Dolphin-Assisted Therapy for Children with Special Needs: A Pilot Study

ERIC Educational Resources Information Center

Dilts, Rachel; Trompisch, Norbert; Bergquist, Timothy M.

2011-01-01

Dolphin-assisted therapy (DAT), as a part of animal-assisted therapy and complementary and alternative medicine, yields several positive results. This study intended to add to DAT effectiveness research while using a standardized assessment. In the Ukraine, a DAT program called DolphinSwim agreed to take part in research with 37 voluntary…

Graduate Education.

ERIC Educational Resources Information Center

Eng, Jacqueline; And Others

1991-01-01

Discusses the advantages of getting graduate degrees in pharmaceutical sciences, physical therapy, occupational therapy, nursing, and respiratory therapy. Looks at the cost of education, degrees offered, research and clinical options, availability of programs, and career options. (JOW)

The Use of Art and Music Therapy in Substance Abuse Treatment Programs

PubMed Central

Aletraris, Lydia; Paino, Maria; Edmond, Mary Bond; Roman, Paul M.; Bride, Brian E.

2014-01-01

While the implementation of evidence-based practices (EBPs) in the treatment of substance use disorders (SUD) has attracted substantial research attention, little consideration has been given to parallel implementation of complementary and alternative medical (CAM) practices. Using data from a nationally representative sample (N = 299) of U.S. substance abuse treatment programs, this study modeled organizational factors falling in the domains of patient characteristics, treatment ideologies, and structural characteristics, associated with the use of art therapy and music therapy. We found that 36.8% of treatment programs offered art therapy and 14.7% of programs offered music therapy. Programs with a greater proportion of women were more likely to use both therapies, and programs with larger proportions of adolescents were more likely to offer music therapy. In terms of other treatment ideologies, programs’ use of Motivational Enhancement Therapy (MET) was positively related to offering art therapy, while use of Contingency Management (CM) was positively associated with offering music therapy. Finally, our findings showed a significant relationship between requiring 12-step meetings and the use of both art therapy and music therapy. With increasing use of CAM in a diverse range of medical settings, and recent federal legislation likely to reduce barriers in accessing CAM, the inclusion of CAM in addiction treatment is growing in importance. Our findings suggest treatment programs may be utilizing art and music therapies to address unique patient needs of women and adolescents. PMID:25514689

Developing a Master's Student's Research and Practitioner Skills through Collaboration with a Doctoral Researcher

ERIC Educational Resources Information Center

Abrams, Rachel; Nolan, Emily

2016-01-01

Art therapy master's programs are required to include research coursework in their curriculum; however, they differ in content and types of required projects. Students encouraged to conduct studies that increase the evidence base of art therapy may struggle to do so. This article describes a research collaboration that allowed a master's level…

Wilderness Therapy: Foundations, Theory and Research.

ERIC Educational Resources Information Center

Davis-Berman, Jennifer; Berman, Dene S.

This book provides an overview of the history, theoretical basis, research, development, evaluation, and current status of wilderness therapy programs for troubled adolescents. An introduction explores theories of adolescence and adolescent development, problems facing adolescents in contemporary society, limitations of traditional mental health…

NExT: Advancing Promising Cancer Therapies

Cancer.gov

The NCI Experimental Therapeutics (NExT) program works with researchers and top scientific experts to advance promising or novel cancer therapies from the earliest stages of research to clinical trials. Learn about recent successes from NExT in this Cancer Currents blog post.

Value of qualitative research in the study of massage therapy.

PubMed

Kania, Ania; Porcino, Antony; Vehoef, Marja J

2008-12-15

Qualitative inquiry is increasingly used in health research because it is particularly suited to the study of complex topics or issues about which little is known and concerning which quantification cannot easily create or effectively convey understanding. By exploring the lived experience of people providing and receiving massage therapy and the meaning that those people ascribe to those experiences, in-depth understanding of the nature of massage therapy and of how it affects people's lives is possible. Qualitative research may also provide insights into the outcomes, process and context of massage therapy that cannot be fully achieved through quantification alone.The purpose of the present article is to describe qualitative research and to discuss its value to the massage therapy profession. The target audience is massage therapists who want to be able to better understand the research literature, novice massage therapy researchers who are unfamiliar with qualitative research, and teachers of research methods courses in massage therapy training programs who want to include qualitative research methods in their curriculum.

[Translational/regulatory science researches of NIHS for regenerative medicine and cellular therapy products].

PubMed

Sato, Yoji

2014-01-01

In 2013, the Japanese Diet passed the Regenerative Medicine Promotion Act and the revisions to the Pharmaceutical Affairs Act, which was also renamed as the Therapeutic Products Act (TPA). One of the aims of the new/revised Acts is to promote the development and translation of and access to regenerative/cellular therapies. In the TPA, a product derived from processing cells is categorized as a subgroup of "regenerative medicine, cellular therapy and gene therapy products" (RCGPs), products distinct from pharmaceuticals and medical devices, allowing RCGPs to obtain a conditional and time- limited marketing authorization much earlier than that under the conventional system. To foster not only RCGPs, but also innovative pharmaceuticals and medical devices, the Ministry of Health, Labour and Welfare recently launched Translational Research Program for Innovative Pharmaceuticals, Medical Devices and RCGPs. This mini-review introduces contributions of the National Institute of Health Sciences (NIHS) to research projects on RCGPs in the Program.

The Gene Therapy Resource Program: A Decade of Dedication to Translational Research by the National Heart, Lung, and Blood Institute.

PubMed

Flotte, Terence R; Daniels, Eric; Benson, Janet; Bevett-Rose, Jeneé M; Cornetta, Kenneth; Diggins, Margaret; Johnston, Julie; Sepelak, Susan; van der Loo, Johannes C M; Wilson, James M; McDonald, Cheryl L

2017-12-01

Over a 10-year period, the Gene Therapy Resource Program (GTRP) of the National Heart Lung and Blood Institute has provided a set of core services to investigators to facilitate the clinical translation of gene therapy. These services have included a preclinical (research-grade) vector production core; current Good Manufacturing Practice clinical-grade vector cores for recombinant adeno-associated virus and lentivirus vectors; a pharmacology and toxicology core; and a coordinating center to manage program logistics and to provide regulatory and financial support to early-phase clinical trials. In addition, the GTRP has utilized a Steering Committee and a Scientific Review Board to guide overall progress and effectiveness and to evaluate individual proposals. These resources have been deployed to assist 82 investigators with 172 approved service proposals. These efforts have assisted in clinical trial implementation across a wide range of genetic, cardiac, pulmonary, and blood diseases. Program outcomes and potential future directions of the program are discussed.

Evaluation of a Prison Occupational Therapy Informal Education Program: A Pilot Study.

PubMed

Crabtree, Jeffrey L; Ohm, David; Wall, Jarrod M; Ray, Joseph

2016-12-01

This pilot study explored the strengths and weaknesses of an informal education program and identified elements of the program valued by participants. Participants were men living in a minimum security prison who had been incarcerated for ten or more years. The outside researcher was joined by three former program participants as co-researchers. Together, they interviewed 27 residents who completed the informal education program. Interviews were transcribed and de-identified. Researchers used the summative content analysis approach to analyze the data. Initial content analysis yielded five concepts: doing (engaging in purposeful activities); information (program handouts and discussions that included data and descriptions of all of the topics discussed); re-entry fears (socialization; making amends with victims and/or reuniting with family and friends); technology (includes, but not limited to, using smartphones, internet and other technology in all areas of occupation); and self-worth as a person. Further interpretation per the summative content analysis method yielded three themes: doing (engaged in purposeful activities), validation of self-worth (confirmation of being a valued human being in spite of having committed a serious crime) and concerns about the future (being able to successfully engage in virtually all occupations). Whilst informal education programs may help people who are incarcerated gain information, gain a sense of self-worth and allay some reentry fears, understanding the long-term affect such programs may have such as preparing them for successful re-entry to society or reducing recidivism rates, will require long-term follow-up. Regardless of the occupational therapy intervention, the practice of occupational therapy in the criminal justice system needs to be client-centred. Because of the small number of participants and limited access to participants, one should not generalize the findings of this study to other situations or populations. Further research to examine the effectiveness of an occupational therapy education program is warranted. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Neutron capture therapy: Years of experimentation---Years of reflection

DOE Office of Scientific and Technical Information (OSTI.GOV)

Farr, L.E.

1991-12-16

This report describes early research on neutron capture therapy over a number of years, beginning in 1950, speaking briefly of patient treatments but dwelling mostly on interpretations of our animal experiments. This work carried out over eighteen years, beginning over forty years ago. Yet, it is only fitting to start by relating how neutron capture therapy became part of Brookhaven`s Medical Research Center program.

Neutron capture therapy: Years of experimentation---Years of reflection

DOE Office of Scientific and Technical Information (OSTI.GOV)

Farr, L.E.

1991-12-16

This report describes early research on neutron capture therapy over a number of years, beginning in 1950, speaking briefly of patient treatments but dwelling mostly on interpretations of our animal experiments. This work carried out over eighteen years, beginning over forty years ago. Yet, it is only fitting to start by relating how neutron capture therapy became part of Brookhaven's Medical Research Center program.

Exploring Adventure Therapy as an Early Intervention for Struggling Adolescents

ERIC Educational Resources Information Center

Dobud, Will

2016-01-01

This paper presents an account of a research project that explored the experiences of adolescents struggling with behavioral and emotional issues, who participated in a 14-day adventure therapy program in Australia referred to by the pseudonym, "Onward Adventures". All participants of this program over the age of 16 who completed within…

A Content Analysis of Quantitative Research in Journal of Marital and Family Therapy: A 10-Year Review.

PubMed

Parker, Elizabeth O; Chang, Jennifer; Thomas, Volker

2016-01-01

We examined the trends of quantitative research over the past 10 years in the Journal of Marital and Family Therapy (JMFT). Specifically, within the JMFT, we investigated the types and trends of research design and statistical analysis within the quantitative research that was published in JMFT from 2005 to 2014. We found that while the amount of peer-reviewed articles have increased over time, the percentage of quantitative research has remained constant. We discussed the types and trends of statistical analysis and the implications for clinical work and training programs in the field of marriage and family therapy. © 2016 American Association for Marriage and Family Therapy.

WE-G-BRB-02: The Role of Program Project Grants in Study of 3D Conformal Therapy, Dose Escalation and Motion Management

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fraass, B.

2015-06-15

Over the past 20 years the NIH has funded individual grants, program projects grants, and clinical trials which have been instrumental in advancing patient care. The ways that each grant mechanism lends itself to the different phases of translating research into clinical practice will be described. Major technological innovations, such as IMRT and proton therapy, have been advanced with R01-type and P01-type funding and will be discussed. Similarly, the role of program project grants in identifying and addressing key hypotheses on the potential of 3D conformal therapy, normal tissue-guided dose escalation and motion management will be described. An overview willmore » be provided regarding how these technological innovations have been applied to multi-institutional NIH-sponsored trials. Finally, the panel will discuss regarding which research questions should be funded by the NIH to inspire the next advances in radiation therapy. Learning Objectives: Understand the different funding mechanisms of the NIH Learn about research advances that have led to innovation in delivery Review achievements due to NIH-funded program project grants in radiotherapy over the past 20 years Understand example advances achieved with multi-institutional clinical trials NIH.« less

Selectivity of physiotherapist programs in the United States does not differ by institutional funding source or research activity level.

PubMed

Riley, Sean P; Covington, Kyle; Landry, Michel D; McCallum, Christine; Engelhard, Chalee; Cook, Chad E

2016-01-01

This study aimed to compare selectivity characteristics among institution characteristics to determine differences by institutional funding source (public vs. private) or research activity level (research vs. non-research). This study included information provided by the Commission on Accreditation in Physical Therapy Education (CAPTE) and the Federation of State Boards of Physical Therapy. Data were extracted from all students who graduated in 2011 from accredited physical therapy programs in the United States. The public and private designations of the institutions were extracted directly from the classifications from the 'CAPTE annual accreditation report,' and high and low research activity was determined based on Carnegie classifications. The institutions were classified into four groups: public/research intensive, public/non-research intensive, private/research intensive, and private/non-research intensive. Descriptive and comparison analyses with post hoc testing were performed to determine whether there were statistically significant differences among the four groups. Although there were statistically significant baseline grade point average differences among the four categorized groups, there were no significant differences in licensure pass rates or for any of the selectivity variables of interest. Selectivity characteristics did not differ by institutional funding source (public vs. private) or research activity level (research vs. non-research). This suggests that the concerns about reduced selectivity among physiotherapy programs, specifically the types that are experiencing the largest proliferation, appear less warranted.

The Impact of a Therapy Dog Program on Children's Reading: Follow-Up and Extension to ELL Students

ERIC Educational Resources Information Center

Kirnan, Jean; Ventresco, Nina E.; Gardner, Thomas

2018-01-01

An initiative in which therapy dogs were integrated into a school-wide reading curriculum was analyzed to determine the effect on student reading in the program's second year. Prior research on the first year of this specific program (Kirnan et al. in "Early Child Educ J" 44(6):637-651) demonstrated improvement in reading scores only for…

The clinical case for proton beam therapy

PubMed Central

2012-01-01

Abstract Over the past 20 years, several proton beam treatment programs have been implemented throughout the United States. Increasingly, the number of new programs under development is growing. Proton beam therapy has the potential for improving tumor control and survival through dose escalation. It also has potential for reducing harm to normal organs through dose reduction. However, proton beam therapy is more costly than conventional x-ray therapy. This increased cost may be offset by improved function, improved quality of life, and reduced costs related to treating the late effects of therapy. Clinical research opportunities are abundant to determine which patients will gain the most benefit from proton beam therapy. We review the clinical case for proton beam therapy. Summary sentence Proton beam therapy is a technically advanced and promising form of radiation therapy. PMID:23083010

Information literacy skills of occupational therapy graduates: promoting evidence-based practice in the MOT curriculum.

PubMed

Powell, Carol A; Case-Smith, Jane

2010-10-01

Are Master of Occupational Therapy (MOT) graduates more successful than BS graduates in accessing and analyzing research literature? This retrospective cohort study used a survey sent to Ohio State University MOT graduates, asking why they need information for their practice, what types of information they seek, and how they search for and use it. Results suggest that the MOT program has fostered higher-level skills than did the BS program in independent writing, a greater focus on evidence-based practice, and the use of bibliographic databases. The MOT graduates report high confidence in their ability to apply research to practice and high satisfaction with the lifelong learning skills they learned. The survey findings support the importance of collaboration between Occupational Therapy faculty and medical librarians in developing MOT educational programs.

Prevalence of Physical Disability and Accommodation Needs among Students in Physical Therapy Education Programs

ERIC Educational Resources Information Center

Hinman, Martha R.; Peterson, Cathryn A.; Gibbs, Karen A.

2015-01-01

Most research on graduate students with disabilities (SWDs) has focused on medical education. The purposes of this study were to: (1) estimate the prevalence of students with physical disabilities (SWPDs) in physical therapy programs, (2) identify common types of physical disabilities, (3) document the types of accommodations requested by SWPDs,…

Is there an occupational therapy employment crisis within Australia? An investigation into two consecutive cohorts of occupational therapy graduates from a single Victorian University identifying trends in employment.

PubMed

Fay, Pearse; Adamson, Lynne

2017-12-01

Within the context of growing concerns about a potential oversupply of occupational therapist, this research examines when, where and how long new graduates take to gain employment and identifies influences upon the health and university systems. A mixed method research design, using an online survey was adopted to investigate the topic. Two consecutive cohorts of graduates from a single university program were invited to participate. Seventy-five (58%) responses were received, with 63 (84%) currently employed in an occupational therapy role. Of the 12 (16%) not employed, only 3 (4%) described themselves as actively seeking employment in an occupational therapy role. A wide spread of employment settings and scope of practice areas was reported. Findings suggest that occupational therapy graduates are gaining employment in a range of settings and practice areas, relatively quickly. This research adds evidence to the conversation around graduate employment within a region of Australia. The Australian population, health system and university changes are possible factors influencing employment. The research reveals the difficulties in understanding the current situation with limitations in data collected, varied terminology and an ever changing job seeking environment. The research provides a starting point for the occupational therapy profession to further understand the directions the profession is taking. University programs may also benefit by using the research to tailor course content to assist graduates in gaining employment or to present students with the prospects of new employment opportunities. © 2017 Occupational Therapy Australia.

New analyses of the National Institute of Mental Health Treatment of Depression Collaborative Research Program: do different treatments reflect different processes?

PubMed

Herbert, Gregory L; Callahan, Jennifer; Ruggero, Camilo J; Murrell, Amy R

2013-01-01

To determine whether or not different therapies have distinct patterns of change, it is useful to investigate not only the end result of psychotherapy (outcome) but also the processes by which outcomes are attained. The present study subjected data from the National Institute of Mental Health Treatment of Depression Collaborative Research Program to survival analyses to examine whether the process of psychotherapy, as conceptualized by the phase model, differed between psychotherapy treatment approaches. Few differences in terms of progression through phases of psychotherapy were identified between cognitive behavior therapy and interpersonal therapy. Additionally, results indicate that phases of psychotherapy may not represent discrete, sequentially invariant processes.

WE-G-BRB-01: The Importance of NIH Funding in Innovation in Radiation Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Deye, J.

Over the past 20 years the NIH has funded individual grants, program projects grants, and clinical trials which have been instrumental in advancing patient care. The ways that each grant mechanism lends itself to the different phases of translating research into clinical practice will be described. Major technological innovations, such as IMRT and proton therapy, have been advanced with R01-type and P01-type funding and will be discussed. Similarly, the role of program project grants in identifying and addressing key hypotheses on the potential of 3D conformal therapy, normal tissue-guided dose escalation and motion management will be described. An overview willmore » be provided regarding how these technological innovations have been applied to multi-institutional NIH-sponsored trials. Finally, the panel will discuss regarding which research questions should be funded by the NIH to inspire the next advances in radiation therapy. Learning Objectives: Understand the different funding mechanisms of the NIH Learn about research advances that have led to innovation in delivery Review achievements due to NIH-funded program project grants in radiotherapy over the past 20 years Understand example advances achieved with multi-institutional clinical trials NIH.« less

WE-G-BRB-03: Innovating the Delivery of Radiation Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bortfeld, T.

2015-06-15

Over the past 20 years the NIH has funded individual grants, program projects grants, and clinical trials which have been instrumental in advancing patient care. The ways that each grant mechanism lends itself to the different phases of translating research into clinical practice will be described. Major technological innovations, such as IMRT and proton therapy, have been advanced with R01-type and P01-type funding and will be discussed. Similarly, the role of program project grants in identifying and addressing key hypotheses on the potential of 3D conformal therapy, normal tissue-guided dose escalation and motion management will be described. An overview willmore » be provided regarding how these technological innovations have been applied to multi-institutional NIH-sponsored trials. Finally, the panel will discuss regarding which research questions should be funded by the NIH to inspire the next advances in radiation therapy. Learning Objectives: Understand the different funding mechanisms of the NIH Learn about research advances that have led to innovation in delivery Review achievements due to NIH-funded program project grants in radiotherapy over the past 20 years Understand example advances achieved with multi-institutional clinical trials NIH.« less

Home programs for upper extremity recovery post-stroke: a survey of occupational therapy practitioners.

PubMed

Donoso Brown, Elena V; Fichter, Renae

2017-12-01

Upper extremity hemiparesis is an impairment post-stroke that impacts quality of life. Home programs are an intervention strategy used by many occupational therapists to support continued motor recovery post-stroke, yet little is known about how these programs are designed and implemented. The purpose of this study was to describe how occupational therapy practitioners approach this task and specifically what strategies they use to support adherence and what types of technology are most commonly used. An on-line survey methodology was used. Participants were recruited through multiple sources including state associations and occupational therapy educational program directors. A total of 73 occupational therapy practitioners submitted complete surveys. It was found that majority of occupational therapy practitioners in the sample (n = 53) reported creating home programs focused on upper extremity motor recovery more than 80% of the time. Range of motion and strengthening were reported as being in the top three most commonly used interventions by more than half the sample, however incorporating clients' goals and interests were reported most often as strategies to create meaning in the home program. Respondents also reported limited incorporation of technology and strategies to support adherence. Personal motivation was reported by occupational therapy practitioners to be a key moderator of adherence to a home program. Occupational therapy practitioners often provide home programs for individuals post-stroke focusing on upper extremity function. Future research that aims to understand stakeholders' perspectives on home programs and determine effective strategies for ensuring adherence is needed.

Evidence-based review of interventions for autism used in or of relevance to occupational therapy.

PubMed

Case-Smith, Jane; Arbesman, Marian

2008-01-01

Occupational therapy practitioners are among the professionals who provide services to children and adults with autism spectrum disorder (ASD), embracing both leadership and supportive roles in service delivery. The study's primary aims were as follows: (1) to identify, evaluate, and synthesize the research literature on interventions for ASD of relevance to occupational therapy and (2) to interpret and apply the research literature to occupational therapy. A total of 49 articles met the authors' criteria and were included in the review. Six categories of research topics were identified, the first 3 of which are most closely related to occupational therapy: (1) sensory integration and sensory-based interventions; (2) relationship-based, interactive interventions; (3) developmental skill-based programs; (4) social cognitive skill training; (5) parent-directed or parent-mediated approaches; and (6) intensive behavioral intervention. Under each category, themes supported by research evidence and applicable to occupational therapy were defined. The findings have implications for intervention methods, communication regarding efficacious practices to professionals and consumers, and future occupational therapy research.

