Carola Muñoz

Women's Health Research Institute

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Luís Nacul

London School of Hygiene & Tropical Medicine

Travis Boulter

Provincial Health Services Authority

Carolyn Gotay

University of British Columbia

Emily Meagher

Women's Health Research Institute

Tianna Magel

University of British Columbia

Melody Tsai

Women's Health Research Institute

Aditi Shah

Group for Research in Decision Analysis

Sarah Neil‐Sztramko

McMaster University

Chris Carlsten

University of British Columbia

James C. Johnston

BC Centre for Disease Control

Cooperative Institutions

Universidad de Zaragoza

Universidad de Granada

Consejo Superior de Investigaciones Científicas

Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition

University of British Columbia

Instituto de Ciencia y Tecnología de Alimentos y Nutrición

University of Crete

University of Toronto

Inserm

Université de Lille

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The Impact of an Intervention to Improve Sleep Quality in Normal, Overweight, and Obese Female Shift Workers

Canadian Journal of Diabetes (2015)

Carolyn Gotay Hui Shen Carola Muñoz

Sleep

Normal weight

10.1016/j.jcjd.2015.01.256

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Citations (1)

Improving Sleep Quality for Women Who Work Night Shifts : A Pilot Study of a Sleep Hygiene Intervention

Carolyn Gotay Carola Muñoz Hui Shen Kristan J. Aronson Kristin Campbell

Sleep hygiene

Sleep

10.14288/1.0397202

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Complex Chronic Diseases Program: Program Description & Health Outcomes Assessment from a Clinical Data Registry

medRxiv (Cold Spring Harbor Laboratory) (2024)

Emily Meagher Tianna Magel Travis Boulter Carola Muñoz Nicole Prestley

Introduction The Complex Chronic Diseases Program (CCDP) was funded by the BC Ministry of Health to address gaps in health services provision for Complex Chronic Diseases (CCDs). The Program offers medical interventions and education on self-management for people with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), Fibromyalgia (FM), and Chronic Lyme-Like Syndrome (CLLS). The CCDP Data Registry was created in 2017 for monitoring participant outcomes and program evaluation. Methods This research outlined the CCDP model of care and analyzed patient-reported questionnaires and clinical data collected longitudinally from consented CCDP Data Registry participants spanning June 2017 through September 2022. T-tests and linear regression modelling were conducted to ascertain changes in symptom presentation across program involvement. These analyses specifically targeted data at the following time points: baseline, 6 months follow-up, and discharge. Results Data reported in this study represented 668 eligible participants from the 1-year Program. Demographically, the average age was 49 years old (SD=13), 90% were women (n=557), 54% were diagnosed with ME/CFS and FM (n=360), and 36% reported being on long term illness/disability (n=219). Between baseline and discharge, participants with ME/CFS and FM reported improvements in overall physical and mental health, but no significant improvement in other symptom domains such as sleep, fatigue, and pain. The duration of disease at baseline was only related to sleep quality. The previous, more individualized model of care showed better mental health outcomes at 6-months follow-up. Discussion This analysis showed that CCDP patients experienced relatively severe and persistent symptom presentations. Participants involved in the Program experienced some health benefits at discharge, but further research and interventions are needed to optimize health outcomes. The reliance on self-report of symptoms and the absence of a control group without intervention limit the significance of these findings. A Strategic Direction Plan was developed by the CCDP which emphasized improved training, decentralized services, fast-tracking of eligible individuals, and enhanced education for better patient outcomes.

10.1101/2024.05.25.24307912

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Condiciones sociolaborales de los médicos generales del municipio de Pasto

Carola Muñoz

La investigacion que se presenta comprende las caracteristicas demograficas de los medicos generales en el ente territorial, las cuales se perfilan a traves de la consideracion de variables significativas tales como la edad, sexo, estrato socio economico, lugar de nacimiento, universidad donde cursaron estudio, nivel de ingresos, lugares de trabajo, la seguridad social, lo mismo que sus condiciones laborales, las perspectivas objetivas y subjetivas de vida y sus expectativas laborales, de capacitacion, de trabajo y otras de tipo socio economico, frente al actual panorama tanto de empleo como de ejercicio de la profesion a la luz de las normas que regulan la Salud, en especial la ley 100 de 1993 y su modelo de funcionalidad en el pais, de cara a un entorno global. De tal manera, el presente documento, es el primero en su genero que se realiza en Narino y representa un significativo avance para la comprension y dinamica de la poblacion objeto de analisis y se constituye en un excelente punto de partida no solamente para futuras investigaciones, sino para emprender acciones concretas dentro del quehacer de la Secretaria de Salud como entidad responsable para proponer estrategias que optimicen el mejoramiento en la prestacion de servicios en nuestro territorio.

