Day 2 :
JFK Medical Center, USA
Keynote: The impact of the MAP (Mindfulness Attention Program) on Neurologic symptoms associated with Brain Injury (BI)
Time : 10:00-10:45
Joanne Azulay is clinical Neuropsychologist and Researcher at the JFK Johnson Rehabilitation Institute- USA and is an Assistant Clinical Professor of Physical Medicine and Rehabilitation at Robert Wood Johnson Medical School/ Rutgers University and Neuroscience at Seton Hall University. Dr. Azulay received her doctoral training in Clinical Psychology from Seton Hall University, completed her residency at UMDNJ Robert Wood Johnson Medical School. Dr. Azulay has been treating and researching in the field of neurologic disorders with a specialty in cognitive disorders of concussion. She has studied meditation in the Tibetan tradition as well as MBSR. Bringing together her training in mental health, brain injury and meditation, Dr. Azulay has been lecturing, publishing and teaching nationally and internationally for both patients and non-patients alike
Objective: To introduce a mindfulness meditation treatment program called the Mindfulness Attention Program (MAP). This program was developed and researched to address neurologic symptoms and has been running successfully for over ten years to address memory, attention and self-regulation deficits associated with neurologic disorders such as TBI, Stroke, Parkinson's, and Autoimmune disorders.
Design: Over the last six years we have assessed a convenience sample in a post acute brain injury rehabilitation center. Participants completed outcome measures and neuropsychological testing pre and post treatment intervention.
Participants: Participants included sixty- eight individuals with neurologic disorders and a time post onset greater than 7 months.
Intervention: The intervention consisted of a 10-week group (with weekly, 2-hour sessions) mindfulness program designed to facilitate implementation with a neurologic population. The treatment-involved the enhancement of attentional skills, increased awareness of internal and external experiences and exploration of physical and emotional pain.
Main Outcome Measures: Primary outcome measures included the Perceived Quality of Life Scale (PQOL), Perceived Self-Efficacy Scale (PSE) and the Neurobehavioral Symptom Inventory (NSI). Additional measures included neuropsychological (NP) tests, a self –report problem solving inventory, an emotional regulation measure and self-report measure of mindfulness.
Results: Clinically meaningful improvements were noted on measures of quality of life (Cohen’s d = 0.53) perceived self-efficacy (Cohen’s d = 0.57), and emotional regulation (Cohen’s d = 0.70), with smaller but still significant effects on measures of central-executive aspects of working memory.
Conclusion: A modified mindfulness program called the MAP is a powerful intervention with the cognitive, emotional and physical symptoms associated with a neurologic population.
Chiangmai University, Thailand
Time : 11:15-12:00
Background: Informal sector is one of the important industries employing a large number of people on its workforce, especially in the developing country like Thailand. The workers in the informal sector suffer from various types of occupational risks and musculoskeletal pain (MSP). Ergonomic risks and mental agony are recognized as important in the development and progression of MSP that can result in potentially huge cost in terms of health problems and economic burden for the individual and society. This study aimed to focus on the association among ergonomic risks, mental agony and MSP as well as discusses potential solution and recommended practices for minimizing the negative ergonomic and psychological consequences of the Thai informal sector.
Method: Total of 979 home-based handicraft workers were invited to participate in the study; 174 workers gave incomplete responses resulting a final response rate of 82.23%. The analysis sample comprised of 805 workers including ten groups of handicraft profession in Chiangmai and Lumpun provinces, Thailand. Research instruments were consisted of an interview questionnaire and the ergonomic checklist. The three levels of MSP participants were compared using chi-square test. Multiple regression analyses evaluated the significant impacts of independent variables on the dependent variable.
Results: The overall prevalence of MSP in the Thai home-based handicraft workers was 96.5%. The most common location for MSP was upper back (86.8%). Poor work methods was found to be a highest prevalence for ergonomic risks (100%) while burnout was found to be a highest prevalence of mental risk (97.2%). Analysis with the chi-square test indicated significant differences between mental agony and ergonomic (except work method) risks for the three levels of MSP (P<0.001). The analysis with multiple regression suggested mental risks were more important than ergonomic risks in explaining variations in MSP. Workstation design (β =0.087, t=2.475 p<0.05) and work methods (β =0.087, t=2.190 p<0.05) were the most significant ergonomic risk factors while burnout (β =0.313, t=6.273 p<0.001) was the strongest mental risk factor impacting the severity of MSP. The model explained 16.3 of the variance for MSP severity. On the other hand, anxiety (β =0.704, t=26.246 p<0.001) and work methods (β =0.085, t=3.177 p<0.01) were the significant risk factors impacting the severity of burnout. The model explained 51.8% of the variance in burnout severity.
Conclusions: The Thai informal sector is a high risk occupational sector to develop various types of MSP. The prevalence of MSP is very high. Both ergonomic risks and mental agony have significant impacts. To prevent MSP, an interdisciplinary and a multi-level approaches are needed, MSP and occupational risk assessment should be conducted from time to time. If significant risk factors are observed, appropriate interventions and management should be taken. Thai government should push more active political agendas and action frameworks for reducing MSP, mental agony and unorganized surroundings derived from informal employment.