Role of physical therapy in management of knee osteoarthritis.

PubMed

Fitzgerald, G Kelley; Oatis, Carol

2004-03-01

The purposes of this review are to: (1) describe treatments that physical therapists may use to supplement exercise programs to enhance the benefit of rehabilitation, (2) discuss current research related to the mode of delivery of physical therapy treatment, and (3) identify characteristics from recent research that may influence the responsiveness of individuals with knee osteoarthritis to physical therapy. Physical therapists provide a variety of interventions, such as manual therapy techniques, balance, coordination, and functional retraining techniques, knee taping techniques, electrical stimulation, and foot orthotics to assist in overcoming some of the barriers that make participation in exercise and physical activity difficult. Recent research implies that a number of factors may influence the responsiveness to physical therapy treatment for individuals with knee osteoarthritis. Factors such as the mode of treatment delivery, treatment compliance issues, mechanical characteristics such as joint laxity and malalignment, and radiographic severity are discussed. Future studies are needed to improve our understanding of factors that can influence the responsiveness of patients with knee osteoarthritis to exercise and physical activity programs. The question may not be which mode of therapy works best, but rather, which patient and/or disease characteristics will tell us who will and who will not respond to a given mode of therapy.

A decade of building massage therapy services at an academic medical center as part of a healing enhancement program.

PubMed

Rodgers, Nancy J; Cutshall, Susanne M; Dion, Liza J; Dreyer, Nikol E; Hauschulz, Jennifer L; Ristau, Crystal R; Thomley, Barb S; Bauer, Brent A

2015-02-01

The use of complementary and integrative medicine therapies is steadily becoming an integral part of health care. Massage therapy is increasingly offered to hospitalized patients for various conditions to assist with the management of common symptoms such as pain, anxiety, and tension. This article summarizes a decade of building the massage therapy service at a large tertiary care medical center, from the early pilot studies and research to the current program offerings, and the hopes and dreams for the future. Copyright © 2014 Elsevier Ltd. All rights reserved.

Facts and Statistics

MedlinePlus

... Drug Listings Blood Cancer Conferences Researchers & Healthcare Professionals Academic Grants Academic Grant Programs Apply for a Grant Grant Finder Therapy Acceleration Program Academic Concierge Biotechnology Accelerator Clinical Trials Division Resources for ...

77 FR 63840 - Cellular, Tissue and Gene Therapies Advisory Committee; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-17

...] Cellular, Tissue and Gene Therapies Advisory Committee; Notice of Meeting AGENCY: Food and Drug... meeting will be closed to the public. Name of Committee: Cellular, Tissue and Gene Therapies Advisory... to hear updates of research programs in the Gene Transfer and Immunogenicity Branch, Office of...

Reducing university students' stress through a drop-in canine-therapy program.

PubMed

Binfet, John-Tyler; Passmore, Holli-Anne; Cebry, Alex; Struik, Kathryn; McKay, Carson

2018-06-01

Increasingly colleges and universities are offering canine therapy to help students de-stress as a means of supporting students' emotional health and mental well-being. Despite the popularity of such programs, there remains a dearth of research attesting to their benefits. Participants included 1960 students at a mid-size western Canadian University. The study's aims were to assess the stress-reducing effects of a weekly drop-in, canine-therapy program and to identify how long participants spent with therapy canines to reduce their stress. Demographic information was gathered, length of visit documented and a visual analog scale (VAS) was used to assess entry and exit self-reports of stress. Participants' self-reported stress levels were significantly lower after the canine therapy intervention. Participants spent an average of 35 min per session. This study supports the use of drop-in, canine therapy as a means of reducing university students' stress. The findings hold applied significance for both counseling and animal therapy practitioners regarding the dose intervention participants seek to reduce their stress.

The Present and Future of MFT Doctoral Education in Research-Focused Universities

ERIC Educational Resources Information Center

Sprenkle, Douglas H.

2010-01-01

Doctoral education is greatly impacted by context, and the large majority of marital and family therapy (MFT) doctoral programs are PhD programs in research-focused universities. I believe their primary mission is to equip students to become scientist-practitioners and do original research that will advance the science of the discipline, whereas…

A framework for promoting scholarship productivity in occupational therapy curricula.

PubMed

Scott, P J; Justiss, M J; Schmid, A A; Fisher, T F

2013-01-01

This paper describes a curricular model to support the production of quality research and development of occupational therapy professional students, prepared to become leaders in the production and utilization of evidence for practice. This model is designed for programs with faculty challenged by the dual mandate of program excellence and expectations for scholarly productivity needed for tenure and promotion: typically programs at research universities. The essence of the model is the paralleling of research and competencies for clinical practice where faculty and students participate as a community of scholars. It is based on the literature that addresses the tensions between achieving excellence in research and scholarly productivity, and excellence in teaching. The experience of one university with this model over a five-year period of time is shared with the student-faculty productivity outcomes. These outcomes include dissemination of 55 collaborative peer reviewed products and faculty has generated support for 25 paid graduate assistantships. The combination of student outcomes and faculty support for their research has strengthened the ability of the faculty to excel in meeting the University mandate of scholarship while providing a high quality professional educational program.

WE-G-BRB-00: NIH-Funded Research: Instrumental in the Pursuit of Clinical Trials and Technological Innovations

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

Over the past 20 years the NIH has funded individual grants, program projects grants, and clinical trials which have been instrumental in advancing patient care. The ways that each grant mechanism lends itself to the different phases of translating research into clinical practice will be described. Major technological innovations, such as IMRT and proton therapy, have been advanced with R01-type and P01-type funding and will be discussed. Similarly, the role of program project grants in identifying and addressing key hypotheses on the potential of 3D conformal therapy, normal tissue-guided dose escalation and motion management will be described. An overview willmore » be provided regarding how these technological innovations have been applied to multi-institutional NIH-sponsored trials. Finally, the panel will discuss regarding which research questions should be funded by the NIH to inspire the next advances in radiation therapy. Learning Objectives: Understand the different funding mechanisms of the NIH Learn about research advances that have led to innovation in delivery Review achievements due to NIH-funded program project grants in radiotherapy over the past 20 years Understand example advances achieved with multi-institutional clinical trials NIH.« less

76 FR 64429 - Advisory Committee on Prosthetics and Special-Disabilities Programs; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-18

... research services available to the Committee. Additionally, the Committee will discuss future agenda topics... state-of-the art prosthetics and the associated rehabilitation research, development, and evaluation of... will be briefed by the Chief Disability and Medical Assessment Officer; Physical Therapy Program...

Internet-based Cognitive Behavioral Therapy for Depression: Current Progress & Future Directions

PubMed Central

Webb, Christian A.; Rosso, Isabelle M.; Rauch, Scott L.

2016-01-01

The World Health Organization (WHO) estimates that during a given 12-month period approximately 34 million people suffering from major depressive disorder go untreated in Europe and the Americas alone.1 Barriers to treatment include geographic distance, lack of mental health insurance, prohibitive cost of treatment, long wait-lists, and perceived stigma. Over the past two decades internet-based cognitive behavioral therapy (iCBT) programs have proliferated. A growing body of research supports the efficacy of iCBT for depression and other psychiatric conditions, and these programs may help address barriers that hinder access to effective treatment. The present review describes common iCBT programs along with the evidence base supporting their efficacy in reducing symptoms of depression, reviews research on moderators of treatment response, and provides suggestions for future directions in research and care. PMID:28475503

Tenure Eligible/Tenure Track Investigator | Center for Cancer Research

Cancer.gov

The HIV and AIDS Malignancy Branch (HAMB), Center for Cancer Research (CCR), National Cancer Institute (NCI), National Institutes of Health (NIH), is a national leader in research in the cancers associated with HIV/AIDS, in the development of therapies for HIV infection, and in oncogenic viruses.  We are seeking a tenure-eligible or tenure-track investigator in the field of HIV–related malignancies or viral oncogenesis.  It is anticipated that the investigator will establish an independent translational research program targeted to the study of the treatment, pathogenesis, and/or prevention of viral-induced or other HIV-associated tumors. The program can be primarily clinical, laboratory-based, or a combination of the two, and can also include animal model studies.  There is the potential to interface with a strong existing clinical research program. Potential areas of focus may include, but are not limited to, therapies for HIV malignancies, including novel immunologic approaches; viral oncogenesis; pathogenesis of HIV-associated malignancies; and virus host interactions, including immunologic interactions. 

A Short Course in Family Therapy: Translating Research Into Practice

ERIC Educational Resources Information Center

Williams, Robert

2005-01-01

This article outlines a graduate-level, one-time-only family therapy course that prepares counseling trainees to be competent at entry-level family therapy in the United States. The approach outlined addresses the training concerns of programs that significantly emphasize individual-focused paradigms and that have limited time to train counseling…

76 FR 26363 - Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-06

... previous case-mix classification system. It also includes a discussion of a Non-Therapy Ancillary component... facilities. Finally, it proposes certain changes relating to the payment of group therapy services and... Payment for SNF Non-Therapy Ancillary Costs 1. Previous Research 2. Conceptual Analysis 3. Analytic Sample...

Implementing a cardiac resynchronization therapy program in a county hospital.

PubMed

Merchant, Karen; Laborde, Ann

2005-09-01

Clinical trials and research literature show the benefits of cardiac resynchronization therapy and implantable cardioverter defibrillator devices in improving the quality of life for selected patients with heart failure. While translating these positive research results into clinical practice is a major effort requiring a strategic planning process, implementing these practices in-house may result in cost savings and possible increased revenue. The authors describe the planning and implementation process used to introduce these therapies in a cardiac catheterization laboratory at a county teaching hospital.

Coming Together to Calm the Hunger: Group Therapy Program for Adults Diagnosed with Anorexia Nervosa

ERIC Educational Resources Information Center

Ponech, Heather; McBride, Dawn Lorraine

2012-01-01

This project provides a comprehensive overview of the research literature on anorexia nervosa in female adults and concludes by offering 14 group therapy lesson plans for anorexia nervosa that therapists may use in their practice. There is a remarkable lack of research on the efficacy of treatment designed for individuals diagnosed with anorexia…

A Randomized, Controlled Trial of Meditation Compared to Exposure Therapy and Education Control on PTSD in Veterans

DTIC Science & Technology

2014-10-01

alternative therapy for PTSD. Our collaborative group (Maharishi University of Management Research Institute, VA San Diego Healthcare System, University of...Prolonged Exposure, and PTSD Health Education, and are supervised by the research team for quality control . No study-related adverse events have...by the research team for quality control . For home practice, over 70% of subjects have indicated compliance with their home practice program (at

"The Whole Is Greater Than the Sum of the Parts": Prison Staff Perceptions of Domestic Violence Rehabilitation Programs.

PubMed

Shoham, Efrat; Zelig, Anat; Hasisi, Badi; Weisburd, David; Haviv, Noam

2017-11-01

This qualitative study is part of a mixed methods research project that examined the effectiveness of the primary rehabilitation program for domestic violence offenders in the Israeli Prison Services-the "House of Hope." The quantitative part of the study showed that the "House of Hope" program was effective in reducing recidivism among participating inmates. The purpose of this qualitative study was to describe the rehabilitation program according to the perspectives of the program staff. For this purpose, semistructured interviews were conducted with the department staff during the study as well as with past directors. The qualitative findings suggested that the success of the program probably stemmed from a synergistic combination of several components, for example, identifying the characteristics of domestic violence offenders and adjusting treatment programs to their needs, along with exposure to psychological treatment in varied therapies (cognitive behavioral therapy, psychoeducational, and psychodynamic) and formats (group therapy and individual therapy) during a 1-year stay in a hierarchical therapeutic community. Other components mentioned are staff professionalism, stability, and the program's location in a therapeutic-oriented prison that is architecturally designed and built to create a less stressful environment for the inmates and the staff.

Reflections on Recent Research Into Animal-Assisted Interventions in the Military and Beyond.

PubMed

Rumayor, Christina B; Thrasher, Amy M

2017-11-25

The purpose of the present review was threefold: to address the current state of Animal-Assisted Interactions (AAI) within the military; to summarize recent literature (within the past three years) in the field of AAI; and to discuss trends in AAI research since 2014. With regard to AAI within the military, several canine interaction programs have been utilized to assist service members in coping with various issues. Therapy dogs have been deployed with Combat-Operational Stress Control units; they have been integrated into medical clinics and behavioral health treatment programs in garrison; and policy has been developed to address the use of therapy animals in military treatment facilities. General research in AAI has demonstrated efficacy for certain presenting issues (stress management, trauma, autism spectrum disorder) and specific populations (children, the elderly, acute care patients). Overall trends in research include calls for increased consideration for animal welfare in AAI and increased rigor in research methodology. Current research supports the structured use of therapy dogs in the treatment of various disorders and with specific populations, including military service members and veterans; however, the need for additional research with rigorous methodology remains.

Meeting the Challenge of Instructor Shortages: A Blended Teaching and Learning Model for a Neuroscience Course in a Doctor of Physical Therapy Program.

PubMed

Ge, Weiqing

2018-01-01

Physical therapy workforce shortages are expected to increase for all 50 states through 2030. There is a recognized nationwide unprecedented shortage of well-prepared physical therapy instructors. One practical solution can be to share instructors among Doctor of Physical Therapy (DPT) programs using a blended teaching and learning model. The purpose of this project was to evaluate the effectiveness of a blended teaching and learning model for a neuroscience course in a DPT program. Faculty members from two DPT programs collaborated to develop, implement, and evaluate a blended teaching and learning model. The Blackboard Learning Management System (LMS) was available at both institutions and chosen as the learning platform. The design of this research study was retrospective nonexperimental observational. The overall feedback from the students was positive. Most students (91.6%) strongly agreed or agreed that the content of the course was appropriate for learning neuroscience. The students taking this blended course performed slightly better than the students taking the traditional course, though there was no significant difference (p=0.06). The results support the use of a blended teaching and learning model to meet faculty shortage challenges. Future research with a larger sample size is necessary.

Patients' mental models and adherence to outpatient physical therapy home exercise programs.

PubMed

Rizzo, Jon

2015-05-01

Within physical therapy, patient adherence usually relates to attending appointments, following advice, and/or undertaking prescribed exercise. Similar to findings for general medical adherence, patient adherence to physical therapy home exercise programs (HEP) is estimated between 35 and 72%. Adherence to HEPs is a multifactorial and poorly understood phenomenon, with no consensus regarding a common theoretical framework that best guides empirical or clinical efforts. Mental models, a construct used to explain behavior and decision-making in the social sciences, may serve as this framework. Mental models comprise an individual's tacit thoughts about how the world works. They include assumptions about new experiences and expectations for the future based on implicit comparisons between current and past experiences. Mental models play an important role in decision-making and guiding actions. This professional theoretical article discusses empirical research demonstrating relationships among mental models, prior experience, and adherence decisions in medical and physical therapy contexts. Specific issues related to mental models and physical therapy patient adherence are discussed, including the importance of articulation of patients' mental models, assessment of patients' mental models that relate to exercise program adherence, discrepancy between patient and provider mental models, and revision of patients' mental models in ways that enhance adherence. The article concludes with practical implications for physical therapists and recommendations for further research to better understand the role of mental models in physical therapy patient adherence behavior.

Dolphin-Assisted Therapy as a Verbal Operant Condition for Children with Autism

ERIC Educational Resources Information Center

Terrasi, Renee Marie

2007-01-01

This study examined the effects of Dolphin-Assisted Therapy (DAT) as a reinforcer for verbal operant production in children with Autism Spectrum Disorder. Three children who attended a dolphin therapy program participated in this single subject research study. Baseline data was collected for each child via a video tape provided by parents and…

Faculty perceptions of occupational therapy program directors' leadership styles and outcomes of leadership.

PubMed

Snodgrass, Jeff; Shachar, Mickey

2008-01-01

This research study investigated the relationship between faculty perceptions of occupational therapy program directors' leadership styles and outcomes of leadership and the effects of moderating demographic and institutional characteristics. Data for this study were collected utilizing the Multifactor Leadership Questionnaire Form 5X and the self-designed Demographic and Institution Questionnaire. The study working sample included 184 graduate occupational therapy faculty members from 98 (65%) of all accredited academic occupational therapy programs in the United States for the 2005-06 academic year. Major findings from the study indicate that, in general, transformational leadership had a significant (p < 0.001) positive predictive relationship with the leadership outcomes whereas transactional leadership had a significant (p < 0.001) negative predictive relationship. The contingent reward leadership attribute (although belonging to the transactional leadership construct) was found to be a positive predictor of leadership outcomes. Demographic and institutional characteristics did not have a significant (p > 0.01) influence on perceived leadership styles and leadership outcomes. The results of this research show that the most effective occupational therapy leaders in academia have been found to be those who adopt and utilize a full range of leadership styles that combine both transformational and transactional contingent reward leadership styles and suggest common effectiveness for other allied health fields.

Effectiveness of interventions to prevent falls in people with Alzheimer's disease and related dementias.

PubMed

Jensen, Lou E; Padilla, René

2011-01-01

A systematic review was conducted to determine the effectiveness of interventions to prevent falls in people with Alzheimer's disease (AD) and related dementias. Twelve research reports met inclusion criteria. Studies reported on three types of intervention: (1) exercise- and motor-based interventions, (2) nursing staff-directed interventions, and (3) multidisciplinary interventions. Strategies were offered as single or multifaceted intervention programs. All types of intervention resulted in benefit, although the evidence for effectiveness is tentative because of the studies' limitations. More research is needed to better understand appropriate dosages of intervention. No evidence was found for the effectiveness of prevention programs accessed as part of occasional respite care. Occupational therapy was seldom involved in the interventions researched. Because effective fall prevention programs are embedded in people's daily routines and encouraged participation in occupation, the contribution occupational therapy practitioners can make to the care of people with AD has yet to be fully realized.

Mindfulness-based cognitive therapy for anxiety symptoms in older adults in residential care.

PubMed

Helmes, Edward; Ward, Bradley G

2017-03-01

Anxiety in older people is under-diagnosed and poorly treated despite significant impairments that arise from anxiety. Mindfulness-based cognitive therapy (MBCT) has been shown to be a promising treatment for anxiety. The aim of this study was to determine the effect of an MBCT program on anxiety symptoms in older people living in residential care. Fifty-two participants (34 females) were randomly allocated into therapy and control groups using a 2 × 3 mixed design. The average age of participants was 83 years. The group effect showed significant improvements on all measures at the end of the seven-week program in the therapy group, while the control group did not show significant changes. This study represents one of the first studies of the effectiveness of an MBCT program on anxiety symptoms for older people using a randomized controlled trial. The study has implications for future research that include the effectiveness of MBCT for the treatment of anxiety symptoms in older people, the utility of group therapy programs in residential care and the benefits of using specialized instruments for older populations.

Taking Our Seat at the Table: Community Cancer Survivorship.

PubMed

Polo, Katie M; Smith, Caitlin

Cancer survivors are at risk for occupational performance issues related to activities of daily living, instrumental activities of daily living, work, and social and community participation. Occupational therapy practitioners can address these performance issues by offering services within existing community cancer survivorship programs that focus on adaptive and compensatory strategies to facilitate meaningful lifestyles and optimize health and well-being. Occupational therapy services do not currently exist at these community sites, nor are occupational therapy practitioners recognized as providers in existing community cancer survivorship programs. Recognition of practitioners' distinct value in cancer survivorship, advocacy for occupational therapy services in the community, development of supporting documentation for occupational therapy's role in community survivorship, and research on the efficacy of interventions in community cancer survivorship are needed to expand occupational therapy's role with this growing population. Copyright © 2017 by the American Occupational Therapy Association, Inc.

Post-Doctoral Training Program in Bio-Behavioral Breast Cancer Research

DTIC Science & Technology

2005-05-01

therapy with a particular interest in Rational Emotive- Behavior Therapy ( REBT ) and its application to clinical populations, including breast cancer...Implication for my idiosyncratic practice of REBT . Psychological Annals of Oradea State University (Annalele Universitatii din Oradea-Psihologie), 4: 29-55

Increasing Fathers' Participation in Therapeutic Intervention Programs for Exceptional Children.

ERIC Educational Resources Information Center

Revelj, Elizabeth O.

In response to a research review indicating that few programs address the father's role in early intervention and preschool programs for the young exceptional child, a three-month practicum was designed which included fathers in physical therapy sessions and in daily home exercise programming for their developmentally disabled children. Practicum…

WE-G-BRB-04: Leveraging Innovation to Design Future Clinical Trials

DOE Office of Scientific and Technical Information (OSTI.GOV)

Michalski, J.

Over the past 20 years the NIH has funded individual grants, program projects grants, and clinical trials which have been instrumental in advancing patient care. The ways that each grant mechanism lends itself to the different phases of translating research into clinical practice will be described. Major technological innovations, such as IMRT and proton therapy, have been advanced with R01-type and P01-type funding and will be discussed. Similarly, the role of program project grants in identifying and addressing key hypotheses on the potential of 3D conformal therapy, normal tissue-guided dose escalation and motion management will be described. An overview willmore » be provided regarding how these technological innovations have been applied to multi-institutional NIH-sponsored trials. Finally, the panel will discuss regarding which research questions should be funded by the NIH to inspire the next advances in radiation therapy. Learning Objectives: Understand the different funding mechanisms of the NIH Learn about research advances that have led to innovation in delivery Review achievements due to NIH-funded program project grants in radiotherapy over the past 20 years Understand example advances achieved with multi-institutional clinical trials NIH.« less

Randomized Controlled Trial of Problem-Solving Therapy for Minor Depression in Home Care

ERIC Educational Resources Information Center

Gellis, Zvi D.; McGinty, Jean; Tierney, Lynda; Jordan, Cindy; Burton, Jean; Misener, Elizabeth

2008-01-01

Objective: Data are presented from a pilot research program initiated to develop, refine, and test the outcomes of problem-solving therapy that targets the needs of older adults with minor depression in home care settings. Method: A pilot randomized clinical trial compares the impact of problem-solving therapy for home care to treatment as usual…

Therapy for Child Psychological Maltreatment

ERIC Educational Resources Information Center

Leeson, Fiona; Nixon, Reginald D. V.

