1
|
Mirza M, Trimboli C, Hartman J, Gamble A, Rfat M, Bentley J, Gross M, Alheresh R, Hussein Q, Markos T. Examining Barriers to Rehabilitation and Addressing Rehabilitation Needs among Persons with Forced Migration Experiences: Interdisciplinary Perspectives. Arch Phys Med Rehabil 2024:S0003-9993(24)00990-0. [PMID: 38763346 DOI: 10.1016/j.apmr.2024.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 04/01/2024] [Accepted: 05/02/2024] [Indexed: 05/21/2024]
Abstract
Globally, human displacement is at a record high. According to the United Nations High Commissioner for Refugees, 110 million people have been forcibly displaced worldwide due to persecution, mass conflict, or human rights violations. Conflicts continue to rage in different part of the world such as Ukraine, Palestine, Sudan, and Tigray. Large-scale political upheaval is also on the rise in many countries including Haiti, Venezuela, and Iran among others. Natural disasters fueled by climate change will further contribute to large-scale forced migration. Persons with forced migration experiences (PFME) tend to have significant rehabilitation needs due to high risk of physical injuries, mental trauma, and exacerbation of pre-existing health problems during displacement. Rehabilitation practitioners in host countries must be well equipped to address the complex needs of this population. However, there is currently limited literature to guide best practice. In this paper, a group of interdisciplinary professionals examine rehabilitation needs among PFME, provide examples of established and emerging rehabilitation interventions with PFME in the context of asylum and resettlement, identify barriers to accessing rehabilitation services in host countries, and propose avenues for professional advocacy in this area.
Collapse
Affiliation(s)
- Mansha Mirza
- University of Illinois Chicago, Department of Occupational Therapy.
| | | | - Jeff Hartman
- University of Wisconsin School of Medicine and Public Health, Doctor of Physical Therapy Program
| | - April Gamble
- Wchan Organization for Victims of Human Rights Violations, Kurdistan, Iraq
| | - Mustafa Rfat
- Washington University in St. Louis, Brown School of Social Work
| | - Jacob Bentley
- Department of Rehabilitation Medicine, University of Washington, Seattle
| | | | - Rawan Alheresh
- University of Jordan, Department of Occupational Therapy
| | - Qusay Hussein
- The University of Texas at Austin, Steve Hicks School of Social Work
| | | |
Collapse
|
2
|
Long G, Duo W, Man L, Haoning M, Ping Y, Mingsheng T, Yuxiang S. The impact of post-traumatic stress on the clinical outcome in a cohort of patients with knee osteoarthritis and knee arthroplasty: A prospective study. J Orthop Sci 2024; 29:847-853. [PMID: 37055273 DOI: 10.1016/j.jos.2023.03.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 01/18/2023] [Accepted: 03/26/2023] [Indexed: 04/15/2023]
Abstract
BACKGROUND Knee osteoarthritis (KOA) is one of the most common musculoskeletal disorders and commonly occurs in older adults, predominantly female populations. Both populations have intimate links with trauma-related stress. Therefore, we intended to evaluate the prevalence of post-traumatic stress disorder (PTSD), which arises from KOA and determine its effects on the postoperative results in patients undergoing total knee arthroplasty (TKA). METHODS The patients who fulfilled the diagnosis of KOA from February 2018 to October 2020 were interviewed. Patients were interviewed by a senior psychiatrist about evaluating their overall experience during their most difficult or stressful situations. KOA patients who underwent TKA were further analyzed to investigate whether PTSD influences the postoperative results. The PTSD Checklist-Civilian Version (PCL-C) and Western Ontario McMaster Universities (WOMAC) Osteoarthritis Index were used to assess PTS symptoms and clinical outcomes after TKA, respectively. RESULTS 212 KOA patients completed this study with a mean follow-up of 16.7 months (7-36 months). The mean age was 62.5 ± 12.3 years, and 53.3% (113/212) were women. 64.6% of the sample (137/212) underwent TKA to relieve the symptoms of KOA. Patients with either PTS or PTSD tended to be younger (P < 0.05), female (P < 0.05) and undergo TKA (P < 0.05) than their counterparts. WOMAC-pain (P < 0.05), WOMAC-stiffness (P < 0.05), and WOMAC-physical function (P < 0.05) both before TKA and 6 months after TKA in the PTSD group is significantly higher compared to their counterparts. Logistic regression analysis showed that a history of OA-inducing trauma (adjusted OR = 2.0, 95% CI = 1.7-2.3, P = 0.003), posttraumatic KOA (adjusted OR = 1.7, 95% CI = 1.4-2.0, P < 0.001), and invasive treatment (adjusted OR = 2.0, 95% CI = 1.7-2.3, P = 0.032), were significantly associated with PTSD in KOA patients. CONCLUSIONS Patients with KOA, especially those undergoing TKA, are associated with PTS symptoms and PTSD, indicating the need to evaluate it and offer care for them.
