Questions and responses 41st Parliament, 2nd session October 16, 2013, to August 2, 2015

With regard to the introduction of reforms planned to the grant funding programs of the Canadian Institutes of Health Research (CIHR), including, but not limited to, the proposed “Foundation Scheme”: (a) where and when will interruptions in funding occur, how many positions (researchers, staff and trainees) will be impacted for the 2015 and 2016 funding periods, and what amount of funding would normally be available to applicants during these periods; (b) what steps is the government taking to mitigate any potential funding gaps, or extend the funding, for any highly-qualified personnel and trainees impacted; and (c) does the government intend to allocate contingency funding to CIHR, earmarked for gaps that become evident as the reforms are introduced?

With respect to research conducted or funded by the Department of Veterans Affairs: (a) how much has been spent each year on such research; and (b) what is the (i) name, (ii) description, (iii) purpose of each research project, including duration, broken down by year from 2006 to 2014?

With regard to the study and treatment of eating disorders: (a) how many major eating disorder studies have been funded by the Canadian Institutes of Health Research (CIHR) including treatment, prevention or epidemiology research; (b) how many CIHR peer review committees include members who have expertise in eating disorders; (c) are questions about eating disorders included in national databases; (d) what Health Canada eating disorder initiatives are in place; (e) what are the reasons for which Health Canada does not include low body mass index (BMI) as a separate category; (f) is the Public Health Agency of Canada tracking eating disorders in terms of prevalence, access to treatment and availability of services; (g) is Statistics Canada tracking eating disorders; (h) what are the rates of eating disorders among First Nations, on reserve and in the territories; (i) what barriers to care for Aboriginal Canadians have been identified; (j) have eating disorders been integrated into obesity prevention initiatives in Aboriginal communities; (k) are these initiatives gender and culturally sensitive; (l) in the case of obesity-related research or healthy weight initiatives conducted by the government, are there safeguards in place to ensure ‘no harm’; (m) has the government conducted any research studies examining the full spectrum of eating disorders, from those affecting people with low BMIs to those affecting people with high BMIs; (n) what research efforts by Canada are underway to address those refractory cases currently being treated in long term care mental health facilities; (o) what actions is the Mental Health Commission of Canada (MHCC) taking concerning eating disorders; (p) are eating disorders included in MHCC reports; (q) of the MHCC management (board, executive staff and directors) are there any persons with expertise in eating disorders; (r) has the MHCC developed guidelines for treatment and/or prevention of eating disorders and, if not, why not; (s) have Health Canada or other government agencies performed a review of funded eating disorder services and, if not, why not; (t) have Health Canada or other government agencies tracked co-morbid disorders such as eating disorders coupled with psychiatric illnesses; and (u) have Health Canada or other government agencies tracked eating disorders coupled with medical disorders?

