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Article: Conceptualizing a Rehabilitation 'Model of Care' for Improving the Quality of Life of People with Parkinson's in India.

Barretto, Maria / D'souza, Nicole

2023 Volume 26, Issue 4, Page(s) 387–394

Abstract: Given the rise in the elderly population and predicted increase in age-related diseases like Parkinson's disease, as well as the treatment gaps in Low-and-Middle-Income Countries (LMICs), there is an urgent need to develop a culturally and ... ...

Abstract	Given the rise in the elderly population and predicted increase in age-related diseases like Parkinson's disease, as well as the treatment gaps in Low-and-Middle-Income Countries (LMICs), there is an urgent need to develop a culturally and socioeconomically viable Parkinson's model of care that would be multidisciplinary, replicable, affordable, and accessible to those who need it the most. We present here an outline of a rehabilitation model of care, which incorporates a standardized group therapy format, community-based Parkinson's Support Centers, collaboration with local stakeholders to ensure sustainability, and active engagement of People with Parkinson's (PwPs) and caregivers (CGs) in rehabilitation programs. This model of care incorporates a unique 16-session multi-disciplinary community rehabilitation module for PwPs and CGs which is evidence-based, easily deliverable by non-medical facilitators, relevant to PwPs and CGs, adaptable to different groups, practical and beneficial, and effective in a group - format. This rehabilitation model of care, encompassing the multidisciplinary rehabilitation module, holds promise for implementation in LMICs due to its dynamic nature, cost-effectiveness, community-based approach and easy adaptability to telehealth platforms. We share our experience of developing the model and outline implications for practice and insights about community rehabilitation work in LMICs.
Language	English
Publishing date	2023-07-28
Publishing country	India
Document type	Journal Article
ZDB-ID	2240174-X
ISSN	1998-3549 ; 0972-2327
ISSN (online)	1998-3549
ISSN	0972-2327
DOI	10.4103/aian.aian_366_23
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Delivering Load-Modifying Gait Retraining Interventions via Telehealth in People With Medial Knee Osteoarthritis: A Pilot Randomized Placebo-Controlled Clinical Trial.

D'Souza, Nicole / Hutchison, Laura / Grayson, Jane / Hiller, Claire / Kobayashi, Sarah / Simic, Milena

Journal of applied biomechanics

2023 Volume 40, Issue 1, Page(s) 50–65

Abstract: We aimed to investigate the effects of delivering 3 gait retraining interventions (toe-in, toe-out, and placebo gait) on proxy measures of medial knee load (early- and late-stance peak knee adduction moment [KAM], KAM impulse, and varus thrust) in people ...

Abstract	We aimed to investigate the effects of delivering 3 gait retraining interventions (toe-in, toe-out, and placebo gait) on proxy measures of medial knee load (early- and late-stance peak knee adduction moment [KAM], KAM impulse, and varus thrust) in people with knee osteoarthritis, using a hybrid model of face-to-face and telehealth-delivered sessions over 5 months. This was an originally planned 3-arm randomized placebo-controlled clinical trial. However, during the 2021 COVID-19 outbreak and lockdown in Sydney, Australia, the study became a pilot randomized controlled trial with the remainder of interventions delivered via telehealth. Nine individuals with symptomatic medial knee osteoarthritis were allocated to receive either a toe-in, toe-out, or posture re-education (placebo) gait retraining intervention. Primary outcomes of early- and late-stance peak KAM, KAM impulse, and varus thrust were assessed at baseline and follow-up. Eight participants returned for their follow-up gait assessment. Participants in both active intervention groups (toe-in and toe-out) achieved foot progression angle changes at follow-up. Overall, knee biomechanics in the placebo group did not change at follow-up. It is possible to achieve biomechanical changes in individuals with medial knee osteoarthritis when delivering gait retraining interventions via a hybrid model of face-to-face and telehealth.
MeSH term(s)	Humans ; Osteoarthritis, Knee/therapy ; Pilot Projects ; Gait ; Knee Joint ; Biomechanical Phenomena ; Telemedicine
Language	English
Publishing date	2023-10-25
Publishing country	United States
Document type	Randomized Controlled Trial ; Journal Article
ZDB-ID	1145288-2
ISSN	1543-2688 ; 1065-8483
ISSN (online)	1543-2688
ISSN	1065-8483
DOI	10.1123/jab.2023-0089
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Article ; Online: Toe-in and toe-out gait retraining interventions to reduce proxy measures of medial knee joint load in people with medial knee osteoarthritis: Protocol for a randomised placebo-controlled trial.

