1,721,174 research outputs found
Mind and body therapy for fibromyalgia
No full textThis is the protocol for a review and there is no abstract. The objectives are as follows:1. To review the efficacy of mind and body therapies in comparison to standard care2. To review the efficacy of mind and body therapies in comparison to an attention placebo3. To review the comparative efficacy of different types of mind and body therapies4. To compare the efficacy of mind and body therapies at 1, 3 and 6 month follow-u
Validity of Symptom Reporting Following Mild Traumatic Brain Injury
No full textObjective: Recent evidence of persistent reporting of symptoms after mild Traumatic Brain Injury (mTBI) has come under question, with the suggestion that participants may be over-reporting symptoms more generally. This study set out to determine the proportion of people reporting atypical symptoms and to explore the relationship between acute (1 month) atypical symptom reporting and perceptions of recovery and experience of typical symptoms following mTBI.
Methodology: Data was drawn from the longitudinal population-based Brain Injury Incidence and Outcomes New Zealand (NZ) in the Community (BIONIC) study that was conducted in the Hamilton and Waikato districts. Cases included patients who had experienced a traumatic brain injury between the 1 st March 2010 and 28th February 2011. Cases were identified from the ACC database, community healthcare services, such as general practitioners (GPs) and physiotherapists, hospital admissions and discharges, sports clubs, concussion clinics and self-referrals. Participants completed the Rivermead Post-Concussion Questionnaire (RPQ) assessment at one month (n = 261) and twelve months post-injury (n = 193), in addition to data on a series of distractor (atypical) symptoms. Typical symptoms generally relate to post-concussion symptoms, while atypical symptoms do not form part of a concussion clinical presentation. Characteristics of the sample were analysed and the proportion of participants reporting atypical and typical mTBI symptoms were explored at both timepoints. T-tests were used when data satisfied parametric assumptions; if not satisfied, the Chi square tests tested non-parametric equivalent statistics (for nominal/categorical variables). The significance level was set at p <0.05. A regression analysis determined whether increased atypical symptoms reported at one month predicted persistent symptoms and perceptions of recovery at twelve months.
Results: Data was available for n = 261 participants at one month and n = 193 at twelve months. Atypical symptoms were reportedly experienced by 25% of participants at one month and 16% of participants at twelve months. Atypical symptom reporting was higher in females than males. Sex, ethnicity, atypical symptoms and typical symptoms at one month following mTBI were significantly predictive of the one-year outcome, explaining 46% in the variance in typical post-concussion symptoms and 31 % of the variation in perceptions of recovery.
Conclusion: One in four people reported atypical symptoms in the acute phase (intense symptoms at one month) post-injury, which reduced over time (twelve months). However, the models did not explain all the variance in the outcome, and other factors are likely to influence outcomes from mTBI. Given links to symptom reporting and perceptions of recovery at twelve months post-injury, acute atypical symptom reporting could be a red flag to indicate those who may experience poorer long-term outcomes and require additional support to facilitate recovery
Pharmacological and Non-Pharmacological Treatment in People Living with Myotonic Dystrophy in NZ
No full textThis study aimed to investigate the type and funding of pharmacological and non-pharmacological medications taken by people diagnosed with myotonic dystrophy (DM) in NZ, and to explore the factors associated with medication use.
Data on 213 individuals with a confirmed diagnosis of myotonic dystrophy identified through a nationwide population-based prevalence study, MDPrev, were extracted. Socio-demographic information, details of funded, non-funded prescription medications they were taking or not taking as well as use of herbal or vitamin supplements, nutritional supplements and complementary therapies were analysed. Chi square and t-tests were used to determine any differences between those who were taking medication and those who weren’t to identify any associations between demographic characteristics and medication use. Correlation analysis was then performed and a regression model to determine predictors of medication use.
The findings revealed that medication use amongst individuals with myotonic dystrophy was high, with a number of associated comorbidities and symptoms being treated simultaneously. There were 120 different prescription medicines identified and grouped according to the WHO ATC/DDD classification. Some participants reported taking up to 13 medications with the majority taking up to four different medications. Use of some medications, for example modafinil, was low in NZ, potentially due to this being an unfunded medication in NZ. Modafinil is recommended for managing symptoms common in myotonic dystrophy, such as excessive daytime sleepiness. The study suggests therefore that funding of medicines that have strong evidence for in international literature, could make a difference in management of the symptoms associated with this condition more effectively in NZ. Use of herbal, nutritional and complementary therapies was diverse and low.
