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Introduction: Migraine is a complex neurological condition which requires evidence based treatment, tailored to the individual. International evidence shows that treatment is often sub-optimal, but the experience of people with migraine in NZ is unknown. Aim: This study aimed to describe the barriers people with migraine disease face when seeking care for their condition in Aotearoa New Zealand (NZ). Methods: The Migraine in Aotearoa New Zealand Survey (MiANZ) was delivered online via SurveyMonkey from 22 August 2022 to 7 October 2022. Questions included: sociodemographics, the Migraine Disability Assessment Scale (MIDAS), ability to access health care, perception of health professionals' knowledge and open-ended questions. Analysis used a mixed method approach. Results: Five hundred and thirty people from NZ responded, of whom 82% (433/530) were female and 77% (409/530) NZ European/other. Eighty-eight percent (467/530) had accessed primary care for migraine, with 36% (167/467) finding GPs' knowledge of migraine to be excellent or very good. Forty-two percent (222/530) reported at least one instance where they had felt judged because of migraine by a health professional. Themes from free-text data included patient perception of health professionals' knowledge of migraine, the presence of stigma within medical practice and systemic barriers to accessing effective health care. Discussion: People with migraine in NZ report significant barriers when trying to access effective management. Barriers were in both primary and secondary care and impacted the ability of people with migraine to manage their condition. More current migraine continuing medical education for GPs and other health professionals, better development and communication of care plans between primary and secondary care and patients and measures to address stigma are required to improve management of this complex disease. What is already known: International research shows that people with migraine face significant barriers to accessing effective management. Known barriers include expense of health care and treatments, lack of or misdiagnosis and inadequate access to and communication of effective treatment strategies. What this study adds: This is the first study in Aotearoa New Zealand to document barriers to effective migraine management. Findings are taken from the perspective of people with migraine. Issues were identified in a range of areas including health professional knowledge and training, poor interface between primary and secondary care, inadequately communicated care plans and patients feeling stigmatised by health professionals. We offer recommendations to improve access to effective migraine management. [ABSTRACT FROM AUTHOR]

Trigeminal neuralgia (TN) associated with brainstem lesions as revealed by Magnetic resonance imaging (MRI), is a rare condition. The MRI often shows a distinctive single pontine in cases of TN (SPL-TN). While the significance of this MRI finding remains unclear, various case reports suggest a potential link to chronic injury in the pontine pathways of the trigeminal nerve. In this report, we present the case of a 42-year-old female who was referred for TN that is refractory to medical treatment with an ipsilateral MRI lesion over the pons who had an excellent response to a trigeminal nerve bock, shedding light on the intriguing interplay between TN and pontine lesions.

Type 2 diabetes mellitus, an endocrine disorder, and Parkinson's disease, a neurological condition, are common diseases that negatively affect individuals' quality of life. The incidence of Parkinson's disease is typically higher in diabetic individuals than in non-diabetic individuals. Several studies have reported that the use of hypoglycemic agents (such as glibenclamide, tolbutamide, and glipizide) is associated with a reduced risk of Parkinson's disease in diabetic individuals. This study evaluated the effect of gliclazide in an experimental rat model. Rats were given a high-fructose diet for 14 d, followed by intraperitoneal administration of alloxan to induce diabetes, mimicking human conditions. All diabetic rats then received intraperitoneal haloperidol for the next 7 d to induce Parkinson's disease. The drugtreated group additionally received gliclazide. The effects of gliclazide on motor and cognitive functions were evaluated using the rotarod test, bar test, inclined plane test, Y-maze, and Morris water maze. Study findings showed that gliclazide counteracted the effects of the haloperidol and fructose-fed alloxan regimen on motor and cognitive function, as evidenced by a significant reduction in cataleptic score, latency time to reach the top of the inclined plane, and improved fall-off time in the rotarod test. Additionally, gliclazide reduced the latency to find the hidden platform in the Morris water maze and increased the percentage of alteration behavior in the Y-maze. In light of these results, gliclazide, a sulfonylurea, appears protective and could be a candidate for clinical trials in individuals using antidiabetic drugs, particularly those with early-stage Parkins on's disease. [ABSTRACT FROM AUTHOR]

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Nearly 3 million people in the UK have a neurological condition; stroke, traumatic brain injury, Parkinson's disease, multiple sclerosis, brain tumour, motor neurone disease, among others – all affecting the person for the rest of their life. The NHS provides treatment at the onset of a condition but after that, there is a huge need for ongoing support. Research shows that those who are supported and know more about their condition are less likely to have to call on further in-hospital and GP care. There is enormous scope for improving the quality of life for those with neurological conditions. The right support—therapeutic and social—makes all the difference. The book, which this article is based on, shows how those with neurological conditions benefit from integrated ongoing support provided in the local community and self-help, and how lives can be improved. It explains good practice and encouraging methods in the support and treatment of those with life changing conditions. [ABSTRACT FROM AUTHOR]