With respect to any information in the government's possession regarding Alzheimer’s disease and related dementias (ADRDs) in Canada: (a) how many Canadians are impacted by ADRDs today, (i) what is the incidence and prevalence in Canada, broken down by gender and by 5-year cohort above 65 years of age, (ii) what is the average age of onset, (ii) what is the average time from diagnosis to requiring informal caregiving, (iii) what is the average time from diagnosis to requiring formal caregiving; (b) how many Canadians are currently in hospital, as a result of having ADRDs, (i) what are the benefits and risks of having people with ADRDs in regular hospital care, (ii) do people with ADRDs get the care they need in hospital care and if not, why not; (c) how do the number of hospitalizations compare for older adults with ADRDs than for age-matched older adults without ADRDs, (i) how do clinical outcomes compare for hospitalized people with ADRDs than for age-matched older adults without ADRDs; (d) what is the average cost of an acute care bed in hospital compared with the cost of a bed in long-term care; (e) what is the average length of time people with ADRDs spend in fully dependent care, and how does this length of time compare with other conditions, including, but not limited to, cardiovascular disease and cancer, (i) how does this length of time impact the health economics of ADRDs; (f) how many Canadians are caregivers to people with ADRDs, (i) what is the average length of time (in years) caregivers provide to people with ADRDs, both informally and within formal care, (ii) what is the annual estimated value of the care caregivers provide for those with ADRDs in Canada, (iii) how many Canadian caregivers suffer stress, illness, or economic hardship as a result of caregiving, (iv) what are the estimated economic costs to the health care and social care systems; (g) what training do medical students and practising family physicians receive to ensure dementia is detected before it reaches a critical level; (h) do best practices exist for people with ADRDs, (i) how does care vary from one province and territory to another, and from one facility to another; (i) what research and studies has the government done, and what funding has it given following (i) the World Health Organization and Alzheimer’s Disease International report, “Dementia: A Public Health Priority”, and the Alzheimer Society of Canada’s report, “Rising Tide: The Impact of Dementia on Canadian Society”, (ii) what are the dates, results, recommendations, and funding amounts; (j) what is done by the government to (i) promote a dementia-friendly society, (ii) make ADRDs a national public health and social care priority, (iii) improve public and professional attitudes to, and understanding of, ADRDs, (iv) replicate some of the evidence-based approaches and solutions already adopted by countries to tackle ADRDs, (v) prioritize research, (vi) raise awareness about prevention, (vii) promote early diagnosis and management, (viii) strengthen workforce training and capacity, (ix) implement responsive care and health service delivery, especially for caregivers; (k) what research and studies has the government done, and what funding has it given regarding the need to work with the provinces, territories and stakeholders to develop a community-based dementia framework, designed to keep persons with dementia safely at home for as long as possible, (i) what are the dates, results, recommendations, and funding amounts; (l) what research, studies, funding has the government devoted to how a community-based dementia strategy would impact (i) emergency department overcrowding, (ii) hospitalizations, (iii) Alternative Level of Care rates, (iv) long-term bed placement, (v) freeing-up of hospital beds, (vi) hospital overcrowding, (vii) wait times, (viii) number of new nursing homes that would need to be built, (ix) quality of life for those with ADRDs, (x) costs; (m) how are ADRDs expected to increase over the next 20 years, (i) what are the estimated costs to families and the health care system; (n) how are healthcare costs and healthcare resources expected to increase over the next 20 years given the rapidly increasing numbers of persons with ADRDs; (o) what research, studies, funding has the government devoted to developing a pan-Canadian brain strategy to address (i) neurodevelopmental brain conditions, (ii) neurodegenerative brain conditions, (iii) brain and spinal cord injury, (iv) what are the dates of any studies, results, recommendations, and funding amounts; (p) what research, studies, and funding has the government given to developing a pan-Canadian dementia strategy, (i) what are the dates of any studies, results, recommendations, and funding amounts; (q) what consultations has the government undertaken with respect to a pan-Canadian brain strategy, (i) how many stakeholders are calling for such a strategy, (ii) how many Canadians and their families do each of the identified stakeholders represent; and (r) what consultations has the government undertaken with respect to a pan-Canadian dementia strategy, (i) how many stakeholders are calling for such a strategy, (ii) how many Canadians and their families do each of the identified stakeholders represent?

With regard to the February 2014 Canadian Institutes for Health Research (CIHR) Management Response to the recommendations of the Final Report of the Task Force on Ethics Reform, approved by the Governing Council of the CIHR: (a) precisely what information was gathered through the “international environmental scan”; and (b) what specific recommendations, in support of the recent appointment of Dr. Jane Aubin as the “Ethics Champion,” and Dr. Paul Garfinkel as the Chair of the Standing Committee on Ethics, were given to CIHR Management and CIHR Governing Council by each of (i) the CIHR Science Council, (ii) the CIHR Standing Committee on Ethics, (iii) the CIHR Institute Advisory Board Ethics Designates?

