Do Psychosocial Interventions Improve Quality of Life and Wellbeing in Adults with Neuromuscular Disorders? A Systematic Review and Narrative Synthesis

Background: Quality of life and well-being are frequently restricted in adults with neuromuscular disorders. As such, identification of appropriate interventions is imperative. Objective: The objective of this paper was to systematically review and critically appraise quantitative studies (RCTs, controlled trials and cohort studies) of psychosocial interventions designed to improve quality of life and well-being in adults with neuromuscular disorders. Method: A systematic review of the published and unpublished literature was conducted. Studies meeting inclusion criteria were appraised using a validated quality assessment tool and results presented in a narrative synthesis. Results: Out of 3,136 studies identified, ten studies met criteria for inclusion within the review. Included studies comprised a range of interventions including: cognitive behavioural therapy, dignity therapy, hypnosis, expressive disclosure, gratitude lists, group psychoeducation and psychologically informed rehabilitation. Five of the interventions were for patients with Amyotrophic Lateral Sclerosis (ALS). The remainder were for patients with post-polio syndrome, muscular dystrophies and mixed disorders, such as Charcot-Marie-Tooth disease, myasthenia gravis and myotonic dystrophy. Across varied interventions and neuromuscular disorders, seven studies reported a short-term beneficial effect of intervention on quality of life and well-being. Whilst such findings are encouraging, widespread issues with the methodological quality of these studies significantly compromised the results. Conclusion: There is no strong evidence that psychosocial interventions improve quality of life and well-being in adults with neuromuscular disorders, due to a paucity of high quality research in this field. Multi-site, randomised controlled trials with active controls, standardised outcome measurement and longer term follow-ups are urgently required.

Our Landscape, Ourselves: Integrating Process and Traditional food Principles for Wellbeing + Resilience in the Swinomish Tribal Community

Thesis (Master's)--University of Washington, 2016-08

Développement d’un indice du potentiel TOD pour l’agglomération de Montréal

Résumé : Les aménagements axés sur le transport en commun (transit-oriented development ou TOD) reposent sur la création de développements résidentiels à proximité d’un nœud de transport existant. Dans le cadre de cet essai, on cherche plutôt à identifier les quartiers existants de Montréal possédant déjà les caractéristiques propices à l’aménagement d’un TOD, mais mal desservis par les transports en commun. En s’inspirant d’une étude menée aux Pays-Bas, on a eu recours à une analyse spatiale multicritères afin de concevoir un «indice du potentiel TOD», comportant quatre critères jugés essentiels, soit : la densité d’habitants, la mixité des utilisations du sol, la mixité sociale, ainsi que la distance aux transports. Malgré la difficulté d’intégrer l’ensemble des critères identifiés dans la littérature, les résultats révèlent un fort potentiel TOD sur le Plateau Mont-Royal, dans le Sud-Ouest, Hochelaga-Maisonneuve et plus particulièrement dans Anjou et Saint-Michel. On recommande notamment un secteur situé dans Saint-Michel, dont le potentiel TOD pourrait être enrichi par la création de plus fortes connexions au réseau de transports en commun.