Collapse
Affiliation(s)
| | - Wang Duo
- School of Music and Dance, Hubei Minzu University, China
| | - Li Man
- General Hospital of Enshi Tujia & Miao Autonomous Prefecture, China
| | | | - Yi Ping
- China-Japan Friendship Hospital, China
| | | | - Song Yuxiang
- Department of Anesthesiology, The First Medical Center of PLA General Hospital, Beijing, China.
| |
Collapse
|
3
|
Zhang L, Wan R, Iyendo TO, Apuke OD, Tunca EA. A randomized control trial establishing the effectiveness of using interactive television-based art, music, and poetry therapies for treating the post-traumatic stress disorder of children exposed to traumatic events. Psychiatry Res 2023; 330:115582. [PMID: 37979317 DOI: 10.1016/j.psychres.2023.115582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 10/24/2023] [Accepted: 10/28/2023] [Indexed: 11/20/2023]
Abstract
This study aimed to compare the effectiveness of interactive television-based music, art, and poetry therapies in reducing symptoms of posttraumatic stress disorder among school children who have experienced abduction. A randomized control trial was adopted using school children from three selected secondary schools in Northern Nigeria that have experienced the issue of kidnapping. The treatment is characterized by (1) group setting, (2) TV instruction (3) school collaboration, and (4) use of artistic mediation. The study sample comprised 470 students randomly divided into a control group of 235 and an experiment group of 235. The treatment group was further divided into art (N = 78), music (N = 78) and poetry (N = 79), respectively. Results suggest that interactive television art, music and poetry therapies are an effective intervention strategy for reducing the PTSD of school children who have experienced kidnapping in Nigeria. However, art therapy is more effective in reducing PTSD. This study has offered empirical evidence that could guide the planning and implementation of therapies aimed at assisting school children to recover from traumatic experiences.
Collapse
Affiliation(s)
- Lei Zhang
- College of Literature Law and art, East China University of Technology, Nanchang City, Jiangxi Province, China.
| | - Ran Wan
- Architecture and Design College, Nanchang University, No.999, Xuefu Road, Honggu district, Nanchang City, Jiangxi Province, China, 330031.
| | - Timothy Onosahwo Iyendo
- Department of Architecture, Faculty of Environmental Sciences, Nile University of Nigeria, Plot 681, Institute Area, Federal Capital Territory, Abuja, Nigeria.
| | - Oberiri Destiny Apuke
- Faculty of Communication and Media Studies, Department of Mass Communication, Taraba State University, PMB 1167 Jalingo, Nigeria.
| | - Elif Asude Tunca
- The European University of Lefke, Faculty of Communication Sciences, Department of New Media and Journalism, Lefke, Northern Cyprus, TR-10 Mersin, Turkey.