With regard to Canadians with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): (a) how much money has the Canadian Institute for Health Research (CIHR) invested or allocated into researching ME/CFS in 2012-2013 and 2013-2014, specifically into: (i) the etiology, (ii) diagnostic markers, (iii) pathophysiology, (iv) treatment of ME/CFS; (b) how much research has CIHR funded into treating ME/CFS with (i) Rituximab, (ii) other autoimmune medications, (iii) anti-viral medications, (iv) other medications; (c) what strategies has CIHR designed and implemented to ensure that ME/CFS research is fairly funded; (d) what strategies has CIHR designed and implemented to (i) develop a ME/CFS scientific research community in Canada, (ii) ensure that the ME/CFS research community is multidisciplinary bringing together immunologists, neurologists, cardiologists, endocrinologists, system biologists, geneticists, etc.; (e) has CIHR considered creating a new institute to focus on this emerging area; (f) has CIHR outlined areas of ME/CFS research as priorities for funding, and designating a specific amount of money for ME/CFS research and, if so, how much; (g) will CIHR amend the grant application process to remove the barriers for new and stigmatized conditions to ensure that ME/CFS as an emerging area of research has a fair chance of being funded; (h) how has the government, including (i) Health Canada (HC), (ii) CIHR, (iii) Public Health Agency of Canada (PHAC), (iv) Employment and Social Development Canada (ESDC), (v) Statistics Canada (StatCan), (vi) Department of Justice Canada (JUS), (vii) Treasury Board of Canada Secretariat (TBS) and (viii) Canada Revenue Agency (CRA) educated itself on ME/CFS; (i) did representatives from (i) HC, (ii) CIHR, (iii) PHAC attend or will they be attending (1) the Invest in ME International Conferences, (2) the Biennial International Association for CFS/ME Conference in Ottawa in 2011, (3) 2014 Stanford University ME/CFS Symposium on March 19, 2014, (4) the Biennial International Association for CFS/ME Conference co-hosted by Stanford University from March 20-23, 2014; (j) to what extent has the government, including (i) HC, (ii) CIHR, (iii) PHAC, (iv) ESDC, (v) StatCan, (vi) JUS, (vii) TBS, (viii) CRA, fulfilled its obligation under the UN Convention on Rights of Persons with Disabilities (article 4.3) to closely consult with and actively involve people with ME/CFS through their representative organizations, notably the National ME/FM Action Network; (k) when will (i) the Minister of Health, (ii) Health Canada (iii) CIHR, (iv) PHAC, (v) ESDC, (vi) StatCan, (vii) JUS, (viii) TBS, (ix) CRA next meet with the National ME/FM Action Network; (l) when will foundational documents, notably (i) CFS/ME: A Primer for Clinical Practitioners, (ii) Profile and Impact of 23 Chronic Conditions in the 2005 Canadian Community Health Survey, be posted on government information websites in English and French; (m) how is the government working with the provinces, territories, professional organizations, educational institutions and other stakeholders to meet the needs of Canadians with ME/CFS; (n) what steps has the government taken to ensure that ME/CFS patients in its jurisdiction have access to appropriate medical care; (o) how many medical professionals in Canada including (i) doctors, (ii) nurses currently specialize in ME/CFS and how is the Health Human Resources Strategy ensuring that there will be an adequate supply of health providers specializing in ME/CFS in Canada in the future; (p) how is the Health Care Policy Contribution Program being used to improve health care for ME/CFS patients; (q) how is the government working with stakeholders to deal with other needs of Canadians with ME/CFS shown by the 2005 and 2010 Canadian Community Health Survey (CCHS) including (i) reducing the levels of unmet home care needs, (ii) reducing the levels of food insecurity, (iii) increasing the sense of community belonging experienced by Canadians with this condition; (r) why has the CCHS decided to monitor the extent and impact of ME/CFS, only every four years; (s) will the government review disability programs and services to ensure that they cover the full spectrum of disabilities so that people with ME/CFS have fair and equitable access and will the government review the information and documents it disseminates to ensure that ME/CFS issues are presented adequately and fairly; (t) when will the Canada Pension Plan-Disability Adjudication Tool that guides adjudicators in their assessment of ME/CFS, Fibromyalgia, Multiple Chemical Sensitivities and Chronic Pain cases be reviewed in conjunction with the stakeholder communities to ensure that people with the conditions have fair and equal access to Canada Pension Plan-Disability; and (u) when will the Canada Pension Plan-Disability Adjudication Tool that guides adjudicators in their assessment of ME/CFS, Fibromyalgia, Multiple Chemical Sensitivities and Chronic Pain cases be posted on government websites?

