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The prevalence of unhealthy lifestyle habits such as smoking has seldom been described in neuromuscular disorders, including myotonic dystrophy type 1 (DM1). However, it is essential to document the unhealthy lifestyle habits as they can exacerbate existing impairments and disabilities. The objectives are: 1) To determine the prevalence of risk factors among individuals with DM1; 2) To compare the prevalence among classic and mild phenotypes.
A survey was done on a sample of two-hundred (200) patients with DM1 as part of a larger study. Lifestyle risk factors included being overweight or obese, tobacco smoking, illicit drug use, excessive alcohol consumption and physical inactivity. A registered nurse administered the validated public health survey. Categorization of risk factors were based on national standards and compared with provincial and regional prevalences.
50% of DM1 patients were overweight or obese, 23.6% were regular smokers, and 76% were physically inactive. Except for overweight and obesity, significant differences were observed between patients with classic and mild phenotypes for all the other lifestyle risk factors: those with the classic phenotype being more often regular smokers, consuming more often illicit drugs and being less physically active.
The results of this study will provide guidance for the development of better adapted and focussed health promotion interventions in the future.
This chapter reviews the manner in which sleep deprivation and circadian misalignment lead to impaired performance among healthcare providers. Several sleep and circadian factors affect the performance of physicians-in-training as well as other healthcare providers. In addition to acute sleep restriction, residents suffer chronic sleep restriction. Extended-duration work shifts also increase the likelihood of fatigue-related, self-reported medical errors. As learning is central to medical residency, any factor impairing resident learning is of concern. The only randomized evidence regarding elimination of 30-h shifts, and substitution with 16-h shifts, suggests that errors could in fact decrease by more than double this amount with widespread implementation of a 16-h shift limit. Lab- and field-based studies show us that extended resident shifts impair cognition and likely impair learning. Such impairment translates into error, poor patient care, and resident harm.