Hutchison, Laura / D'Souza, Nicole / Grayson, Jane / Hiller, Claire / Kobayashi, Sarah / Simic, Milena

Contemporary clinical trials

2023 Volume 134, Page(s) 107355

Abstract: Objective: Our primary aim is to determine the effect of a six-week toe-in, toe-out and active placebo gait retraining program on proxy measures of medial knee joint load and varus thrust in people with medial knee osteoarthritis. Our secondary aim is ... ...

Abstract	Objective: Our primary aim is to determine the effect of a six-week toe-in, toe-out and active placebo gait retraining program on proxy measures of medial knee joint load and varus thrust in people with medial knee osteoarthritis. Our secondary aim is to determine the intervention effects on patient reported outcomes and physical function and determine if changes are maintained at three-months follow-up. Methods: We will conduct a three-arm randomised placebo-controlled trial. Ninety participants with medial knee osteoarthritis will be randomised and stratified via varus thrust status (presence/absence) to: toe-in, toe-out or placebo gait retraining (an intervention that does not change proxy measures of medial knee joint load). The intervention involves weekly clinician-supervised sessions with biofeedback, knee osteoarthritis education, motor learning and behaviour change principles, and daily gait retraining practice. Primary outcomes are proxy measures of medial knee joint load: knee adduction moment (early- and late-stance peaks and impulse), and varus thrust (presence/absence). Secondary outcomes include pain, physical function, medication and health care utilisation, quality of life, work ability, treatment blinding, intervention credibility and other biomechanical outcomes. Assessment timepoints are at baseline, six weeks (post intensive training), and three-months following the six-week intervention. Conclusion: Our trial will determine whether toe-in or toe-out gait retraining is most effective at reducing proxy measures of medial knee joint load and varus thrust in people with medial knee osteoarthritis. This study will also evaluate if toe-in or toe-out gait retraining interventions are superior at improving pain, physical function and quality of life compared to placebo. Clinical trial registration: This clinical trial protocol is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12621000414819).
MeSH term(s)	Humans ; Osteoarthritis, Knee/therapy ; Quality of Life ; Australia ; Knee Joint ; Gait ; Pain ; Toes ; Randomized Controlled Trials as Topic
Language	English
Publishing date	2023-10-03
Publishing country	United States
Document type	Clinical Trial Protocol ; Journal Article
ZDB-ID	2182176-8
ISSN	1559-2030 ; 1551-7144
ISSN (online)	1559-2030
ISSN	1551-7144
DOI	10.1016/j.cct.2023.107355
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Article: NMR Relaxometry Studies on the Drying Kinetics of Cellulose Nanofibers

Suekuni, Murilo Toledo / D’Souza, Nicole / Allgeier, Alan M.

Industrial & engineering chemistry process design and development. 2022 Apr. 15, v. 61, no. 16

2022

Abstract: Nanocellulose is an emerging biopolymer with increasing interest from a variety of engineering fields. Given the complex textural properties and structural changes induced by drying, understanding the dehydration dynamics of nanocellulose is highly ... ...

Abstract	Nanocellulose is an emerging biopolymer with increasing interest from a variety of engineering fields. Given the complex textural properties and structural changes induced by drying, understanding the dehydration dynamics of nanocellulose is highly important. However, common bulk characterization techniques cannot be performed in real working conditions and usually require aggressive sample preparation. As an alternative, time-domain nuclear magnetic resonance (TD-NMR) can be applied with minimum interference. Here, well-established drying kinetic models and TD-NMR relaxometry were used to monitor water evaporation in a cellulose nanofiber slurry. The applied equations reasonably predicted the moisture contents from gravimetry but provided no information about the fluid/solid distribution during the drying event. As a complement, relaxometry results indicated the presence of water in different confinement environments based on obtained transverse relaxation time distributions. Free (bulk) water was observed during the initial 24 h of drying, and intrapore water presented a bimodal fashion with similar temporal trends but different rates. Lastly, the drying kinetic models were applied to the ratio of areas obtained from T₂ curves with a notable fit. The results discussed here support the use of relaxometry experiments as a viable method for drying kinetic studies with potential expansion to a myriad of wetted systems.
Keywords	biopolymers ; cellulose ; cellulose nanofibers ; evaporation ; gravimetry ; nuclear magnetic resonance spectroscopy ; process design ; slurries
Language	English
Dates of publication	2022-0415
Size	p. 5475-5483.
Publishing place	American Chemical Society
Document type	Article
ZDB-ID	1484436-9
ISSN	1520-5045 ; 0888-5885
ISSN (online)	1520-5045
ISSN	0888-5885
DOI	10.1021/acs.iecr.1c04878
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Relationship Between Knee Biomechanics and Pain in People With Knee Osteoarthritis: A Systematic Review and Meta-Analysis.