With regard to diagnosis, treatment, awareness and prevention, and research of eating disorders: (a) do the Canadian Institutes of Health Research (CIHR) and Health Canada (HC) have any statistics about how many Canadians suffer from each of the following conditions, (i) anorexia nervosa, (ii) bulimia nervosa, (iii) binge eating disorder; (b) do the CIHR and HC have any statistics about the average costs of each of (i) anorexia nervosa, (ii) bulimia nervosa, (iii) binge eating disorder to the health system; (c) do the CIHR and HC have any statistics about how many Canadians (i) recover, (ii) relapse, (iii) die each year as a result of eating disorders; (d) do the CIHR and HC have any statistics about what treatment is available for eating disorders, broken down by province and territory, from (i) daily care to long-term residential care, (ii) how many publicly funded beds are available; (e) do the CIHR and HC have any statistics about how many Canadian psychiatrists specialize in eating disorders, and any statistics or information about what succession planning is in place to replace those who specialize in these disorders, broken down by province and territory; (f) do the CIHR and HC have any statistics about what eating disorders training programs are available for health professionals, and any statistics or information on what succession planning is in place to replace those who serve Canadians with eating disorders, broken down by province and territory; (g) do the CIHR and HC have any statistics about what long-term, publicly-funded residential care facilities are available, (i) the average wait time for treatment by such a facility, (ii) how many Canadians are forced to leave the country for treatment, (iii) the average cost to the family for out-of-country treatment, (iv) the cost to the health care system if the province or territory reimburses families for out-of-country treatment; (h) do the CIHR and HC have any statistics about Canadians who are forced to go abroad for private treatment, and any statistics or information on what follow-up care, is available, if any, broken down by province and territory; (i) do the CIHR and HC have any statistics about the average economic costs for eating disorders to families including, but not limited to, (i) weekly uninsured costs of appointments to psychologists, (ii) nutritionists, (iii) being unable to work or house oneself; (j) do the CIHR and HC have any statistics about what specific eating disorder diagnostic data the Hospital Mental Health Database captures, as well as information about this data; (k) do the CIHR and HC have any statistics about what percentage of deaths related to eating disorders are not being captured by the Hospital Morbidity Database (HMD); (l) what discussion, if any, has the government had with its provincial and territorial counterparts about coding eating disorders in hospitalization records; (m) what discussion, if any, has the government had with its provincial and territorial counterparts about the Discharge Abstract Database covering all jurisdictions of Canada; (n) what, if any, discussion has the government had with its provincial and territorial counterparts about coding eating disorders in the National Ambulatory Care Reporting System; (o) why has HC or any other government agency not undertaken a review of funded eating disorder services in Canada; (p) what are the specific details of each of the “many initiatives” referred to in the government’s response to written question Q-225, that HC supports related to eating disorders; (q) why does the Public Health Agency of Canada not conduct surveillance activities related to eating disorders, and what government agency does conduct such surveillance activities; (r) why does HC not include low body mass index as a separate category; (s) for each of the 57 projects related to eating disorders that Canadian Institutes of Health Research CIHR funded between 2006 and 2013, (i) what are the details of the project, (ii) what is the funding, (iii) was the principal investigator a member of any of CIHR’s review committees; (t) of CIHR’s 11 peer review committees, which ones include a member who has expertise in eating disorders, and for each committee listed, identify the individual with eating disorders expertise; (u) which of CIHR’s peer review committees includes a Canadian living with an eating disorder; and (v) what consideration, if any, has been given to a (i) national eating disorders awareness and education campaign, (ii) pan-Canadian strategy to address eating disorders, including early diagnosis and access to the full range of necessary care, (iii) national registry, (iv) robust research program?

