Appropriateness and Consciousness in Community Based Rehabilitation through Participatory Action Research

Community-based rehabilitation (CBR) in Phuttamonthon District, Nakhonpathom Province, one of the metropolitan areas located in central Thailand, was examined in terms of factors influencing existence of CBR and movement of CBR participants through Participatory Action Research (PAR). The results showed some factors and consciousness or intentionality within the CBR phenomena, which could effect the sustainability of CBR. Thus, WHO’s concept of CBR may be redefined: CBR is not only a static strategy but also dynamic consciousness within a community

Evaluation of Master of Arts Program in Rehabilitation Counseling and Guidance Service for Persons with Disabilities in Thailand

This research examines the positive and negative aspects of the Master’s Degree in Rehabilitation Counseling and Guidance for persons with disabilities in Thailand, since it began in 1997. A CIPP model was utilized for the program evaluation. Multiple methods were used to collect the data, and both retrospective and prospective data collection were undertaken. The research results indicated many positive outcomes. They also indicated certain features of rehabilitation within the Thai context differed significantly from traditional rehabilitation counseling programs in Western countries

Mindfulness based interventions in multiple sclerosis: a systematic review

<b>Background</b> Multiple sclerosis (MS) is a stressful condition; depression, anxiety, pain and fatigue are all common problems. Mindfulness based interventions (MBIs) mitigate stress and prevent relapse in depression and are increasingly being used in healthcare. However, there are currently no systematic reviews of MBIs in people with MS. This review aims to evaluate the effectiveness of MBIs in people with MS.<p></p> <b>Methods</b> Systematic searches were carried out in seven major databases, using both subject headings and key words. Papers were screened, data extracted, quality appraised, and analysed by two reviewers independently, using predefined criteria. Study quality was assessed using the Cochrane Collaboration risk of bias tool. Perceived stress was the primary outcome. Secondary outcomes include mental health, physical health, quality of life, and health service utilisation. Statistical meta-analysis was not possible. Disagreements were adjudicated by a third party reviewer.<p></p> <b>Results</b> Three studies (n = 183 participants) were included in the final analysis. The studies were undertaken in Wales (n = 16, randomised controlled trial - (RCT)), Switzerland (n = 150, RCT), and the United States (n = 17, controlled trial). 146 (80%) participants were female; mean age (SD) was 48.6 (9.4) years. Relapsing remitting MS was the main diagnostic category (n = 123, 67%); 43 (26%) had secondary progressive disease; and the remainder were unspecified. MBIs lasted 6–8 weeks; attrition rates were variable (5-43%); all employed pre- post- measures; two had longer follow up; one at 3, and one at 6 months. Socio-economic status of participants was not made explicit; health service utilisation and costs were not reported. No study reported on perceived stress. All studies reported quality of life (QOL), mental health (anxiety and depression), physical (fatigue, standing balance, pain), and psychosocial measures. Statistically significant beneficial effects relating to QOL, mental health, and selected physical health measures were sustained at 3- and 6- month follow up.<p></p> <b>Conclusion</b> From the limited data available, MBIs may benefit some MS patients in terms of QOL, mental health, and some physical health measures. Further studies are needed to clarify how MBIs might best serve the MS population.<p></p&gt

Anti–3‐hydroxy‐3‐methylglutaryl‐coenzyme a reductase autoantibody‐positive necrotizing autoimmune myopathy with dermatomyositis‐like eruption

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/143804/1/mus26072.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/143804/2/mus26072_am.pd

COVID-19-associated risks and effects in myasthenia gravis (CARE-MG)

During the COVID-19 pandemic, patients with neuromuscular disorders, especially patients with autoimmune myasthenia gravis, might be at greater risk of worse outcomes than otherwise healthy people because of an immunocompromised state related to immunotherapy and possible respiratory and bulbar muscular weakness

