Search

Cognitive fatigability is an objective performance decrement that occurs over time during a task requiring sustained cognitive effort. Although cognitive fatigability is a common and debilitating symptom in multiple sclerosis (MS), there is currently no standard for its quantification. The objective of this study was to validate the Paced Auditory Serial Addition Test (PASAT) discrete and regression-based normative data for quantifying performance and cognitive fatigability in an Ontario-based sample of individuals with MS. Healthy controls and individuals with MS completed the 3″ and 2″ versions of the PASAT. PASAT performance was measured with total correct, dyad, and percent dyad scores. Cognitive fatigability scores were calculated by comparing performance on the first half (or third) of the task to the last half (or third). The results revealed that the 3″ PASAT was sufficient to detect impaired performance and cognitive fatigability in individuals with MS given the increased difficulty of the 2″ version. In addition, using halves or thirds for calculating cognitive fatigability scores were equally effective methods for detecting impairment. Finally, both the discrete and regression-based norms classified a similar proportion of individuals with MS as having impaired performance and cognitive fatigability. These newly validated discrete and regression-based PASAT norms provide a new tool for clinicians to document statistically significant cognitive fatigability in their patients. [ABSTRACT FROM AUTHOR]

Background: Multiple sclerosis (MS) has been associated with certain comorbidities in general population studies, but it is unknown how comorbidity may affect immigrants with MS. Objective: To compare prevalence of comorbidities in immigrants and long-term residents at MS diagnosis, and in matched control populations without MS. Methods: We identified incident MS cases using a validated definition applied to health administrative data in Ontario, Canada, from 1994 to 2017, and categorized them as immigrants or long-term residents. Immigrants and long-term residents without MS (controls) were matched to MS cases 3:1 on sex, age, and geography. Results: There were 1534 immigrants and 23,731 long-term residents with MS matched with 4585 and 71,193 controls, respectively. Chronic obstructive pulmonary disease (COPD), diabetes, hypertension, ischemic heart disease, migraine, epilepsy, mood/anxiety disorders, schizophrenia, inflammatory bowel disease (IBD), and rheumatoid arthritis were significantly more prevalent among immigrants with MS compared to their controls. Prevalence of these conditions was generally similar comparing immigrants to long-term residents with MS, although COPD, epilepsy, IBD, and mood/anxiety disorders were less prevalent in immigrants. Conclusion: Immigrants have a high prevalence of multiple comorbidities at MS diagnosis despite the "healthy immigrant effect." Clinicians should pay close attention to identification and management of comorbidity in immigrants with MS. [ABSTRACT FROM AUTHOR]

Canada has one of the highest rates of multiple sclerosis (MS) in the world, affecting 1 in every 385 individuals. This neurodegenerative condition is unpredictable and variable in symptom profile and disease course making it difficult to manage. Canadians with MS are high users of healthcare services; however, they report multiple unmet needs, high disease burden, and low satisfaction with healthcare. Access to healthcare is vital to health maintenance and may explain these poor experiences. Access is often measured using utilisation as a proxy, which may fail to capture the complexities of access experiences that this population faces. The Candidacy Framework offers an alternative to utilisation measures, by examining the process of accessing care, while considering the impact of social patterning and health system environments on this process. The aim of the current study is to align the experiences of persons with MS in accessing healthcare services with the stages of the Candidacy Framework. Forty‐eight individuals with MS living across Ontario were recruited to participate in one of five focus groups or ten individual interviews. Analysis included a first inductive phase, using constant comparative methods, followed by a deductive phase, using content analysis. The Candidacy Framework was not able to capture all experiences shared by persons with MS, including patient‐centred care, past experiences and outcome expectation, and care outcomes. We propose these concepts be included as refinements to the current Framework, providing a more thorough explanation of the experiences of persons with MS in accessing care to manage their condition. [ABSTRACT FROM AUTHOR]