Hutchison, Laura / Grayson, Jane / Hiller, Claire / D'Souza, Nicole / Kobayashi, Sarah / Simic, Milena

Arthritis care & research

2022 Volume 75, Issue 6, Page(s) 1351–1361

Abstract: Objective: Our primary aim was to determine the cross-sectional relationship between knee biomechanics during gait and pain in people with medial knee osteoarthritis. Our secondary aim was to evaluate differences in knee biomechanics between symptomatic ...

Abstract	Objective: Our primary aim was to determine the cross-sectional relationship between knee biomechanics during gait and pain in people with medial knee osteoarthritis. Our secondary aim was to evaluate differences in knee biomechanics between symptomatic and asymptomatic participants with medial knee osteoarthritis. Methods: Four online databases were searched from inception to July 2021. Eligible studies included people with medial/nonspecific knee osteoarthritis and a reported relationship between knee biomechanics during gait and pain or biomechanics of symptomatic and asymptomatic participants. Two reviewers independently extracted data and evaluated risk of bias. Random-effects meta-analyses were performed when three or more studies reported the same biomechanical variable for pooling (knee adduction moment [KAM], KAM impulse, varus thrust, and peak knee flexion moment [KFM]). Results: Forty studies were included. Methodological quality ranged from 4 to 9/10. Forty-seven unique biomechanical variables were reported. For the KAM, there was no correlation with pain for peak values pooled (early stance and overall) (r = 0.00, 95% confidence interval [95% CI]: -0.12, 0.11, k = 16), a small negative correlation for early stance peak alone (r = -0.09, 95% CI -0.18, -0.002, k = 12), and a medium positive correlation for the overall peak during stance (r = 0.30, 95% CI 0.17, 0.42, k = 4). Metaregression identified that body mass index moderated the peak KAM-pain relationship (P < 0.001). KAM impulse had a small positive correlation with pain (r = 0.23, 95% CI 0.04, 0.40, k = 5), and people with varus thrust had 3.84 greater odds of reporting pain compared with people without (95% CI 1.72, 8.53, k = 3). Meta-analyses for the peak KFM and pain correlation and secondary aim were nonsignificant. Conclusion: Some knee gait biomechanics were associated with pain in this cohort. Longitudinal studies are required to determine causality.
MeSH term(s)	Humans ; Osteoarthritis, Knee/diagnosis ; Biomechanical Phenomena ; Knee Joint ; Knee ; Gait ; Pain
Language	English
Publishing date	2022-12-28
Publishing country	United States
Document type	Meta-Analysis ; Systematic Review ; Journal Article ; Review ; Research Support, Non-U.S. Gov't
ZDB-ID	645059-3
ISSN	2151-4658 ; 0893-7524 ; 2151-464X
ISSN (online)	2151-4658
ISSN	0893-7524 ; 2151-464X
DOI	10.1002/acr.25001
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Zs.A 2446: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
Zs.A 24: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)

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Article ; Online: Re-thinking global and public health projects during the COVID-19 pandemic context: Considerations and recommendations for early- and not-so-early-career researchers.

Spagnolo, Jessica / Gautier, Lara / Seppey, Mathieu / D'souza, Nicole Anne

Social sciences & humanities open

2020 Volume 2, Issue 1, Page(s) 100075

Abstract: This commentary aims to provide a glimpse into some of the early and continuing impacts of the COVID-19 pandemic on our global and public health projects: research in low-resourced settings; research with vulnerable populations, such as asylum seekers, ... ...

Abstract	This commentary aims to provide a glimpse into some of the early and continuing impacts of the COVID-19 pandemic on our global and public health projects: research in low-resourced settings; research with vulnerable populations, such as asylum seekers, Indigenous communities, children, and mental health service users; and research with healthcare professionals, frontline workers, and health planners. In the early context of restrictions caused by COVID-19, this commentary highlights our research setbacks and challenges, and the ways in which we are adapting research methodologies, while considering ethical implications related to the pandemic and their impacts on conducting global and public health research. As we learn to become increasingly aware of some of our limitations in the face of the pandemic, some positives are also worth highlighting: we are mobilizing our training and research skills to participate in COVID-19 projects and to disseminate knowledge on COVID-19, including through papers such as this one. However, we do acknowledge that these opportunities have not been equitable. Each thematic section of this commentary concludes with key recommendations related to research in the early and continuing context of the COVID-19 pandemic that we believe to be applicable to early- and not-so-early-career researchers working in the global and public health fields.
Language	English
Publishing date	2020-10-21
Publishing country	England
Document type	Journal Article
ISSN	2590-2911
ISSN (online)	2590-2911
DOI	10.1016/j.ssaho.2020.100075
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Re-thinking global and public health projects during the COVID-19 pandemic context: considerations and recommendations for early- and not-so-early- career researchers

Spagnolo, Jessica Gautier Lara Seppey Mathieu D’souza Nicole

Social Sciences & Humanities Open

Abstract: This commentary aims to provide a glimpse into some of the early and continuing impacts of the COVID-19 pandemic on our global and public health projects with different particularities: research in low-income and socially disadvantaged settings;research ... ...