2010-01-01

Research of childhood psychological maltreatment has documented a range of severe and long-lasting difficulties for children who experience this type of abuse. Consequences can include but are not limited to emotional and behavioural problems, low self-esteem, and relationship difficulties. Accordingly, the development of therapy programs to…

Lessons learned: a pilot study on occupational therapy effectiveness for children with sensory modulation disorder.

PubMed

Miller, Lucy Jane; Schoen, Sarah A; James, Katherine; Schaaf, Roseann C

2007-01-01

The purpose of this pilot study was to prepare for a randomized controlled study of the effectiveness of occupational therapy using a sensory integration approach (OT-SI) with children who have sensory processing disorders (SPD). A one-group pretest, posttest design with 30 children was completed with a subset of children with SPD, those with sensory modulation disorder. Lessons learned relate to (a) identifying a homogeneous sample with quantifiable inclusion criteria, (b) developing an intervention manual for study replication and a fidelity to treatment measure, (c) determining which outcomes are sensitive to change and relate to parents' priorities, and (d) clarifying rigorous methodologies (e.g., blinded examiners, randomization, power). A comprehensive program of research is needed, including multiple pilot studies to develop enough knowledge that high-quality effectiveness research in occupational therapy can be completed. Previous effectiveness studies in OT-SI have been single projects not based on a unified long-term program of research.

[Evaluation of an intensive therapy program for treatment of severe behavioral disorders in mentally handicapped patients with autistic or psychotic behavior].

PubMed

Elbing, U; Rohmann, U H

1993-09-01

The development of severely disturbed and socially accepted behavior in mentally handicapped persons with autistic or psychotic symptoms is documented before, during and after an intensive therapy program conducted in a residential institution for mentally handicapped persons. Seven single case studies were made as long term observation with a duration between 18 and 33 weeks, mostly with a multiple baseline design. One or two follow ups with at least four weeks length were conducted in six out of seven cases up to four years after the end of the intensive therapy. The main results show (1) the decrease of disturbed behavior and the increase of socially accepted behavior during the therapy program, and (2) the significant reduction of the disturbed behavior patterns taking place during the baseline phase before the beginning of the therapy in all cases but one. The results are discussed under the aspects of a possible explanation for the findings and their impact on the discussion about psychotherapy research.

Manufacturing/Cell Therapy Specialist | Center for Cancer Research

Cancer.gov

Within the Leidos Biomedical Research Inc.’s Clinical Research Directorate, the Clinical Monitoring Research Program (CMRP) provides high-quality comprehensive and strategic operational support to the high-profile domestic and international clinical research initiatives of the National Cancer Institute (NCI), National Institute of Allergy and Infectious Diseases (NIAID),

Enhancing Fidelity in Adventure Education and Adventure Therapy

ERIC Educational Resources Information Center

Tucker, Anita R.; Rheingold, Alison

2010-01-01

Although the importance of addressing and evaluating treatment and program fidelity is clearly emphasized in the literature on psychology, education, and health, little attention has been given to fidelity in adventure literature or research. Program fidelity refers to whether or not, and how well, a specific intervention or program was…

INEL BNCT Program

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ackermann, A.L.

1991-08-01

This Bulletin presents a summary of accomplishments and highlights in the Idaho National Engineering Laboratory's (INEL) Boron Neutron Capture Therapy (BNCT) Program for August 1991. This bulletin includes information on the brain tumor and melanoma research programs, Power Burst Facility (PBF) technical support and modifications, PBF operations, and updates to the animal data charts.

A Randomized Controlled Trial of Group Coping-Oriented Therapy vs Supportive Therapy in Schizophrenia: Results of a 2-Year Follow-up.

PubMed

Schaub, Annette; Mueser, Kim T; von Werder, Thomas; Engel, Rolf; Möller, Hans-Jürgen; Falkai, Peter

2016-07-01

Over the past 30 years, illness management programs and cognitive-behavioral therapy for psychosis have gained prominence in the treatment of schizophrenia. However, little is known about the long-term benefits of these types of programs when delivered during inpatient treatment following a symptom exacerbation. To evaluate this question, we conducted a randomized controlled trial comparing the long-term effects of a group-based coping-oriented program (COP) that combined the elements of illness management with cognitive behavioral-therapy for psychosis, with an equally intensive supportive therapy (SUP) program. 196 inpatients with DSM-IV schizophrenia were randomized to COP or SUP, each lasting 12 sessions provided over 6-8 weeks. Outcome measures were collected in the hospital at baseline and post-assessment, and following discharge into the community 1 and 2 years later. We compared the groups on rehospitalizations, symptoms, psychosocial functioning, and knowledge about psychosis. Intent-to-treat analyses indicated that patients in COP learned significantly more information about psychosis, and had greater reductions in overall symptoms and depression/anxiety over the treatment and follow-up period than patients in SUP. Patients in both groups improved significantly in other symptoms and psychosocial functioning. There were no differences between the groups in hospitalization rates, which were low. People with schizophrenia can benefit from short-term COPs delivered during the inpatient phase, with improvements sustaining for 2 years following discharge from the hospital. More research is needed to evaluate the long-term impact of coping-oriented and similar programs provided during inpatient treatment. © The Author 2016. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.

An interpretative phenomenological analysis of an improvisational music therapy program for cancer patients.

PubMed

Pothoulaki, Maria; MacDonald, Raymond; Flowers, Paul

2012-01-01

Although there are an increasing number of qualitative studies investigating the benefits of music therapy interventions in cancer care settings, few studies have adopted a phenomenological approach to explore how and why such interventions work. The aim of this study was to explore the psychological processes involved in an improvisational music therapy program for cancer patients. Nine individuals took part in an improvisational music therapy program and participated in semi-structured interviews. Interpretative Phenomenological Analysis (IPA) was employed as a theoretical and methodological framework for the analysis of the interviews. Recurrent themes revealed a variety of social and psychological benefits related to the experience of music therapy, such as facilitating peer support and group interaction, increasing self-confidence, relaxation, the generation of positive feelings, stress relief and feelings of enhanced communication through music. There was also an emphasis upon the importance of social interaction and communication. This paper highlights a number of key benefits connected with music therapy for patients with cancer and the effectiveness of IPA in applied health psychology research.

WE-H-209-01: Advances in Ultrasound Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hynynen, K.

Focused ultrasound has been shown to be the only method that allows noninvasive thermal coagulation of tissues and recently this potential has been explored for image-guided drug delivery. In this presentation, the advances in ultrasound phased array technology for energy delivery, exposure monitoring and control will be discussed. Experimental results from novel multi-frequency transmit/receive arrays will be presented. In addition, the feasibility of fully electronically focused and steered high power arrays with many thousands of transducer elements will be discussed. Finally, some of the recent clinical and preclinical results for the treatment of brain disease will be reviewed. Learning Objectives:more » Introduce FUS therapy principles and modern techniques Discuss use of FUS for drug delivery Cover the technology required to deliver FUS and monitor therapy Present clinical examples of the uses of these techniques This research was supported by funding from The Canada Research Chair Program, Grants from CIHR and NIH (no. EB003268).; K. Hynynen, Canada Foundation for Innovation; Canadian Institutes of Health Research; Focused Ultrasound Surgery Foundation; Canada Research Chair Program; Natural Sciences and Engineering Research Council of Canada; Ontario Research Fund; National Institutes of Health; Canadian Cancer Society Research Institute; The Weston Brain Institute; Harmonic Medical; Focused Ultrasound Instruments.« less

WE-H-209-00: Carson/Zagzebski Distinguished Lectureship: Image Guided Ultrasound Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

Focused ultrasound has been shown to be the only method that allows noninvasive thermal coagulation of tissues and recently this potential has been explored for image-guided drug delivery. In this presentation, the advances in ultrasound phased array technology for energy delivery, exposure monitoring and control will be discussed. Experimental results from novel multi-frequency transmit/receive arrays will be presented. In addition, the feasibility of fully electronically focused and steered high power arrays with many thousands of transducer elements will be discussed. Finally, some of the recent clinical and preclinical results for the treatment of brain disease will be reviewed. Learning Objectives:more » Introduce FUS therapy principles and modern techniques Discuss use of FUS for drug delivery Cover the technology required to deliver FUS and monitor therapy Present clinical examples of the uses of these techniques This research was supported by funding from The Canada Research Chair Program, Grants from CIHR and NIH (no. EB003268).; K. Hynynen, Canada Foundation for Innovation; Canadian Institutes of Health Research; Focused Ultrasound Surgery Foundation; Canada Research Chair Program; Natural Sciences and Engineering Research Council of Canada; Ontario Research Fund; National Institutes of Health; Canadian Cancer Society Research Institute; The Weston Brain Institute; Harmonic Medical; Focused Ultrasound Instruments.« less

Helping Older Adults Sustain Their Physical Therapy Gains: A Theory-Based Intervention to Promote Adherence to Home Exercise Following Rehabilitation.

PubMed

Gallagher, Kristel M

2016-01-01

The benefits of exercise gained by older adults during physical therapy are often not maintained once the program is over. This lack of sustained benefits is thought to be partially the result of poor adherence to the prescribed home exercise program to be continued once therapy is completed. Most of what is known about older adults' adherence to physical therapy and home exercise comes from research seeking to identify and understand predictors of adherence, rather than trying to enhance adherence explicitly. The purpose of this study was to test a theoretically grounded approach to promoting adherence to home exercise programs in older adults. Sixty older adults (M age = 69.3 (6.87) years) in a program of physical therapy received 1 of 2 print messages and magnets promoting adherence to home exercise. The content of the messages was informed by the goal-specific tenets of socioemotional selectivity theory-one message described the emotional and meaningful benefits of home exercise, such as time with loved ones and independence, and one message described facts and information about physiological benefits, such as balance and strength. Adherence to home exercise was measured 2 weeks after participants were discharged from physical therapy by calculating the percentage of the prescribed exercises participants reported completing at home. An analysis of covariance indicated that there was no statistically significant difference in adherence rates between participants receiving either message. However, a 2×2 analysis of covariance did reveal a significant interaction between the type of message participants received and the time at which they received that message. Post hoc analyses separately examined the rates of adherence in participants who received the intervention message with time remaining in their therapy program and participants who received the intervention message on the day of discharge. In the subset of participants who received their intervention message with time remaining in their therapy program, those who received the emotion and meaning message were somewhat more adherent to their home exercise program than those who received the facts and information message (63.6% vs 50.8%; P = .07). Those who received the emotion and meaning message also performed on average more exercises outside of their home exercise program (2.4 vs 1.3; P = .06). Despite lacking a statistically significant difference between message groups, the results of this study suggest that highlighting the emotional and meaningful benefits of home exercise versus providing facts and information about the physiological benefits may encourage older adults to be adherent to their home exercise programs. This may especially be the case if they receive the information while still in therapy. As this was the first study to empirically test an intervention targeting adherence to post-physical therapy home exercise in older adults, future research is needed to better understand what motivates older adults to be adherent.

The effect of a therapy dog on the communication skills of an adult with aphasia.

PubMed

LaFrance, Caroline; Garcia, Linda J; Labreche, Julianne

2007-01-01

Little evidence-based research has been published within the field of communication disorders on the role of dogs as catalysts for human communication. This single participant study, a point of entry into this realm of research, explores the effects of a therapy dog on the communication skills of a patient with aphasia receiving intensive speech and language therapy within a rehabilitation setting. The researchers conclude that the presence of the dog does have the potential to stimulate both overt social-verbal and social-nonverbal communication. As a result of this activity the reader will be able to (1) describe the beneficial role of dogs to serve as catalysts for human communication (2) describe ways in which a person with aphasia may be assisted by a therapy dog and (3) become familiar with an animal-assisted therapy (AAT) program set-up for patients with communication disorders within a rehabilitation setting.

INEEL BNCT research program. Annual report, January 1, 1996--December 31, 1996

DOE Office of Scientific and Technical Information (OSTI.GOV)

Venhuizen, J.R.

1997-04-01

This report is a summary of the progress and research produced for the Idaho National Engineering and Environmental Laboratory (INEEL) Boron Neutron Capture Therapy (BNCT) Research Program for calendar year 1996. Contributions from the individual investigators about their projects are included, specifically, physics: treatment planning software, real-time neutron beam measurement dosimetry, measurement of the Finnish research reactor epithermal neutron spectrum, BNCT accelerator technology; and chemistry: analysis of biological samples and preparation of {sup 10}B enriched decaborane.

LATIS3D: The Goal Standard for Laser-Tissue-Interaction Modeling

NASA Astrophysics Data System (ADS)

London, R. A.; Makarewicz, A. M.; Kim, B. M.; Gentile, N. A.; Yang, T. Y. B.

2000-03-01

The goal of this LDRD project has been to create LATIS3D-the world's premier computer program for laser-tissue interaction modeling. The development was based on recent experience with the 2D LATIS code and the ASCI code, KULL. With LATIS3D, important applications in laser medical therapy were researched including dynamical calculations of tissue emulsification and ablation, photothermal therapy, and photon transport for photodynamic therapy. This project also enhanced LLNL's core competency in laser-matter interactions and high-energy-density physics by pushing simulation codes into new parameter regimes and by attracting external expertise. This will benefit both existing LLNL programs such as ICF and SBSS and emerging programs in medical technology and other laser applications. The purpose of this project was to develop and apply a computer program for laser-tissue interaction modeling to aid in the development of new instruments and procedures in laser medicine.

INEL BNCT Program: Volume 5, No. 9

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ackermann, A.L.

1991-01-01

This Bulletin presents a summary of accomplishments and highlights of the Idaho National Engineering Laboratory's (INEL) Boron Neutron Capture Therapy (BNCT) Program for September 1991. This bulletin includes information on the brain tumor and melanoma research programs, Power Burst Facility (PBF) technical support and modifications, PBF operations, and updates to the animal data charts.

Exploring Animal-Assisted Programs with Children in School and Therapeutic Contexts

ERIC Educational Resources Information Center

Friesen, Lori

2010-01-01

Animal-Assisted programs with children are becoming increasingly popular in school and therapeutic settings. This article provides an overview of the benefits accrued by children as well as the concerns with programs which involve animals, and therapy dogs in particular, in these environments. Research over the past 30 years indicates that therapy…

Research on Psychotherapy Integration: Recommendations and Conclusions from an NIMH Workshop.

ERIC Educational Resources Information Center

Wolfe, Barry E.; Goldfried, Marvin R.

1988-01-01

Describes National Institute of Mental Health (NIMH) workshop (March 1986) which invited 14 psychotherapy researchers to consider key issues associated with psychotherapy integration. Discusses recommendations developed to initiate a research program encompassing conceptual clarification, efficacy studies of systematic eclectic therapies, the role…

Role of conceptual models in a physical therapy curriculum: application of an integrated model of theory, research, and clinical practice.

PubMed

Darrah, Johanna; Loomis, Joan; Manns, Patricia; Norton, Barbara; May, Laura

2006-11-01

The Department of Physical Therapy, University of Alberta, Edmonton, Alberta, Canada, recently implemented a Master of Physical Therapy (MPT) entry-level degree program. As part of the curriculum design, two models were developed, a Model of Best Practice and the Clinical Decision-Making Model. Both models incorporate four key concepts of the new curriculum: 1) the concept that theory, research, and clinical practice are interdependent and inform each other; 2) the importance of client-centered practice; 3) the terminology and philosophical framework of the World Health Organization's International Classification of Functioning, Disability, and Health; and 4) the importance of evidence-based practice. In this article the general purposes of models for learning are described; the two models developed for the MPT program are described; and examples of their use with curriculum design and teaching are provided. Our experiences with both the development and use of models of practice have been positive. The models have provided both faculty and students with a simple, systematic structured framework to organize teaching and learning in the MPT program.

Meaning and challenges in the practice of multiple therapeutic massage modalities: a combined methods study.

PubMed

Porcino, Antony J; Boon, Heather S; Page, Stacey A; Verhoef, Marja J

2011-09-20

Therapeutic massage and bodywork (TMB) practitioners are predominantly trained in programs that are not uniformly standardized, and in variable combinations of therapies. To date no studies have explored this variability in training and how this affects clinical practice. Combined methods, consisting of a quantitative, population-based survey and qualitative interviews with practitioners trained in multiple therapies, were used to explore the training and practice of TMB practitioners in Alberta, Canada. Of the 5242 distributed surveys, 791 were returned (15.1%). Practitioners were predominantly female (91.7%), worked in a range of environments, primarily private (44.4%) and home clinics (35.4%), and were not significantly different from other surveyed massage therapist populations. Seventy-seven distinct TMB therapies were identified. Most practitioners were trained in two or more therapies (94.4%), with a median of 8 and range of 40 therapies. Training programs varied widely in number and type of TMB components, training length, or both. Nineteen interviews were conducted. Participants described highly variable training backgrounds, resulting in practitioners learning unique combinations of therapy techniques. All practitioners reported providing individualized patient treatment based on a responsive feedback process throughout practice that they described as being critical to appropriately address the needs of patients. They also felt that research treatment protocols were different from clinical practice because researchers do not usually sufficiently acknowledge the individualized nature of TMB care provision. The training received, the number of therapies trained in, and the practice descriptors of TMB practitioners are all highly variable. In addition, clinical experience and continuing education may further alter or enhance treatment techniques. Practitioners individualize each patient's treatment through a highly adaptive process. Therefore, treatment provision is likely unique to each practitioner. These results may be of interest to researchers considering similar practice issues in other professions. The use of a combined-methods design effectively captured this complexity of TMB practice. TMB research needs to consider research approaches that can capture or adapt to the individualized nature of practice.

Cognitive rehabilitation for patients with schizophrenia in Korea.

PubMed

Lee, Won Hye; Lee, Woo Kyeong

2017-02-01

Psychosocial rehabilitation programs received mental health professional support in addition to traditional medication therapy. Many psychosocial programs were developed since the 1990s, including cognitive remediation therapy. In this review, we focus on cognitive remediation therapy in Korea since the 1990s. We review several cognitive rehabilitation programs developed in Korea and their outcome studies and suggest future research directions and prospects. We reviewed cognitive rehabilitation programs including social cognitive training as well as more recent forms of computerized cognitive rehabilitation. Although there are differences in cognitive domains by training targets, almost all neurocognitive remediation trainings in Korea have beneficial effects on early visual processing, various attention types, and executive function. Future studies need to investigate the mechanisms and various mediators underlying the relationships between cognitive functions and functional outcomes. With more comprehensive cognitive and social cognitive programs, we can enhance both cognition and functional outcomes of the patients with schizophrenia. Copyright © 2016 Elsevier B.V. All rights reserved.

Prevalence and Predictors of Neoadjuvant Therapy for Stage IIIA Non-Small Cell Lung Cancer in the National Cancer Database: Importance of Socioeconomic Status and Treating Institution

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sher, David J., E-mail: david_sher@rush.edu; Liptay, Michael J.; Fidler, Mary Jo

Purpose: The optimal locoregional therapy for stage IIIA non-small cell lung cancer (NSCLC) is controversial, with definitive chemoradiation therapy (CRT) and neoadjuvant therapy followed by surgery (NT-S) serving as competing strategies. In this study, we used the National Cancer Database to determine the prevalence and predictors of NT in a large, modern cohort of patients. Methods and Materials: Patients with stage IIIA NSCLC treated with CRT or NT-S between 2003 and 2010 at programs accredited by the Commission on Cancer were included. Predictors were categorized as clinical, time/geographic, socioeconomic, and institutional. In accord with the National Cancer Database, institutions were classifiedmore » as academic/research program and as comprehensive and noncomprehensive community cancer centers. Logistic regression and random effects multilevel logistic regression were performed for univariable and multivariable analyses, respectively. Results: The cohort consisted of 18,581 patients, 3,087 (16.6%) of whom underwent NT-S (10.6% induction CRT, 6% induction chemotherapy). The prevalence of NT-S was constant over time, but there were significant relative 31% and 30% decreases in pneumonectomy and right-sided pneumonectomy, respectively, over time (P trend <.02). In addition to younger age, lower T stage, and favorable comorbidity score, indicators of higher socioeconomic status were strong independent predictors of NT-S, including white race, higher income, and private/managed insurance. The type of institution (academic/research program vs comprehensive or noncomprehensive community cancer centers, odds ratio 1.54 and 2.08, respectively) strongly predicted NT-S, but treatment volume did not. Conclusions: Neoadjuvant therapy followed by surgery was an uncommon treatment approach in Commission on Cancer programs, and the prevalence of postinduction pneumonectomy decreased over time. Higher socioeconomic status and treatment at academic institutions were significant predictors of NT-S. Further research should be performed to enable a better understanding of these disparities.« less

Pilot Trial of Inpatient Cognitive Therapy for the Prevention of Suicide in Military Personnel with Acute Stress Disorder or Post-Traumatic Stress Disorder

DTIC Science & Technology

2010-08-01

Therapy (PACT) as a targeted inpatient treatment for individuals admitted for a recent suicide attempt to a military hospital . (2) To assess the... therapy (PACT). Invited presentation at the Department of Defense Suicide Prevention Research Program Working Group, Frederick, MD. Martin, J. S ...depressed and anxious outpatients. Cognitive Behaviour Therapy , 36, 170-178. Bhar, S ., Ghahramanlou-Holloway, M., Brown, G., & Beck, A. T. (2008). Self

Bridging the Gap in Neurotherapeutic Discovery and Development: The Role of the National Institute of Neurological Disorders and Stroke in Translational Neuroscience.