With respect to the chronic cerebrospinal venous insufficiency (CCSVI) clinical trial being undertaken by Dr. Traboulse: (a) what milestones are reportable to the government, (i) on what date(s) is reporting expected to occur, (ii) how will this information be communicated to patients, the medical community, and the general public; (b) on what date did each of the trial sites pass ethical review; (c) on what date did recruitment of patients begin for each of the trial sites; (d) how many patients with multiple sclerosis (MS) are being recruited for each site, and how is consistency in diagnosis and treatment being ensured across sites; (e) who is performing the diagnoses for CCSVI for each site, (i) how is the diagnosis being performed, including, but not limited to, ultrasound and venogram, (ii) how many diagnoses has each person undertaking the diagnosis at each site performed prior to the study, and by whom was each person trained; (f) who is performing the procedures for each site, (i) how is the procedure being performed, including, but not limited to, anesthetic, balloon size, (ii) how many procedures has each person undertaking the procedure at each site performed prior to the study, and by whom was each person trained; (g) what are the selection criteria for the trial, including, but not limited to, type of MS, Expanded Disability Status Scale (EDSS) score, venous abnormality/malformed valve/stenosis, mobility, (i) how do these criteria compare with the international literature, (ii) with how many international studies to date will the selection criteria be analytically comparable; (h) if both progressive and relapsing-remitting forms of MS are to be examined in the trial, how will statistical significance be ensured given that 50 of 100 patients will undergo a “sham” procedure, 25 patients will have a progressive form of the disease, and 25 will have a relapsing-remitting form of the disease, and will people with both primary progressive and secondary progressive forms of the disease be included, and if so, how will statistical significance be ensured; (i) given that research has shown numerous venous abnormalities in the head, neck, and chest of MS patients, (i) how will statistical significance be ensured if there are only a limited number of patients, but multiple types of venous or valvular abnormality, (ii) how will a venous stenosis be measured (e.g. diameter, size); (j) what outcomes will be measured, including, but not limited to, EDSS, Modified Fatigue Impact Scale, Multiple Sclerosis Impact Scale, and Multiple Sclerosis Quality of Life Inventory, and at what time scales; (k) will patient-reported quality of life scores be included, and if so, what is the specific methodology; (l) what specific follow-up care will patients undergoing the “sham” procedure and treatment receive, and at what specific time periods; (m) if patients received the “sham” procedure, within what time period will they receive treatment; (n) how will the results of this study be interpreted within the growing international body of research, (i) to how many studies will this study be compared, (ii) to how many studies will this study be directly comparable; (o) what long-term follow-up will those enrolled in the trial receive and for what time period; (p) what is the cost of the trial, and what are each of the partners contributing, including, but not limited to funding, equipment, expertise, pharmaceutical products; (q) what is the cost of each diagnosis, (i) what is the cost of each “sham” procedure, (ii) what is the cost of each procedure; and (r) who is overseeing the trial, (i) the safety of the patients, (ii) the integrity of the results?

With regard to The Royal Society of Canada (RSC) Expert Panel on Safety Code 6: (a) which department and persons within the government were responsible for contracting RSC to conduct the expert panel; (b) what were the criteria for selecting an organization to conduct the expert panel; (c) what is the mandate of the expert panel; and (d) why was the sentence “certain members of the general public may be more susceptible to harm from microwave exposure” removed from the 2009 Safety Code 6 update and will it be included in this year’s update of Safety Code 6 following the conclusion of RSC Expert Panel on Safety Code 6?

With regard to Health Canada’s Radiofrequency Exposure Guidelines known as Safety Code 6: (a) how was the code established; (b) does the code deal with potential dangers from all electromagnetic devices; (c) what is the distinction between thermal and non-thermal effects of exposure to radiofrequency (RF) energy; (d) does existing research on the thermal effects of exposure to RF energy adequately determine whether such exposure is safe for humans; (e) does existing research on the non-thermal effects of exposure to RF energy adequately determine whether such exposure is safe for humans; (f) what work is Health Canada undertaking to remedy the uncertainty surrounding the non-thermal effects of exposure to RF energy by carrying out additional research into the non-thermal effects of exposure to RF energy; and (g) are changes to the code planned to include the most up-to-date scientific research on devices such as Hydro “smart” meters?

With regard to the Royal Society of Canada’s Expert Panel on Potential Health Risks of Radiofrequency Fields from Wireless Telecommunication Devices, commissioned by Health Canada: (a) for the period of 1990-2012, how have panel members been selected; (b) for the period of 1990-2012, what has been the composition of the Panel by (i) professional background, (ii) regional origin; (c) are any conflict of interest provisions imposed on committee members and, if so, what are they; and (d) with regard to the conflict of interest provisions referred to in (c), who determines if they apply?