Serial anthropometry predicts peripheral nerve dysfunction in a community cohort

Background Obesity is a risk factor for glucose intolerance, but the independent role of obesity in the development of peripheral neuropathy is unclear. This study assessed the impact of body size trajectories on prevalent nerve dysfunction in community‐dwelling women with and without glucose intolerance. Methods Annual (1996–2008) anthropometric measures of weight, height, waist circumference and body mass index [BMI, weight (kg)/height (m 2 )] were assessed in the Study of Women's Health Across the Nation – Michigan site. Glucose intolerance was defined annually on the basis of current use of diabetes medications, self‐reported diabetes diagnosis and, when available, fasting glucose. Peripheral nerve dysfunction in 2008 was defined as abnormal monofilament testing or ≥4 symptoms or signs. Linear mixed models were used to determine trajectories of anthropometry by subsequently identified nerve dysfunction status. Results Mean BMI was 32.4 kg/m 2 at baseline, and 27.8% of the women had nerve dysfunction in 2008. BMI, weight and waist circumference increased over time. Women who would have nerve dysfunction were significantly larger than women without dysfunction, independent of glucose intolerance. At mean baseline age of 46, BMI, weight and waist circumference differed significantly ( p ‐value < 0.01) by subsequent nerve dysfunction status, independent of glucose intolerance and hypertension. These body size differences were maintained but not exacerbated over time. Conclusions Peripheral nerve dysfunction is prevalent among community‐dwelling women. Twelve years before the nerve assessment, anthropometry differed between women who would and would not have nerve dysfunction, differences that were maintained over time. Obesity deserves attention as an important and potentially modifiable risk factor for peripheral nerve dysfunction. Copyright © 2012 John Wiley & Sons, Ltd.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/96327/1/dmrr2367.pd

Mindfulness-based stress reduction for people with multiple sclerosis ? a feasibility randomised controlled trial

Background: Multiple sclerosis (MS) is a stressful condition. Mental health comorbidity is common. Stress can increase the risk of depression, reduce quality of life (QOL), and possibly exacerbate disease activity in MS. Mindfulness-Based Stress Reduction (MBSR) may help, but has been little studied in MS, particularly among more disabled individuals. Methods: The objective of this study was to test the feasibility and likely effectiveness of a standard MBSR course for people with MS. Participant eligibility included: age &#62; 18, any type of MS, an Expanded Disability Status Scale (EDSS) &#60;/= 7.0. Participants received either MBSR or wait-list control. Outcome measures were collected at baseline, post-intervention, and three-months later. Primary outcomes were perceived stress and QOL. Secondary outcomes were common MS symptoms, mindfulness, and self-compassion. Results: Fifty participants were recruited and randomised (25 per group). Trial retention and outcome measure completion rates were 90% at post-intervention, and 88% at 3 months. Sixty percent of participants completed the course. Immediately post-MBSR, perceived stress improved with a large effect size (ES 0.93; p &#60; 0.01), compared to very small beneficial effects on QOL (ES 0.17; p = 0.48). Depression (ES 1.35; p &#60; 0.05), positive affect (ES 0.87; p = 0.13), anxiety (ES 0.85; p = 0.05), and self-compassion (ES 0.80; p &#60; 0.01) also improved with large effect sizes. At three-months post-MBSR (study endpoint) improvements in perceived stress were diminished to a small effect size (ES 0.26; p = 0.39), were negligible for QOL (ES 0.08; p = 0.71), but were large for mindfulness (ES 1.13; p &#60; 0.001), positive affect (ES 0.90; p = 0.54), self-compassion (ES 0.83; p &#60; 0.05), anxiety (ES 0.82; p = 0.15), and prospective memory (ES 0.81; p &#60; 0.05). Conclusions: Recruitment, retention, and data collection demonstrate that a RCT of MBSR is feasible for people with MS. Trends towards improved outcomes suggest that a larger definitive RCT may be warranted. However, optimisation changes may be required to render more stable the beneficial treatment effects on stress and depression. Trial registration: ClinicalTrials.gov Identifier NCT02136485; trial registered 1st May 2014