Abstract	This commentary aims to provide a glimpse into some of the early and continuing impacts of the COVID-19 pandemic on our global and public health projects with different particularities: research in low-income and socially disadvantaged settings;research with vulnerable populations, such as refugees, asylum seekers, Indigenous communities, children, and mental health service users;and research with healthcare professionals and health planners In the early context of restrictions caused by COVID-19, this commentary highlights our research setbacks and challenges, and the ways in which we are adapting research methodologies, while considering ethical implications related to the pandemic and their impacts on conducting global and public health research As we learn to become increasingly aware of some of our limitations in the face of the pandemic, some positives are also worth highlighting: we are mobilizing our training and research skills to participate in COVID-19 projects and to disseminate knowledge on COVID-19, including through papers such as this one However, we do acknowledge that these opportunities have not been equitable Each thematic section of this commentary concludes with key recommendations related to research in the early and continuing context of COVID-19 that we believe to be applicable to early- and not-so-early- career researchers working in the global and public health fields
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #885440
Database	COVID19

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Article ; Online: Equitable and sustainable funding for community-based organisations in global mental health.

Larrieta, June / Wuerth, Milena / Aoun, May / Bemme, Dörte / D'souza, Nicole / Gumbonzvanda, Nyaradzayi / Esponda, Georgina Miguel / Roberts, Tessa / Yoder-Maina, Angi / Zamora, Emilia / Qureshi, Onaiza / Giacaman, Rita

The Lancet. Global health

2023 Volume 11, Issue 3, Page(s) e327–e328

MeSH term(s)	Humans ; Mental Health ; Global Health
Language	English
Publishing date	2023-01-27
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2723488-5
ISSN	2214-109X ; 2214-109X
ISSN (online)	2214-109X
ISSN	2214-109X
DOI	10.1016/S2214-109X(23)00015-3
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Article ; Online: Re-thinking global and public health projects during the COVID-19 pandemic context

Spagnolo, Jessica / Gautier, Lara / Seppey, Mathieu / D’souza, Nicole Anne

Social Sciences & Humanities Open

Considerations and recommendations for early- and not-so-early-career researchers

2020 Volume 2, Issue 1, Page(s) 100075

Keywords	covid19
Language	English
Publisher	Elsevier BV
Publishing country	us
Document type	Article ; Online
ISSN	2590-2911
DOI	10.1016/j.ssaho.2020.100075
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The ethics of relationality in implementation and evaluation research in global health: reflections from the Dream-A-World program in Kingston, Jamaica.

D'souza, Nicole A / Guzder, Jaswant / Hickling, Frederick / Groleau, Danielle

BMC medical ethics

2018 Volume 19, Issue Suppl 1, Page(s) 50

Abstract: Background: Despite recent developments aimed at creating international guidelines for ethical global health research, critical disconnections remain between how global health research is conducted in the field and the institutional ethics frameworks ... ...

Abstract	Background: Despite recent developments aimed at creating international guidelines for ethical global health research, critical disconnections remain between how global health research is conducted in the field and the institutional ethics frameworks intended to guide research practice. Discussion: In this paper we attempt to map out the ethical tensions likely to arise in global health fieldwork as researchers negotiate the challenges of balancing ethics committees' rules and bureaucracies with actual fieldwork processes in local contexts. Drawing from our research experiences with an implementation and evaluation project in Jamaica, we argue that ethical research is produced through negotiated spaces and reflexivity practices that are centred on relationships between researchers and study participants and which critically examine issues of positionality and power that emerge at multiple levels. In doing so, we position ethical research practice in global health as a dialectical movement between the spoken and unspoken, or, more generally, between operationalized rules and the embodied relational understanding of persons. Global health research ethics should be premised not upon passive accordance with existing guidelines on ethical conduct, but on tactile modes of knowing that rely upon being engaged with, and responsive to, research participants. Rather than focusing on the operationalization of ethical practice through forms and procedures, it is crucial that researchers recognize that each ethical dilemma encountered during fieldwork is unique and rooted in social contexts, interpersonal relationships, and personal narratives.
MeSH term(s)	Ethics, Research ; Global Health ; Jamaica ; Program Evaluation ; Research Design
Language	English
Publishing date	2018-06-15
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2041552-7
ISSN	1472-6939 ; 1472-6939
ISSN (online)	1472-6939
ISSN	1472-6939
DOI	10.1186/s12910-018-0282-5
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