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Epidemiology of Myalgic Encephalomyelitis among individuals with self-reported Chronic Fatigue Syndrome in British Columbia, Canada, and their health-related quality of life

medRxiv (Cold Spring Harbor Laboratory) (2024)

Enkhzaya Chuluunbaatar Melody Tsai Travis Boulter Carola Muñoz Kathleen Kerr

ABSTRACT Background There is no accurate data on the epidemiology of Myalgic Encephalomyelitis/ Chronic Fatigue Syndrome (ME/CFS) in Canada. The aims of the study were to describe the epidemiology of confirmed ME/CFS cases and their health-related quality of life (HRQoL). Methods This is a cross-sectional study with British Columbia Generations Project (BCGP) participants who self-reported having CFS and population-based controls with no fatiguing illness. Participants completed the Symptoms Assessment Questionnaire, RAND 36-item Health Survey, and Phenotyping Questionnaire Short-form. These assessments enabled the identification and characterization of “confirmed cases” of ME/CFS. Those with self-reported diagnoses who did not meet study diagnosis of ME/CFS were subcategorized as “non-ME/CFS cases.” Results We included 187 participants, 45.5% (n=85) self-reported cases and 54.5% (n=102) controls; 34% (n=29) of those who self-reported ME/CFS fulfilled diagnostic criteria for ME/CFS. The population prevalence rates were 1.1% and 0.4% for self-reported and confirmed ME/CFS cases respectively. Participants displayed significantly lower scores in all eight SF-36 domains compared to the other groups. Mental component scores were similar between ME/CFS and non-ME/CFS groups. The main risk factor for low HRQoL scores was fatigue severity (β = - 0.6, p<0.001 for physical health; β = -0.7, p<0.001 for mental health). Conclusions The majority of self-reported cases do not meet diagnostic criteria for ME/CFS, suggesting that self-reported CFS may not be a reliable indicator for a true ME/CFS diagnosis. HRQoL indicators were consistently lower in ME/CFS and non-ME/CFS cases compared to controls, with ME/CFS cases having lower scores in most domains. Having higher symptom severity scores and perceived poorer health were the significant affecting factors of lower HRQoL. Although self-report can be used as screening to identify cases in populations, we suggest studies of ME/CFS should include appropriate medically confirmed clinical diagnosis for validity. Further large-scale population-based studies with simultaneous medical assessment are suggested to further characterize validity parameters of self-reported diagnosis.

Encephalomyelitis

10.1101/2024.05.16.24307437

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Fatigue presentation, severity, and related outcomes 12 weeks post-COVID-19 hospitalization

medRxiv (Cold Spring Harbor Laboratory) (2022)

Tianna Magel Emily Meagher Travis Boulter Arianne Albert Melody Tsai

Abstract Background Increasing evidence on long-term health outcomes following SARS CoV-2 infection shows post-viral symptoms can persist for months. The aim of the present study was to examine the prevalence and outcome predictors of post-viral fatigue and related symptoms 3 and 6 months following infection. Methods A prospective cohort of patients hospitalized with COVID-19 (n=88) were recruited from a Post-COVID-19 Respiratory Clinic (PCRC) in Vancouver, Canada to examine predictors of long-term fatigue and substantial fatigue. Multivariable logistic and linear regression analysis were used to examine the relationship between patient predictors (medical history at the time of hospitalization and follow-up patient-reported outcome measures) and the presentation of fatigue and substantial fatigue at 3 and 6 months follow-up. Results The number of patients exhibiting fatigue and substantial fatigue was 58 (67%) and 14 (16%) at 3 months and 47 (60%) and 6 (7%) at 6 months post-infection, respectively. Adjusted analysis revealed the number of pre-existing comorbidities to be associated with fatigue (OR 2.21; 95% CI 1.09-4.49; 0.028) and substantial fatigue (OR 1.73; 95% CI 1.06-2.95; 0.033) at 3 months follow-up. Except for shortness of breath, self-care, and time, all follow-up variables were found to be associated with fatigue and substantial fatigue at 3 months follow-up. Conclusion Fatigue and substantial fatigue are common, and decrease from 3 to 6 months; however, a significant number of patients continue to exhibit long-term fatigue at 6 months follow-up. Further research is needed to clarify the causality of viral infections and co-factors in the development and severity of fatigue as a symptom and in meeting post-viral fatigue syndrome or ME/CFS diagnostic criteria.