| |
Collapse
|
4
|
Gever VC, Iyendo TO, Obiugo-Muoh UO, Okunade JK, Agujiobi-Odoh N, Udengwu N, Talabi FO, Nwokolo PN. Comparing the effect of social media-based drama, music and art therapies on reduction in post-traumatic symptoms among Nigerian refugees of Russia's invasion of Ukraine. J Pediatr Nurs 2023; 68:e96-e102. [PMID: 36470757 DOI: 10.1016/j.pedn.2022.11.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 11/16/2022] [Accepted: 11/16/2022] [Indexed: 12/05/2022]
Abstract
PURPOSE The objective of this study was to ascertain the effectiveness of social media-based music, art and drama therapies in treating PTSD symptoms among Nigerian evacuees from the Russia-Ukraine war. DESIGN AND METHODS This study was a quasi-experiment involving a sample of 330 participants that were randomly assigned to control and treatment groups. The treatment group was further classified into three groups according to the different contents of the therapies they received. RESULTS The study result showed that social media-based therapies effectively reduced PTSD symptoms for participants in the treatment group, unlike those who did not receive the intervention. Comparatively, drama therapy was more effective than art and music therapies. The reason drama therapy was more effective could be because it engaged the minds and body of the participants more than the other therapies. CONCLUSION Although art, music and drama therapies are effective treatment options for reducing symptoms of PTSD among victims of war, drama therapy is the most effective among them all. PRACTICAL IMPLICATIONS The result of this study has practical implications for health promotion from the perspective of nursing services by showing that social media-based therapies could serve as viable and cost-effectivealternativese to face-to-face group therapy.
Collapse
Affiliation(s)
| | - Timothy Onosahwo Iyendo
- Department of Architecture, Faculty of Engineering, Nile University of Nigeria, Abuja, Nigeria.
| | | | | | | | - Ngozi Udengwu
- Department of Theatre and Film Studies, University of Nigeria, Nsukka, Nigeria.
| | - Felix Olajide Talabi
- Department of Mass Communication, Redeemer's University, Ede, Osun State, Nigeria.
| | - Peter N Nwokolo
- Department of Mass Communication, University of Nigeria, Nsukka, Nigeria.
| |
Collapse
|
5
|
Ning M, Wen S, Zhou P, Zhang C. Ventral tegmental area dopaminergic action in music therapy for post-traumatic stress disorder: A literature review. Front Psychol 2022; 13:1014202. [PMID: 36300072 PMCID: PMC9589351 DOI: 10.3389/fpsyg.2022.1014202] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 09/21/2022] [Indexed: 11/24/2022] Open
Abstract
Post-traumatic stress disorder (PTSD) is a debilitating sequela of extraordinary traumatic sufferings that threaten personal health and dramatically attenuate the patient's quality of life. Accumulating lines of evidence suggest that functional disorders in the ventral tegmental area (VTA) dopaminergic system contribute substantially to PTSD symptomatology. Notably, music therapy has been shown to greatly ameliorate PTSD symptoms. In this literature review, we focused on whether music improved PTSD symptoms, based on VTA dopaminergic action, including the effects of music on dopamine (DA)-related gene expression, the promotion of DA release and metabolism, and the activation of VTA functional activities. In addition, the strengths and limitations of the studies concerning the results of music therapy on PTSD are discussed. Collectively, music therapy is an effective approach for PTSD intervention, in which the VTA dopaminergic system may hold an important position.
Collapse
Affiliation(s)
- Meng Ning
- School of Music, Huainan Normal University, Huainan, China
| | - Shizhe Wen
- School of Educational Sciences, Lingnan Normal University, Zhanjiang, China
| | - Peiling Zhou
- School of Educational Sciences, Lingnan Normal University, Zhanjiang, China
- Peiling Zhou
| | - Changzheng Zhang
- School of Educational Sciences, Lingnan Normal University, Zhanjiang, China
- *Correspondence: Changzheng Zhang
| |
Collapse
|
6
|
Scrine E. The Limits of Resilience and the Need for Resistance: Articulating the Role of Music Therapy With Young People Within a Shifting Trauma Paradigm. Front Psychol 2021; 12:600245. [PMID: 33584471 PMCID: PMC7873431 DOI: 10.3389/fpsyg.2021.600245] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 01/04/2021] [Indexed: 12/01/2022] Open
Abstract
A broad sociocultural perspective defines trauma as the result of an event, a series of events, or a set of circumstances that is experienced as physically or emotionally harmful or life threatening, with lasting impacts on an individual’s physical, social, emotional, or spiritual wellbeing. Contexts and practices that aim to be “trauma-informed” strive to attend to the complex impacts of trauma, integrating knowledge into policies and practices, and providing a sanctuary from harm. However, there is a body of critical and decolonial scholarship that challenges the ways in which “trauma-informed” practice prioritizes individualized interventions, reinscribes colonial power relations through its conceptualizations of safety, and obscures the role of systemic injustices. Within music therapy trauma scholarship, research has thus far pointed to the affordances of music in ameliorating symptoms of trauma, bypassing unavailable cognitive processes, and working from a strengths-based orientation. In critiquing the tendency of the dominant trauma paradigm to assign vulnerability and reinforce the individual’s responsibility to develop resilience through adversity, this conceptual analysis outlines potential alternatives within music therapy. Drawing on a case example from a research project with young people in school, I elucidate the ways in which music therapy can respond to power relations as they occur within and beyond “trauma-informed” spaces. I highlight two overarching potentials for music therapy within a shifting trauma paradigm: (1) as a site in which to reframe perceived risk by fostering young people’s resistance and building their political agency and (2) in challenging the assumption of “safe spaces” and instead moving toward practices of “structuring safety.”