PubMed

Mott, Meghan; Koroshetz, Walter

2015-07-01

The mission of the National Institute of Neurological Disorders and Stroke (NINDS) is to seek fundamental knowledge about the brain and nervous system and to use that knowledge to reduce the burden of neurological disease. NINDS supports early- and late-stage therapy development funding programs to accelerate preclinical discovery and the development of new therapeutic interventions for neurological disorders. The NINDS Office of Translational Research facilitates and funds the movement of discoveries from the laboratory to patients. Its grantees include academics, often with partnerships with the private sector, as well as small businesses, which, by Congressional mandate, receive > 3% of the NINDS budget for small business innovation research. This article provides an overview of NINDS-funded therapy development programs offered by the NINDS Office of Translational Research.

A National Survey of School-Based Physical Therapists and Secondary Transition Practices

ERIC Educational Resources Information Center

Doty, Antonette

2010-01-01

Researchers in the fields of physical therapy and special education transition have stated the need to explore how therapy programs impact the outcomes for transition-age students. Limited information exists to determine the level of involvement and role of physical therapists in secondary transition. In what transition activities are physical…

Art-Based Learning Strategies in Art Therapy Graduate Education

ERIC Educational Resources Information Center

Deaver, Sarah P.

2012-01-01

This mixed methods research study examined the use of art-based teaching methods in master's level art therapy graduate education in North America. A survey of program directors yielded information regarding in which courses and how frequently art-based methods (individual in-class art making, dyad or group art making, student art projects as…

Gerontology and the Arts.

ERIC Educational Resources Information Center

Jones, Jean Ellen, Ed.

1982-01-01

Reviews research on the place of the arts in programs for the elderly. In nine articles deals with characteristics and attitudes of adult students in art and music, dance therapy, and creativity. Discusses the aging advocacy movement and suggests it can be useful to program planners and gerontologists. (JAC)

The FRIENDS Cognitive Behavioral Program in Japanese Schools: An Examination of the Treatment Effects

ERIC Educational Resources Information Center

Matsumoto, Yuki; Shimizu, Eiji

2016-01-01

Cognitive behavioral therapy (CBT) for childhood anxiety is effective in schools; however, researchers have reported mixed results and expressed concerns regarding sociocultural differences in treating childhood anxiety. This study examined the efficacy of the FRIENDS program, which is a CBT program used at a universal school level. Students (N =…

INEL BNCT Program: Volume 5, No. 9. Bulletin, September 1991

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ackermann, A.L.

1991-12-31

This Bulletin presents a summary of accomplishments and highlights of the Idaho National Engineering Laboratory`s (INEL) Boron Neutron Capture Therapy (BNCT) Program for September 1991. This bulletin includes information on the brain tumor and melanoma research programs, Power Burst Facility (PBF) technical support and modifications, PBF operations, and updates to the animal data charts.

Cell Therapy for Lung Diseases. Report from an NIH–NHLBI Workshop, November 13–14, 2012

PubMed Central

Matthay, Michael A.; Anversa, Piero; Bhattacharya, Jahar; Burnett, Bruce K.; Chapman, Harold A.; Hare, Joshua M.; Hei, Derek J.; Hoffman, Andrew M.; Kourembanas, Stella; McKenna, David H.; Ortiz, Luis A.; Ott, Harald C.; Tente, William; Thébaud, Bernard; Trapnell, Bruce C.; Weiss, Daniel J.; Yuan, Jason X.-J.

2013-01-01

The National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health convened the Cell Therapy for Lung Disease Working Group on November 13–14, 2012, to review and formulate recommendations for future research directions. The workshop brought together investigators studying basic mechanisms and the roles of cell therapy in preclinical models of lung injury and pulmonary vascular disease, with clinical trial experts in cell therapy for cardiovascular diseases and experts from the NHLBI Production Assistance for Cell Therapy program. The purpose of the workshop was to discuss the current status of basic investigations in lung cell therapy, to identify some of the scientific gaps in current knowledge regarding the potential roles and mechanisms of cell therapy in the treatment of lung diseases, and to develop recommendations to the NHLBI and the research community on scientific priorities and practical steps that would lead to first-in-human trials of lung cell therapy. PMID:23713908

Cultural competence education in university rehabilitation programs.

PubMed

Matteliano, Mary A; Stone, John H

2014-01-01

The Center of International Rehabilitation Research, Information, and Exchange (CIRRIE) has prepared curriculum guides for rehabilitation professionals in occupational therapy, physical therapy, speech language pathology, and rehabilitation counseling. The objective is to provide a resource to faculty who wish to include or strengthen cultural competency education in their program and courses. CIRRIE assessed students'cultural needs, and solicited assistance from experts in the field to assist with the development of the guides. After the guides were published CIRRIE conducted surveys to assess their usefulness. Survey responses were highest among occupational therapy faculty. Among faculty who responded, most intended to use the cultural competence activities, case studies, and resources that the guides offer throughout their curriculum.

Mesenchymal Stem Cell Therapy for Acute Radiation Syndrome: Innovative Medical Approaches in Military Medicine

DTIC Science & Technology

2015-01-30

mesenchymal stem cells . Cytokine Growth Factor Rev. 2009;20:419–27. 8. Wang L, Li Y, Chen X, Chen J, Gautam SC, Xu Y, et al. MCP...Literature 3. DATES COVERED (From - To) 4. TITLE AND SUBTITLE Mesenchymal stem cell therapy for acute radiation syndrome: innovative medical...Independent Research Program 14. ABSTRACT See reprint. 15. SUBJECT TERMS Acute radiation syndrome, Mesenchymal stem cell , cell therapy,

Comparison of international guideline programs to evaluate and update the Dutch program for clinical guideline development in physical therapy

PubMed Central

Van der Wees, Philip J; Hendriks, Erik JM; Custers, Jan WH; Burgers, Jako S; Dekker, Joost; de Bie, Rob A

2007-01-01

Background Clinical guidelines are considered important instruments to improve quality in health care. Since 1998 the Royal Dutch Society for Physical Therapy (KNGF) produced evidence-based clinical guidelines, based on a standardized program. New developments in the field of guideline research raised the need to evaluate and update the KNGF guideline program. Purpose of this study is to compare different guideline development programs and review the KNGF guideline program for physical therapy in the Netherlands, in order to update the program. Method Six international guideline development programs were selected, and the 23 criteria of the AGREE Instrument were used to evaluate the guideline programs. Information about the programs was retrieved from published handbooks of the organizations. Also, the Dutch program for guideline development in physical therapy was evaluated using the AGREE criteria. Further comparison the six guideline programs was carried out using the following elements of the guideline development processes: Structure and organization; Preparation and initiation; Development; Validation; Dissemination and implementation; Evaluation and update. Results Compliance with the AGREE criteria of the guideline programs was high. Four programs addressed 22 AGREE criteria, and two programs addressed 20 AGREE criteria. The previous Dutch program for guideline development in physical therapy lacked in compliance with the AGREE criteria, meeting only 13 criteria. Further comparison showed that all guideline programs perform systematic literature searches to identify the available evidence. Recommendations are formulated and graded, based on evidence and other relevant factors. It is not clear how decisions in the development process are made. In particular, the process of translating evidence into practice recommendations can be improved. Conclusion As a result of international developments and consensus, the described processes for developing clinical practice guidelines have much in common. The AGREE criteria are common basis for the development of guidelines, although it is not clear how final decisions are made. Detailed comparison of the different guideline programs was used for updating the Dutch program. As a result the updated KNGF program complied with 22 AGREE criteria. International discussion is continuing and will be used for further improvement of the program. PMID:18036215

Comparison of international guideline programs to evaluate and update the Dutch program for clinical guideline development in physical therapy.

PubMed

Van der Wees, Philip J; Hendriks, Erik J M; Custers, Jan W H; Burgers, Jako S; Dekker, Joost; de Bie, Rob A

2007-11-23

Clinical guidelines are considered important instruments to improve quality in health care. Since 1998 the Royal Dutch Society for Physical Therapy (KNGF) produced evidence-based clinical guidelines, based on a standardized program. New developments in the field of guideline research raised the need to evaluate and update the KNGF guideline program. Purpose of this study is to compare different guideline development programs and review the KNGF guideline program for physical therapy in the Netherlands, in order to update the program. Six international guideline development programs were selected, and the 23 criteria of the AGREE Instrument were used to evaluate the guideline programs. Information about the programs was retrieved from published handbooks of the organizations. Also, the Dutch program for guideline development in physical therapy was evaluated using the AGREE criteria. Further comparison the six guideline programs was carried out using the following elements of the guideline development processes: Structure and organization; Preparation and initiation; Development; Validation; Dissemination and implementation; Evaluation and update. Compliance with the AGREE criteria of the guideline programs was high. Four programs addressed 22 AGREE criteria, and two programs addressed 20 AGREE criteria. The previous Dutch program for guideline development in physical therapy lacked in compliance with the AGREE criteria, meeting only 13 criteria. Further comparison showed that all guideline programs perform systematic literature searches to identify the available evidence. Recommendations are formulated and graded, based on evidence and other relevant factors. It is not clear how decisions in the development process are made. In particular, the process of translating evidence into practice recommendations can be improved. As a result of international developments and consensus, the described processes for developing clinical practice guidelines have much in common. The AGREE criteria are common basis for the development of guidelines, although it is not clear how final decisions are made. Detailed comparison of the different guideline programs was used for updating the Dutch program. As a result the updated KNGF program complied with 22 AGREE criteria. International discussion is continuing and will be used for further improvement of the program.

Fostering and Inspiring Research Engagement (FIRE): program logic of a research incubator scheme for allied health students.

PubMed

Ziviani, Jenny; Feeney, Rachel; Schabrun, Siobhan; Copland, David; Hodges, Paul

2014-08-01

The purpose of this study was to present the application of a logic model in depicting the underlying theory of an undergraduate research scheme for occupational therapy, physiotherapy, and speech pathology university students in Queensland, Australia. Data gathered from key written documents on the goals and intended operation of the research incubator scheme were used to create a draft (unverified) logic model. The major components of the logic model were inputs and resources, activities/outputs, and outcomes (immediate/learning, intermediate/action, and longer term/impacts). Although immediate and intermediate outcomes chiefly pertained to students' participation in honours programs, longer-term outcomes (impacts) concerned their subsequent participation in research higher-degree programs and engagement in research careers. Program logic provided an effective means of clarifying program objectives and the mechanisms by which the research incubator scheme was designed to achieve its intended outcomes. This model was developed as the basis for evaluation of the effectiveness of the scheme in achieving its stated goals.

17th Annual Meeting of the German Society for Gene Therapy.

PubMed

Büning, Hildegard; Baum, Christopher; Ehrhardt, Anja; Nettelbeck, Dirk M; Ogris, Manfred

2011-01-01

The 17th Annual Meeting of the German Society for Gene Therapy was held at the Chemistry and Pharmacy Campus of the University of Munich in conjunction with and supported by the British Society for Gene Therapy, the Viral Vectors Study Group of the German Society for Virology, the Research Priority Program SPP1230, the Nanosystems Initiative Munich and the Helmholtz Center Munich. The German Research Foundation provided financial support for the invited international speakers. In addition to 25 invited lectures, 21 oral presentations were selected out of more than 100 submitted abstracts. State-of-the-art advances in the field of gene therapy were presented, a field that has considerably evolved within recent years. More than 200 researchers from Germany and other European countries, as well as the USA, Canada and Japan attended the meeting. Prior to the official meeting, a public day was organized, in which the interested public could participate in talks and discussions concerning gene therapy issues. Furthermore, at the 'kids workshop' young scientists aged 8-10 years were discovering cellular and genetic mechanisms and the principles of gene therapy.

Summer Prostate Cancer Research Training Program

DTIC Science & Technology

2015-07-01

cellular resistance to oxidative stress associated with cancer therapy. His laboratory was also the first to discover that glucose deprivation...cellular resistance to oxidative stress associated with cancer therapy. His laboratory was also the first to discover that glucose deprivation...Professor & Starch Faculty Fellow in the Department of Psychology. The current focus of the Lutgendorf laboratory investigates how stress is

The Effectiveness of Art Therapy for Teaching Social Skills to Children with Autism Spectrum Disorder

ERIC Educational Resources Information Center

D'Amico, Miranda; Lalonde, Corinne

2017-01-01

The purpose of this quasi-experimental research study was to evaluate the effectiveness of art therapy for teaching social skills to children with autism spectrum disorder (ASD). The program we tested was structured to provide a therapeutic setting for children to discuss difficulties they experience in their social interactions, and give them…

A pilot analysis of the psychological themes found during the CARING at Columbia--Music Therapy program with refugee adolescents from North Korea.

PubMed

Choi, Carolyn Mi Hwan

2010-01-01

The purpose of this study was to identify the psychological themes found during the modified CARING at Columbia-Music Therapy (CAC-MT) program with refugee adolescents from North Korea. Nine students attending an alternative school participated in this study. Academically, students belong to an equivalent middle school level. Students participated in a music therapy program comprised of 25 sessions. A multiple case analysis was conducted to gather qualitative results. Students were found to be exposed to various psychosocially stressful life situations such as lack of social support system, family separation, academic difficulty, and economic hardship throughout their adaptation process to their new country. There were 5 common psychological themes--avoidance, distrust, loneliness, feelings of loss, and fear--found among the refugee students over the course of the CAC-MT treatment. For future research, studies with a larger sample size and differing types of session structure should be conducted to closely examine the effects of this program on refugee adolescents.

Staff Attitudes Regarding the Impact of a Therapy Dog Program on Military Behavioral Health Patients.

PubMed

Brisson, Sara; Dekker, Anthony H

Human-animal interactions in the form of animal-assisted therapy (AAT) have become common in both civilian and military health care facilities. Evidence supports AAT as a beneficial therapeutic alternative for patients with physical disabilities and psychological disorders. Few studies have been conducted in the civilian health care setting to evaluate staff attitudes regarding the impact of an AAT program on behavioral health (BH) patients. To our knowledge, no research has examined staff attitudes on the impact and effectiveness of AAT on active-duty Servicemembers in a BH program at a military facility. At the completion of a year-long AAT dog program and after institutional review board exemption, an anonymous, six-question survey was used to examine staff attitudes (n = 29) regarding the impact and continuation of the program with military BH patients. Most staff members (86%) believed the AAT dog program had a positive impact on the BH patients, including improved patient mood, greater patient relaxation, improved patient attitude toward therapy, and increased social interactions among patients. All the staff reported a desire to continue the program at the military facility. Most BH staff thought the year-long AAT dog program had a positive impact on patients. All staff supported continuation of the program. 2017.

Strategies for More Rapid Translation of Cellular Therapies for Children: A US Perspective

PubMed Central

Silberstein, Leslie E.; Lindblad, Robert W.; Welniak, Lisbeth A.; Mondoro, Traci Heath; Wagner, John E.

2013-01-01

Clinical trials for pediatric diseases face many challenges, including trial design, accrual, ethical considerations for children as research subjects, and the cost of long-term follow-up studies. In September 2011, the Production Assistance for Cellular Therapies Program, funded by the National Heart, Lung, and Blood Institute of the National Institutes of Health, sponsored a workshop, “Cell Therapy for Pediatric Diseases: A Growing Frontier,” with the overarching goal of optimizing the path of discovery in research involving novel cellular therapeutic interventions for debilitating pediatric conditions with few or no available treatment options. Academic and industry investigators in the fields of cellular therapy and regenerative medicine described the obstacles encountered in conducting a clinical trial from concept to conclusion. Patient and parent advocates, bioethicists, biostatisticians, regulatory representatives from the US Food and Drug Administration, and translational scientists actively participated in this workshop, seeking to identify the unmet needs specific to cellular therapies and treatment of pediatric diseases and propose strategies to facilitate the development of novel therapies. In this article we summarize the obstacles and potential corrective strategies identified by workshop participants to maximize the speed of cell therapy translational research for childhood diseases. PMID:23837178

Realising the Mass Public Benefit of Evidence-Based Psychological Therapies: The IAPT Program

PubMed Central

Clark, David M

2018-01-01

Empirically supported psychological therapies have been developed for many mental health conditions. However, in most countries only a small proportion of the public benefit from these advances. The English Improving Access to Psychological Therapies (IAPT) program aims to bridge the gap between research and practice by training over 10,500 new psychological therapists in empirically supported treatments and deploying them in new services for the treatment of depression and anxiety disorders. Currently IAPT treats over 560,000 patients per year, obtains clinical outcome data on 98.5% of these individuals and places this information in the public domain. Around 50% of patients treated in IAPT services recover and two-thirds show worthwhile benefits. The clinical and economic arguments on which IAPT is based are presented, along with details of the service model, how the program was implemented, and recent findings about service organization. Limitations and future directions are outlined. PMID:29350997

Cellular Therapies Clinical Research Roadmap: lessons learned on how to move a cellular therapy into a clinical trial.

PubMed

Ouseph, Stacy; Tappitake, Darah; Armant, Myriam; Wesselschmidt, Robin; Derecho, Ivy; Draxler, Rebecca; Wood, Deborah; Centanni, John M

2015-04-01

A clinical research roadmap has been developed as a resource for researchers to identify critical areas and potential pitfalls when transitioning a cellular therapy product from the research laboratory, by means of an Investigational New Drug (IND) application, into early-phase clinical trials. The roadmap describes four key areas: basic and preclinical research, resource development, translational research and Good Manufacturing Practice (GMP) and IND assembly and submission. Basic and preclinical research identifies a new therapeutic concept and demonstrates its potential value with the use of a model of the relevant disease. During resource development, the appropriate specialists and the required expertise to bring this product into the clinic are identified (eg, researchers, regulatory specialists, GMP manufacturing staff, clinicians and clinical trials staff, etc). Additionally, the funds required to achieve this goal (or a plan to procure them) are identified. In the next phase, the plan to translate the research product into a clinical-grade therapeutic is developed. Finally regulatory approval to start the trial must be obtained. In the United States, this is done by filing an IND application with the Food and Drug Administration. The National Heart, Lung and Blood Institute-funded Production Assistance for Cellular Therapies program has facilitated the transition of a variety of cellular therapy products from the laboratory into Phase1/2 trials. The five Production Assistance for Cellular Therapies facilities have assisted investigators by performing translational studies and GMP manufacturing to ensure that cellular products met release specifications and were manufactured safely, reproducibly and at the appropriate scale. The roadmap resulting from this experience is the focus of this article. Copyright © 2015 International Society for Cellular Therapy. Published by Elsevier Inc. All rights reserved.

78 FR 27408 - National Cancer Institute; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-10

... Support; 93.398, Cancer Research Manpower; 93.399, Cancer Control, National Institutes of Health, HHS... ``Development of Blood-based Methods for the Detection of Cancer Recurrence in Post-Therapy Breast Cancer... Officer, Research Programs Review Branch, Division of Extramural Activities, National Cancer Institute...

Effectiveness of Interventions Within the Scope of Occupational Therapy Practice to Improve Motor Function of People With Traumatic Brain Injury: A Systematic Review.

PubMed

Chang, Pei-Fen J; Baxter, Mary Frances; Rissky, Jenna

2016-01-01

After traumatic brain injury (TBI), many people experience significant motor function impairments. To help occupational therapy practitioners make informed decisions in choosing treatment strategies to improve clients' motor function, we undertook a systematic review and synthesized applicable findings of intervention studies. Of 2,306 articles identified in the literature search, we reviewed 47 full-text articles, of which 16 met approved criteria. We found moderate evidence that various exercise programs increase motor function and limited evidence that people with TBI can benefit from rehabilitation and computer-based programs. We offer implications for practice, education, and research. Copyright © 2016 by the American Occupational Therapy Association, Inc.

Do respiratory therapists receive training and education in smoking cessation? A national study of post-secondary training programs.

PubMed

Jordan, Timothy R; Khubchandani, Jagdish; Wiblishauser, Michael; Glassman, Tavis; Thompson, Amy

2011-10-01

To assess the tobacco-related education provided by post-secondary respiratory therapy training programs in the United States. A cross-sectional research design was used to survey the entire population of program directors of post-secondary, respiratory therapy training programs in the United States. A valid and reliable questionnaire was developed and mailed using a 2-wave mailing technique (73% return rate). Internal reliability coefficients (Cronbach alpha) for the various components of the questionnaire ranged from 0.78 to 0.91. More than half of programs (56%) offered no teaching on the 5R's. Nearly half (47%) offered no teaching on the 5A's. Of the 13 tobacco-related topics listed in the basic science and clinical science sections of the questionnaire, only one topic (i.e., diseases linked to tobacco use) received 3h or more of instruction by approximately a third of programs (35.8%). The majority of programs (>90%) spent no time teaching students about the socio-political aspects of tobacco use cessation. Moreover, 41% of programs did not formally evaluate students' competence in providing smoking cessation counseling to patients. Tobacco-related education is a very minor component of the education and training received by respiratory therapy students in the United States. Respiratory therapy training programs in the United States have great potential to strengthen the tobacco-related education that they provide to students. Practicing respiratory therapists would likely benefit from continuing medical education focused on how to use evidence-based smoking cessation counseling techniques with patients. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Telehealth, Wearable Sensors, and the Internet: Will They Improve Stroke Outcomes Through Increased Intensity of Therapy, Motivation, and Adherence to Rehabilitation Programs?

