The effectiveness of aromatherapy and reflexology in neurodegenerative disorders: a systematic review and meta-analysis

Many neurodegenerative conditions are chronic disorders and result in a range of debilitating symptoms, with many people turning to complementary therapies. A systematic review and meta-analysis were conducted to investigate the evidence on effectiveness of aromatherapy and reflexology on all neurodegenerative conditions. We identified nine eligible studies (total sample n = 504 participants) all of which were on multiple sclerosis only. A meta-analysis was conducted including data from six studies, which demonstrated no significant benefit of aromatherapy/reflexology; however, the sample sizes were small and of low quality. This systematic review confirmed that it is not possible to draw conclusions regarding the effectiveness of reflexology and aromatherapy in multiple sclerosis. Larger high-quality studies are required to test these widely used therapies

Remote Consultations for People with Parkinson’s and Cognitive Impairment – A Qualitative Study with Patients, Caregivers and Healthcare Professionals

Background: The Covid-19 pandemic led to many consultations being conducted remotely. Cognitive impairment is recognised as a potential barrier to remote healthcare interactions and is common and heterogeneous in Parkinson’s. Research studies have shown remote consultations in Parkinson’s to be feasible, but little is known about real life experience, especially for those with cognitive impairment. We explored the experiences and perceptions of remote consultations for people with Parkinson’s and cognitive impairment. Objective: To explore the experiences of remote consultations for People with Parkinson’s and Cognitive Impairments, from the perspective of service users and professionals, and investigate considerations for future service delivery. Method: Semi-structured interviews were conducted remotely with 11 people with Parkinson’s and cognitive impairment, 10 family caregivers and 24 Healthcare Professionals in 2020-2021. Purposive sampling was used. Interviews were audio-recorded, transcribed and analysed using thematic analysis. Results: Four themes were identified: The Nature of Remote Interactions; Challenges Exacerbated by Being Remote; Expectation versus Reality; and Optimising for the Future. Remote consultations were considered to be ‘transactional’ and less personal, with difficulties building rapport, and different in role to in-person consultations. The loss of non-verbal communication and ability of Healthcare Professionals to ‘sense’ led to remote consultations being perceived as riskier by all groups. Issues arising from communication and cognitive impairment, balancing of the person with Parkinson’s and caregiver voice, and discussions of the future, affect this population specifically. Remote consultations were reported to have been more successful than anticipated in all three groups. Obstacles were not always as expected, for example age was less of a barrier than predicted. Video consultations were perceived as being preferable to telephone consultations by most participants, but not accessible to all people with Parkinson’s. With widespread expectation of ongoing remote consultations, potential improvements for these three groups and healthcare services were identified, including practice, preparation, increased awareness of issues, expectation management by Healthcare Professionals, and more time and flexibility for consultations. Conclusion: Advantages and challenges of remote consultations for this population are identified. Consultations could be improved with increased support, practice, preparation, awareness of issues, and more time and flexibility within services

Delivering Optimal Care to People with Cognitive Impairment in Parkinson’s Disease: A Qualitative Study of Patient, Caregiver, and Professional Perspectives

Background: Cognitive impairment is common in Parkinson’s disease (PD) and associated with lower quality of life. Cognitive impairment in PD manifests differently to other dementia pathologies. Provision of optimal care requires knowledge about the support needs of this population. // Methods: Eleven people with PD and cognitive impairment (PwP), 10 family caregivers, and 27 healthcare professionals were purposively sampled from across the United Kingdom. Semistructured interviews were conducted in 2019–2021, audio-recorded, transcribed, and analysed using reflexive thematic analysis. // Results: Cognitive impairment in PD conveyed increased complexity for clinical management and healthcare interactions, the latter driven by multifactorial communication difficulties. Techniques that helped included slow, simple, and single messages, avoiding topic switching. Information and emotional support needs were often unmet, particularly for caregivers. Diagnostic pathways were inconsistent and awareness of cognitive impairment in PD was poor, both contributing to underdiagnosis. Many felt that PwP and cognitive impairment fell through service gaps, resulting from disjointed, nonspecific, and underresourced services. Personalised care was advocated through tailoring to individual needs of PwP and caregivers facilitated by flexibility, time and continuity within services, and supporting self-management. // Conclusions: This study highlights unmet need for people with this complex condition. Clinicians should adapt their approach and communication techniques for this population and provide tailored information and support to both PwP and caregivers. Services need to be more streamlined and collaborative, providing more time and flexibility. There is a need for wider awareness and deeper understanding of this condition and its differences from other types of dementia

Letters to Grannie

Two letters to Grannie on illustrated children's stationary. One from Dorothy the other from Thelma regarding sent fruit, lambs grown, thanks for the pin box which Mother would keep until Dorothy was bigger. Dorothy Elizabeth Foster (1893-1964) & Thelma Marie(Chesterman) (1896-1954) were the granddaughters of Clara Jane Bell and Charles Henry Leake, the youngest son of John Leake. From the Leake Collection L1/N18 &1

Getting there and staying there: identifying the characteristics of organisational cultures that keep women in academic leadership roles