Abstract Background The poorer physical health of autistic adults compared to non-autistic adults has been highlighted by several epidemiological studies. However, research has so far been limited to specific geographical areas and has primarily focused on young autistic individuals (aged 35 years and younger). Recent studies indicate a higher rate of mortality in autistic people, as well as poorer quality of self-reported healthcare interactions. This study aims to determine, first, whether autistic people experience greater levels of non-communicable health conditions and second, whether these are explained by differences in demographics (i.e. sex, country of residence, ethnicity, education level), alcohol use, smoking, body mass index (BMI), or family history of medical conditions. Method We employed a cross-sectional, convenience-sampling study via an anonymous, online survey of autistic and non-autistic adults (n = 2305, mean age = 41.6, 65.9% female, 49% autistic). The survey asked participants to self-report information about their demographics, autism diagnosis, diet, exercise, sleep, sexual health, substance use, personal medical history, and family medical history (for all first-degree, biological relatives). Binomial logistic regression across four iterative models of increasing complexity was applied to assess rates of physical health conditions. The Benjamini–Hochberg correction was used to account for multiple testing, and only physical health conditions that achieved at least 1% endorsement within the overall sample (n > 22) were included in the analysis to reduce risk of Type I errors. We also used novel network analysis methods to test whether there are increased levels of multimorbidity between autistic and non-autistic people. Results There were significantly elevated rates of non-communicable conditions across all organ systems in autistic people, including gastrointestinal, neurological, endocrine, visual, ear/nose/throat, skin, liver and kidney, and haematological conditions. We confirmed previous findings by showing highly significant differences in rates of neurological and gastrointestinal symptoms (p

Neurodiversity activists have advocated for the inclusion of individuals with disabilities to represent their own needs; however, youth with neurological conditions continue to be excluded from the conversation. This study used photovoice with adolescents to explore what they learned and experienced at a Canadian sleepaway summer camp for youth with complex neurological conditions. Thirteen participants took photographs and discussed their pictures in an interview. The analysis of the qualitative data explored topics including skill building, friendship, and self-worth. The results of this study uncovered a previously discounted perspective regarding camp environments; insights from the participants themselves. Insights from the youth illustrate that there are different ways to think about camp, beyond respite for caregivers. The frequently overlooked perspectives explored by this research highlight the importance of engaging youth with neurological conditions in research and understanding their opinions on the programs they use. Children with disabilities have the right to freely express their opinion on the programs they access. We explored what adolescents learned throughout their time at a sleepaway summer camp specifically for youth with neurological conditions. A participatory photovoice methodology was used to allow youth to guide the research process and to explore their own thoughts and feelings about attending summer camp. This research shows that youth with neurological conditions can be active research participants and elucidate deep and profound insights into their experiences at summer camp. Youth described learning new skills such as how to socialize with peers, personal growth and development, and overarching life lessons such as gaining the confidence to be themselves. Engaging youth with neurological conditions is important to understand their perspectives on participating in services and be able to develop meaningful programs. [ABSTRACT FROM AUTHOR]

Multiple sclerosis (MS) can lead to numerous deficits in body functions, including balance and mobility impairment. This study examined the effect of lower back and lower extremity kinesiology tape (KT) application on static balance and physical functioning performance in people with MS (pwMS) and compared that to a non-elastic tape. This pilot randomized study recruited and enrolled 10 participants with MS that were allocated into two groups: kinesio (n = 6) and non-elastic (n = 4) tape. Participants were assessed with and without the respective tape on static balance with eyes open and closed and various physical function tests. Effect sizes for the Kinesio tape intervention were found to be small, while effect sizes for the sham tape/place condition varied from small to high. For both groups, the tendency was to reduce or maintain performance on the tests comparing tape and no tape. A subsequent, mixed-factor ANOVA revealed no significant difference between KT or sham tape/placebo. Our findings suggest that KT applied on lower back and lower extremity muscles does not seem to improve static balance and physical function performance in pwMS. [ABSTRACT FROM AUTHOR]

Copyright of Revista Latinoamericana de Hipertension is the property of Revista Latinoamericana de Hipertension and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The poorer physical health of autistic adults compared to non-autistic adults has been highlighted by several epidemiological studies. However, research has so far been limited to specific geographical areas and has primarily focused on young autistic individuals (aged 35 years and younger). Recent studies indicate a higher rate of mortality in autistic people, as well as poorer quality of self-reported healthcare interactions. This study aims to determine, first, whether autistic people experience greater levels of non-communicable health conditions and second, whether these are explained by differences in demographics (i.e. sex, country of residence, ethnicity, education level), alcohol use, smoking, body mass index (BMI), or family history of medical conditions. Method: We employed a cross-sectional, convenience-sampling study via an anonymous, online survey of autistic and non-autistic adults (n = 2305, mean age = 41.6, 65.9% female, 49% autistic). The survey asked participants to self-report information about their demographics, autism diagnosis, diet, exercise, sleep, sexual health, substance use, personal medical history, and family medical history (for all first-degree, biological relatives). Binomial logistic regression across four iterative models of increasing complexity was applied to assess rates of physical health conditions. The Benjamini–Hochberg correction was used to account for multiple testing, and only physical health conditions that achieved at least 1% endorsement within the overall sample (n > 22) were included in the analysis to reduce risk of Type I errors. We also used novel network analysis methods to test whether there are increased levels of multimorbidity between autistic and non-autistic people. Results: There were significantly elevated rates of non-communicable conditions across all organ systems in autistic people, including gastrointestinal, neurological, endocrine, visual, ear/nose/throat, skin, liver and kidney, and haematological conditions. We confirmed previous findings by showing highly significant differences in rates of neurological and gastrointestinal symptoms (p < 0.0001). In addition, we established in the largest sample to date that Ehler-Danlos Syndrome (EDS) was more likely to occur among autistic females compared to non-autistic females. Finally, we found a higher prevalence of Coeliac's disease among autistic individuals compared to non-autistic individuals after controlling for sex, ethnicity, country of residence, alcohol use, smoking, and BMI, but these results became non-significant after accounting for family history. Limitations: Our study is biased towards females, white individuals, highly educated people, and UK residents, likely due to sampling biases. Our self-report study design may also exclude those who lack access to computers, or those with intellectual disability. Our network analysis is also limited in size. Conclusions: This study provides evidence of widespread, physical health comorbidity that spans nearly all major organ systems in autistic adults compared to non-autistic adults, using both binary logistic regression and network models. Healthcare professionals must be made aware of the range of co-occurring physical health conditions that may be more common among autistic people. However, our findings also point towards potential avenues requiring further exploration, such as the association of autism with both Coeliac's disease and EDS. [ABSTRACT FROM AUTHOR]

