Cynllun Cyflawni ar gyfer Cyflyrau Niwrolegol-Mae ymgynghori yn dod i ben yn fuan

The deadline for the Welsh Government’s Neuro Conditions Delivery Plan consultation is 31 January 2014. The consultation can be found online .

WAMES will be submitting a response and would like to hear your views. Contact Jan.

The Wales Neurological Alliance is also coordinating a response. They are inviting us to answer a few questions to help them. So far they have received comments about the Delivery Plan relating largely to MS. They would like to hear from people about a wide range of neurological conditions including ME.

Complete the survey online by Friday 10th January 2014.

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Need for psychological support for neurological conditions

A new report states the case for psychological support for people living with neurological conditions in West Wales. A range of cognitive dysfunction and mental health issues are outlined, many of which are shared by a number of conditions. It was noticed however that hypersensitivity to light, noise, busyness, chemicals, odours and touch was more commonly found in ME than other conditions.

Cognitive problems that can result from neurological conditions are often downplayed by medical professionals in importance compared to physical impairment but can severely affect daily life.

Recommendations include extending the neuropsychology service, possibly with a clinical psychologist who has an interest in neuropsychology based in Hywel Dda HB, who works under the governance of the neuropsychologist in Morriston hospital in Swansea, and clear information provision on how to access primary care counseling support and mental health services.

The report was published in November and presented at a Neurological Cross party group meeting in Carmarthen. Neurologists, neuropsychologists and Health Board staff jopined patients and carers at the meeting and supported the call for better service provision.

Psychological Support for People with Neurological Conditions in West Wales

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Cynllun Cyflawni ar gyfer Cyflyrau Niwrolegol ymgynghori

Mae’r Cynllun Cyflawni ar gyfer Cyflyrau Niwrolegol yn cynnig fframwaith ar gyfer gweithredu i Fyrddau Iechyd Lleol ac Ymddiriedolaethau. Mae’n nodi’r hyn y mae Llywodraeth Cymru yn ei ddisgwyl gan y GIG yng Nghymru o ran cynllunio, sicrhau a darparu gofal o ansawdd uchel sy’n canolbwyntio ar yr unigolyn i unrhyw un sydd wedi’i effeithio gan gyflwr niwrolegol. Mae’n canolbwyntio ar ddiwallu angen y boblogaeth, mynd i’r afael â gwahaniaethau o ran hygyrchedd gwasanaethau a lleihau anghydraddoldeb mewn canlyniadau iechyd drwy 6 thema:

  • Codi ymwybyddiaeth o gyflyrau niwrolegol
  • Gwneud diagnosis amserol o gyflyrau niwrolegol
  • Gofal cyflym ac effeithiol
  • Byw gyda chyflwr niwrolegol
  • Gwella gwybodaeth
  • Targedu ymchwil

Ar gyfer pob thema, mae’n nodi’r canlynol:

  • Disgwyliadau o ran cyflawni ar gyfer rheoli cyflyrau niwrolegol
  • Blaenoriaethau penodolar gyfer 2013-2016
  • Cyfrifoldeb am ddatblygu a chymryd camau i gyflawni’r blaenoriaethau penodol
  • Dangosyddion canlyniadau poblogaeth a mesurau sicrwydd y GIG

Mae’r rhain yn ategu’r gofynion ansawdd a gefnogwyd yn Adroddiad y Grŵp Gorchwyl a Gorffen ar Lwybrau Gofal ar gyfer Cyflyrau Niwrolegol Hirdymor, y mae’n rhaid ei ddarparu ochr yn ochr â’r Cynllun Cyflawni hwn.

Mae gwasanaethau i bobl sydd mewn perygl o gael strôc, neu sydd wedi cael strôc, yn cael eu trafod ar wahân yn y Cynllun Cyflawni ar gyfer Strôc.

Yn 2009, cyhoeddodd y Grŵp Gorchwyl a Gorffen ar Lwybrau Gofal ar gyfer Cyflyrau Niwrolegol Hirdymor ei adroddiad a’i argymhellion. Cefnogai set o egwyddorion generig ar gyfer datblygu gwasanaethau i gynorthwyo pobl â chyflyrau niwrolegol hirdymor i reoli eu cyflwr, cadw’n annibynnol a sicrhau’r ansawdd bywyd gorau posibl drwy broses integredig o addysgu, rhannu gwybodaeth, asesu, cynllunio gofal a darparu gwasanaethau. Yn sgil hynny, cyhoeddwyd nifer o lwybrau gofal ar gyfer cyflyrau niwrolegol yn cynnwys epilepsi, clefyd niwronau motor, dystroffi’r cyhyrau, clefyd Parkinson ac anaf i’r ymennydd.

Roedd gofal iechyd arbenigol safonau niwrowyddorau Cymru gyfan ar gyfer plant a phobl ifanc, a gyhoeddwyd ym mis Gorffennaf 2009, yn nodi safonau gofal a nifer o gamau gweithredu allweddol.