The study highlighted that access to neurology services was a major predictor of medication use. There are only 8 centres in NZ with neurology clinics, access to neurology services needs to be considered for individuals with myotonic dystrophy who are not within easy reach of one of these centres, or by funding and making available more clinics throughout the country. Given the high use and frequency of medications used by people with myotonic dystrophy, increased access medication-review services through community pharmacies could assist in the effective medication use and management of symptoms. In alignment with current literature, this study also suggests that a multidisciplinary approach to management of a complex and multi-systemic chronic progressive condition like myotonic dystrophy may be more effective, and perhaps setting up of neuromuscular clinics that involve a wide range of specialists such as cardiology and gastroenterology, is likely to make significant difference to prescribing and use of appropriate medication
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Concussion Awareness in Youth and Young Adults Engaged in Equestrian Sports in New Zealand
No full textEngagement of people in physical activity has benefits for both physical and mental health. However, there is also an increased risk of injury, including traumatic brain injuries (TBI) and concussion. Whilst considerable attention has been given to addressing concussion in contact sports such as rugby, high rates of TBI's have also been found in people engaging in equestrian activities. There is limited research on concussion awareness in equestrian sports to inform prevention initiatives. This present research has looked at concussion awareness and helmet use within youth and young adults engaged in equestrian sports in New Zealand, through use of an anonymous, online, cross sectional questionnaire. A sample of 258 youth and young adults involved in equestrian sports completed the online survey. Participants displayed good overall knowledge of concussion symptoms, however some gaps were found to exist. Discrepancies between attitude and behavior about concussion management were also found, particularly in relation to helmet use and returning to riding and school. Current concussion education programmes would benefit from using a multi layered approach that address some of the social elements that have been shown to impact attitude, and are particularly salient for the youth and young adult cohort. Additionally a unified set of concussion guidelines that extends across all sports would help to minimize the confusion surrounding concussion management and return to sport rules
Employment Status and Work Performance in Adults With Myotonic Dystrophy
No full textAims
The primary aims of this study were to identify the rates of employment (defined as the number of people in paid employment) and factors influencing work performance in adults with myotonic dystrophy. The secondary aim was to determine time loss from work due to their health.
Study Design
This cross-sectional study drew upon data collected from a broader study exploring the prevalence and outcomes of genetic muscle disorders in New Zealand (MD-Prev). This study extracted the demographic, diagnostic and questionnaire data for adults (aged ≥16 years) diagnosed with myotonic dystrophy type 1 and 2 from the MD-Prev database.
Participants
The MD-Prev study identified 327 adults with a confirmed diagnosis of myotonic dystrophy in New Zealand. They were all invited to participate in a multi-domain assessment, and 202 participants consented.
Outcome Measures
The Work Limitations Scale (WLQ-25) was used to measure work performance. Personal, occupational and environmental factors were considered in the analysis of work performance. This holistic view included measures to address self-efficacy, mood, cognition, physical functioning, pain, fatigue, sleep and support. A Spearman correlation helped identify factors associated with work performance. A Mann-Whitney U test compared data between those employed and unemployed to determine if there was a significant difference between these groups that could explain employment status. A chi-square test compared age, gender, ethnicity, and type of myotonic dystrophy between participants and non-consenters.
Results
Out of 202 participants, only 69 were employed at the time of the study. Despite a low employment rate, 73% had not taken time off work due to their health in the previous fortnight.
Physical and mental-interpersonal demands of a job affected work performance for 62.1% and 57.4% of the sample. Over 50% of those working reported no difficulty in time management (56.7%), and work-output (55.9%), which indicates participants are performing well in certain aspects of their job demands. Pain and fatigue impacted significantly on meeting work demands followed by depression, cognition, sleep, and physical functioning.
Age, gender and ethnicity did not influence employment status. However, there was a significant difference in ethnicity between those who did and did not participate in the assessments suggesting caution in the representation of findings for people of non-European ethnicity. Participants who completed tertiary education had a greater chance of employment with 56.5% of them in professional roles.
Conclusion
This study builds on previous research and highlights that people with myotonic dystrophy are a minority group in the New Zealand labour sector. Work performance was most disturbed at the physical level, with fatigue and pain being the main factors influencing all domains of work performance. Addressing pain and fatigue management in addition to symptoms of depression, cognition and environmental barriers may facilitate work performance and productivity. Encouragingly many people employed in this study were performing well in most aspects of their role.
These findings may provide insight for health professionals, disability services, and employers when supporting a person with myotonic dystrophy into sustainable careers that will accommodate their long-term capabilities as their condition progresses.
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