BACKGROUND: Many overlapping factors impair motor performance and quality of life in neurological patients. Eccentric resistance training (ET) has potential benefits for improving motor performance and treating motor impairments better than some traditional rehabilitation approaches. OBJECTIVE: To estimate the effect of ET in neurological settings. METHODS: Seven databases were reviewed up to May 2022 according to PRSIMA guidelines to find randomized clinical trials involving adults with a neurological condition, who underwent ET as set by the American College of Sports Medicine. Motor performance (main outcome) was assessed as strength, power and capacities during activity. Secondary outcomes (impairments) were muscle structure, flexibility, muscle activity, tone, tremor, balance and fatigue. Tertiary outcomes were risk of fall, and self-reports of quality of life. RESULTS: Ten trials were included, assessed using Risk of Bias 2.0 tool, and used to compute meta-analyses. Effective effects in favour of ET were found for strength and power, but not for capacities during activity. Mixed results were found for secondary and tertiary outcomes. CONCLUSION: ET may be a promising intervention to better improve strength/power in neurological patients. More studies are needed to improve the quality of evidence underlying changes responsible for these results. [ABSTRACT FROM AUTHOR]

Objectives: We aimed to clarify the etiology, diagnostic process, and treatment of temporomandibular joint (TMJ) luxation, as the standard care is mainly based on case-reports and systematic studies are lacking. The hypotheses were that luxation occurs spontaneously, recurrence manifests particularly among geriatric patients, and surgery is needed infrequently. Patients and materials: A retrospective study of TMJ luxation patients (n = 260) from 2007 to 2020 was designed and implemented. The primary outcome was type of TMJ luxation (i.e., recurrent or non-recurrent), and secondary outcomes were the need for and type of surgical intervention. Predictor variables comprised age, sex, presence of neurological condition, and mechanism of luxation. Administered treatment and clinical outcomes were recorded. Results: Of luxation, 61.9% was recurrent and 40.0% due to spontaneous cause. Only 1.9% of patients underwent surgical intervention. The presence of neurological condition caused a 1.34-fold risk for recurrence of luxation and general condition a 1.57-fold risk. Conclusions: TMJ luxation is often recurrent, bilateral, and spontaneous. Recurrent luxation is associated with geriatric and neurological conditions, and in this group recurrent TMJ luxation predicted death. Clinical relevance: Our findings contribute to more effective diagnostics and treatment of TMJ luxation patients. We show that there is a need to standardize diagnostic measures and treatment patterns. Moreover, collaboration with other specialities, especially neurology and geriatrics, is important. [ABSTRACT FROM AUTHOR]

Peer-based interventions are increasingly popular and cost-effective therapeutic opportunities to support others experiencing similar life circumstances. However, little is known about the similarities and differences among peer-based interventions and their outcomes for people with neurological conditions. This scoping review aims to describe and compare the characteristics of existing peer-based interventions for adults with common neurological conditions. We searched MEDLINE, CINAHL, PsychInfo, and Embase for research on peer-based interventions for individuals with brain injury, Parkinson's, multiple sclerosis, spinal cord injury, and stroke up to June 2019. The search was updated in March 2021. Fifty-three of 2472 articles found were included. Characteristics of peer-based intervention for this population vary significantly. They include individual and group-based formats delivered in-person, by telephone, or online. Content varied from structured education to tailored approaches. Participant outcomes included improved health, confidence, and self-management skills; however, these varied based on the intervention model. Various peer-based interventions exist, each with its own definition of what it means to be a peer. Research using rigorous methodology is needed to determine the most effective interventions. Clear definitions of each program component are needed to better understand the outcomes and mechanism of action within each intervention. Rehabilitation services can draw on various peer support interventions to add experiential knowledge and support based on shared experience to enhance outcomes. Fulfilling the role of peer mentor may be beneficial and could be encouraged as part of the rehabilitation process for people with SCI, TBI, Stroke, PD, or MS. In planning peer-based interventions for TBI, Stroke, SCI, PD, and MS populations, it is important to clearly define intervention components and evaluate outcomes to measure the impact of the intervention. [ABSTRACT FROM AUTHOR]

Research on caregiving after neurotrauma and neurological disability critically extends the focus beyond individuals with neurological conditions to family, friends, and significant others who also are greatly impacted. This article introduces a thematic issue of NeuroRehabilitation on the topic with 10 articles that coalesce around the three approaches of (a) literature reviews, (b) empirical studies, and (c) caregiver intervention studies. This introductory article introduces each of these articles and synthesizes them to chart important future directions for research on caregiving after neurotrauma and neurological disability including: (a) a focus on evidence-based common factors caregiver interventions, (b) dissemination and implementation science approaches to imbedding caregiver interventions into health care systems, and (c) cultural considerations in the context of caregiving. This thematic issue helps rehabilitation clinicians incorporate more of a systems perspective to improve the functioning not only of individuals with neurological conditions but also their caregivers. [ABSTRACT FROM AUTHOR]