PubMed

Burridge, Jane H; Lee, Alan Chong W; Turk, Ruth; Stokes, Maria; Whitall, Jill; Vaidyanathan, Ravi; Clatworthy, Phil; Hughes, Ann-Marie; Meagher, Claire; Franco, Enrico; Yardley, Lucy

2017-07-01

Stroke, predominantly a condition of older age, is a major cause of acquired disability in the global population and puts an increasing burden on health care resources. Clear evidence for the importance of intensity of therapy in optimizing functional outcomes is found in animal models, supported by neuroimaging and behavioral research, and strengthened by recent meta-analyses from multiple clinical trials. However, providing intensive therapy using conventional treatment paradigms is expensive and sometimes not feasible because of social and environmental factors. This article addresses the need for cost-effective increased intensity of practice and suggests potential benefits of telehealth (TH) as an innovative model of care in physical therapy. We provide an overview of TH and present evidence that a web-supported program, used in conjunction with constraint-induced therapy (CIT), can increase intensity and adherence to a rehabilitation regimen. The design and feasibility testing of this web-based program, "LifeCIT," is presented. We describe how wearable sensors can monitor activity and provide feedback to patients and therapists. The methodology for the development of a wearable device with embedded inertial and mechanomyographic sensors, algorithms to classify functional movement, and a graphical user interface to present meaningful data to patients to support a home exercise program is explained. We propose that wearable sensor technologies and TH programs have the potential to provide most-effective, intensive, home-based stroke rehabilitation.

Targeted Alpha Therapy: The US DOE Tri-Lab (ORNL, BNL, LANL) Research Effort to Provide Accelerator-Produced 225Ac for Radiotherapy

NASA Astrophysics Data System (ADS)

John, Kevin

2017-01-01

Targeted radiotherapy is an emerging discipline of cancer therapy that exploits the biochemical differences between normal cells and cancer cells to selectively deliver a lethal dose of radiation to cancer cells, while leaving healthy cells relatively unperturbed. A broad overview of targeted alpha therapy including isotope production methods, and associated isotope production facility needs, will be provided. A more general overview of the US Department of Energy Isotope Program's Tri-Lab (ORNL, BNL, LANL) Research Effort to Provide Accelerator-Produced 225Ac for Radiotherapy will also be presented focusing on the accelerator-production of 225Ac and final product isolation methodologies for medical applications.

Summer Prostate Cancer Research Training Program

DTIC Science & Technology

2016-07-01

a large increase cellular resistance to oxidative stress associated with cancer therapy. His laboratory was also the first to discover that...genomic instability and gene amplification that resulted in a large increase cellular resistance to oxidative stress associated with cancer therapy. His... Starch Faculty Fellow in the Department of Psychology. The current focus of the Lutgendorf laboratory investigates how stress is related to

Student-Faculty Perceptions of Multicultural Training in Accredited Marriage and Family Therapy Programs in Relation to Students' Self-Reported Competence

ERIC Educational Resources Information Center

Inman, Arpana G.; Meza, Marisol M.; Brown, Andrae L.; Hargrove, Byron K.

2004-01-01

Although the marriage and family therapy field's recent attention to multicultural issues is laudable, there appears to be little clarity on what constitutes an effective multicultural competence. The field continues to be challenged at different levels-training, practice, research, the setting of the standards and the work of the commission on…

Internet Cognitive Behavioural Therapy for Panic Disorder: Does the Inclusion of Stress Management Information Improve End-State Functioning?

ERIC Educational Resources Information Center

Richards, Jeffrey C.; Klein, Britt; Austin, David W.

2006-01-01

Previous research has established Internet-based cognitive behavioural therapy (CBT) for panic disorder (PD) as effective in reducing panic severity and frequency. There is evidence, however, that such programs are less effective at improving overall end-state functioning, defined by a PD clinician severity rating of [less than or equal to] 2 and…

Determine the Impact of Novel BRCA1 Translation Start Sites on Therapy Resistance in Ovarian Cancer

DTIC Science & Technology

2017-09-01

Award Number: W81XWH-15-1-0197 TITLE: PRINCIPAL INVESTIGATOR: Neil Johnson, Ph.D. CONTRACTING ORGANIZATION: Institute for Cancer Research...Therapy Resistance in Ovarian Cancer The views, opinions and/or findings contained in this report are those of the author(s) and should not be...Start Sites on Therapy 5b. GRANT NUMBER Resistance in Ovarian Cancer W81XWH-15-1-0197 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER Neil

Research Findings on Neurolinguistic Programming: Nonsupportive Data or an Untestable Theory?

ERIC Educational Resources Information Center

Sharpley, Christopher F.

1987-01-01

Examines the experimental literature on neurolinguistic programming (NLP). Sharpley (l984) and Einspruch and Forman (l985) concluded that the effectiveness of this therapy was yet to be demonstrated. Presents data from seven recent studies that further question the basic tenets of NLP and their application in counseling situations. (Author/KS)

The Role of Transport Use in Adolescent Wilderness Treatment: Its Relationship to Readiness to Change and Outcomes

ERIC Educational Resources Information Center

Tucker, Anita R.; Bettmann, Joanna E.; Norton, Christine L.; Comart, Casey

2015-01-01

Background: Considering the sensitive ethical issues related to involuntary treatment of adolescents, research investigating youth transport practices and treatment outcomes is clearly needed. Youth transport is common practice in many private pay programs, including wilderness therapy programs. Objective: This study of 350 adolescents in…

Navy-ASEE Summer Faculty Research Program. Navy-ASEE Sabbatical Leave Program.

DTIC Science & Technology

1994-09-01

University Arnall Physical Therapy N. Arizona Univ. I Azimi-Sadjadi Elec. Eng. Colorado St. Univ. Baird Chem. Univ. of Alabama in Huntsville I Bandy Mech...provide the framework for the analysis of data in magneto -optics and on tunneling structures for a number of years. Dr. Bilal M. Ayyub Associate

Acceptance and Commitment Therapy for adults who stutter: psychosocial adjustment and speech fluency.

PubMed

Beilby, Janet M; Byrnes, Michelle L; Yaruss, J Scott

2012-12-01

The aim of the present study was to assess the effectiveness of an Acceptance and Commitment Therapy group intervention program for adults who stutter (N=20). The program consisted of 2-h therapeutic sessions conducted weekly for eight consecutive weeks. It was an integrated program designed to improve: (a) psychosocial functioning, (b) readiness for therapy and change, (c) utilisation of mindfulness skills and psychological flexibility, and (d) frequency of stuttering. The findings provide innovative evidence for Acceptance and Commitment Therapy as an effective intervention with statistically significant improvements in psychosocial functioning, preparation for change and therapy, utilisation of mindfulness skills, and overall speech fluency. Follow-up data collected at three months post-treatment revealed that therapeutic gains were successfully maintained over time. These findings enhance the understanding of the impact of stuttering on psychological wellbeing and offer a new perspective on what might constitute successful stuttering treatment. Further, clinical research support is provided for Acceptance and Commitment Therapy delivered in a group format as a promising and novel intervention for adults who stutter. The reader will be able to: (a) appreciate the potential for Acceptance and Commitment Therapy for adults who stutter; (b) identify the improvements participants experienced in psychosocial functioning and frequency of stuttered speech; (c) appreciate the six core processes of Acceptance and Commitment Therapy; and (d) appreciate the differences between an ACT model of intervention for adults who stutter compared to a CBT approach. Copyright © 2012 Elsevier Inc. All rights reserved.

Dental Therapists as New Oral Health Practitioners: Increasing Access for Underserved Populations.

PubMed

Brickle, Colleen M; Self, Karl D

2017-09-01

The development of dental therapy in the U.S. grew from a desire to find a workforce solution for increasing access to oral health care. Worldwide, the research that supports the value of dental therapy is considerable. Introduction of educational programs in the U.S. drew on the experiences of programs in New Zealand, Australia, Canada, and the United Kingdom, with Alaska tribal communities introducing dental health aide therapists in 2003 and Minnesota authorizing dental therapy in 2009. Currently, two additional states have authorized dental therapy, and two additional tribal communities are pursuing the use of dental therapists. In all cases, the care provided by dental therapists is focused on communities and populations who experience oral health care disparities and have historically had difficulties in accessing care. This article examines the development and implementation of the dental therapy profession in the U.S. An in-depth look at dental therapy programs in Minnesota and the practice of dental therapy in Minnesota provides insight into the early implementation of this emerging profession. Initial results indicate that the addition of dental therapists to the oral health care team is increasing access to quality oral health care for underserved populations. As evidence of dental therapy's success continues to grow, mid-level dental workforce legislation is likely to be introduced by oral health advocates in other states. This article was written as part of the project "Advancing Dental Education in the 21 st Century."

[The effect of a group therapy for the offenders of family violence].

PubMed

Hyun, Mi Yeul

2008-06-01

The purpose of this study was to evaluate the contribution of group therapy to the improvement of self-esteem, anger, stress coping and communication of those who were violent in to family. The research design was a one-group- pretest-posttest design in quasi-experimental research, and the period of this study was from March to October, 2005. Participants were 14 offenders who were ordered to be counseled according to 'the special exemption law for punishing domestic violence.' Group therapy was applied once a week for 8 weeks. Results were collected by using a questionnaire for self-esteem, anger, stress coping and communication. In the data analysis, Wilcoxon signed test with SPSS/WIN 12.0 program was used. The scores of self-esteem and communication showed statistically significant improvement from pre to post therapy. However, the scores of anger and stress coping were not significantly changed from pre to post therapy. This group therapy was effective in improving the self-esteem and communication in offenders of family violence.

Relationship Education Research: Current Status and Future Directions

PubMed Central

Markman, Howard J.; Rhoades, Galena K.

2011-01-01

The overarching aim of this paper is to review research on relationship education programs and approaches that have been published or accepted for publication since the last review article in 2002. This paper provides a critical overview of the relationship education field and sets an agenda for research and practice for the next decade. A theme weaved throughout the paper are the ways in which relationship education is similar and different from couples therapy and we conclude that there can be a synergistic, healthy marriage between the two. We then provide recommendations for future directions for research in the relationship education field. Finally, the co-authors comment on our experiences in both the relationship education field and couples therapy field as both researchers and interventionists. PMID:22283386

Exploring the relationship between client perspectives, clinical expertise and research evidence.

PubMed

Roulstone, Sue

2015-06-01

This paper examines the relationship between components of evidence-based practice (clinical expertise, patient perspective and research evidence). Findings are examined from two research programs: the Better Communication Research Program and Child Talk, including exploratory studies of the views of parents and children regarding speech-language pathology and studies of current practice by SLPs in England. Systematic reviews of the research literature were also undertaken. The paper analyses relationships between outcomes valued by children and parents and those reported in the literature and in practice, parents' perspectives regarding intervention in comparison with clinicians' reports of practice and the extent to which research evidence underpins current practice is examined. Parents and children value functional outcomes and positive experiences; these are not routinely measured in research or practice. Therapy is perceived positively by most parents; however, some are ambivalent and less clear about the rationale. Commonly used interventions are supported by evidence, but there are gaps regarding some critical therapy components. The paper discusses four challenges to evidence-based practice: the consistency and clarity of descriptions of interventions; consensus based models of practice; understanding of the mechanisms of change; and, finally, the operationalization of client preferences within an evidence-based practice framework.

Effect of music therapy on oncologic staff bystanders: a substantive grounded theory.

PubMed

O'Callaghan, Clare; Magill, Lucanne

2009-06-01

Oncologic work can be satisfying but also stressful, as staff support patients and families through harsh treatment effects, uncertain illness trajectories, and occasional death. Although formal support programs are available, no research on the effects of staff witnessing patients' supportive therapies exists. This research examines staff responses to witnessing patient-focused music therapy (MT) programs in two comprehensive cancer centers. In Study 1, staff were invited to anonymously complete an open-ended questionnaire asking about the relevance of a music therapy program for patients and visitors (what it does; whether it helps). In Study 2, staff were theoretically sampled and interviewed regarding the personal effects of witnessing patient-centered music therapy. Data from each study were comparatively analyzed according to grounded theory procedures. Positive and negative cases were evident and data saturation arguably achieved. In Study 1, 38 staff unexpectedly described personally helpful emotional, cognitive, and team effects and consequent improved patient care. In Study 2, 62 staff described 197 multiple personal benefits and elicited patient care improvements. Respondents were mostly nursing (57) and medical (13) staff. Only three intrusive effects were reported: audibility, initial suspicion, and relaxation causing slowing of work pace. A substantive grounded theory emerged applicable to the two cancer centers: Staff witnessing MT can experience personally helpful emotions, moods, self-awarenesses, and teamwork and thus perceive improved patient care. Intrusive effects are uncommon. Music therapy's benefits for staff are attributed to the presence of live music, the human presence of the music therapist, and the observed positive effects in patients and families. Patient-centered oncologic music therapy in two cancer centers is an incidental supportive care modality for staff, which can reduce their stress and improve work environments and perceived patient care. Further investigation of the incidental benefits for oncologic staff witnessing patient-centered MT, through interpretive and positivist measures, is warranted.

Outward Bound--An Adjunctive Psychiatric Therapy: Preliminary Research Findings.

ERIC Educational Resources Information Center

Stich, Thomas F.; Sussman, Lewis R.

According to a small study, Outward Bound can enhance the treatment of hospitalized psychiatric patients. Researchers measured the effect of a therapeutic Outward Bound program of prescribed physical and social tasks on the contentment and self-esteem of seven patients undergoing short-term treatment at the Veterans Administration Hospital in…

Animal Assisted Therapy and the Reading Education Assistance Dogs[RTM] (R.E.A.D.) Program as Perceived by Volunteer R.E.A.D. Facilitators: A National Study

ERIC Educational Resources Information Center

Swift, Catherine Hayes

2009-01-01

This study investigated the demographics and perceptions of participants who utilize animals in academic programs, specifically the volunteers who use dogs to work with at-risk children in reading programs. It presented an argument for incorporating research-supported elements of reading tutor skills into the volunteer tutor training for the…

The effectiveness of parent participation in occupational therapy for children with developmental delay

PubMed Central

Lin, Chien-Lin; Lin, Chin-Kai; Yu, Jia-Jhen

2018-01-01

Introduction This study aims to explore the impact of Parent Participation Program on the development of developmental delay children. Methods Pretest-posttest equivalent-group experimental design study was used in this paper. A total of 30 pairs of developmental delay children aged 0–72 months and their parents participated into this study. They were divided into two groups, namely control group and experimental group, according to parents’ wishes. The objects of study in control group received 16 courses of direct rehabilitation therapy; those in experimental group received 8 courses of direct rehabilitation therapy and 8 courses of instruction and tracking of Parent Participation Program. The duration of the intervention was 8 weeks. All cases should be evaluated before and after the intervention, to analyze the difference before and after intervention and among groups. The statistical methods in this paper included descriptive analysis, Chi-square test, independent sample t-test, pair-sample t-test. Results and conclusion The intervention of Parent Participation Occupational Program has positive impact on the development of developmental delay children in various fields. Among all the intervention results, the progress of the experimental group is 1.895 times more than that of the control group. With parent involvement, Parent Participation Occupational Therapy can promote the cognitive ability, language ability, action ability (gross and fine movement), social competence and self-care ability of children with developmental delay. Finally, the researcher presents suggestions and directions for future research in accordance with the results. PMID:29503546

Mental health consumer participation in education: a structured literature review.

PubMed

Arblaster, Karen; Mackenzie, Lynette; Willis, Karen

2015-10-01

Consumer participation in design, delivery and evaluation of occupational therapy educational programs is a recently introduced requirement for accreditation. It aligns with the principle of recovery, which underpins Australian mental health policy. Graduates' capabilities for recovery-oriented practice are thought to be enhanced through learning from consumers' lived experience. This structured literature review evaluates the current evidence for mental health consumer participation in health professional education to inform occupational therapy educators. Searches were completed in five online databases, one journal and published reading lists on the topic. Studies were included if they addressed mental health consumer participation in health professional education programs, were published in peer reviewed journals between 2000 and 2014 and were in English. Articles were critically reviewed, and analysed for key findings related to stages of the educational process and recovery-oriented practice capabilities. An emerging body of evidence for consumer participation in mental health education was identified. Studies are characterised by a lack of quality and a low to medium level of evidence. Findings relate to design, planning, delivery and evaluation of education as well as to most aspects of recovery-oriented practice. Emphases on exploratory research and proximal outcomes, and a reliance on published outcome measurement instruments designed for other purposes are key limitations in this body of evidence. This study identifies a weak evidence base for the requirement for consumer participation in occupational therapy programs, specifically related to mental health curricula. A research agenda is proposed in response. © 2015 Occupational Therapy Australia.

Cultivations...and potting on a strategic plan for a social and horticultural therapy program.

PubMed

Smilski, Andrea

2008-01-01

This research endeavored to develop a strategic growth plan for St. Ann's Garden Club (SAGC), a Non-Profit Social and Horticultural Therapy program, located at Providence Farm in Duncan, British Columbia. SAGC is a day program for older adults with mental illness and/or drug/alcohol addiction. The aim of the program is to be sustainable within the context of stakeholders needs, preferences, and resources and therefore they sought a strategic analysis prior to launching a growth strategy. SAGC has valuable intangible resources that contribute to strong core competencies and effectiveness despite facing many program issues requiring change in order for them to be sustainable. These same issues are shared by many public and non-profit health and wellness programs as they struggle to remain relevant in today's changing healthscape. To adequately focus the study and provide sound direction, the strategic analysis highlighted SAGC's environment, opportunities, issues, priorities, and requirements and was conducted through multiple iterations of the action research cycle. Data was gathered using surveys, interviews, and a focus group. The findings supported a capital campaign to build as new larger clubhouse and establish a more diverse sustainable funding base. Using a resource based perspective, a three year strategic plan was formulated for SAGC to help them cultivate growth and sustainability.

Effects of a Program of Adapted Therapeutic Horse-Riding in a Group of Autism Spectrum Disorder Children

ERIC Educational Resources Information Center

García-Gómez, Andrés; Risco, Manuel López; Rubio, Jesús Carlos; Guerrero, Eloisa; García-Peña, Inés Magdalena

2014-01-01

Introduction: The use of horses in therapy has a fairly long history. There are many references to the therapeutic benefits of this activity. Such therapies have been undergoing a boom internationally in recent years. However scientific research into the effective use of this activity in children with autism is still in the early stages of…

Behavioral Marital Therapy (BMT) for Alcoholics and Wives: Review of Literature and a Proposed Research Program.

ERIC Educational Resources Information Center

O'Farrell, Timothy J.; Cutter, Henry S. G.

After describing a social learning formulation of the male alcoholic's marriage, this paper reviews the few studies of behavioral marital therapy (BMT) for alcoholics and their wives. Although none of these studies are as rigorous as one might wish and many of them are merely case studies, a review of the literature shows that behavioral marital…

Development of education program for physical therapy assistant in Quang Tri province of Vietnam.

PubMed

Noh, Jin Won; Cho, Sang Hyun; Kim, Min Hee; Kim, Eun Joo

2017-02-01

[Purpose] The purpose of the present study was to develop an education program for physical therapy assistants in order to provide high quality physical therapy for the province of Quang Tri in Vietnam. [Subjects and Methods] Subjects consisted of 9 professors in Quang Tri medical college and 1 physical therapist in Quang Tri General hospital. The survey research to lecturer for education of physical therapy assistant in Quang Tri medical college was conducted as pre-analysis of demand for the physical therapy assistant curriculum development. The priority rank of expectation and consciousness were measured in curriculum subjects. [Results] Results of educational expectation of the curriculum total educational expectation were presented as minimum 4 to maximum 5. In the result of educational expectation according to background variable, the differences of educational expectation on scores according to the educational experience were significant. Among the consciousness priority of each curriculum subject, the priority rank of basic kinesiology and physical therapy for international medicine & surgery were 9, the highest first rank frequency. [Conclusion] The curriculum for physical therapy assistant was developed to 5 main subjects including a total of 420 hours (120 hours of theory and 300 hours of practice).

Development of education program for physical therapy assistant in Quang Tri province of Vietnam

PubMed Central

Noh, Jin Won; Cho, Sang Hyun; Kim, Min Hee; Kim, Eun Joo

2017-01-01

[Purpose] The purpose of the present study was to develop an education program for physical therapy assistants in order to provide high quality physical therapy for the province of Quang Tri in Vietnam. [Subjects and Methods] Subjects consisted of 9 professors in Quang Tri medical college and 1 physical therapist in Quang Tri General hospital. The survey research to lecturer for education of physical therapy assistant in Quang Tri medical college was conducted as pre-analysis of demand for the physical therapy assistant curriculum development. The priority rank of expectation and consciousness were measured in curriculum subjects. [Results] Results of educational expectation of the curriculum total educational expectation were presented as minimum 4 to maximum 5. In the result of educational expectation according to background variable, the differences of educational expectation on scores according to the educational experience were significant. Among the consciousness priority of each curriculum subject, the priority rank of basic kinesiology and physical therapy for international medicine & surgery were 9, the highest first rank frequency. [Conclusion] The curriculum for physical therapy assistant was developed to 5 main subjects including a total of 420 hours (120 hours of theory and 300 hours of practice). PMID:28265176

Influence of Music Therapy on Coping Skills and Anger Management in Forensic Psychiatric Patients: An Exploratory Study.

