mallet C, Jehanno P, Mercier JC, Ilharrebor...
The purpose of this study was to analyze the results of diaphyseal forearm fractures in the emergency department in children.
The purpose of this study was to analyze the results of diaphyseal forearm fractures in the emergency department in children.
Key Study: Reducing Time to Pain Medication Administration for Pediatric Patients with Long Bone Fractures in the Emergency Department
Schuman, S S, Regen, R B, Stuart, L H, Harrell, C, Jones, T L, Stewart, B M, Berg, A M, Longjohn, M and Kink, R J
Schuman, S S, Regen, R B, Stuart, L H, Harrell, C, Jones, T L, Stewart, B M, ...
The purpose of this quality improvement project was to develop a protocol with the goal to administer pain medication to children presenting with suspected long bone fractures 47 minutes of emergency department arrival.
The purpose of this quality improvement project was to develop a protocol with the goal to administer pain medication to children presenting with suspected long bone fractures 47 minutes of emergency department arrival.
Key Study: Emergency room closed reduction versus in situ splinting in the treatment of paediatric supracondylar humerus fractures
Sylvia, SM, Maguire, KJ, Molho, DA, Levens, BJ, Stone, MEJ, Hanstein, R, Schulz, JF and Fornari, ED
Sylvia, SM, Maguire, KJ, Molho, DA, Levens, BJ, Stone, MEJ, Hanstein, R, Schu...
The purpose of this study was to investigate if outcomes or complications differ between two management methods.
The purpose of this study was to investigate if outcomes or complications differ between two management methods.
Key Study: Management of Paediatric Buckle (Torus) Wrist Fractures in Irish Emergency Departments: A National Survey
Abdelhady, A, Ahmed, A, Umana, E and O'Donnell, J
Abdelhady, A, Ahmed, A, Umana, E and O'Donnell, J
Buckle fractures are the most common wrist fractures reported in the paediatric age group. National Institute for Clinical Excellence (NICE) recommends using a non-rigid immobilisation with no follow up for these patients and appropriate discharge advice. A telephone survey was conducted to assess the variation in practice in Irish hospitals regarding the mpediatrianagement of buckle fractures.
Buckle fractures are the most common wrist fractures reported in the paediatric age group. National Institute for Clinical Excellence (NICE) recommends using a non-rigid immobilisation with no follow up for these patients and appropriate discharge advice. A telephone survey was conducted to assess the variation in practice in Irish hospitals regarding the mpediatrianagement of buckle fractures.
Key Study: Multiple interventions improve analgesic treatment of supracondylar humerus fractures in a pediatric emergency department
Porter, RN, Chafe, RE, Newhook, LA and Murnaghan, KD
Porter, RN, Chafe, RE, Newhook, LA and Murnaghan, KD
To measure the effectiveness of a set of interventions in improving the rate and timeliness of analgesic medication administration, as well as appropriate backslab immobilization (application of a moldable plaster or fiberglass splint), in a pediatric ED.
To measure the effectiveness of a set of interventions in improving the rate and timeliness of analgesic medication administration, as well as appropriate backslab immobilization (application of a moldable plaster or fiberglass splint), in a pediatric ED.
Emergency Medicine Cases Podcast: Pediatric fever without a source
Dr. Sarah Reid & Dr. Gina Neto
Dr. Sarah Reid & Dr. Gina Neto
Episode 48:In this episode, with the help of Dr. Sarah Reid and Dr. Gina Neto from the Childrens Hospital of Eastern Ontario, we will elucidate how to deal with fever phobia, when a rectal temp is necessary, how to pick out the kids with fever that we need to worry about, how to work up kids with fever depending on their age, risk factors and clinical picture, who needs a urinalysis, who needs a CXR, who needs blood cultures and who needs an LP, and much more. Posted online: August 2014.
Episode 48:In this episode, with the help of Dr. Sarah Reid and Dr. Gina Neto from the Childrens Hospital of Eastern Ontario, we will elucidate how to deal with fever phobia, when a rectal temp is necessary, how to pick out the kids with fever that we need to worry about, how to work up kids with fever depending on their age, risk factors and clinical picture, who needs a urinalysis, who needs a CXR, who needs blood cultures and who needs an LP, and much more. Posted online: August 2014.
Emergency Medicine Cases Podcast: Pediatric abdominal pain & appendicitis
Dr. Anna Jarvis & Dr. Stephen Freedman
Dr. Anna Jarvis & Dr. Stephen Freedman
Episode 19 Part 1:In Part 1 of this Episode on Pediatric Abdominal Pain, Dr. Anna Jarvis & Dr. Stephen Freedman discuss the nuances of the history, physical and work up of Pediatric Abdominal Pain & Appendicitis and key pearls on how to distinguish serious surgical causes from the very common diagnosis of gastroenteritis. An in-depth discussion on the pearls of the history, physical exam, lab tests, imaging including serial ultrasounds vs CT abdomen, clinical decision rules such as the Alvarado Score, best analgesics and antibiotics in pediatric appendicitis follows. Published online: December 2011.
Episode 19 Part 1:In Part 1 of this Episode on Pediatric Abdominal Pain, Dr. Anna Jarvis & Dr. Stephen Freedman discuss the nuances of the history, physical and work up of Pediatric Abdominal Pain & Appendicitis and key pearls on how to distinguish serious surgical causes from the very common diagnosis of gastroenteritis. An in-depth discussion on the pearls of the history, physical exam, lab tests, imaging including serial ultrasounds vs CT abdomen, clinical decision rules such as the Alvarado Score, best analgesics and antibiotics in pediatric appendicitis follows. Published online: December 2011.