Background: The use of patient-reported outcome (PRO) measures is an emerging field in health care. In the Central Denmark Region, epilepsy outpatients can participate in remote PRO-based follow-up by completing a questionnaire at home instead of attending a traditional outpatient appointment. This approach aims to encourage patient engagement and is used in approximately half of all epilepsy outpatient consultations. However, dropout in this type of follow-up is a challenging issue., Objective: This study aimed to examine the association between potential self-reported determinants and dropout in remote PRO-based follow-up for patients with epilepsy., Methods: This prospective cohort study (n=2282) explored the association between dropout in remote PRO-based follow-up for patients with epilepsy and 9 potential determinants covering 3 domains: health-related self-management, general and mental health status, and patient satisfaction. The associations were examined using multiple logistic regression analyses with adjustment for sex, age, education, and cohabitation., Results: A total of 770 patients (33.7%) dropped out of remote PRO-based follow-up over 5 years. Statistically significant associations were identified between all potential determinants and dropouts in PRO-based follow-up. Patients with low social support had an odds ratio of 2.20 (95% CI 1.38-3.50) for dropout. Patients with poor health ratings had an odds ratio of 2.17 (95% CI 1.65-2.85) for dropout. Similar estimates were identified for the remaining determinants in question., Conclusions: Patients with reduced self-management, poor health status, and low patient satisfaction had higher odds of dropout in remote PRO-based follow-up. However, further research is needed to determine the reasons for dropout., (© Sofie Bech Vestergaard, Mette Roost, David Høyrup Christiansen, Liv Marit Valen Schougaard. Originally published in JMIR Formative Research (https://formative.jmir.org).)

Introduction: Dynamic Balance (DB) is the ability to maintain balance while the body is moving. The Four-Square Step Test (FSST) is a reliable and valid tool to assess DB in older populations. Previous research demonstrated the normative score of FSST for the community-dwelling older population. Aim: To estimate the reference score of FSST among 8 to 15-year olds. Materials and Methods: FSST is a test that can be used for both therapeutic and diagnostic purposes to evaluate an individual’s dynamic standing balance. A total of 90 School goers were recruited for this research. Participants had to cross the four sticks in a predetermined order. The sticks were each 90 cm long and were positioned in a cross pattern on the ground. They were instructed not to touch any sticks when they were crossing them. The amount of time it took to complete the test was recorded. Results: The normative value of FSST was (mean±SD 11.43±1.24) Geometric mean (11.37), skewness (0.30), kurtosis (0.65), median (25, 75 IQR) 11.25 (11.25,12.07), range (8.00-15.00). Conclusion: The total time taken by the participants to finish the test was 9 to 12 seconds. Analysing these results against findings to previous research, children between the ages of 8 and 15 were found to finish the FSST faster than average adults. In clinical practice, the standard reference score may be employed to rule out abnormalities related to children’s DB. [ABSTRACT FROM AUTHOR]

Introduction: Epilepsy is one of the most common neurologic conditions occurring in persons under 21 years of age. Vitamin D deficiency is highly prevalent among children with epilepsy. Antiepileptic drugs (AEDs) are associated with decreased Bone Mineral Density (BMD) as AEDs increase catabolism of 25-hydroxy vitamin D by induction of the hepatic P 450 enzyme system, which leads to relative hypocalcaemia, increased levels of parathyroid hormone (PTH) and subsequently low BMD. Aim: To evaluate the association of ionic calcium and vitamin D3 in paediatric epileptic patients who were on AEDs with BMD. Materials and Methods: This was an observational cross-sectional study carried out at Department of Paediatrics, SPMC, Bikaner, Rajasthan, India from December 2020 to November 2021. A total of 150 epileptic patients aged 5 to 15 years who were on AED therapy for more than six months and a comparable group of 130 age and gender matched healthy individuals participated in this study. Serum vitamin D3, Alkaline Phosphatase (ALP), ionic calcium and phosphorous levels were assessed and compared between both the groups. Using OSTEOPRO DEXA BMD at the lumbar spine was calculated. Mann-Whitney test and t-test were used to compare quantitative data whereas Chi-square test was used to compare qualitative data in two groups. Non parametric tests (Spearman Correlation) were used to explore the correlation between the two variables. The p-value of <0.05 was considered to be statistically significant. Results: The mean age of study group and control group were 9.94±2.61 years and 10.09±2.53 years respectively. Mean serum ionic calcium (1.09±0.13 mmol/L) was significantly lower in study group as compared to controls (1.15±0.13 mmol/L) with p-value <0.001. Mean serum phosphorous and serum ALP levels were not significantly different in study and control group. The mean Vitamin D3 level (16.70±5.35 ng/mL) was lower in children receiving AEDs as compared to controls (19.08±5.39 ng/mL) with p-value <0.001. Serum levels of ionic calcium and Vitamin D3 were found to be significantly lower in groups with polytherapy and enzyme inducer group of AEDs (p<0.05) whereas only statistically significant difference in vitamin D3 was found in subjects with more than two years of AED therapy. The mean Lumbar Spine Bone Mineral Apparent Density (LSBMAD) of the study and control group were 0.47±0.14 g/cm² and 0.61±0.12 g/cm² respectively. Conclusion: Epileptic children receiving multiple drugs for longer duration showed more decline in calcium and serum 25 hydroxy vitamin D compared to those with single drug for shorter duration. [ABSTRACT FROM AUTHOR]