PubMed

Hakvoort, Laurien; Bogaerts, Stefan; Thaut, Michael H; Spreen, Marinus

2015-07-01

The effect of music therapy on anger management and coping skills is an innovative subject in the field of forensic psychiatry. This study explores the following research question: Can music therapy treatment contribute to positive changes in coping skills, anger management, and dysfunctional behavior of forensic psychiatric patients? To investigate this question, first a literature review is offered on music therapy and anger management in forensic psychiatry. Then, an explorative study is presented. In the study, a pre- and post-test design was used with a random assignment of patients to either treatment or control condition. Fourteen participants' complete datasets were collected. All participants received "treatment as usual." Nine of the participants received a standardized, music therapy anger management program; the five controls received, unplanned, an aggression management program. Results suggested that anger management skills improved for all participants. The improvement of positive coping skills and diminishing of avoidance as a coping skill were measured to show greater changes in music therapy participants. When controlling for the exact number of treatment hours, the outcomes suggested that music therapy might accelerate the process of behavioral changes. © The Author(s) 2013.

Adapting the Home After a Stroke

MedlinePlus

... and the Program in Occupational Therapy at Washington University in St. Louis School of Medicine . The research ... the Leonard Davis School of Gerontology at the University of Southern California), with additional contributions from Laura ...

Evaluating the Real-World Effectiveness of Cognitive-Behavior Therapy Efficacy Research on Eating Disorders: A Case Study from a Community-based Clinical Setting

PubMed Central

Lowe, Michael R.; Bunnell, Douglas W.; Neeren, Amy M.; Chernyak, Yelena; Greberman, Laurel

2009-01-01

Objective There is a growing consensus that there is a need to test the real-world effectiveness of eating disorder therapies that show promise in efficacy research. The current paper provides a narrative account of an NIMH-funded study that attempted to apply efficacy findings from CBT research to an Intensive Outpatient Program (IOP) at the largest community-based eating disorder program in the United States. Method We describe the study as originally envisioned as well as the various challenges that the researchers and the IOP staff encountered in implementing this study. Results The different training, assumptions, and “ways of knowing” of the research team and the treatment staff in regard to the nature of eating disorders and their treatment created multiple challenges for both groups during the study period. We describe valuable lessons learned about how to - and how not to -implement effectiveness designs in clinical settings that are relatively unfamiliar with empirically-based research findings. Discussion It is hoped that our experience in attempting to apply efficacy-based research findings on eating disorders treatment in a community-based clinical setting will prove helpful to other researchers and service providers engaging in such translational research. PMID:20063375

Community engagement: outcomes for occupational therapy students, faculty and clients.

PubMed

Schindler, Victoria P

2014-06-01

Students in health care professions, including occupational therapy, are required to develop knowledge, skills and attitudes in mental health and research. Persons diagnosed with a mental illness, a learning disability or an autism-spectrum disorder desire to achieve goals in higher education and employment. Faculty in health care programmes strives to meet professional goals and accreditation and institution requirements for teaching, service and scholarship. The Bridge Program, a programme based on principles of community engagement, was developed to meet the needs of these three stakeholders. The objective of this paper is to provide programme description and outcomes of the effectiveness of the Bridge Program for all three stakeholders. This uses mixed methods research design including descriptive and quantitative and qualitative one-group pre-test-post-test designs. Instruments consisted of the Occupational Therapy Student and Mental Health Population Scale and the Canadian Occupational Performance Measure. Quantitative results support that graduate occupational therapy students gained research and clinical skills (n = 100; p = .000); clients increased performance and satisfaction toward goals (n = 113; p = .000) and faculty (n = 1) achieved goals related to teaching, service and scholarship. Programmes based on principles of community engagement can address the needs of the community, can provide outcomes that advance knowledge about community practice and can result in benefits for all stakeholders. This paper is limited to generalization and instrumentation and recommends an ongoing evaluation of other community engagement programmes involving all stakeholders in the future research. Copyright © 2014 John Wiley & Sons, Ltd.

Prevention or Pork? A Hard-Headed Look at Youth-Oriented Anti-Crime Programs.

ERIC Educational Resources Information Center

Mendel, Richard A.

This report reviews the facts underlying the debate about delinquency in the United States, focusing on evidence of how well various approaches to crime succeed in practice. Do youth programs such as family therapies and recreation initiatives actually make a cost-effective contribution to controlling crime? Research supports a strong foundation…

Effects of a Play-Based Teacher Consultation (PBTC) Program on Interpersonal Skills of Elementary School Teachers in the Classroom

ERIC Educational Resources Information Center

Carlson, Sarah E.

2011-01-01

The purpose of this study was to examine the effectiveness of a play-based teacher consultation (PBTC) program on individual teachers' interpersonal classroom behaviors and teacher-child relationships. The research questions addressed the application of child-centered play therapy principles and PBTC increasing teacher responsiveness, decreasing…

The effect of a music therapy social skills training program on improving social competence in children and adolescents with social skills deficits.

PubMed

Gooding, Lori F

2011-01-01

Three separate studies were conducted in school, residential and after-school care settings to test the effectiveness of a music therapy-based social skills intervention program on improving social competence in children and adolescents. A total of 45 children (n = 12; n = 13; n = 20) aged 6-17 years with social skills deficits participated in a group-based five session intervention program. The same curriculum, adapted to be age appropriate, was used at all 3 sites. Specific deficits within the social skills areas of peer relations and self-management skills were targeted. Active interventions like music performance, movement to music and improvisation were used. Cognitive-behavioral techniques like modeling, feedback, transfer training and problem solving were also incorporated. Data on social functioning were collected before, during, and after the music therapy intervention from participants, appropriate adult personnel and via behavioral observations. Results indicated that significant improvements in social functioning were found in (a) school participant pre and post self-ratings, (b) researcher pre and post ratings of school participants, (c) case manager's pre and post treatment ratings for the residential participants, (d) after-school care participants' pre and post self-ratings, and (e) behavioral observations at all three settings. Additional changes, although not significant, were noted in teacher ratings, residential participant self- and peer ratings, and after-school case manager ratings. Results from these studies suggest that the music therapy intervention was effective in improving social competence in children and adolescents with social deficits. More research is warranted to provide additional guidance about the use of music therapy interventions to improve social functioning.

Developing Home-Based Virtual Reality Therapy Interventions.

PubMed

Lin, Janice; Kelleher, Caitlin L; Engsberg, Jack R

2013-02-01

Stroke is one of the leading causes of serious long-term disability. However, home exercise programs given at rehabilitation often lack in motivational aspects. The purposes of this pilot study were (1) create individualized virtual reality (VR) games and (2) determine the effectiveness of VR games for improving movement in upper extremities in a 6-week home therapy intervention for persons with stroke. Participants were two individuals with upper extremity hemiparesis following a stroke. VR games were created using the Looking Glass programming language and modified based on personal interests, goals, and abilities. Participants were asked to play 1 hour each day for 6 weeks. Assessments measured upper extremity movement (range of motion and Action Research Arm Test [ARAT]) and performance in functional skills (Canadian Occupational Performance Measure [COPM] and Motor Activity Log [MAL]). Three VR games were created by a supervised occupational therapist student. The participants played approximately four to six times a week and performed over 100 repetitions of movements each day. Participants showed improvement in upper extremity movement and participation in functional tasks based on results from the COPM, ARAT, and MAL. Further development in the programming environment is needed to be plausible in a rehabilitation setting. Suggestions include graded-level support and continuation of creating a natural programming language, which will increase the ability to use the program in a rehabilitation setting. However, the VR games were shown to be effective as a home therapy intervention for persons with stroke. VR has the potential to advance therapy services by creating a more motivating home-based therapy service.

Effects of occupational therapy on quality of life of patients with metastatic prostate cancer

PubMed Central

Huri, Meral; Huri, Emre; Kayihan, Hulya; Altuntas, Onur

2015-01-01

Objectives: To evaluate the efficiency of occupational therapy relative to a home program in improving quality of life (QoL) among men who were treated for metastatic prostate cancer (MPC). Methods: Fifty-five men were assigned randomly to either the 12-week cognitive behavioral therapy based occupational therapy (OT-CBSM) intervention (treatment group) or a home program (control group) between March 2012 and August 2014 in the Department of Occupational Therapy, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey. The Canadian Occupational Performance Measure (COPM) was used to measure the occupational performance and identify difficulties in daily living activities. The QoL and symptom status were measured by The European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire C30 and its Prostate Cancer Module. A 12-week OT-CBSM intervention including client-centered training of daily living activities, recreational group activities, and cognitive behavioral stress management intervention were applied. Results: The COPM performance and satisfaction scores, which indicate occupational participation and QoL increased statistically in the treatment group in relation to men who were included in the home-program (p≤0.05). Conclusion: A 12-week OT-CBSM intervention was effective in improving QoL in men treated for MPC, and these changes were associated significantly with occupational performance. PMID:26219446

NCI support for particle therapy: past, present, future.

PubMed

Deye, James A

2012-11-01

In light of the rising worldwide interest in particle therapy, and proton therapy specifically in the United States, the National Cancer Institute (NCI) is being asked more often about funding for such research and facilities. Many of the questions imply that NCI is naive to the exciting possibilities inherent in particle therapies, and thus they wish to encourage NCI to initiate and underwrite such programs. In fact, NCI has a long track record of support for the translation of hadrons from the physics laboratory to the therapy clinic by way of technology development and scientific investigations of physical and biological processes as well as clinical outcomes. Early work has included continuous funding since 1961 of proton treatments for more than 15,000 patients and facility construction at the Harvard/Massachusetts General Hospital (MGH) site; treatment of 227 patients with the pi-meson facility at Los Alamos between 1974 and 1981; funding of more than $69M for seven neutron therapy centers between 1971 and 1989; many funded projects in boron neutron capture radiation therapy through the present time; and numerous radiobiology projects over the past 50 y. NCI continues to play an active role in the incorporation of protons into randomized clinical trials through the Children's Oncology Group, Radiation Therapy Oncology Group, and the Program Project Grant (P01), which is co-directed by the MGH and MD Anderson Cancer Center. This has required funding development and implementation of guidelines that enable intercomparison of dosimetry and treatment between facilities. NCI has also funded recent efforts to develop new physical processes for the production of particles such as protons. With regard to the future, while it is true that there are no specific funding opportunity announcements directed to particle therapy research, it is also true that NCI remains open to reviewing any research that is compatible with an established mechanism. However, given the very substantial resources that these facilities currently require along with the highly competitive economic environment that now exists, it is clear that scientific review of such grant applications will look to leverage the scientific pursuits that are the NCI mandate with the reality of the clinical practices, just as is the case for photon radiation research. Such leveraging should be enhanced by the growing opportunities and need for international collaborations. On the other hand, these collaborations are complicated by the fact that these particle therapies are now fully reimbursable modalities, which makes it difficult to separate research (the NCI mission) from clinical practice development. This paper seeks to illuminate these new realities in order to encourage the pursuit and funding of the scientific underpinnings of physical methods, radiobiology, and clinical practice with particle therapy.

[Development and Effects of a Cognitive-behavioral Therapy Based Program in Reducing Internalized Stigma in Patients with Schizophrenia].

PubMed

Kim, Mi Young; Jun, Seong Sook

2016-06-01

This study was done to develop a internalized stigma reducing program based on cognitive-behavioral therapy and appropriate for patients with schizophrenia and to evaluate its effectiveness. The study design was a mixed method research. Qualitative study, 13 patients with schizophrenia who had experience in overcoming stigma were purposively chosen for interviews and data were analyzed using Giorgi method. Quantitative study, 64 patients with schizophrenia (experimental group=32, control group=32) were recruited. The cognitive-behavioral therapy-based program for reducing internalized stigma in patients with schizophrenia was provided for 8 weeks (12 sessions). Data were collected from June. 20, 2013 to Feb. 14, 2014. Quantitative data were analyzed using χ²-test, t-test, repeated measures ANOVA with the SPSS program. Qualitative results, from the experience of coping with stigma in patients with schizophrenia seventeen themes and five themes-clusters were drawn up. Quantitative results showed that internalized stigma, self-esteem, mental health recovery and quality of life were significantly better in the experimental group compared to the control group. Study findings indicate that this program for reducing internalized stigma in patients with schizophrenia is effective and can be recommended as a rehabilitation program intervention to help patients with schizophrenia to cope with internalized stigma.

Cellular Therapies Clinical Research Roadmap: Lessons learned on how to move a cellular therapy into a clinical trial

PubMed Central

Ouseph, Stacy; Tappitake, Darah; Armant, Myriam; Wesselschmidt, Robin; Derecho, Ivy; Draxler, Rebecca; Wood, Deborah; Centanni, John M.

2014-01-01

A clinical research roadmap has been developed as a resource for researchers to identify critical areas and potential pitfalls when transitioning a cellular therapy product from the research laboratory, via and Investigational New Drug (IND) application, into early phase clinical trials. The roadmap describes four key areas; basic and preclinical research, resource development, translational research and good manufacturing practice (GMP), and IND assembly and submission. Basic and preclinical research identifies a new therapeutic concept and demonstrates its potential value using a model of the relevant disease. During resource development the appropriate specialists and the required expertise to bring this product into the clinic are identified (e.g., researchers, regulatory specialists, GMP manufacturing staff, clinicians, and clinical trials staff, etc.). Additionally, the funds required to achieve this goal (or a plan to procure them) are identified. In the next phase the plan to translate the research product into a clinical grade therapeutic is developed. Finally regulatory approval to start the trial must be obtained. In the United States this is done by filing an IND application with the Food and Drug Administration. The NHLBI-funded Production Assistance for Cellular Therapies (PACT) program has facilitated the transition of a variety of cellular therapy products from the laboratory into Phase1/2 trials. The five PACT facilities have assisted investigators by performing translational studies and GMP manufacturing to ensure that cellular products met release specifications and were manufactured safely, reproducibly, and at the appropriate scale. The roadmap resulting from this experience is the focus of this article. PMID:25484311

Cognitive Enhancement for Elderly Facing Dementia with the Use of Cognitive Rehabilitation Therapy Techniques and Psychological Treatment. A Case Study.

PubMed

Stratakou, Georgia Dim; Plerou, Antonia

2017-01-01

Psychological therapies in order to provide cognitive enhancement have gained some momentum the last decades. The goal of this case study was to evaluate the effects of a cognitive enhancement training program on daily living activities, cognition, and depression in a demented elderly participant. A 6-month training program was proposed for the participant, whose overall evaluation results suggest significant deficits impairment but whose response rate to the proposed tasks of the treatment was interestingly high. However, additional research is needed to overall evaluate the efficacy of the proposed method to elderly adults.

Neutron therapy in Saudi Arabia: an overview and results of dose searching study in head and neck cancer.

PubMed

el-Akkad, S; Schultz, H P; Ahmad, K; Clubb, B; McArthur, P; Dobson, H; DeVol, E

1992-01-01

The King Faisal Specialist Hospital and Research Centre is the only center in the Middle East that incorporates a neutron therapy facility. The neutron beam is produced by a cyclotron, which produces a beam by either a (d(15)+Be) or (p(26)+Be) reaction. The beam from the proton reaction is selected for therapy because of its superior physical characteristics. These were verified by an intercomparison conducted by the European Organization for Research on Treatment of Cancer (EORTC) Heavy Particle Therapy Group. Full beam data are presented. The first study in the neutron therapy Program is on the treatment of squamous cancers of the head and neck. This consists of two parts. Part I is a dose searching phase and Part II is a comparison of our current photon treatment versus neutrons using the neutron dose selected by Part I of the study. Results of the dose searching phase (Part I) are presented.

Meeting the Demands of Professional Education: A Study of Mind Mapping in a Professional Doctoral Physical Therapy Education Program

ERIC Educational Resources Information Center

Pollard, Elicia L.

2010-01-01

The purposes of this study are to investigate whether the quiz scores of physical therapy students who integrated mind mapping in their learning strategies are significantly different than the quiz scores of students who did not use mind mapping to learn in a lecture-based research course and examine the students' perceptions of mind mapping as a…

Do occupational therapy and physical therapy curricula teach critical thinking skills?

PubMed

Vogel, Kimberly A; Geelhoed, Michael; Grice, Kimatha O; Murphy, Douglas

2009-01-01

This study evaluated whether critical thinking ability can be improved through participation in occupational therapy (OT) and physical therapy (PT) curricula. The researchers compared levels of the critical thinking skills of OT and PT students at the beginning and end of their programs to determine whether changes occurred and to examine facets of the curricula that may have caused the differences. The curricula include teaching strategies of problem-based learning modules, small group discussion and problem-solving, case studies, clinical observation, and evidence-based practice assignments, as well as teaching about critical thinking as a process in itself. Fifty OT and PT students completed the Watson-Glaser Critical Thinking Appraisal at the beginning and end of 20 mos of the academic phase of their master's degree programs. Researchers analyzed the data using a one-way repeated-measures ANOVA. Results showed no differences between OT and PT students on the pretest or post-test and no differences for PT students between the pretest and post-test. OT students' scores increased significantly from pretest to post-test. The influence of the timing of teaching critical thinking skills in the resulting differences between the two curricula, as well as the validity of the Watson-Glaser Critical Thinking Appraisal is a valid measure of critical thinking changes in allied health students are discussed.

Cardiopulmonary Rehabilitation, Exercise Training, and Preventive Cardiology: An Overview of a Decade of Research at the Ochsner Heart and Vascular Institute: Presented in part at Grand Rounds, Research Series, Ochsner Medical Institutions, May 17, 1999

PubMed Central

Lavie, Carl J.; Milani, Richard V.; Cassidy, Mark M.; Gilliland, Yvonne E.; Bernal, J. Alberto

1999-01-01

A decade of research from the Ochsner Heart and Vascular Institute's cardiopulmonary rehabilitation and exercise training programs demonstrates the benefits of this therapy on coronary risk factors, exercise capacity, cardiopulmonary parameters, behavioral characteristics, and quality of life in various subgroups of patients, including the elderly, women, obese patients, and groups with dyslipidemia and psychological distress, as well as in patients with congestive heart failure or severe lung disease. Substantial data from our program support the idea that cardiopulmonary rehabilitation and exercise training programs are underemphasized and underutilized for the secondary prevention of coronary artery disease. PMID:21845136

Effects of Mirror Therapy in Stroke Patients With Complex Regional Pain Syndrome Type 1: A Randomized Controlled Study.

PubMed

Pervane Vural, Secil; Nakipoglu Yuzer, Guldal Funda; Sezgin Ozcan, Didem; Demir Ozbudak, Sibel; Ozgirgin, Nese

2016-04-01

To investigate the effects of mirror therapy on upper limb motor functions, spasticity, and pain intensity in patients with hemiplegia accompanied by complex regional pain syndrome type 1. Randomized controlled trial. Training and research hospital. Adult patients with first-time stroke and simultaneous complex regional pain syndrome type 1 of the upper extremity at the dystrophic stage (N=30). Both groups received a patient-specific conventional stroke rehabilitation program for 4 weeks, 5 d/wk, for 2 to 4 h/d. The mirror therapy group received an additional mirror therapy program for 30 min/d. We evaluated the scores of the Brunnstrom recovery stages of the arm and hand for motor recovery, wrist and hand subsections of the Fugl-Meyer Assessment (FMA) and motor items of the FIM-motor for functional status, Modified Ashworth Scale (MAS) for spasticity, and visual analog scale (VAS) for pain severity. After 4 weeks of rehabilitation, both groups had significant improvements in the FIM-motor and VAS scores compared with baseline scores. However, the scores improved more in the mirror therapy group than the control group (P<.001 and P=.03, respectively). Besides, the patients in the mirror therapy arm showed significant improvement in the Brunnstrom recovery stages and FMA scores (P<.05). No significant difference was found for MAS scores. In patients with stroke and simultaneous complex regional pain syndrome type 1, addition of mirror therapy to a conventional stroke rehabilitation program provides more improvement in motor functions of the upper limb and pain perception than conventional therapy without mirror therapy. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Accelerating biomedical innovation: a case study of the SPARK program at Stanford University, School of Medicine.

PubMed

Kim, Esther S; Omura, Paige M C; Lo, Andrew W

2017-07-01

Translating academic medical research into new therapies is an important challenge for the biopharmaceutical industry and investment communities, which have historically favored later-stage assets with lower risk and clearer commercial value. The Stanford SPARK program is an innovative model for addressing this challenge. The program was created in 2006 to educate students and faculty about bringing academic research from bench to bedside. Every year, the program provides mentorship and funding for approximately a dozen SPARK 'scholars,' with a focus on impacting patient lives, regardless of economic factors. By reviewing the detailed structure, function and operation of SPARK we hope to provide a template for other universities and institutions interested in de-risking and facilitating the translation of biomedical research. Copyright © 2017 Elsevier Ltd. All rights reserved.