With respect to the Ebola vaccine developed at the National Microbiology Laboratory (NML): (a) on what date did research for the vaccine begin; (b) what are the names of the scientists involved in the research, and what are their positions; (c) why was the vaccine research initially undertaken; (d) was the research undertaken at any time in relation to anti-bioterrorism, and, if so, during what periods and with what specific mandate; (e) who provided funding for the research and development of the vaccine; (f) was the Government of Canada the only contributor to the research and development fund; (g) how much funding did the government provide, broken down by (i) percentage, (ii) department, (iii) date, (iv) dollar amount of contribution; (h) on what date was a robust immune response demonstrated to the vaccine; (i) on what date were research findings published and in what journal, and, if none were published, why not; (j) on what date was the vaccine patented and when was the initial patent application brought; (k) in which countries is the vaccine patented; (l) during what specific time period was the vaccine produced, (i) how many vials were produced, (ii) who was informed of this production, (iii) how were they informed; (m) was there a competitive process to sell the licensing rights or other entitlements relating to the vaccine; (n) if the process in (m) was created, (i) who developed the criteria for the licensing rights or other entitlements, broken down by position and department, (ii) what were the criteria to obtain the licensing rights or other entitlements, (iii) on what date was the competitive process launched, (iv) how many companies bid for the rights, (v) which companies bid for the rights and on what dates, (vi) how did NewLink Genetics (including Bioprotection Systems Corporation) meet the criteria for the licensing rights or other entitlements; (o) on what date was NewLink Genetics awarded the rights or entitlements; (p) what specific experience did NewLink Genetics have with vaccines, specifically when it comes to manufacturing capacity; (q) what NewLink Genetics products had reached the point of commercial production at the time of its bidding and purchase of the rights; (r) on what date did NewLink Genetics purchase the rights or entitlements from the Public Health Agency of Canada (PHAC), and for what cost; (s) as part of the licensing agreement, was NewLink Genetics expected to meet any milestones by any particular dates, (i) if so, when, (ii) if not, why not; (t) as part of the licensing agreement, what percentage royalties would NewLink Genetics pay Canada on any sales of the vaccine; (u) to date, how much income has the government obtained from licensing the vaccine, broken down by (i) up-front payments, (ii) milestone payments, (iii) any other payments; (v) did any of the NML or PHAC scientists/staff have any associations or links or monetary or proprietary interests or any other association with NewLink Genetics, and, if so, what are they; (w) did Canadian officials and the licensee meet annually in face-to-face meetings as required by Article 7.9 of the license agreement, and, if so, for all meetings, what is (i) the date, (ii) location, (iii) the names of all persons in attendance; (x) on what date did NewLink Genetics begin clinical trials of the vaccine; (y) how long was the delay between the onset of the commercial relationship with NewLink Genetics and start of clinical trials, broken down by (i) days, (ii) months, (iii) years; (z) what reason was given for the delay in (y); (aa) did the government question the progress of the clinical trials, if so, on what specific dates, and, if not, why not; (bb) in Canada's licensing agreement with NewLink Genetics, did Canada have the right to let other manufacturers make the vaccine for use in other countries "for compassionate care purposes" if NewLink had not received regulatory approval for the vaccine in the target country; (cc) did anyone in Canada urge the government to terminate its agreement with NewLink Genetics, and, if so, (i) who did so, (ii) on what dates, (iii) why; (dd) did anyone outside Canada request that Canada cancel NewLink's rights under the license, and, if so, (i) who did so, (ii) on what dates, (iii) why; (ee) did the government terminate the agreement, (i) if so, why, (ii) if not, why not; (ff) if the government terminated the agreement with NewLink Genetics, would Merck have paid the government the $30 million up front and $20 million once larger formal trials begun that went to NewLink Genetics, and would the government have been eligible to receive royalties on sales in certain markets; (gg) did the government approve of NewLink Genetics sub-licensing the vaccine to Merck; (hh) on what date did the government pay for IDT Biologika, to manufacture approximately 1 500 vials of the vaccine suitable for human trials, (i) how much was paid, (ii) was the Department of Defence involved, and, if so, why, (iii) did the Department of Defence contribute any funds; (ii) on what date did the Ebola outbreak begin in West Africa; (jj) on what date did the government reveal it had in storage an experimental vaccine that might be of use in combating the epidemic; (kk) on what date did the government offer vaccine to the World Health Organization (WHO); (ll) how many vials were sent to the WHO by the government, (i) on what date did the vials arrive, (ii) were there any delays; (mm) what are the results of the eight, phase l clinical trials in terms of (i) safety, (ii) immunogenic response, (iii) dose strength for phase 2/3 clinical trials; (nn) on what date did phase 2/3 clinical trials begin in Guinea, Liberia, and Sierra Leone; and (oo) what was the government’s involvement overall, broken down by (i) expertise, (ii) funding, (iii) personnel, (iv) other?