Chronic Fatigue

Presentation (obstetrics)

10.1101/2022.10.18.22280199

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Promoting healthy European lifestyle by exercise and nutrition in adolescents: The HELENA study

Luís A. Moreno M González-Gross Marcos Antônio Pesquero David Jiménez‐Pavón María‐José Sánchez

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Fatigue presentation, severity, and related outcomes in a prospective cohort following post-COVID-19 hospitalization in British Columbia, Canada

Frontiers in Medicine (2023)

Tianna Magel Emily Meagher Travis Boulter Arianne Albert Melody Tsai

Introduction Increasing evidence on long-term health outcomes following SARS CoV-2 infection shows post-viral symptoms can persist for months. These symptoms are often consistent with those of Myalgic Encephalomyelitis or Chronic Fatigue Syndrome (ME/CFS). The aim of the present study was to examine the prevalence and outcome predictors of post-viral fatigue and related symptoms 3- and 6-months following symptom onset. Methods A prospective cohort of patients hospitalized with Coronavirus disease (COVID-19) ( n = 88) were recruited from a Post-COVID-19 Respiratory Clinic (PCRC) in Vancouver, Canada to examine predictors of long-term fatigue and substantial fatigue. Multivariable mixed effects analyses examined the relationship between patient predictors, including pre-existing comorbidities, patient reported outcome measures, and fatigue and substantial fatigue at follow-up. Results The number of patients experiencing fatigue or substantial fatigue at 3 months post-infection were 58 (67%) and 14 (16%) respectively. At 6 months these numbers declined to 47 (60%) patients experiencing fatigue and 6 (6%) experiencing substantial fatigue. Adjusted analysis, for sex, age, and time, revealed the number of pre-existing comorbidities to be associated with fatigue (OR 2.21; 95% CI 1.09–4.49; 0.028) and substantial fatigue (OR 1.73; 95% CI 1.06–2.95; 0.033) at 3 months follow-up. Except for shortness of breath, self-care, and follow-up time, all follow-up variables were found to be associated with fatigue and substantial fatigue at 3 months. Conclusion Fatigue and substantial fatigue are common after COVID-19 infection but often diminish over time. A significant number of patients continue to exhibit long-term fatigue at 6 months follow-up. Further research is needed to clarify the causality of viral infections in the development and severity of fatigue as a symptom and in meeting post-viral fatigue syndrome or ME/CFS diagnostic criteria.

Chronic Fatigue

10.3389/fmed.2023.1179783

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Citations (7)

Development of Epidemiological Research Guidelines for Myalgic Encephalomyelitis / Chronic Fatigue Syndrome in Canada

Enkhzaya Chuluunbaatar Travis Boulter Carola Muñoz Sunita Vohra Rahul Shetty

The Interdisciplinary Canadian Collaborative ME Research Network (ICanCME), established in 2019, aims to foster research in Canada and contribute to finding the causes and possible treatments for myalgic encephalomyelitis /chronic fatigue syndrome (ME/CFS), thereby reducing the impact of ME/CFS on the health of Canadians. The main objectives of this paper are to suggest standards for ME/CFS research for the collection of data from participants (Recommended Data Elements) and to consider other factors, such as design, language, cultural issues, equity, and diversity. Consensus of the relevant contents of this research guideline was reached during the ICanCME working group meetings and were based on existing guidelines. Members of the working group contributed to guideline development based on their respective expertise. The proposed research guidelines could improve research quality and advance knowledge in the field of ME/CFS, and ultimately benefit ME/CFS patients.

Encephalomyelitis

10.20944/preprints202405.1571.v1

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Development of a Physical Activity Intervention for Women Shift Workers

Health Behavior and Policy Review (2017)

Sarah Neil‐Sztramko Carolyn Gotay Paul A. Demers Carola Muñoz Kristin L. Campbell

10.14485/hbpr.4.4.10

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Citations (3)