Imaging techniques including transcranial Doppler (TCD), magnetic resonance imaging (MRI), computed tomography (CT), and cerebral angiography are available for cerebrovascular disease diagnosis. TCD is a less expensive, non-invasive, and practically simpler approach to diagnosing cerebrovascular disorders than the others. TCD is a commonly available and inexpensive diagnostic tool. However, owing to its large operator dependency, it has a narrow application area. Cerebrovascular disease indicates a group of disorders that alter the flow of blood in the brain. The brain's functions can be temporarily or permanently impaired as a result of this change in blood flow. Timely diagnosis and treatment can restore the brain-impaired functions, resulting in a much-improved prognosis for the patients. This review summarizes the basic principles underlying the TCD imaging technique and its utility as a diagnostic tool for cerebrovascular disease. [ABSTRACT FROM AUTHOR]

Imaging techniques including transcranial Doppler (TCD), magnetic resonance imaging (MRI), computed tomography (CT), and cerebral angiography are available for cerebrovascular disease diagnosis. TCD is a less expensive, non-invasive, and practically simpler approach to diagnosing cerebrovascular disorders than the others. TCD is a commonly available and inexpensive diagnostic tool. However, owing to its large operator dependency, it has a narrow application area. Cerebrovascular disease indicates a group of disorders that alter the flow of blood in the brain. The brain’s functions can be temporarily or permanently impaired as a result of this change in blood flow. Timely diagnosis and treatment can restore the brain-impaired functions, resulting in a much-improved prognosis for the patients. This review summarizes the basic principles underlying the TCD imaging technique and its utility as a diagnostic tool for cerebrovascular disease.

This study built upon previous quasi-experimental design research studying the effectiveness of a 12-week dance therapy program for persons with a physical disability (DTPD) aiming to improve mobility. We conducted a single-case experimental design (SCED), including pre- and post-interventions measures, with seven participants with repeated measures during pre-dance (A1), dance program (B) and post-dance phases (A2). Five participants completed the study and significantly (p < 0.05) improved their scores on the MiniBESTest; 2/5 and 4/5 improved scores for the 4 Square Step Test and the Multidirectional Reach Test–Behind, respectively, with very large effect size (ES). Aggregated ES (A1-A2) went from moderate to very large. Results support the effectiveness of the DTPD program for adults with neurological conditions, and for the use of SCED to explore effectiveness of dance interventions for heterogeneous cohorts. [ABSTRACT FROM AUTHOR]

Multiple sclerosis (MS) is an autoimmune disease which is inflammatory in nature and shows gliosis and demyelination which lead to acute and chronic symptoms impairing the quality of life due to disability. Presence of immune-mediated response in Central Nervous System leads to the above presentation. MS is the most common condition of CNS which causes disability. Treatment of Multiple Sclerosis consists of treating the exacerbations along with slowing the disease process and including symptomatic therapies. The most invalidating symptom in people with MS is Fatigue. This case reports shows the effectiveness of endurance and respiratory training towards the delaying the progression of symptoms in MS. [ABSTRACT FROM AUTHOR]

Objective: To study characteristics and outcomes of patients with stroke, traumatic brain injury (TBI), and epilepsy with discharge against medical advice (DAMA).Data Sources/study Setting: Retrospective analysis of the 2013 Nationwide Readmissions Database, a nationally representative inpatient administrative dataset.Study Design: Associations between predictors and DAMA at index admission were analyzed using adjusted logistic models. We examined 30-day all-cause readmissions.Data Collection Methods: Patients aged ≥18 years at index admission for International Classification of Diseases-9 diagnosis code of epilepsy, TBI, or stroke were included.Principal Findings: Discharge against medical advice occurred in 1998/58278 patients (3.43 percent) in the epilepsy group, 1762/211 213 (0.83 percent) in the stroke group, and 1289/74 652 (1.73 percent) in the TBI group. Factors consistently associated with increased likelihood of DAMA included lower age, male sex, non-Medicare and nonprivate insurance, lower socioeconomic status, and behavioral risk factors (smoking history, alcohol history, and drug use). The crude 30-day all-cause readmission rate for those with DAMA from their index admission was 16.4 percent for the stroke cohort, 13.9 percent for epilepsy, and 13.4 percent for TBI. DAMA at index admission was significantly associated with increased risk of 30-day all-cause readmission among all groups (adjusted odds ratio 1.79, 95% CI: 1.65-1.94, P < .0001).Conclusions: Age, sex, insurance status, socioeconomic status, and behavioral factors were associated with DAMA in neurological patients. Further research is needed to develop interventions to reduce DAMA in high-risk groups. [ABSTRACT FROM AUTHOR]