Emergency Medicine Cases Podcast: Pediatric Pain Management
Dr. Samina Ali & Dr. Anthony Crocco
Dr. Samina Ali & Dr. Anthony Crocco
Episode 67: Pain is the most common reason for seeking health care. It accounts for 80% of ED visits. The WHO has declared that “optimal pain treatment is a human right”. As has been shown in multiple ED-based Pediatric pain management studies, Pediatric pain is all too often under-estimated and under-treated. Why does this matter? Under-estimating and under-treating pediatric pain may have not only short term detrimental effects but life-long detrimental effects as well; not to mention, screaming miserable children disturbing other patients in your ED and complaints to the hospital from parents. Whether it’s venipuncture, laceration repair, belly pain or reduction of a fracture we need to have the skills and knowledge to optimize efficient and effective pain management in all the kids we see in the ED. What are the indications for intranasal fentanyl? intranasal ketamine? Why should codeine be contra-indicated in children? How do triage-initaited pain protocols improve pediatric pain management? Which are most effective skin analgesics for venipuncture? To help you make these important pediatric pain management decisions, in this podcast we have one of the most prominent North American researchers and experts in Emergency Pediatric pain management, Dr. Samina Ali and not only the chief of McMaster Children’s ED but also the head of the division of Pediatric EM at McMaster University, Dr. Anthony Crocco.
Episode 67: Pain is the most common reason for seeking health care. It accounts for 80% of ED visits. The WHO has declared that “optimal pain treatment is a human right”. As has been shown in multiple ED-based Pediatric pain management studies, Pediatric pain is all too often under-estimated and under-treated. Why does this matter? Under-estimating and under-treating pediatric pain may have not only short term detrimental effects but life-long detrimental effects as well; not to mention, screaming miserable children disturbing other patients in your ED and complaints to the hospital from parents. Whether it’s venipuncture, laceration repair, belly pain or reduction of a fracture we need to have the skills and knowledge to optimize efficient and effective pain management in all the kids we see in the ED. What are the indications for intranasal fentanyl? intranasal ketamine? Why should codeine be contra-indicated in children? How do triage-initaited pain protocols improve pediatric pain management? Which are most effective skin analgesics for venipuncture? To help you make these important pediatric pain management decisions, in this podcast we have one of the most prominent North American researchers and experts in Emergency Pediatric pain management, Dr. Samina Ali and not only the chief of McMaster Children’s ED but also the head of the division of Pediatric EM at McMaster University, Dr. Anthony Crocco.
Emergency Medicine Cases Podcast: Cyanotic Infant
Dr. Gary Joubert & Dr. Anton Helman
Dr. Gary Joubert & Dr. Anton Helman
Best Case Ever #48: In anticipation of EM Cases’ upcoming episode, Congenital Heart Disease Emergencies, Dr. Gary Joubert discusses his Best Case Ever of a four month old infant who presents with intermittent cyanosis. The Cyanotic Infant can present a significant challenge to the EM provider as the differential is wide, ranging from benign causes such as GERD to life threatening heart disease that may present atypically in a well-appearing child. Dr. Joubert provides some simple clinical pearls to help ED providers along the way. Published online: July 2016.
Best Case Ever #48: In anticipation of EM Cases’ upcoming episode, Congenital Heart Disease Emergencies, Dr. Gary Joubert discusses his Best Case Ever of a four month old infant who presents with intermittent cyanosis. The Cyanotic Infant can present a significant challenge to the EM provider as the differential is wide, ranging from benign causes such as GERD to life threatening heart disease that may present atypically in a well-appearing child. Dr. Joubert provides some simple clinical pearls to help ED providers along the way. Published online: July 2016.
Emergency Medicine Cases Podcast: Congenital Heart Disease Emergencies
Dr. Gary Joubert & Dr. Ashley Strobel
Dr. Gary Joubert & Dr. Ashley Strobel
Episode 84: You might be surprised to learn that the prevalence of critical cardiac disease in infants is almost as high as the prevalence of infant sepsis. Critical congenital heart defects are often missed in the ED. For a variety of reasons, there are currently more children with congenital heart disease presenting to the ED than ever before and these numbers will continue to grow in the future. With the goal of learning a practical approach to congenital heart disease emergencies using the child’s age, colour and few simple tests, Dr. Strobel and Dr. Joubert will discuss some key actions, pearls and pitfalls so that the next time you’re faced with that crashing baby in the resuscitation room, you’ll know exactly what to do. This podcast topic was chosen based on a Canada-wide needs assessment by TREKK – translating emergency knowledge for kids.
Published online: August 2016.
Episode 84: You might be surprised to learn that the prevalence of critical cardiac disease in infants is almost as high as the prevalence of infant sepsis. Critical congenital heart defects are often missed in the ED. For a variety of reasons, there are currently more children with congenital heart disease presenting to the ED than ever before and these numbers will continue to grow in the future. With the goal of learning a practical approach to congenital heart disease emergencies using the child’s age, colour and few simple tests, Dr. Strobel and Dr. Joubert will discuss some key actions, pearls and pitfalls so that the next time you’re faced with that crashing baby in the resuscitation room, you’ll know exactly what to do. This podcast topic was chosen based on a Canada-wide needs assessment by TREKK – translating emergency knowledge for kids.
Published online: August 2016.
Emergency Medicine Cases Rapid Review: Congenital Heart Disease Part 1
Gilbride P, Lloyd T, Cheng E, Calldrige N & Yee M
Gilbride P, Lloyd T, Cheng E, Calldrige N & Yee M
Emergency Medicine Cases Rapid Review: Congenital Heart Disease Part 2
Gilbride P, Lloyd T, Cheng E, Calldrige N & Yee M
Gilbride P, Lloyd T, Cheng E, Calldrige N & Yee M