Collapse
Affiliation(s)
- Elly Scrine
- Creative Arts and Music Therapy Research Unit, Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, VIC, Australia
| |
Collapse
|
7
|
Beck BD, Meyer SL, Simonsen E, Søgaard U, Petersen I, Arnfred SMH, Tellier T, Moe T. Music therapy was noninferior to verbal standard treatment of traumatized refugees in mental health care: Results from a randomized clinical trial. Eur J Psychotraumatol 2021; 12:1930960. [PMID: 34285768 PMCID: PMC8266250 DOI: 10.1080/20008198.2021.1930960] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Background: Many people with refugee backgrounds suffer from trauma-related complex social and psychological problems, and compliance with standard psychological treatment tends to be low. More culturally adaptable treatment options seem to be needed. Objective: We aimed to investigate whether the music therapy method: 'trauma-focused music and imagery' (tr-MI), characterized by a particular focus on arousal and affect regulation, would be equally effective as the standard psychological talk therapies for ameliorating trauma symptoms in Danish refugees. Methods: A pragmatic, noninferiority, parallel, randomized controlled trial with six-month follow-up was carried out at three clinics for refugees in the public mental health services of the Psychiatry (DK). Seventy-four adults diagnosed with posttraumatic stress disorder (PTSD) were allocated to either music therapy sessions (tr-MI, N = 39) or psychological treatment as usual (TAU, N = 35). Western classical music, new age music, and music from the participants' own national culture were used to generate inner imagery, following a phased treatment protocol. Homework entailed listening to music. The primary outcome was the measurement of trauma symptoms by the Harvard Trauma Questionnaire, section IV (HTQ-IV); secondary measures were somatoform and psychoform dissociation (DSS-20), SDQ-20), attachment (RAAS), and well-being (WHO-5). Treatment effects reflected by primary and secondary measures were estimated using linear mixed models. Results: Tr-MI was noninferior to TAU (mean difference at follow-up HTQ-IV: 0.14, CI (-0.10; 0.38), with a - 0.3 noninferiority margin). A high dropout rate of 40% occurred in the TAU group, compared to 5% in the music therapy group. Secondary measures generated small to medium effect sizes in both groups, with significant medium effect sizes for well-being and psychoform dissociation at follow-up in tr-MI. Conclusions: Tr-MI is an innovative form of psychological treatment in refugee mental health services. Trials comparing music therapy to standardized therapy are needed to substantiate the evidence base for tr-MI therapy.