Aim: To determine the prevalence of prevailing head position to one side (PHP) in young infants and to evaluate its associations with reaching performance, neurological condition and perinatal and socio-economic factors.Methods: Observational study in 500 infants (273 boys) 2-6 months corrected age, representative of the Dutch population (median gestational age 39.7 weeks (27-42); birthweight 3438 g (1120-4950). Prevailing head position to one side and reaching performance were assessed with the Infant Motor Profile; neurological condition with the Standardized Infant NeuroDevelopmental Assessment. Socio-economic information and perinatal information were obtained by questionnaire and medical records. Associations were analysed with uni- and multivariable statistics.Results: Prevailing head position to one side was observed in 100 infants (20%), and its prevalence decreased from 49% at 2 months to 0% at 6 months. Only in infants aged 4-5 months PHP was significantly associated with worse reaching and an at-risk neurological score. Prevailing head position to one side was weakly associated with prenatal substance exposure, post-natal admission to a paediatric ward and paternal native Dutch background.Conclusion: Prevailing head position to one side at 2-3 months is a frequently occurring sign with limited clinical significance. Yet, PHP at 4-5 months is associated with a worse functional and neurological condition. Therefore, PHP at 4-5 months could serve as a red flag indicating possible challenges in later development. [ABSTRACT FROM AUTHOR]

Charles Bonnet Syndrome (CBS) is a condition of the visually impaired, in which hallucinations – or, more appropriately, visions – of geometric patterns, people, and objects appear within the visual field. Most people with CBS are older adults, a function of increased likelihood of visual deterioration in later life, but the condition can occur at any age. Diagnostic criteria vary among professions, but generally includes awareness that the visions are not real, the absence of other accompanying sensory hallucinations, and the absence of dementia or other neurological condition. The mechanism by which the phenomenon occurs is not well understood, although some speculation exists that it is akin to phantom limb syndrome. Although there has recently been increasing awareness about the condition, many in the fields of medicine, optometry, and social work have not heard of it. As front-line providers for clients, it is important that social workers be well informed about the condition to alleviate anxiety our clients may have about expressing their experiences with the condition. [ABSTRACT FROM AUTHOR]

Background: Adults with long-term neurological conditions can face complex challenges including anxiety and depression. Emerging research suggests the utility of third-wave approaches (the third development of psychotherapies) in working transdiagnostically with these difficulties. Aims: This systematic review sought to summarise and appraise the quality of published empirical studies using third-wave therapies such as Compassion Focused Therapy; Acceptance and Commitment Therapy; and Mindfulness-Based Cognitive Therapy or Mindfulness-Based Stress Reduction. Method: Review procedures followed PRISMA guidelines, with 437 abstracts screened, 24 full-text articles retrieved and 19 studies found to meet inclusion criteria. Six out of seven randomised studies had unclear or high risk of bias, whilst the majority of non-randomised studies were considered moderate quality. Results: Overall, studies reported a statistically significant reduction in emotional distress. Of the 13 studies that used model-specific process measures, 10 found statistically significant improvements in transdiagnostic factors. Discussion: The findings indicate that third-wave therapies show promise in addressing transdiagnostic difficulties within neurological conditions. A number of methodological and conceptual issues for the included studies were highlighted during the quality appraisal process. Clinical implications include consideration of intervention length and use of outcome measures. Research implications are discussed by considering the progressive stages of development for behavioural treatments. [ABSTRACT FROM AUTHOR]

Introduction Wellbeing is an important goal and outcome measure for people living with Parkinson’s disease. Previous wellbeing studies have used standardised measures and not explored the individual understandings of wellbeing and how it is affected by engagement in meaningful occupations. The aim of this study was to explore individual definitions of wellbeing and perceived associations between engagement in daily occupations and wellbeing for people living at home with Parkinson’s disease. Method A qualitative descriptive design was used. Participants completed 24-hour time diaries prior to completing semi-structured interviews which explored participants’ individual definitions of wellbeing and perceptions of associations between wellbeing and engagement in occupation. Transcribed interviews were analysed using thematic analysis. Results Seventeen participants were recruited and 11 completed interviews. Participants defined wellbeing in terms of independence and satisfaction in being able to contribute to others’ lives. Participants identified engagement in meaningful occupation as supporting their wellbeing and maintaining relationships and identity. Conclusion This study expands what is known about wellbeing for people living with Parkinson’s disease. Understanding the individual meaning of wellbeing and facilitating engagement in the occupations individuals with Parkinson’s disease identify as meaningful may assist them to maintain wellbeing despite the presence of disease. [ABSTRACT FROM AUTHOR]

This paper presents an overview of genetic variation associated with the onset and progression of 14 neurological disorders, focusing primarily on association studies. The 14 disorders are heterogeneous in terms of their frequency, age of onset, etiology and progression. There is substantially less evidence on progression than onset. With regard to onset, the conditions are diverse in terms of their epidemiology and patterns of familial aggregation. While the muscular dystrophies and Huntington’s disease are monogenic diseases, for the other 12 conditions only a small proportion of cases is associated with specific genetic syndromes or mutations. Excluding these, some familial aggregation remains for the majority of cases. There is considerable variation in the volume of evidence by condition, and by gene within condition. The volume of evidence is greatest for Alzheimer’s disease, Parkinson’s disease, multiple sclerosis and amyotrophic lateral sclerosis. As for common complex chronic diseases, genome wide association studies have found that validated genomic regions account for a low proportion of heritability. Apart from multiple sclerosis, which shares several susceptibility loci with other immune-related disorders, variation at HLA-DRB5 being associated both with Parkinson’s disease and Alzheimer’s disease, and the association of the C9orf72 repeat expansion with ALS and frontotemporal degeneration, there was little evidence of gene loci being consistently associated with more than one neurological condition or with other conditions. With the exception of spina bifida, for which maternal MTHFR genotype is associated with risk in the offspring, and corroborates other evidence of the importance of folate in etiology, there was little evidence that the pathways influenced by genetic variation are related to known lifestyle or environmental exposures. [ABSTRACT FROM AUTHOR]