16 page(s

Karantzas et al. (2020) COVID-19 Relationship Wellbeing & Loneliness

It has been assumed that the COVID-19 pandemic has negatively impacted parental and family relationships due to issues including economic problems, strains of home confinement and social isolation. Despite these assumptions, there has been little research to date investigating the impact of COVID-19 stressors on parents’ relationship wellbeing and loneliness. Hence, there is an insufficient evidence base with which to guide policy or action in this most critical arena. The current study reports data from a large national representative sample (N=1,829) of Australian parents, surveyed during the early phases of the COVID-19 lockdown. Drawing on widely studied relationship models of vulnerability-stress and stress-buffering, Structural Equation Models (SEM) were derived to test the extent that COVID-19 stressors, personal vulnerabilities (mental health problems, attachment insecurity), relationship adaptation processes (constructive communication, partner support), and the interactions between these variables, predicted relationship quality and loneliness. After controlling for pre-pandemic stressors, relationship adaptations buffered the negative effects of COVID-19 stressors and personal vulnerabilities on relationship quality and loneliness. The findings provide support for a model of stress-buffering over a model of vulnerability-stress. The findings have important implications for the identification of parents at risk of relationship difficulties and social disconnection during the pandemic, and for policy and practice in how best to strengthen relationships and human connection during COVID-19

Delivering Optimal Care to People with Cognitive Impairment in Parkinson’s Disease: A Qualitative Study of Patient, Caregiver, and Professional Perspectives

Background. Cognitive impairment is common in Parkinson’s disease (PD) and associated with lower quality of life. Cognitive impairment in PD manifests differently to other dementia pathologies. Provision of optimal care requires knowledge about the support needs of this population. Methods. Eleven people with PD and cognitive impairment (PwP), 10 family caregivers, and 27 healthcare professionals were purposively sampled from across the United Kingdom. Semistructured interviews were conducted in 2019–2021, audio-recorded, transcribed, and analysed using reflexive thematic analysis. Results. Cognitive impairment in PD conveyed increased complexity for clinical management and healthcare interactions, the latter driven by multifactorial communication difficulties. Techniques that helped included slow, simple, and single messages, avoiding topic switching. Information and emotional support needs were often unmet, particularly for caregivers. Diagnostic pathways were inconsistent and awareness of cognitive impairment in PD was poor, both contributing to underdiagnosis. Many felt that PwP and cognitive impairment fell through service gaps, resulting from disjointed, nonspecific, and underresourced services. Personalised care was advocated through tailoring to individual needs of PwP and caregivers facilitated by flexibility, time and continuity within services, and supporting self-management. Conclusions. This study highlights unmet need for people with this complex condition. Clinicians should adapt their approach and communication techniques for this population and provide tailored information and support to both PwP and caregivers. Services need to be more streamlined and collaborative, providing more time and flexibility. There is a need for wider awareness and deeper understanding of this condition and its differences from other types of dementia

Compound impact of cognitive and physical decline: A qualitative interview study of people with Parkinson's and cognitive impairment, caregivers and professionals

Abstract Background Cognitive impairment is common in Parkinson's disease and is associated with poorer quality of life and increased caregiver distress, but little qualitative information is available on lived experiences of people with Parkinson's who also have cognitive impairment. Objectives The aim of this study was to explore the challenges of cognitive impairment in Parkinson's, triangulating the perspectives of people with Parkinson's, caregivers and healthcare professionals. Methods Semistructured interviews were conducted with 11 people with Parkinson's and cognitive impairment, 10 family caregivers and 27 healthcare professionals, using purposive sampling in the United Kingdom (2019–2021). Cognitive impairment was identified by healthcare professionals and required subjective symptoms. Relevant cognitive diagnoses were recorded. Interviews were audio‐recorded, transcribed and analysed using reflexive thematic analysis. Results An overarching concept of the compound impact of cognitive and physical decline was developed, with six themes. Four themes describe the experience of living with cognitive impairment in Parkinson's: (1) Challenges in Daily Activities, (2) Psychological Impact and (3) Evolving Communication Difficulties together contributing to (4) Social Shift, encompassing a reduction in wider social activities but intensification of close relationships with increased dependence. A fifth theme (5) Living Well describes positive influences on these experiences, encompassing intrinsic motivation, self‐management strategies and supportive relationships. Furthermore, underlying and shaping the whole experience was the sixth theme: (6) Preconceptions about Cognitive Impairment, describing fear and denial of symptoms and poor understanding of the nature of cognitive impairment in Parkinson's, with differences to other dementia pathologies. Conclusions Cognitive impairment superimposed on the existing challenges of Parkinson's has a multifaceted impact and makes living with the condition arduous. Increased understanding of the experiences of this group and employing the identified facilitators for living well may be able to improve patient and caregiver experiences. Patient or Public Contribution Two people with Parkinson's and cognitive impairment and three caregivers contributed to the study. Between them they contributed throughout the entirety of the project, giving input at conceptualisation as well as advice and review of interview questions, participant information leaflets, recruitment, interpretation of findings and summaries of the project