Collapse
Affiliation(s)
- B D Beck
- Institute for Communication and Psychology, Aalborg University, Aalborg, Denmark.,Research Unit for Psychotherapy & Psychopathology, Mental Health Service West, Copenhagen University Hospital - Psychiatry Region Zealand, Slagelse, Denmark
| | - S L Meyer
- Research Unit for Psychotherapy & Psychopathology, Mental Health Service West, Copenhagen University Hospital - Psychiatry Region Zealand, Slagelse, Denmark.,Institute of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - E Simonsen
- Psychiatric Research Unit, Region Zealand; Department of Clinical Medicine, Copenhagen University, Copenhagen, Denmark
| | - U Søgaard
- Psychiatric Research Unit, Region Zealand; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - I Petersen
- Odense University Hospital and Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - S M H Arnfred
- Research Unit for Psychotherapy & Psychopathology, Mental Health Service West, Copenhagen University Hospital - Psychiatry Region Zealand, Slagelse, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - T Tellier
- Psychiatric Centre North Zealand, Mental health services in the Capital Region of Denmark
| | - T Moe
- Research Unit for Psychotherapy & Psychopathology, Mental Health Service West, Copenhagen University Hospital - Psychiatry Region Zealand, Slagelse, Denmark
| |
Collapse
|
8
|
Trauma and Mental Health during the Global Pandemic: Abstract Book of the ESTSS 2021 Virtual ConferenceEditors: Annett Lotzin, A.A.A. Manik J. Djelantik, Marloes B. Eidhof, Anke de Haan, & Jana Kiralj. Eur J Psychotraumatol 2021; 12:1940588. [PMID: 35251526 PMCID: PMC8635624 DOI: 10.1080/20008198.2021.1940588] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
|
9
|
Harvey AR. Links Between the Neurobiology of Oxytocin and Human Musicality. Front Hum Neurosci 2020; 14:350. [PMID: 33005139 PMCID: PMC7479205 DOI: 10.3389/fnhum.2020.00350] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 08/04/2020] [Indexed: 12/22/2022] Open
Abstract
The human species possesses two complementary, yet distinct, universal communication systems—language and music. Functional imaging studies have revealed that some core elements of these two systems are processed in closely related brain regions, but there are also clear differences in brain circuitry that likely underlie differences in functionality. Music affects many aspects of human behavior, especially in encouraging prosocial interactions and promoting trust and cooperation within groups of culturally compatible but not necessarily genetically related individuals. Music, presumably via its impact on the limbic system, is also rewarding and motivating, and music can facilitate aspects of learning and memory. In this review these special characteristics of music are considered in light of recent research on the neuroscience of the peptide oxytocin, a hormone that has both peripheral and central actions, that plays a role in many complex human behaviors, and whose expression has recently been reported to be affected by music-related activities. I will first briefly discuss what is currently known about the peptide’s physiological actions on neurons and its interactions with other neuromodulator systems, then summarize recent advances in our knowledge of the distribution of oxytocin and its receptor (OXTR) in the human brain. Next, the complex links between oxytocin and various social behaviors in humans are considered. First, how endogenous oxytocin levels relate to individual personality traits, and then how exogenous, intranasal application of oxytocin affects behaviors such as trust, empathy, reciprocity, group conformity, anxiety, and overall social decision making under different environmental conditions. It is argued that many of these characteristics of oxytocin biology closely mirror the diverse effects that music has on human cognition and emotion, providing a link to the important role music has played throughout human evolutionary history and helping to explain why music remains a special prosocial human asset. Finally, it is suggested that there is a potential synergy in combining oxytocin- and music-based strategies to improve general health and aid in the treatment of various neurological dysfunctions.
Collapse
Affiliation(s)
- Alan R Harvey
- School of Human Sciences, The University of Western Australia, Perron Institute for Neurological and Translational Science, Perth, WA, Australia
| |
Collapse
|
10
|
Lara-Cabrera ML, Bjørkly S, De Las Cuevas C, Pedersen SA, Mundal IP. Psychometric properties of the Five-item World Health Organization Well-being Index used in mental health services: Protocol for a systematic review. J Adv Nurs 2020; 76:2426-2433. [PMID: 32510656 DOI: 10.1111/jan.14445] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 04/21/2020] [Accepted: 05/06/2020] [Indexed: 11/30/2022]
Abstract
AIMS To synthesize evidence of the psychometric properties of the Five-item World Health Organization Well-being Index in mental health settings and critically appraise the methodologies of the included studies. DESIGN Protocol for a systematic psychometric review. METHODS The review protocol has been registered in the International Prospective Register for Systematic Reviews. The bibliographic databases MEDLINE, Embase, PsycINFO, CINAHL, Cochrane Library, and Web of Science will be searched for relevant studies. The psychometric properties of each study will be evaluated according to the Consensus-based Standards for the Selection of Health Measurements Instruments. DISCUSSION The results of our psychometric review will synthesize the psychometric properties of the Five-item World Health Organization Well-being Index in mental health settings and identify possible gaps in the literature regarding methodological quality and its reliability, validity, and responsiveness to change. IMPACT The evaluation of patient well-being is important, and the Five-item World Health Organization Well-being Index is an increasingly used patient-reported outcome measure. It is simple to collect, free to use, and consists of five questions using positive health statements. Although the number of studies assessing the validity, reliability, and responsiveness of the questionnaire is increasing worldwide, there is a need to summarize the existing evidence of the psychometric properties of this questionnaire. The proposed study's findings will contribute to future research recommendations and help midwives and nurses in different settings pick an effective, appropriate questionnaire to evaluate patient well-being.