Aim The aim of this study was to report: (1) an analysis of the concepts of coping, adaptation and self-management in the context of managing a neurological condition; and (2) the overlap between the concepts. Background The three concepts are often confused or used interchangeably. Understanding similarities and differences between concepts will avoid misunderstandings in care. The varied and often unpredictable symptoms and degenerative nature of neurological conditions make this an ideal population in which to examine the concepts. Design Concept analysis. Data sources Articles were extracted from a large literature review about living with a neurological condition. The original searches were conducted using SCOPUS, EMBASE, CINAHL and Psych INFO. Seventy-seven articles met the inclusion criteria of: (1) original article concerning coping, adaptation or self-management of a neurological condition; (2) written in English; and (3) published between 1999-2011. Methods The concepts were examined according to Morse's concept analysis method; structural elements were then compared. Results Coping and adaptation to a neurological condition showed statistically significant overlap with a common focus on internal management. In contrast, self-management appears to focus on disease-controlling and health-related management strategies. Coping appears to be the most mature concept, whereas self-management is least coherent in definition and application. Conclusion All three concepts are relevant for people with neurological conditions. Healthcare teams need to be cautious when using these terms to avoid miscommunication and to ensure clients have access to all needed interventions. Viewing the three concepts as a complex whole may be more aligned with client experience. [ABSTRACT FROM AUTHOR]

Objectives: The present study explored the level of self-and informant reported executive functioning in daily living using the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A) in a large sample comprising healthy adults and patient cohorts with neurological and neuropsychiatric disorders. The relationship to neuropsychological test performance and self-reported emotional distress was explored, as well as the applicability of U.S. normative data. Methods: Scores on the self- and informant reported BRIEF-A are presented, along with scores on standardized cognitive tests, and on rating scales of self-reported emotional distress in a Norwegian healthy comparison group (n = 115), patients with severe traumatic brain injury (n = 125), focal frontal lobe damage (n = 29), focal cerebellar lesion (n = 24), Parkinson's disease (n = 42), attention deficit hyperactivity disorder (n = 34), type II bipolar disorder (n = 21), and borderline personality disorder (n = 18). Results: Strong associations were observed between the BRIEF-A and emotional distress in both the healthy group and in neurological groups, while no or weak relationships with IQ and performance-based tests of executive function were seen. The relationship between BRIEF-A and emotional distress was weaker in the neuropsychiatric patient groups, despite high symptom load in both domains. Healthy participants tended to have BRIEF-A scores 1/2-3/4 SD below the U.S. normative mean of T score = 50. Conclusions: The study demonstrates the need to interpret BRIEF-A results within a broad differential diagnostic context, where measures of psychological distress are included in addition to neuropsychological tests. Uncertainty about the appropriateness of U.S. normative data in non-U.S. countries adds to the need for interpretive caution. [ABSTRACT FROM AUTHOR]

Background: As a consequence of the increase of cerebro-vascular accidents, the number of people suffering from motor disabilities is raising. Exoskeletons, Functional Electrical Stimulation (FES) devices and Brain-Machine Interfaces (BMIs) could be combined for rehabilitation purposes in order to improve therapy outcomes.Methods: In this work, a system based on a hybrid upper limb exoskeleton is used for neurological rehabilitation. Reaching movements are supported by the passive exoskeleton ArmeoSpring and FES. The movement execution is triggered by an EEG-based BMI. The BMI uses two different methods to interact with the exoskeleton from the user's brain activity. The first method relies on motor imagery tasks classification, whilst the second one is based on movement intention detection.Results: Three healthy users and five patients with neurological conditions participated in the experiments to verify the usability of the system. Using the BMI based on motor imagery, healthy volunteers obtained an average accuracy of 82.9 ± 14.5 %, and patients obtained an accuracy of 65.3 ± 9.0 %, with a low False Positives rate (FP) (19.2 ± 10.4 % and 15.0 ± 8.4 %, respectively). On the other hand, by using the BMI based on detecting the arm movement intention, the average accuracy was 76.7 ± 13.2 % for healthy users and 71.6 ± 15.8 % for patients, with 28.7 ± 19.9 % and 21.2 ± 13.3 % of FP rate (healthy users and patients, respectively).Conclusions: The accuracy of the results shows that the combined use of a hybrid upper limb exoskeleton and a BMI could be used for rehabilitation therapies. The advantage of this system is that the user is an active part of the rehabilitation procedure. The next step will be to verify what are the clinical benefits for the patients using this new rehabilitation procedure. [ABSTRACT FROM AUTHOR]

