What are the experiences of adults returning to work following recovery from Guillain-Barré syndrome? An interpretative phenomenological analysis

This is the author's accepted manuscript. The final published article is available from the link below. Copyright @ 2009 Informa UK Ltd.Purpose. Guillain-Barré syndrome (GBS) is a transient inflammatory disorder affecting peripheral nerves, characterised by weakness and numbness in limbs, upper body and face. Residual problems affect a large minority, and complicate return to work. This qualitative study explored the experiences of people who returned to work following their diagnosis of GBS and recovery, to gain insight into factors that facilitated or inhibited this process. Method. Five people participated in in-depth interviews. Individual and common experiences were explored through interpretative phenomenological analysis. Findings. Three recurring themes are presented: the perceived value of work; losing and recovering a familiar identity at work; and dilemmas around using support and adaptations at work. Certain individual issues also emerged but are beyond the scope of this article. Participants tended to measure their recovery in terms of returning to work yet continued to experience certain physical and psychosocial difficulties at work related to GBS, which required active coping strategies. Limited public awareness of GBS was perceived as a hindrance when returning to work. Conclusion. This study provides a rich account of the experiences that people encounter returning to work following GBS. Rehabilitation specialists may offer more effective preparation for this process, drawing upon the issues identified

Scoping studies: advancing the methodology

Abstract Background Scoping studies are an increasingly popular approach to reviewing health research evidence. In 2005, Arksey and O'Malley published the first methodological framework for conducting scoping studies. While this framework provides an excellent foundation for scoping study methodology, further clarifying and enhancing this framework will help support the consistency with which authors undertake and report scoping studies and may encourage researchers and clinicians to engage in this process. Discussion We build upon our experiences conducting three scoping studies using the Arksey and O'Malley methodology to propose recommendations that clarify and enhance each stage of the framework. Recommendations include: clarifying and linking the purpose and research question (stage one); balancing feasibility with breadth and comprehensiveness of the scoping process (stage two); using an iterative team approach to selecting studies (stage three) and extracting data (stage four); incorporating a numerical summary and qualitative thematic analysis, reporting results, and considering the implications of study findings to policy, practice, or research (stage five); and incorporating consultation with stakeholders as a required knowledge translation component of scoping study methodology (stage six). Lastly, we propose additional considerations for scoping study methodology in order to support the advancement, application and relevance of scoping studies in health research. Summary Specific recommendations to clarify and enhance this methodology are outlined for each stage of the Arksey and O'Malley framework. Continued debate and development about scoping study methodology will help to maximize the usefulness and rigor of scoping study findings within healthcare research and practice

Environment and shipping drive environmental DNA beta-diversity among commercial ports

The spread of nonindigenous species by shipping is a large and growing global problem that harms coastal ecosystems and economies and may blur coastal biogeographical patterns. This study coupled eukaryotic environmental DNA (eDNA) metabarcoding with dissimilarity regression to test the hypothesis that ship-borne species spread homogenizes port communities. We first collected and metabarcoded water samples from ports in Europe, Asia, Australia and the Americas. We then calculated community dissimilarities between port pairs and tested for effects of environmental dissimilarity, biogeographical region and four alternative measures of ship-borne species transport risk. We predicted that higher shipping between ports would decrease community dissimilarity, that the effect of shipping would be small compared to that of environment dissimilarity and shared biogeography, and that more complex shipping risk metrics (which account for ballast water and stepping-stone spread) would perform better. Consistent with our hypotheses, community dissimilarities increased significantly with environmental dissimilarity and, to a lesser extent, decreased with ship-borne species transport risks, particularly if the ports had similar environments and stepping-stone risks were considered. Unexpectedly, we found no clear effect of shared biogeography, and that risk metrics incorporating estimates of ballast discharge did not offer more explanatory power than simpler traffic-based risks. Overall, we found that shipping homogenizes eukaryotic communities between ports in predictable ways, which could inform improvements in invasive species policy and management. We demonstrated the usefulness of eDNA metabarcoding and dissimilarity regression for disentangling the drivers of large-scale biodiversity patterns. We conclude by outlining logistical considerations and recommendations for future studies using this approach.Fil: Andrés, Jose. Cornell University. Department Of Ecology And Evolutionary Biology;Fil: Czechowski, Paul. Cornell University. Department Of Ecology And Evolutionary Biology; . University of Otago; Nueva Zelanda. Helmholtz Institute for Metabolic, Obesity and Vascular Research; AlemaniaFil: Grey, Erin. University of Maine; Estados Unidos. Governors State University; Estados UnidosFil: Saebi, Mandana. University of Notre Dame; Estados UnidosFil: Andres, Kara. Cornell University. Department Of Ecology And Evolutionary Biology;Fil: Brown, Christopher. California State University Maritime Academy; Estados UnidosFil: Chawla, Nitesh. University of Notre Dame; Estados UnidosFil: Corbett, James J.. University of Delaware; Estados UnidosFil: Brys, Rein. Research Institute for Nature and Forest; BélgicaFil: Cassey, Phillip. University of Adelaide; AustraliaFil: Correa, Nancy. Ministerio de Defensa. Armada Argentina. Instituto Universitario Naval de la Ara. Escuela de Ciencias del Mar; Argentina. Ministerio de Defensa. Armada Argentina. Servicio de Hidrografía Naval; ArgentinaFil: Deveney, Marty R.. South Australian Research And Development Institute; AustraliaFil: Egan, Scott P.. Rice University; Estados UnidosFil: Fisher, Joshua P.. United States Fish and Wildlife Service; Estados UnidosFil: vanden Hooff, Rian. Oregon Department of Environmental Quality; Estados UnidosFil: Knapp, Charles R.. Daniel P. Haerther Center for Conservation and Research; Estados UnidosFil: Leong, Sandric Chee Yew. National University of Singapore; SingapurFil: Neilson, Brian J.. State of Hawaii Division of Aquatic Resources; Estados UnidosFil: Paolucci, Esteban Marcelo. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Museo Argentino de Ciencias Naturales "Bernardino Rivadavia"; ArgentinaFil: Pfrender, Michael E.. University of Notre Dame; Estados UnidosFil: Pochardt, Meredith R.. M. Rose Consulting; Estados UnidosFil: Prowse, Thomas A. A.. University of Adelaide; AustraliaFil: Rumrill, Steven S.. Oregon Department of Fish and Wildlife; Estados UnidosFil: Scianni, Chris. Universidad Nacional de Salta. Facultad de Ciencias Naturales. Instituto para el Estudio de la Biodiversidad de Invertebrados; Argentina. Marine Invasive Species Program; Estados UnidosFil: Sylvester, Francisco. Universidad Nacional de Salta. Facultad de Ciencias Naturales. Instituto para el Estudio de la Biodiversidad de Invertebrados; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Salta; ArgentinaFil: Tamburri, Mario N.. University of Maryland; Estados UnidosFil: Therriault, Thomas W.. Pacific Biological Station; CanadáFil: Yeo, Darren C. J.. National University of Singapore; SingapurFil: Lodge, David M.. Cornell University. Department Of Ecology And Evolutionary Biology