Sut i ymateb:

Cyflwynwch eich sylwadau erbyn 31 Ionawr 2014 arlein,

E-bost majorhealthconditionspolicyteam@wales.gsi.gov.uk

Post:

Tîm Polisi Cyflyrau Iechyd Difrifol, Is-adran Ansawdd Gofal Iechyd, Llywodraeth Cymru, Parc Cathays, Caerdydd  CF10 3NQ

 

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Cywirdeb y cof am symptomau CFS

Abstract

This study serves as an investigation of the reliability of symptom data as reported by individuals with chronic fatigue syndrome (CFS), across three recall time frames (the past week, the past month, and the past 6 months), and at two assessment points (with 1 week in between each assessment).

Multilevel model analyses were used to determine the optimal recall time frame, in terms of test-retest reliability, for each of the Fukuda et al. (1994) case defining symptoms.

Results suggested that the optimal time frame for reliably reporting CFS symptoms was six months for sore throat, lymph node pain, muscle pain, post-exertional malaise, headaches, memory/concentration difficulties, and unrefreshing sleep.

For joint pain, the optimal time frame was one month.

Researchers who are interested in the assessment of CFS symptoms need to take recall time frame into account, especially when the intended goal is to standardize and improve the methods used to reliably and accurately diagnose this complex illness.

Effects of Time Frame on the Recall Reliability of CFS Symptoms, by Evans M, Jason LA, in Evaluation and the Health Professions, 23 September 2013. [Epub ahead of print]

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Dweud eich dweud – pleidleisio newydd ar y wefan WAMES

The first in a new series of polls will help WAMES to be more informed when campaigning on your behalf

Which symptom would you most want health professionals in Wales to help you with?

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Information processing problems in CFS

Research abstract

Information processing difficulties are common in patients with chronic fatigue syndrome (CFS).

It has been shown that the time it takes to process a complex cognitive task, rather than error rate, may be the critical variable underlying CFS patients’ cognitive complaints.

The Attention Network Task (ANT) developed by Fan and colleagues may be of clinical utility to assess cognitive function in CFS, because it allows for simultaneous assessment of mental response speed, also called information processing speed, and error rate under three conditions challenging the attention system.

Comparison of data from two groups of CFS patients (those with and without comorbid major depressive disorder; n=19 and 22, respectively) to controls (n=29) consistently showed that error rates did not differ among groups across conditions, but speed of information processing did.

Processing time was prolonged in both CFS groups and most significantly affected in response to the most complex task conditions. For simpler tasks, processing time was only prolonged in CFS participants with depression. The data suggest that the ANT may be a task that could be used clinically to assess information processing deficits in individuals with CFS.

Attention network test: Assessment of cognitive function in chronic fatigue syndrome by Fumiharu Togo, Gudrun Lange, Benjamin H. Natelson, Karen S. Quigley in Journal of Neuropsychology, 24 September 2013 (Epub before print).

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Nid oes tystiolaeth bod y brechlyn canser ceg y groth yn achosi CFS

The Medicines and Healthcare products Regulatory Agency (MHRA) has found no evidence that Cervarix – an HPV vaccine which protects against cervical cancer- causes chronic fatigue syndrome, also known as ME.

The MHRA’s scientists conducted their study after reports that some women were suffering from chronic fatigue syndrome following vaccination.

Cervarix vaccine was given to over 2 million young women aged between 12 and 18 years as part of the Government’s human papillomavirus (HPV) vaccination programme. The jabs began in September 2008 and ended in September 2012 when the vaccine was replaced by Gardasil, which protects against both cervical cancer and genital warts.

Both vaccines are licensed in the UK. The NHS currently uses Gardasil to vaccinate girls aged 12 – 13 years old.

Scientists at the MHRA analysed patient records to compare the frequency of fatigue syndromes in young women before and after the start of the vaccination programme and the risk following vaccination compared to other time periods.

The study, published in the journal Vaccine, found no evidence of an increased risk of chronic fatigue syndrome in women after having the Cervarix jab. This supports earlier reporting trends from the MHRA’s own Yellow Card surveillance system which collects information from doctors, other healthcare professionals and patients regarding suspected adverse reactions.

Dr Philip Bryan of the MHRA, who co-authored the study, says in a press release: “We have one of the best HPV vaccination programmes in the world that protects women from cervical cancer.

“Our study found no evidence to implicate Cervarix vaccine in development of chronic fatigue syndrome, and we hope that our findings give further reassurance about the safety of the HPV vaccine.â€

Robert Music, Chief Executive of Jo’s Cervical Cancer Trust, says in a prepared statement: “Like all vaccines there are possible side effects to take into consideration and it’s important that those eligible and their guardians make themselves aware of these, but these research findings by the MHRA are very positive and we encourage all those who are eligible to take up the vaccine.

