THE IMPACT OF ETHNIC DISCRIMINATION AND INSTITUTIONAL BETRAYAL ON CANADIAN UNIVERSITY STUDENTS' MENTAL HEALTH.

The aims of this study were to understand associations among mental health symptoms, ethnic discrimination, and institutional betrayal, and explore the potential role of protective factors (e.g. ethnic identity and racial regard) in attenuating the detrimental effects of discrimination and betrayal. A total of 89 racialized Canadian university students were recruited for this study. Self-report measures investigated demographics, mental health symptoms, experiences of discrimination and institutional betrayal, racial regard, and ethnic identity. Experiencing ethnic discrimination was associated with increased symptoms of depression and PTSD, even when controlling for the buffering effects of protective factors. Marginally significant results suggested that institutional betrayal might play a role in this relationship. Experiencing ethnic discrimination is linked to significant posttraumatic consequences. Unhelpful institutional responses may further aggravate symptoms. Universities have a duty to protect victims, and prevent ethnic discrimination.

Effects of napping on neuromuscular fatigue in myasthenia gravis.

INTRODUCTION: The relationship between sleep and neuromuscular fatigue is understood poorly. The goal of this study was to evaluate the effects of napping on quantitative measures of neuromuscular fatigue in patients with myasthenia gravis (MG). METHODS: Eight patients with mild to moderate MG were recruited. Patients underwent maintenance of wakefulness tests (MWT) and multiple sleep latency tests (MSLT). The Quantitative Myasthenia Gravis Score (QMGS) was measured before nap and after each nap to examine the effects of napping and sleep on neuromuscular weakness. RESULTS: Results showed that QMGS improves only after naps where patients slept more than 5 min but not where patients did not sleep or slept less than 5 min. CONCLUSIONS: Daytime napping mitigates neuromuscular fatigue in patients with MG, especially if patients slept for more than 5 min.

Association of social support with quality of life in patients with polyneuropathy.

The aim of this study was to examine the impact of social support on quality of life (QoL) in patients with polyneuropathy. One hundred and fifty-four patients with polyneuropathy were enrolled from a neuromuscular clinic. The QoL Instrument and the Medical Outcome Study-Social Support Survey (MOS-SSS) were used to assess QoL and social support, respectively. Disease severity and clinical factors were also assessed. Neuropathy patients had a lower QoL compared to a previously published normative sample (p < 0.0001) and an MOS-SSS comparable to other patients with chronic disease. Social support correlated weakly with the self esteem and emotional well being mental health dimensions (rs :0.20-0.38) but not the physical health QoL (PH-QoL) domains. Physical and mental QoL also correlated significantly with presence of pain (rs : -0.39 and -0.42, respectively) and number of autonomic symptoms (rs : -0.39 and -0.30, respectively). Social support independently predicts MH-QoL when controlling for age, gender, pain, and the Toronto Clinical Neuropathy Score (TCNS; p < 0.0001). TCNS and gender are independently related to PH-QoL (p < 0.05). This study demonstrates that improved social support serves as an independent predictor of MH-QoL when controlling for age, gender, pain, and severity of neuropathy. Future studies examining the effects of improving social support on QoL in patients with polyneuropathy are recommended.

A patient-oriented research approach to assessing patients' and primary care physicians' opinions on trauma-informed care.

OBJECTIVE: To gather patients' and primary care physicians' (PCP) opinions on trauma-informed Care (TIC) and to investigate the acceptability of recommendations developed by patient, family, and physician advisors. DESIGN: Cross-sectional research survey design and patient engagement. SETTING: Canada, 2017 to 2019. PARTICIPANTS: English-speaking adults and licensed PCPs residing in Canada. MAIN OUTCOME MEASURES: Participants were given a series of questionnaires including a list of physician actions and a list of recommendations consistent with TIC. RESULTS: Patients and PCPs viewed TIC as important. Both patients and PCPs rated the following recommendations as helpful and likely to positively impact patient care: physician training, online trauma resource centres, information pamphlets, the ability to extend appointment times, and clinical pathways for responding to trauma. PCPs' responses were significantly more positive than patients' responses. CONCLUSION: TIC is important to patients and PCPs. Patients and PCPs believe changes to physician training, patient engagement, and systemic factors would be helpful and likely to positively impact patient care. Future research needs to be conducted to investigate whether these recommendations improve patient care.

Characteristics of muscle cramps in patients with polyneuropathy.

Muscle cramps are common in the general population and can be disabling for patients, but there is little evidence comprehensively evaluating cramp characteristics in patients with polyneuropathy. This study describes the prevalence and characteristics of muscle cramps in this patient group. Patients over 18 diagnosed with polyneuropathy were invited to join the study. Patients completed nerve conduction studies, the Toronto Clinical Neuropathy score, neuropathy-specific Vickrey's Quality of Life Assessment and a self-administered questionnaire examining demographics, neuropathy symptoms and cramp characteristics. Two hundred and twenty-five participants were enrolled (28.0% female). Sixty-three percent of patients experienced cramps, occurring on average 6 times per week, lasting 10.5 min and scoring 6 out of 10 on a pain scale and described as disabling by 43.6% of patients. No significant difference was found in cramp prevalence according to underlying pathophysiology (p = 0.52) or fiber type (p = 0.41). Patients with disabling cramps rated their physical (p < 0.0001) and mental (p = 0.04) quality of life lower than patients without disabling cramps. This study confirms that muscle cramps are common, disabling and associated with reduced quality of life in patients with polyneuropathy. Similar prevalence of cramps across predominant nerve fiber type suggests a role of sensory afferents in cramp generation, although this needs to be confirmed in larger cohorts.

Neurologist practice patterns in treatment of muscle cramps in Canada.

Recently an article provided patient perspectives on therapies and perceived effectiveness in preventing muscle cramps. However, there are few studies evaluating physicians' point of view in the management of this common symptom. In our study, we studied physician practice patterns in the treatment of muscle cramps by surveying a group of neurologists in Canada. We demonstrated that most physicians use a combination of pharmacological and non-pharmacological methods in treating muscle cramps. The most commonly used medications are baclofen, quinine and gabapentin, of which baclofen and quinine were reported to be the most tolerated.