Exploring the Feasibility and Benefits of Arts-Based Mindfulness-Based Practices with Young People in Need: Aiming to Improve Aspects of Self-Awareness and Resilience

ERIC Educational Resources Information Center

Coholic, Diana A.

2011-01-01

Research in mindfulness-based methods with young people is just emerging in the practice/research literature. While much of this literature describes promising approaches that combine mindfulness with cognitive-behavioral therapy, this paper describes an innovative research-based group program that teaches young people in need mindfulness-based…

DIFFERENTIAL PATIENT RESPONSE TO INSTRUCTION, COUNSELING, AND DENTAL TREATMENT. PAPER PRESENTED AT A NATIONAL SEMINAR ON ADULT EDUCATION RESEARCH (CHICAGO, FEBRUARY 11-13, 1968).

ERIC Educational Resources Information Center

LUPTON, DANIEL E.

RESEARCH (1) ANALYZED SPECIFIC OUTCOMES OF COUNSELING, INSTRUCTION, AND DENTAL THERAPY, AND (2) DETERMINED THE RELATIVE EFFECTIVENESS OF PATIENT EDUCATION FOR RELIEF OF TEMPOROMANDIBULAR JOINT (TMJ) DYSFUNCTION. SIXTY ADULT PATIENTS ATTENDING THE UNIVERSITY OF ILLINOIS TMJ RESEARCH CENTER WERE RANDOMLY ASSIGNED TO ONE OF THREE PROGRAMS--DENTISTRY,…

Lichenoid dermatitis in three patients with metastatic melanoma treated with anti-PD-1 therapy.

PubMed

Joseph, Richard W; Cappel, Mark; Goedjen, Brent; Gordon, Matthew; Kirsch, Brandon; Gilstrap, Cheryl; Bagaria, Sanjay; Jambusaria-Pahlajani, Anokhi

2015-01-01

Therapies that activate the immune system through blocking the binding of programmed death ligand 1 (PD-L1) present on tumors and PD-1 (programmed death 1) present on activated immune cells are revolutionizing the care for patients with cancer. These therapies work by inhibiting negative regulators of the immune system, thereby decreasing a tumor's ability to evade the immune system. The side effects of anti-PD-1/PD-L1 therapies are generally mild and as expected are related to autoimmune reactions. Two of the most common side effects of anti-PD-1/PD-L1 therapies are rash and pruritus occurring in approximately 20% of patients. Although the rash is generally recognized to be immune mediated, the exact mechanisms of the rash remain unclear. Herein, we report three cases of lichenoid dermatitis in three patients treated with MK-3475 (anti-PD-1) that were characterized with marked T-cell infiltrates with few PD-1-positive cells. The rashes in all three patients were relatively mild, allowing treatment to continue despite the rashes. ©2014 American Association for Cancer Research.

Cognitive behavioral group therapy for anxiety: recent developments.

PubMed

Wolgensinger, Laure

2015-09-01

Anxiety disorders occur frequently, and can have a negative impact on the quality of people's lives. They often begin at an early age and can have some serious consequences. This article is an overview of the recent studies concerning group cognitive-behavioral interventions for anxiety disorders. In the last few years, anxiety disorder prevention for children and adolescents has become an important focus of research work. Group prevention programs are based on standard cognitive behavioral therapy (CBT) strategies and are aimed at preventing anxiety disorders as early as possible. Numerous cognitive behavioral group therapies for children as well as adults have been well studied. There are many CBT protocols that have been developed for treating specific anxiety disorders. Now, specialized CBT programs are available for individuals who suffer from different anxiety disorders, enabling them to be treated together in groups.

78 FR 15726 - Cellular, Tissue and Gene Therapies Advisory Committee; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-12

.... In open session, the committee will hear updates of research programs in the Laboratory of Chemistry... advisory committee meetings and will make every effort to accommodate persons with physical disabilities or...

The Need for Understanding and Engaging the Patient as Consumer of Products Developed by Neural Engineering.

PubMed

French, Jennifer; Lujan, J Luis; Bardot, Dawn; Graczyk, Emily Lauren; Hess-Dunning, Allison; Triolo, Ronald J; Moynahan, Megan; Tan, Winny; Zbrzeski, Adeline

2018-05-21

Neural Engineering is a discipline at the intersection of neuroscience, engineering, and clinical care. Recent major efforts by government and industry aimed at bringing forth personalized therapies, increasing the potential of the neural engineering industry for future growth, eg. the National Institutes of Health (NIH) Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Initiative and Stimulating Peripheral Activity to Relieve Conditions (SPARC) Common Fund Program, the Defense Advanced Research Projects Agency (DARPA) Electrical Prescriptions (ElectRx) and Systems-Based Neurotechnology for Emerging Therapies (SUBNETS) Programs, and the GlaxoSmithKline Bioelectric Medicines Initiative. However, the incremental development of neural technologies can easily become a case of advancing technology for its own sake. This mindset can lead to a solution looking for a problem, without taking into consideration the patient/consumer point of view. Creative Commons Attribution license.

Effects of group music therapy on quality of life, affect, and participation in people with varying levels of dementia.

PubMed

Solé, Carme; Mercadal-Brotons, Melissa; Galati, Adrián; De Castro, Mónica

2014-01-01

There is substantive literature reporting the importance and benefits of music and music therapy programs for older adults, and more specifically for those with dementia. However, few studies have focused on how these programs may contribute to quality of life. Objectives for this exploratory study were: (a) to evaluate the potential effect of group music therapy program participation on the quality of life of older people with mild, moderate, and severe dementia living in a nursing home; (b) to identify and analyze changes in affect and participation that take place during music therapy sessions; and (c) to suggest recommendations and strategies for the design of future music therapy studies with people in various stages of dementias. Sixteen participants (15 women; 1 man), with varying level of dementia participated in 12 weekly music therapy sessions. Based on Global Deterioration Scale (GDS) scores, phases of cognitive function were as follows: mild (n = 9; GDS 3-4), moderate (n = 5; GDS 5), and severe (n = 2; GDS 6-7). Data were collected using the GENCAT scale on Quality of Life. Sessions 1, 6, and 12 were also video recorded for post-hoc analysis of facial affect and participation behaviors. There was no significant difference in quality of life scores from pre to posttest (z = -0.824; p =0.410). However, there was a significant improvement in median subscale scores for Emotional Well-being (z = -2.176, p = 0.030), and significant worsening in median subscale scores for Interpersonal Relations (z =-2.074; p = 0.038) from pre to posttest. With regard to affect and participation, a sustained high level of participation was observed throughout the intervention program. Expressions of emotion remained low. Authors discuss implications of study findings to inform and improve future research in the areas of music therapy, quality of life, and individuals with dementia. © the American Music Therapy Association 2014. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

A Military-Centered Approach to Neuroprotection for Traumatic Brain Injury

PubMed Central

Shear, Deborah A.; Tortella, Frank C.

2013-01-01

Studies in animals show that many compounds and therapeutics have the potential to greatly reduce the morbidity and post-injury clinical sequela for soldiers experiencing TBI. However, to date there are no FDA approved drugs for the treatment of TBI. In fact, expert opinion suggests that combination therapies will be necessary to treat any stage of TBI recovery. Our approach to this research effort is to conduct comprehensive pre-clinical neuroprotection studies in military-relevant animal models of TBI using the most promising neuroprotective agents. In addition, emerging efforts incorporating novel treatment strategies such as stem cell based therapies and alternative therapeutic approaches will be discussed. The development of a non-surgical, non-invasive brain injury therapeutic clearly addresses a major, unresolved medical problem for the Combat Casualty Care Research Program. Since drug discovery is too expensive to be pursued by DOD in the TBI arena, this effort capitalizes on partnerships with the Private Sector (Pharmaceutical Companies) and academic collaborations (Operation Brain Trauma Therapy Consortium) to study therapies already under advanced development. Candidate therapies selected for research include drugs that are aimed at reducing the acute and delayed effects of the traumatic incident, stem cell therapies aimed at brain repair, and selective brain cooling to stabilize cerebral metabolism. Each of these efforts can also focus on combination therapies targeting multiple mechanisms of neuronal injury. PMID:23781213

The Research-Informed Clinician: A Guide to Training the Next-Generation MFT

ERIC Educational Resources Information Center

Karam, Eli A.; Sprenkle, Douglas H.

2010-01-01

The gap between clinical research and practice is a major challenge facing marriage and family therapy (MFT) training programs. Until now, the answer to bridge this gap has primarily been the Boulder Scientist-Practitioner Model. Although realistic for doctoral students, it may not be a good fit for MFT master's students who have primarily…

Mindfulness in occupational therapy education.

PubMed

Gura, Shira Taylor

2010-07-01

ABSTRACT The purpose of this paper is to explore the value of mindfulness and its role in occupational therapy education. The plethora of research on mindfulness-based stress reduction programs has shown consistent and positive results to enhance quality of life in clinical and nonclinical populations. Offering students the opportunities to learn and experience mindfulness could lead to enhanced self-awareness and care, focus and empathy, and a decrease of client judgment enhancing the success of clinical interventions.

Collaborative Pediatric Bone Tumor Program to Improve Access to Specialized Care: An Initiative by the Lebanese Children’s Oncology Group

PubMed Central

Merabi, Zeina; Abboud, Miguel R.; Muwakkit, Samar; Noun, Peter; Gemayel, Gladys; Bechara, Elie; Khalifeh, Hassan; Farah, Roula; Kabbara, Nabil; El-Khoury, Tarek; Al-Yousef, Rasha; Haidar, Rachid; Saghieh, Said; Eid, Toufic; Akel, Samir; Khoury, Nabil; Bayram, Layal; Krasin, Matthew J.; Jeha, Sima; El-Solh, Hassan

2017-01-01

Background Children with malignant bone tumors have average 5-year survival rates of 60% to 70% with current multimodality therapy. Local control modalities aimed at preserving function greatly influence the quality of life of long-term survivors. In developing countries, the limited availability of multidisciplinary care and limited expertise in specialized surgery and pediatric radiation therapy, as well as financial cost, all form barriers to achieving optimal outcomes in this population. Methods We describe the establishment of a collaborative pediatric bone tumor program among a group of pediatric oncologists in Lebanon and Syria. This program provides access to specialized local control at a tertiary children’s cancer center to pediatric patients with newly diagnosed bone tumors at participating sites. Central review of pathology, staging, and treatment planning is performed in a multidisciplinary tumor board setting. Patients receive chemotherapy at their respective centers on a unified treatment plan. Surgery and/or radiation therapy are performed centrally by specialized staff at the children’s cancer center. Cost barriers were resolved through a program development initiative led by St Jude Children’s Research Hospital. Once program feasibility was achieved, the Children’s Cancer Center of Lebanon Foundation, via fundraising efforts, provided continuation of program-directed funding. Results Findings over a 3-year period showed the feasibility of this project, with timely local control and protocol adherence at eight collaborating centers. We report success in providing standard-of-care multidisciplinary therapy to this patient population with complex needs and financially challenging surgical procedures. Conclusion This initiative can serve as a model, noting that facilitating access to specialized multidisciplinary care, resolution of financial barriers, and close administrative coordination all greatly contributed to the success of the program. PMID:28717738

Clinical effectiveness of a cognitive behavioral group treatment program for anxiety disorders: a benchmarking study.

PubMed

Oei, Tian P S; Boschen, Mark J

2009-10-01

Previous research has established efficacy of cognitive behavioral therapy (CBT) for anxiety disorders, yet it has not been widely assessed in routine community clinic practices. Efficacy research sacrifices external validity to achieve maximum internal validity. Recently, effectiveness research has been advocated as more ecologically valid for assessing routine clinical work in community clinics. Furthermore, there is a lack of effectiveness research in group CBT. This study aims to extend existing research on the effectiveness of CBT from individual therapy into group therapy delivery. It aimed also to examine outcome using not only symptom measures, but also measures of related symptoms, cognitions, and life quality and satisfaction. Results from a cohort of patients with various anxiety disorders demonstrated that treatment was effective in reducing anxiety symptoms to an extent comparable with other effectiveness studies. Despite this, only 43% of individuals showed reliable change, and 17% were 'recovered' from their anxiety symptoms, and the post-treatment measures were still significantly different from the level of anxiety symptoms observed in the general population.

Clinical research, prophylaxis, therapy, and care for HIV disease in Africa.

PubMed Central

De Cock, K M; Lucas, S B; Lucas, S; Agness, J; Kadio, A; Gayle, H D

1993-01-01

By the end of the century, citizens of resource-poor countries will constitute 90% of the world's human immunodeficiency virus (HIV)-infected people. Clinical management of such persons in developing countries has been neglected; most AIDS research has concentrated on epidemiology, and donor agencies have generally invested in the prevention of HIV infection. The heavy burden of HIV disease in Africa requires that care for AIDS be addressed, and prevention and care should be seen as interrelated. Prevention and treatment of tuberculosis, the commonest severe infection in persons with AIDS in Africa, illustrate this interrelationship. We outline priorities for applied research on the management of HIV disease in a resource-poor environment, and discuss prophylaxis, therapy for opportunistic diseases, terminal care, and use of antiretroviral therapy. Research should define the standard of care that can realistically be demanded for HIV disease in a resource-poor environment. Research and public health programs for AIDS in developing countries must address AIDS care and attempt to reduce the widening gap between interventions available for HIV-infected persons in different parts of the world. PMID:8214225

Incorporating yoga into an intense physical therapy program in someone with Parkinson's disease: a case report.

PubMed

Moriello, Gabriele; Denio, Christopher; Abraham, Megan; DeFrancesco, Danielle; Townsley, Jill

2013-10-01

The purpose of this case report was to document outcomes following an intense exercise program integrating yoga with physical therapy exercise in a male with Parkinson's disease. The participant performed an intense 1½-hour program (Phase A) incorporating strengthening, balance, agility and yoga exercises twice weekly for 12 weeks. He then completed a new home exercise program developed by the researchers (Phase B) for 12 weeks. His score on the Parkinson's Disease Questionnaire improved 16 points while his score on the High Level Mobility Assessment tool improved 11 points. There were also improvements in muscle length of several lower extremity muscles, in upper and lower extremity muscle strength, in dynamic balance and he continues to work full time 29 months later. There were no improvements in thoracic posture or aerobic power. This intense program was an effective dose of exercise for someone with Parkinson's disease and allowed him to continue to participate in work, leisure, and community activities. Copyright © 2013 Elsevier Ltd. All rights reserved.

Current Perspectives on Therapy Dog Welfare in Animal-Assisted Interventions.

PubMed

Glenk, Lisa Maria

2017-02-01

Research into the effects of animal-assisted interventions (AAIs) has primarily addressed human health outcomes. In contrast, only few publications deal with the therapy dog experience of AAIs. This paper provides an overview on potential welfare threats that therapy dogs may encounter and presents the results of a review of available studies on welfare indicators for therapy dogs during AAIs. Previous investigations used physiological and behavioral welfare indicators and dog handler surveys to identify work-related stress. Research outcomes are discussed in the light of strengths and weaknesses of the methods used. Study results suggest that frequency and duration of AAI sessions, novelty of the environment, controllability, age and familiarity of recipients modulate animal welfare indicators. However, this review reveals that currently, clear conclusions on how the well-being of dogs is influenced by the performance in AAIs are lacking due to the heterogeneity of programs, recipient and session characteristics, small dog sample sizes and methodological limitations. This paper further aimed to identify unresolved difficulties in previous research to pave the way for future investigations supporting the applicability of scientific findings in practice.

Mirror therapy improves hand function in subacute stroke: a randomized controlled trial.

PubMed

Yavuzer, Gunes; Selles, Ruud; Sezer, Nebahat; Sütbeyaz, Serap; Bussmann, Johannes B; Köseoğlu, Füsun; Atay, Mesut B; Stam, Henk J

2008-03-01

To evaluate the effects of mirror therapy on upper-extremity motor recovery, spasticity, and hand-related functioning of inpatients with subacute stroke. Randomized, controlled, assessor-blinded, 4-week trial, with follow-up at 6 months. Rehabilitation education and research hospital. A total of 40 inpatients with stroke (mean age, 63.2y), all within 12 months poststroke. Thirty minutes of mirror therapy program a day consisting of wrist and finger flexion and extension movements or sham therapy in addition to conventional stroke rehabilitation program, 5 days a week, 2 to 5 hours a day, for 4 weeks. The Brunnstrom stages of motor recovery, spasticity assessed by the Modified Ashworth Scale (MAS), and hand-related functioning (self-care items of the FIM instrument). The scores of the Brunnstrom stages for the hand and upper extremity and the FIM self-care score improved more in the mirror group than in the control group after 4 weeks of treatment (by 0.83, 0.89, and 4.10, respectively; all P<.01) and at the 6-month follow-up (by 0.16, 0.43, and 2.34, respectively; all P<.05). No significant differences were found between the groups for the MAS. In our group of subacute stroke patients, hand functioning improved more after mirror therapy in addition to a conventional rehabilitation program compared with a control treatment immediately after 4 weeks of treatment and at the 6-month follow-up, whereas mirror therapy did not affect spasticity.

SlicerRT: radiation therapy research toolkit for 3D Slicer.

PubMed

Pinter, Csaba; Lasso, Andras; Wang, An; Jaffray, David; Fichtinger, Gabor

2012-10-01

Interest in adaptive radiation therapy research is constantly growing, but software tools available for researchers are mostly either expensive, closed proprietary applications, or free open-source packages with limited scope, extensibility, reliability, or user support. To address these limitations, we propose SlicerRT, a customizable, free, and open-source radiation therapy research toolkit. SlicerRT aspires to be an open-source toolkit for RT research, providing fast computations, convenient workflows for researchers, and a general image-guided therapy infrastructure to assist clinical translation of experimental therapeutic approaches. It is a medium into which RT researchers can integrate their methods and algorithms, and conduct comparative testing. SlicerRT was implemented as an extension for the widely used 3D Slicer medical image visualization and analysis application platform. SlicerRT provides functionality specifically designed for radiation therapy research, in addition to the powerful tools that 3D Slicer offers for visualization, registration, segmentation, and data management. The feature set of SlicerRT was defined through consensus discussions with a large pool of RT researchers, including both radiation oncologists and medical physicists. The development processes used were similar to those of 3D Slicer to ensure software quality. Standardized mechanisms of 3D Slicer were applied for documentation, distribution, and user support. The testing and validation environment was configured to automatically launch a regression test upon each software change and to perform comparison with ground truth results provided by other RT applications. Modules have been created for importing and loading DICOM-RT data, computing and displaying dose volume histograms, creating accumulated dose volumes, comparing dose volumes, and visualizing isodose lines and surfaces. The effectiveness of using 3D Slicer with the proposed SlicerRT extension for radiation therapy research was demonstrated on multiple use cases. A new open-source software toolkit has been developed for radiation therapy research. SlicerRT can import treatment plans from various sources into 3D Slicer for visualization, analysis, comparison, and processing. The provided algorithms are extensively tested and they are accessible through a convenient graphical user interface as well as a flexible application programming interface.

78 FR 16860 - National Heart, Lung, and Blood Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-19

... Emphasis Panel; Side Effects of Transfusion and Cellular Therapies. Date: April 8, 2013. Time: 8:30 a.m. to... . (Catalogue of Federal Domestic Assistance Program Nos. 93.233, National Center for Sleep Disorders Research...

75 FR 33629 - Center for Scientific Review; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-14

...: Cancer Molecular Therapy. Date: June 17, 2010. Time: 1:30 p.m. to 3:30 p.m. Agenda: To review and... Federal Domestic Assistance Program Nos. 93.306, Comparative Medicine; 93.333, Clinical Research, 93.306...

Femtosecond pulses for medicine and production technology: overview of a German national project

NASA Astrophysics Data System (ADS)

Dausinger, Friedrich

2002-02-01

With the beginning of the new century the German federal government started the funding of a program intended to exploit the potential of femtosecond technology. In a foregoing competition, five research consortia had been successful and have started their investigations in the following fields. - micro-machining of technical materials for microstructure and drilling - medical therapy in : ophthalmology, dentistry, neurology and ear surgery - metrology - laser safety. Lasers, systems and technologies required in these potential fields of applications will be investigated. The program aims at industrial success and is dominated by industrial partners, therefore. The more fundamental research is done in university institutes and research centers.

Journal of Rehabilitation Research and Development, Volume 30, Number 1, 1993

DTIC Science & Technology

1993-01-01

Dynamical Feedback Control of Robotic Ma- Contact: Osa Jackson-Wyatt, PhD, PT, Physical nipulators with Joint Flexibility. Sira- Ramirez H, Therapy Program...Rehabilitation Research and Development Vol. 30 No. 1 1993 Contact: Hebertt Sira- Ramirez , Departamento Contact: Takayoshi Ueta, MD, Dept. of Orthopedic...Rio de Janeiro, Brazil 172 Journal of Rehabilitation Research and Development Vol. 30 No. 1 1993 Contact. Conference Secretariat, Rua do Ouvidor

GASICA: generic automated stress induction and control application design of an application for controlling the stress state.