Collapse
Affiliation(s)
- Mariela L Lara-Cabrera
- Division of Mental Health, Department of Research and Development, St Olav's University Hospital, Trondheim, Norway.,Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Division of Psychiatry, Tiller Community Mental Health Centre, St. Olav's University Hospital, Trondheim, Norway
| | - Stål Bjørkly
- Faculty of Health and Social Sciences, Molde University College, Molde, Norway.,Centre for Research and Education in Forensic Psychiatry, Oslo University Hospital, Oslo, Norway
| | - Carlos De Las Cuevas
- Department of Internal Medicine, Dermatology and Psychiatry, University of La Laguna, Santa Cruz de Tenerife, Spain
| | - Sindre Andre Pedersen
- Faculty of medicine and health sciences, Library Section for Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Ingunn Pernille Mundal
- Faculty of Health and Social Sciences, Molde University College, Molde, Norway.,Kristiansund Community Mental Health Centre, Møre og Romsdal Health Trust, Møre og Romsdal, Norway
| |
Collapse
|
11
|
Abstract
Identifying the causes of psychiatric and physical symptoms in asylum seekers, refugees and other migrants and making definitive diagnoses can be challenging. Ethical and legal challenges in the UK include the likely deterrent effects of upfront charging for National Health Service (NHS) services. This paper focuses on the fictitious case of an asylum seeker presenting to a mental health service in England, highlighting some of the difficulties in assessing and treating this patient group and providing advice to clinicians on clinical and practical management. Current NHS entitlements for migrants are summarised and a list is presented in the online supplement of non-governmental organisations that can provide further support.
Collapse
Affiliation(s)
| | - Cara Katona
- Camden and Islington Mental Health NHS Trust, UK
| | | |
Collapse
|
12
|
The effects of musical auditory stimulation on heart rate autonomic responses to driving: A prospective randomized case-control pilot study. Complement Ther Med 2019; 46:158-164. [PMID: 31519273 DOI: 10.1016/j.ctim.2019.08.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 08/06/2019] [Accepted: 08/06/2019] [Indexed: 11/23/2022] Open
Abstract
Stress induced by driving has been revealed to increase the chances of cardiovascular complications and is involved or related to traffic accidents. In order to develop strategies to avoid health problems during driving we aimed to evaluate the acute effects of auditory stimulation with music on heart rate variability (HRV) during driving in congested urban traffic. This is a prospective cross-sectional randomized controlled pilot study conducted with five healthy women. Subjects were evaluated on two different random days, whose order of execution was established through a randomization process. In the music protocol the volunteers were exposed to music for the entire 20 min of traffic while in the control protocol the subjects performed the same procedures but were not exposed to any music. We noted that all Higuchi fractal dimension parameters except Kmax 10, Kmax 130 and Kmax 140 were reduced between pre-driving in the control protocol vs. driving in the control protocol. The same changes were noted between pre-driving in the music protocol vs. driving in the control protocol. In conclusion, musical auditory stimulation improved nonlinear HRV changes induced by driving.
Collapse
|
13
|
Strange J. Text Watch. BRITISH JOURNAL OF MUSIC THERAPY 2018. [DOI: 10.1177/1359457518805992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|