The use of the Model of Occupational Self Efficacy in improving the cognitive functioning of individuals with brain injury: A pre- and post-intervention study

BACKGROUND: Individuals diagnosed with a Traumatic Brain Injury (TBI) often experience major limitations in returning to work despite participating in rehabilitation programmes. OBJECTIVE: The aim of the study was to determine whether individuals who sustained a traumatic brain injury experienced improved cognitive functioning after participating in an intervention programme that utilizes the Model of Occupational Self-Efficacy (MOOSE). PARTICIPANTS: Ten (10) individuals who were diagnosed with a mild to moderate brain injury participated in the study. METHOD: The research study was positioned within the quantitative paradigm specifically utilizing a pre and post intervention research design. In order to gather data from the participants, the Montreal Cognitive Assessment (MOCA) was used to determine whether the individual with brain injury’s cognitive functioning improved after participating in a vocational rehabilitation model called the Model of Occupational Self Efficacy (MOOSE). RESULTS: All the participants in this study presented with an improvement in MOCA test scores. The results of the study revealed a statistically significant effect of the intervention (i.e. MOOSE) on cognitive functioning measured using the Montreal Cognitive Assessment, F(4, 6) = 15.95, p = 0.002. CONCLUSION: The findings of this study indicated that MOOSE is a useful model to facilitate the return of individuals living with a TBI back to work. It is also suggested that cognitive rehabilitative activities be included as part of the vocational rehabilitation programme

Mapping the terrain: A conceptual schema for a mental health medication support service in community pharmacy

Objective: Mental health–related problems pose a serious issue for primary care, and community pharmacy could make a significant contribution, but there is a dearth of information. Methods: This article reports synthesis of the literature on mental health interventions across a range of pharmacy models, and pharmacy services in contexts beyond mental health. To best inform the design of a community pharmacy medication support intervention for mental health consumers, the literature was reported as a conceptual schema and subsequent recommendations for development, implementation and evaluation of the service. A broad conceptualisation was taken in this review. In addition to mental health and community pharmacy literature, policy/initiatives, organisational culture and change management principles, and evaluative processes were reviewed. Key words were selected and literature reviews undertaken using EMBASE, PubMed, CINAHL and Web of Science. Results: Recommendations were made around: medication support intervention design, consumer recruitment, implementation in community pharmacy and evaluation. Surprisingly, there is a scarce literature relating to mental health interventions in community pharmacy. Even so, findings from other pharmacy models and broader medicines management for chronic illness can inform development of a medication support service for mental health consumers. Key learnings include the need to expand medicines management beyond adherence with respect to both intervention design and evaluation. Conclusion: The conceptual framework is grounded in the need for programmes to be embedded within pharmacies that are part of the health system as a whole

Quantifying Rates of Evolutionary Adaptation in Response to Ocean Acidification

The global acidification of the earth's oceans is predicted to impact biodiversity via physiological effects impacting growth, survival, reproduction, and immunology, leading to changes in species abundances and global distributions. However, the degree to which these changes will play out critically depends on the evolutionary rate at which populations will respond to natural selection imposed by ocean acidification, which remains largely unquantified. Here we measure the potential for an evolutionary response to ocean acidification in larval development rate in two coastal invertebrates using a full-factorial breeding design. We show that the sea urchin species Strongylocentrotus franciscanus has vastly greater levels of phenotypic and genetic variation for larval size in future CO2 conditions compared to the mussel species Mytilus trossulus. Using these measures we demonstrate that S. franciscanus may have faster evolutionary responses within 50 years of the onset of predicted year-2100 CO2 conditions despite having lower population turnover rates. Our comparisons suggest that information on genetic variation, phenotypic variation, and key demographic parameters, may lend valuable insight into relative evolutionary potentials across a large number of species