“Cervical cancer is a largely preventable disease thanks in part to the HPV vaccination which prevents 70% of cervical cancers. Indeed researchers have said that an 80% uptake year on year could see a two thirds reduction in cervical cancer incidence in women under 30 by 2025.â€

The MHRA says the safety and efficacy of both Cervarix and Gardasil vaccines has been extensively studied in clinical trials before licensing. The most common side-effects are injection-site reactions, fever, headache, fatigue, muscle pain, nausea, vomiting and diarrhoea.

It says Cervarix and Gardasil have now been used in tens of millions of people and their safety is well established. However, as with all vaccines and medicines used in the UK the MHRA will continue to monitor their safety.

Press release

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Cynulliad pobl ifanc – dweud eich dweud

There is still time to tell Funky Dragon, the children and young people’s assembly for Wales, what you think they should be doing in 2013/14.

Their mission is to enable children and young people up to aged 25 in Wales to get their voices heard by Government and others who make decisions about policies and services that affect their lives.

What changes do you want to see in health & social care, education, environment or use of the Welsh language?

Complete the survey:

1) Online

2) Get in touch and ask for a paper copy which can be sent back to Funky Dragon by Fri 18th Oct using a Free Post address.

You can also give your views on a range of topics such as ‘Votes at 16’ or ‘do you feel safe at school’?

Funky Dragon, 1st floor offices, 8 Castle Sq, Swansea, SA1 1DW 01792 450000

OR 9 Wynnstay, Colwyn Bay, Conwy LL29 8NB 01492 532005   enquiries@funkydragon.org

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Brain fog in POTS

Research abstract

PURPOSE: Adolescents with postural tachycardia syndrome (POTS) often experience ill-defined cognitive impairment referred to by patients as ‘‘brain fog.’’ The objective of this study was to evaluate the symptom of brain fog as a means of gaining further insight into its etiology and potential palliative interventions.

METHODS: Eligible subjects who reported having been diagnosed with POTS were recruited from social media web sites. Subjects were asked to complete a 38-item questionnaire designed for this study, and the Wood mental fatigue inventory (WMFI).

RESULTS: Responses were received from 138 subjects with POTS (88 % female), ranging in age from 14 to 29 years; 132 subjects reported brain fog. WMFI scores correlated with brain fog frequency and severity (P\0.001). The top ranked descriptors of brain fog were ‘‘forgetful,’’ ‘‘cloudy,’’ and ‘‘difficulty focusing, thinking and communicating.’’ The most frequently reported brain fog triggers were fatigue (91 %), lack of sleep (90 %), prolonged standing (87 %), dehydration (86 %), and feeling faint (85 %).

Although aggravated by upright posture, brain fog was reported to persist after assuming a recumbent posture. The most frequently reported interventions for the treatment of brain fog were intravenous saline (77 %), stimulant medications (67 %), salt tablets (54 %), intra-muscular vitamin B-12 injections (48 %), and midodrine (45 %).

CONCLUSIONS: Descriptors for ‘‘brain fog’’ are most consistent with it being a cognitive complaint. Factors other than upright posture may play a role in the persistence of this symptom. Subjects reported a number of therapeutic interventions for brain fog not typically used in the treatment of POTS that may warrant further investigation.

What is brain fog? An evaluation of the symptom in postural tachycardia syndrome, by Amanda J. Ross, Marvin S. Medow, Peter C. Rowe, Julian M. Stewart in Clin Auton Res. 2013 Sep 3. [Epub ahead of print]

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Post-exertion malaise in CFS: symptoms & gene expression

Research abstract

BACKGROUND

A primary complaint of chronic fatigue syndrome (CFS) patients is post-exertion malaise, which is a worsening of symptoms following activities such as exercise.

PURPOSE

To examine the link between gene expression for metabolite, adrenergic, immune, and glucocorticoid receptors on leukocytes and symptoms (pain, fatigue, and mood) following a maximal exercise test.

METHODS

Thirteen CFS patients and 11 healthy participants matched on age and fitness underwent blood draws and completed questionnaires immediately before, and 15 minutes, 48 hours, and 72 hours following, maximal exercise.

Symptom and genetic measures collected before and after exercise were compared using a doubly multivariate repeated-measures analysis of variance. Results: This comparison of CFS and healthy participants resulted in a significant multivariate main effect for Group (p < 0.05). Univariate analyses indicated group differences for adrenergic α-2A and glucocorticoid (NR3C1) receptor messenger ribonucleic acid and symptoms of fatigue and confusion. Changes in gene expression were significantly correlated with symptoms.

CONCLUSIONS

Results suggest that increased glucocorticoid sensitivity may contribute to the symptoms of post-exertion malaise in CFS. As NR3C1 interacts with other transcription factors, investigating the resulting cascades may lead to greater understanding of the biological mechanism of post-exertion malaise. This finding, if confirmed, could lead to novel approaches to prevent symptom exacerbation in CFS.

Post-exertion malaise in chronic fatigue syndrome: symptoms and gene expression, by Jacob D. Meyer,, Alan R. Light, Sanjay K. Shukla, Derek Clevidence, Steven Yale, Aaron J. Stegner & Dane B. Cook

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