Logopedics or speech therapy, currently defined as the science of biological speech determinants, constructs the theo - retical foundations for the process of diagnosis and treat ment of communication disorders. The speech therapy approach, focusing on analysis of pathological linguistic facts, utilizes linguistic methods of their description, at the same time indicating their biological, psychological and social mechanisms. The paper presents the procedure for speech therapy diagnosis of acquired speech disorders in neurological patients, and the principles of data interpretation in differentiating symptoms of aphasia, pragnosia, dementia, psychoorganic syndrome and dysarthria based on three interaction categories: text, metatext and context. The state of interaction skills in brain-injured persons differentiates the picture of acquired speech disorders. Thus, unlike the dynamic picture of aphasic disorders, performance disorders in dysarthria are characterized by significant constancy of symptoms. Aphasic texts are disturbed in their grammatical and/or semantic order but are pragmatically coherent whereas utterances of persons with additional non-aphasic speech disorders show disorders of all textological categories, inter alia informativeness, situationality, intertextuality, or acceptability. Verbal behaviors of aphasic persons, unlike the actions of dementia patients, confirm their orientation in time and place. Finally, unlike the utterances of frontal lobe syndrome patients, the texts of aphasic patients contain exponents of the control of disordered behaviors. Diagnosis gains new significance when it arises from the needs of treatment, hence the speech therapist takes into account both the destroyed and the preserved linguistic, cognitive and communication capabilities of neurological patients, which make up their interaction skills. [ABSTRACT FROM AUTHOR]

The survival and life expectancy rates of people with traumatic and degenerative neurological conditions are increasing, sometimes up to several decades. Yet compared to the general population, people with a disability continue to experience poorer health and are at greater risk of developing secondary health problems and facing barriers to services they require. These trends have significant implications for provision of health and rehabilitation services. In this study, the adequacy of health and rehabilitation services provided to people with long-term neurological conditions and their unmet needs were explored from the perspectives of individual users, their nominated family members and key service providers. A qualitative research design with maximum variation sampling was used. Data were collected from semi-structured interviews with 65 participants comprising 25 long-term care service users, nominated family members or friends ( n = 22) and care service providers ( n = 18) in Queensland, Australia. All service users needed assistance with usual daily activities, and 22 were wheelchair dependent. The hours of funded personal care ranged from 2 to 201 hours per week. Data were analysed using framework analysis. Participants generally perceived that specialist medical and hospital services were adequate and satisfactory. They valued supportive health and rehabilitation professionals and receiving client-centred physical rehabilitation. However, the majority of participants ( n = 17) had perceived unmet needs for physical rehabilitation ( n = 14), other health or rehabilitation services ( n = 10) or counselling ( n = 6). Community-based physical maintenance rehabilitation was often perceived as inadequate, costly or inconveniently located. Participants highlighted the importance of personal and family counselling and information provision at time points such as diagnosis. The findings contribute to the limited international evidence on the gaps in health and rehabilitation services for people with neurological conditions receiving lifetime care services in the community. A continuum of integrated rehabilitation services to minimise avoidable impairments, optimise independence and functioning, and sustain quality of life is warranted. [ABSTRACT FROM AUTHOR]

Introduction: Neuro-Functional Training Programme (NFTP): An enhancing primary care initiative that supports self care in patients with a neurological condition, thus engaging and enpowering people. Problem Statement: The NFTP was established by Cork South Lee PCC Physiotherapy in February 2013 as a 4 fold initiative: 1) To facilitate discharge planning of our complex Neurological patients. These include young patients with Acquired Brain Injury, discharges from the National Rehabilitation Hospital and people with congenital conditions. 2) As a wait list management initiative- long review wait list for our progressive neurological patients. 3) Enhancing primary care and community services- ensuring a seamless and integrated passage of care from acute to community. 4) To address barriers that the neurological population experience in relation to exercise participation Context: Primary care Physiotherapists aim to optimise exercise participation thereby enhancing long term self management, preventing secondary complications and supporting self care. The NFTP is a 12 week programme that takes place in Leisureworld Gym, Cork. Aim: The aim of the NFTP is to enable patients with a neurological condition to exercise in a supervised setting. Physiotherpists devise a tailored programme that is specific to their functional impairments and limitations. [ABSTRACT FROM AUTHOR]

This article considers what constitutes a long-term neurological condition, how such a condition should be considered in relation to enhancing psychological wellbeing, where and when this can be done, and how. It draws on the strategic context as well as offering suggestions for practical clinical input that can be the responsibility of a broad range of professional and non-professional people. [ABSTRACT FROM AUTHOR]

Evaluation systems for rehabilitation services are required so that financial providers, service users and those involved in service delivery can assess their efficacy. This article reports on a pilot study to assess a community hospital inpatient rehabilitation unit service, in terms of client change from admission to discharge, using routinely administered measures: the Functional Assessment Measure and the Northwick Park Dependency Scale. Cases considered were acute admissions, predominantly clients with neurological diagnoses. The measurements taken demonstrated a positive change in all areas assessed for the majority of clients. A minority of clients showed no change. It is recommended that future evaluations incorporate goal-achievement measures, in order to assess whether the unit's services have helped clients to reach their specific goals, and consider clients' views of the service. It is also suggested that the financial impact of the service should receive attention and that variation coding might help to identify the reasons why some clients might not benefit from the programme. INSET: COMMENTARY. [ABSTRACT FROM AUTHOR]

SUMMARY The temporal organization of the behaviour of children at risk can exhibit inconsistencies which may impair their adaptation. Seven mother-newborn pairs, selected for neurological and obstetric optimality of the babies, were observed during 2 breast-feedings (2nd after birth and 6th to 9th after birth). During pauses between sucking bouts the behaviours of the two partners were strongly coupled, even in the earlier feedings, which was not the case during sucking bouts themselves. Pauses which contained tactile behaviour were shorter in later feedings than in earlier ones, in contrast to both pauses without tactile behaviour and to bouts. The possible functional relevance of emerging temporal relations between partners' behaviours during breast-feeding is discussed. [ABSTRACT FROM AUTHOR]