Background: The Canadian Physical Activity Guidelines for Adults with Multiple Sclerosis (PAGs) were released in 2013 but have yet to be validated. We aimed to test the effectiveness of the PAGs in improving fitness, mobility, fatigue symptoms, and quality of life (QOL) in a large cohort of adults with multiple sclerosis (MS). Methods: As part of an ongoing randomized controlled trial examining implementation of the PAGs, participants were randomized to either a direct referral group (physician referral to an exercise program following the PAGs; n = 42) or a control group (provided a print copy of the PAGs; n = 37). Physical activity behavior was assessed through weekly physical activity logs. Fitness, mobility, fatigue symptoms, and QOL were assessed at baseline and after 16 weeks. Participants were categorized as either PAG adherers (n = 30) or nonadherers (n = 49) to the PAGs based on achieving the weekly exercise recommendations at least 75% of the time. Results: Adherence to the PAGs was twice as high in the referral group compared with the control group. Adherers experienced significantly greater improvements in peak oxygen consumption (29%), strength (7%-18%), mobility (16%), fatigue symptoms (--36%), and QOL (17%-22%) compared with nonadherers (P < .05). Conclusions: Following the PAGs for at least 12 of 16 weeks results in improvements in fitness, mobility, fatigue symptoms, and QOL, confirming their effectiveness for improving health in people with MS. [ABSTRACT FROM AUTHOR]

Trait personality has been associated with achievement and many of its related outcomes in settings such as education, health, physical activity and sport. Scant trait personality research has been performed among school-age students in physical education, so this study investigates relations between the six-dimension (HEXACO) model of trait personality and anxiety, self-efficacy and intentions to exercise as a function of gender in 316 high school physical education students. Students completed validated measures of these constructs. Results revealed that trait personality (particularly the social self-esteem aspect of extraversion) predicted lower anxiety and higher self-efficacy and intentions to exercise in both females and males. Openness to experience was predictive of both anxiety and lowered self-efficacy in females. It appears that physical educators should consider the role of the HEXACO personality traits and sub-traits in their students and potentially differentiate instruction to better accommodate students who are more vulnerable. From this study, it appears that students who are less extraverted and females who are more open to experience may be at be more at risk for anxiety and lower self-efficacy in physical education which may compromise their intentions to exercise. [ABSTRACT FROM AUTHOR]

Although it is well understood that relationships are linked to healthy development and academic success, research on socialization during recess is limited. From the conceptual framework of belonging, an array of established measures was used to create an online anonymous survey specific to recess. This survey includes modified scales for belongingness, affect, and victimization and discrete items about the social and physical setting. The survey was completed by 520 students from grades 4 through 8. Exploratory and confirmatory factor analyses revealed an excellent fit of the belongingness scale to the data. Victimization related inversely to belongingness and positive affect and predicted negative affect and low belongingness. The article concludes with implications and recommendations for researchers and school-based professionals. [ABSTRACT FROM AUTHOR]

This paper describes a revised measure of self-efficacy to overcome barriers to moderate and vigorous physical activity in a sample of 484 high school students in Toronto, Ontario. The students had a mean age of 15.3 years. Principal axis factoring with oblique rotation yielded five factors: self-efficacy to overcome internal, harassment, physical environment, social mvironment, and responsibilities barriers. Two problematic items were removed, which resulted in a 22-item measure. Subsequent analyses were conducted on responses to this shortened measure. Confirmatory factor analysis supported the five-factor model and demonstrated age- and sexinvariance. The subscales had good internal consistency reliability. Structural regressions demonstrated a strong relationship between the resulting factors and a physical activity measure (energy expenditure), showing predictive validity. [ABSTRACT FROM AUTHOR]

This study examined the effects of making access to television (TV) viewing contingent on physical activity on the liking and reinforcing value of TV and attitudes towards physical activity in overweight and obese children. Secondary data analysis from a randomized controlled trial designed to increase physical activity and reduce TV viewing in 30, 8-12 years old overweight or obese children by making access to TV contingent on physical activity (intervention) or free access to TV (control). Liking of TV and physical activity was measured by a 100 point visual analog scale, while the relative reinforcing value of TV in relation to physical activity was assessed using a questionnaire based on behavioural choice paradigm that provided children an opportunity to work (button presses) to gain access to TV or physical activity according to a progressive ratio schedule of reinforcement. Enjoyment, Adequacy, Predilection and Motivation for physical activity was assessed by self-report questionnaire. Making access to TV contingent on physical activity showed a trend that approached statistical significance towards increased enjoyment of physical activity and did not adversely affect change in the liking or the relative reinforcing value of TV viewing. Making access to TV contingent on physical activity had no adverse effects on the liking or reinforcing value of TV and even showed a suggestive effect of increased enjoyment of physical activity. Thus, given this intervention markedly increased physical activity and reduced TV viewing in overweight and obese children, long-term evaluations of this interventions to assess sustainability of these behavioral changes and associated health benefits are warranted. [ABSTRACT FROM AUTHOR]