PubMed

van der Vijgh, Benny; Beun, Robbert J; van Rood, Maarten; Werkhoven, Peter

2014-01-01

In a multitude of research and therapy paradigms it is relevant to know, and desirably to control, the stress state of a patient or participant. Examples include research paradigms in which the stress state is the dependent or independent variable, or therapy paradigms where this state indicates the boundaries of the therapy. To our knowledge, no application currently exists that focuses specifically on the automated control of the stress state while at the same time being generic enough to be used in various therapy and research purposes. Therefore, we introduce GASICA, an application aimed at the automated control of the stress state in a multitude of therapy and research paradigms. The application consists of three components: a digital stressor game, a set of measurement devices, and a feedback model. These three components form a closed loop (called a biocybernetic loop by Pope et al. (1995) and Fairclough (2009) that continuously presents an acute psychological stressor, measures several physiological responses to this stressor, and adjusts the stressor intensity based on these measurements by means of the feedback model, hereby aiming to control the stress state. In this manner GASICA presents multidimensional and ecological valid stressors, whilst continuously in control of the form and intensity of the presented stressors, aiming at the automated control of the stress state. Furthermore, the application is designed as a modular open-source application to easily implement different therapy and research tasks using a high-level programming interface and configuration file, and allows for the addition of (existing) measurement equipment, making it usable for various paradigms.

GASICA: generic automated stress induction and control application design of an application for controlling the stress state

PubMed Central

van der Vijgh, Benny; Beun, Robbert J.; van Rood, Maarten; Werkhoven, Peter

2014-01-01

In a multitude of research and therapy paradigms it is relevant to know, and desirably to control, the stress state of a patient or participant. Examples include research paradigms in which the stress state is the dependent or independent variable, or therapy paradigms where this state indicates the boundaries of the therapy. To our knowledge, no application currently exists that focuses specifically on the automated control of the stress state while at the same time being generic enough to be used in various therapy and research purposes. Therefore, we introduce GASICA, an application aimed at the automated control of the stress state in a multitude of therapy and research paradigms. The application consists of three components: a digital stressor game, a set of measurement devices, and a feedback model. These three components form a closed loop (called a biocybernetic loop by Pope et al. (1995) and Fairclough (2009) that continuously presents an acute psychological stressor, measures several physiological responses to this stressor, and adjusts the stressor intensity based on these measurements by means of the feedback model, hereby aiming to control the stress state. In this manner GASICA presents multidimensional and ecological valid stressors, whilst continuously in control of the form and intensity of the presented stressors, aiming at the automated control of the stress state. Furthermore, the application is designed as a modular open-source application to easily implement different therapy and research tasks using a high-level programming interface and configuration file, and allows for the addition of (existing) measurement equipment, making it usable for various paradigms. PMID:25538554

Effects of occupational therapy on quality of life of patients with metastatic prostate cancer. A randomized controlled study.

PubMed

Huri, Meral; Huri, Emre; Kayihan, Hulya; Altuntas, Onur

2015-08-01

To evaluate the efficiency of occupational therapy relative to a home program in improving quality of life (QoL) among men who were treated for metastatic prostate cancer (MPC). Fifty-five men were assigned randomly to either the 12-week cognitive behavioral therapy based occupational therapy (OT-CBSM) intervention (treatment group) or a home program (control group) between March 2012 and August 2014 in the Department of Occupational Therapy, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey. The Canadian Occupational Performance Measure (COPM) was used to measure the occupational performance and identify difficulties in daily living activities. The QoL and symptom status were measured by The European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire C30 and its Prostate Cancer Module. A 12-week OT-CBSM intervention including client-centered training of daily living activities, recreational group activities, and cognitive behavioral stress management intervention were applied. The COPM performance and satisfaction scores, which indicate occupational participation and QoL increased statistically in the treatment group in relation to men who were included in the home-program (p less than or equal to 0.05). A 12-week OT-CBSM intervention was effective in improving QoL in men treated for MPC, and these changes were associated significantly with occupational performance.

Training in Influencing Skills from Neuro-Linguistic Programming (Modelled from Hypnosis and Family Therapy), in Combination with Innovative Maths Pedagogy, Raises Maths Attainment in Adult Numeracy Learners

ERIC Educational Resources Information Center

Allan, F.; Bourne, J.; Bouch, D.; Churches, R.; Dennison, J.; Evans, J.; Fowler, J.; Jeffers, A.; Prior, E.; Rhodes, L.

2012-01-01

Case study research suggests that NLP [neuro-linguistic programming] influencing strategies benefit teacher effectiveness. Maths pedagogy involving higher-order questioning, challenge, problem solving and collaborative working may be a way of improving attainment in adult numeracy learning, however, such strategies may be less effective if the…

Effectiveness of a Web-based Intervention for Problem Drinkers and Reasons for Dropout: Randomized Controlled Trial

PubMed Central

de Haan, Hein A; ter Huurne, Elke D; Becker, Eni S; de Jong, Cor AJ

2010-01-01

Background Online self-help interventions for problem drinkers show promising results, but the effectiveness of online therapy with active involvement of a therapist via the Internet only has not been examined. Objective The objective of our study was to evaluate an e-therapy program with active therapeutic involvement for problem drinkers, with the hypotheses that e-therapy would (1) reduce weekly alcohol consumption, and (2) improve health status. Reasons for dropout were also systematically investigated. Method In an open randomized controlled trial, Dutch-speaking problem drinkers in the general population were randomly assigned (in blocks of 8, according to a computer-generated random list) to the 3-month e-therapy program (n = 78) or the waiting list control group (n = 78). The e-therapy program consisted of a structured 2-part online treatment program in which the participant and the therapist communicated asynchronously, via the Internet only. Participants in the waiting list control group received “no-reply” email messages once every 2 weeks. The primary outcome measures were (1) the difference in the score on weekly alcohol consumption, and (2) the proportion of participants drinking under the problem drinking limit. Intention-to-treat analyses were performed using multiple imputations to deal with loss to follow-up. A dropout questionnaire was sent to anyone who did not complete the 3-month assessment. Reasons for dropout were independently assessed by the first and third author. Results Of the 156 individuals who were randomly assigned, 102 (65%) completed assessment at 3 months. In the intention-to-treat analyses, the e-therapy group (n = 78) showed a significantly greater decrease in alcohol consumption than those in the control group (n = 78) at 3 months. The e-therapy group decreased their mean weekly alcohol consumption by 28.8 units compared with 3.1 units in the control group, a difference in means of 25.6 units on a weekly basis (95% confidence interval 15.69-35.80, P < .001). The between-group effect size (pooled SD) was large (d = 1.21). The results also showed that 68% (53/78) of the e-therapy group was drinking less than 15 (females) or 22 (males) units a week, compared with 15% (12/78) in the control group (OR 12.0, number needed to treat 1.9, P < .001). Dropout analysis showed that the main reasons for dropouts (n = 54) were personal reasons unrelated to the e-therapy program, discomfort with the treatment protocol, and satisfaction with the positive results achieved. Conclusions E-therapy for problem drinking is an effective intervention that can be delivered to a large population who otherwise do not seek help for their drinking problem. Insight into reasons for dropout can help improve e-therapy programs to decrease the number of dropouts. Additional research is needed to directly compare the effectiveness of the e-therapy program with a face-to-face treatment program. Trial registration ISRCTN39104853; http://controlled-trials.com/ISRCTN39104853/ISRCTN39104853 (Archived by WebCite at http://www.webcitation.org/5uX1R5xfW) PMID:21163776

Monitoring needs and goal-directed fluid therapy within an enhanced recovery program.

PubMed

Minto, Gary; Scott, Michael J; Miller, Timothy E

2015-03-01

Patients having major abdominal surgery need perioperative fluid supplementation; however, enhanced recovery principles mitigate against many of the factors that traditionally led to relative hypovolemia in the perioperative period. An estimate of fluid requirements for abdominal surgery can be made but individualization of fluid prescription requires consideration of clinical signs and hemodynamic variables. The literature supports goal-directed fluid therapy. Application of this evidence to justify stroke volume optimization in the setting of major surgery within an enhanced recovery program is controversial. This article places the evidence in context, reviews controversies, and suggests implications for current practice and future research. Copyright © 2015 Elsevier Inc. All rights reserved.

Ankle sprains: combination of manual therapy and supervised exercise leads to better recovery.

PubMed

2013-01-01

Ankle sprains often occur when running, walking on uneven ground, or jumping. Usually, people are told to rest, elevate the foot, apply ice, and use an elastic wrap to reduce swelling. This treatment is typically followed by exercises that can be performed at home. Although the pain and swelling usually improve quickly, more than 70% of people who sprain their ankles continue to have problems with them and up to 80% will sprain their ankles again. This suggests that it is important to better care for ankle sprains. One option is manual therapy, where the therapist moves the ankle and surrounding joints to help restore normal joint movement. A research report published in the July 2013 issue of JOSPT examines and compares the outcomes of a home exercise program with a more involved treatment program that includes manual therapy and supervised exercises.

Strengthening healthcare capacity through a responsive, country-specific, training standard: the KITSO AIDS training program's support of Botswana's national antiretroviral therapy rollout.

PubMed

Bussmann, Christine; Rotz, Philip; Ndwapi, Ndwapi; Baxter, Daniel; Bussmann, Hermann; Wester, C William; Ncube, Patricia; Avalos, Ava; Mine, Madisa; Mabe, Elang; Burns, Patricia; Cardiello, Peter; Makhema, Joseph; Marlink, Richard

2008-01-01

In parallel with the rollout of Botswana's national antiretroviral therapy (ART) program, the Botswana Ministry of Health established the KITSO AIDS Training Program by entering into long-term partnerships with the Botswana-Harvard AIDS Institute Partnership for HIV Research and Education and others to provide standardized, country-specific training in HIV/AIDS care. The KITSO training model has strengthened human capacity within Botswana's health sector and been indispensable to successful ART rollout. Through core and advanced training courses and clinical mentoring, different cadres of health care workers have been trained to provide high-quality HIV/AIDS care at all ART sites in the country. Continuous and standardized clinical education will be crucial to sustain the present level of care and successfully address future treatment challenges.

A problem-based learning curriculum for occupational therapy education.

PubMed

Royeen, C B

1995-04-01

To prepare practitioners and researchers who are well equipped to deal with the inevitable myriad changes in health care and in society coming in the 21st century, a new focus is needed in occupational therapy education. In addition to proficiency in clinical skills and technical knowledge, occupational therapy graduates will need outcome competencies underlying the skills of critical reflection. In this article, the author presents (a) the rationale for the need for change in occupational therapy education, (b) key concepts of clinical reasoning and critical reflection pertaining to the outcome such change in occupational therapy education should address, (c) problem-based learning as a process and educational method to prepare occupational therapists in these competencies, and (d) the experience of the Program in Occupational Therapy at Shenandoah University in Winchester, Virginia, in implementing a problem-based learning curriculum.

The First AIDS Drugs | Center for Cancer Research

Cancer.gov

Faced with the burgeoning HIV/AIDS epidemic in the 1980s, NCI’s intramural program developed the first therapies to effectively treat the disease. These discoveries helped transform a fatal diagnosis to the manageable condition it is for many today.

The Stoplight Program: A Proactive Physical Therapy Intervention for Children With Acute Lymphoblastic Leukemia.

PubMed

Tanner, Lynn; Sencer, Susan; Hooke, Mary C

Chemotherapy may cause neuromuscular impairments that can have life-long effects. The Stoplight Program (SLP) was developed as a proactive physical therapy (PT) intervention directed at impairments in children with acute lymphoblastic leukemia (ALL). In this program evaluation, we assessed the feasibility of the SLP delivered as part of standard care and identified body function and activity patterns in patients who received the intervention. Children ages 1 to 22 years, diagnosed with ALL, received an assessment by a physical therapist as part of usual care. The SLP intervention used 3 levels to categorize the impairment levels and intensity of PT. Of the children (n = 135) screened, 46% completed 5 intervention visits and 32% completed the program and met discharge criteria. At initial assessment, 46% of children ages 1 to 5 years and 67% of children ages 6 to 22 years had abnormal motor function. Those completing the program tested within the healthy norms. Research is needed on variables that influence adherence to a PT program and the range of functional impairment and activity limitations in this population.

Respiratory Therapy and Respiratory Therapy Technician. Florida Vocational Program Guide.

ERIC Educational Resources Information Center

Florida State Univ., Tallahassee. Center for Instructional Development and Services.

This program guide identifies primary considerations in the organization, operation, and evaluation of respiratory therapy and respiratory therapy technician programs. An occupational description and program content are presented. The curriculum framework specifies the exact course title, course number, levels of instruction, major course content,…

INEL BNCT Research Program Annual Report 1993

DOE Office of Scientific and Technical Information (OSTI.GOV)

Venhuizen, J.R.

1994-08-01

This report is a summary of the progress and research produced for the Idaho National Engineering Laboratory Boron Neutron Capture Therapy Research Program for calendar year 1993. Contributions from all the principal investigators are included, covering chemistry (pituitary tumor studies, boron drug development including liposomes, lipoproteins, and carboranylalanine derivatives), pharmacology (murine screenings, toxicity testing, boron drug analysis), physics (radiation dosimetry software, neutron beam and filter design, neutron beam measurement dosimetry), and radiation biology (tissue and efficacy studies of small and large animal models). Information on the potential toxicity of borocaptate sodium and boronophenylalanine is presented. Results of 21 spontaneous-tumor-bearing dogsmore » that have been treated with boron neutron capture therapy at the Brookhaven National Laboratory are updated. Boron-containing drug purity verification is discussed in some detail. Advances in magnetic resonance imaging of boron in vivo are discussed. Several boron-carrying drugs exhibiting good tumor uptake are described. Significant progress in the potential of treating pituitary tumors is presented. Measurement of the epithermal-neutron flux of the Petten (The Netherlands) High Flux Reactor beam (HFB11B), and comparison to predictions are shown.« less

Dating Violence Prevention Programming: Directions for Future Interventions

PubMed Central

Shorey, Ryan C.; Zucosky, Heather; Brasfield, Hope; Febres, Jeniimarie; Cornelius, Tara L.; Sage, Chelsea; Stuart, Gregory L.

2012-01-01

Dating violence among college students is a widespread and destructive problem. The field of dating violence has seen a substantial rise in research over the past several years, which has improved our understanding of factors that increase risk for perpetration. Unfortunately, there has been less attention paid to dating violence prevention programming, and existing programs have been marred with methodological weaknesses and a lack of demonstrated effectiveness in reducing aggression. In hopes of sparking new research on dating violence prevention programs, the current review examines possible new avenues for dating violence prevention programming among college students. We discuss clinical interventions that have shown to be effective in reducing a number of problematic behaviors, including motivational interventions, dialectical behavior therapy, mindfulness, and bystander interventions, and how they could be applied to dating violence prevention. We also discuss methodological issues to consider when implementing dating violence prevention programs. PMID:22773916

Biomedical research, development, and engineering at the Johns Hopkins University Applied Physics Laboratory. Annual report 1 October 1978-30 September 1979

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

The Medical Institutions of The Johns Hopkins University and The Johns Hopkins University Applied Physics Laboratory have developed a vigorous collaborative program of biomedical research, development, and systems engineering. An important objective of the program is to apply the expertise in engineering, the physical sciences, and systems analysis acquired by APL in defense and space research and development to problems of medical research and health care delivery. This program has grown to include collaboration with many of the clinical and basic science departments of the medical divisions. Active collaborative projects exist in ophthalmology, neurosensory research and instrumentation development, cardiovascular systems,more » patient monitoring, therapeutic and rehabilitation systems, clinical information systems, and clinical engineering. This application of state-of-the-art technology has contributed to advances in many areas of basic medical research and in clinical diagnosis and therapy through improvement of instrumentation, techniques, and basic understanding.« less

Comparison of optimization algorithms in intensity-modulated radiation therapy planning

NASA Astrophysics Data System (ADS)

Kendrick, Rachel

Intensity-modulated radiation therapy is used to better conform the radiation dose to the target, which includes avoiding healthy tissue. Planning programs employ optimization methods to search for the best fluence of each photon beam, and therefore to create the best treatment plan. The Computational Environment for Radiotherapy Research (CERR), a program written in MATLAB, was used to examine some commonly-used algorithms for one 5-beam plan. Algorithms include the genetic algorithm, quadratic programming, pattern search, constrained nonlinear optimization, simulated annealing, the optimization method used in Varian EclipseTM, and some hybrids of these. Quadratic programing, simulated annealing, and a quadratic/simulated annealing hybrid were also separately compared using different prescription doses. The results of each dose-volume histogram as well as the visual dose color wash were used to compare the plans. CERR's built-in quadratic programming provided the best overall plan, but avoidance of the organ-at-risk was rivaled by other programs. Hybrids of quadratic programming with some of these algorithms seems to suggest the possibility of better planning programs, as shown by the improved quadratic/simulated annealing plan when compared to the simulated annealing algorithm alone. Further experimentation will be done to improve cost functions and computational time.

The mirror therapy program enhances upper-limb motor recovery and motor function in acute stroke patients.

PubMed

Lee, Myung Mo; Cho, Hwi-Young; Song, Chang Ho

2012-08-01

The purpose of this study was to evaluate the effects of the mirror therapy program on upper-limb motor recovery and motor function in patients with acute stroke. Twenty-six patients who had an acute stroke within 6 mos of study commencement were assigned to the experimental group (n = 13) or the control group (n = 13). Both experimental and control group members participated in a standard rehabilitation program, but only the experimental group members additionally participated in mirror therapy program, for 25 mins twice a day, five times a week, for 4 wks. The Fugl-Meyer Assessment, Brunnstrom motor recovery stage, and Manual Function Test were used to assess changes in upper-limb motor recovery and motor function after intervention. In upper-limb motor recovery, the scores of Fugl-Meyer Assessment (by shoulder/elbow/forearm items, 9.54 vs. 4.61; wrist items, 2.76 vs. 1.07; hand items, 4.43 vs. 1.46, respectively) and Brunnstrom stages for upper limb and hand (by 1.77 vs. 0.69 and 1.92 vs. 0.50, respectively) were improved more in the experimental group than in the control group (P < 0.05). In upper-limb motor function, the Manual Function Test score (by shoulder item, 5.00 vs. 2.23; hand item, 5.07 vs. 0.46, respectively) was significantly increased in the experimental group compared with the control group (P < 0.01). No significant differences were found between the groups for the coordination items in Fugl-Meyer Assessment. This study confirms that mirror therapy program is an effective intervention for upper-limb motor recovery and motor function improvement in acute stroke patients. Additional research on mirror therapy program components, intensity, application time, and duration could result in it being used as a standardized form of hand rehabilitation in clinics and homes.

Development of a theory- and evidence-based intervention to enhance implementation of physical therapy guidelines for the management of low back pain

PubMed Central

2014-01-01

Background Systematic planning could improve the generally moderate effectiveness of interventions to enhance adherence to clinical practice guidelines. The aim of our study was to demonstrate how the process of Intervention Mapping was used to develop an intervention to address the lack of adherence to the national CPG for low back pain by Dutch physical therapists. Methods We systematically developed a program to improve adherence to the Dutch physical therapy guidelines for low back pain. Based on multi-method formative research, we formulated program and change objectives. Selected theory-based methods of change and practical applications were combined into an intervention program. Implementation and evaluation plans were developed. Results Formative research revealed influential determinants for physical therapists and practice quality managers. Self-regulation was appropriate because both the physical therapists and the practice managers needed to monitor current practice and make and implement plans for change. The program stimulated interaction between practice levels by emphasizing collective goal setting. It combined practical applications, such as knowledge transfer and discussion-and-feedback, based on theory-based methods, such as consciousness raising and active learning. The implementation plan incorporated the wider environment. The evaluation plan included an effect and process evaluation. Conclusions Intervention Mapping is a useful framework for formative data in program planning in the field of clinical guideline implementation. However, a decision aid to select determinants of guideline adherence identified in the formative research to analyse the problem may increase the efficiency of the application of the Intervention Mapping process. PMID:24428945

Development of a theory- and evidence-based intervention to enhance implementation of physical therapy guidelines for the management of low back pain.

PubMed

Rutten, Geert M; Harting, Janneke; Bartholomew, Leona K; Braspenning, Jozé C; van Dolder, Rob; Heijmans, Marcel Fgj; Hendriks, Erik Jm; Kremers, Stef Pj; van Peppen, Roland Ps; Rutten, Steven Tj; Schlief, Angelique; de Vries, Nanne K; Oostendorp, Rob Ab

2014-01-15

Systematic planning could improve the generally moderate effectiveness of interventions to enhance adherence to clinical practice guidelines. The aim of our study was to demonstrate how the process of Intervention Mapping was used to develop an intervention to address the lack of adherence to the national CPG for low back pain by Dutch physical therapists. We systematically developed a program to improve adherence to the Dutch physical therapy guidelines for low back pain. Based on multi-method formative research, we formulated program and change objectives. Selected theory-based methods of change and practical applications were combined into an intervention program. Implementation and evaluation plans were developed. Formative research revealed influential determinants for physical therapists and practice quality managers. Self-regulation was appropriate because both the physical therapists and the practice managers needed to monitor current practice and make and implement plans for change. The program stimulated interaction between practice levels by emphasizing collective goal setting. It combined practical applications, such as knowledge transfer and discussion-and-feedback, based on theory-based methods, such as consciousness raising and active learning. The implementation plan incorporated the wider environment. The evaluation plan included an effect and process evaluation. Intervention Mapping is a useful framework for formative data in program planning in the field of clinical guideline implementation. However, a decision aid to select determinants of guideline adherence identified in the formative research to analyse the problem may increase the efficiency of the application of the Intervention Mapping process.

Dendritic Cells and Programmed Death-1 Blockade: A Joint Venture to Combat Cancer.

PubMed

Versteven, Maarten; Van den Bergh, Johan M J; Marcq, Elly; Smits, Evelien L J; Van Tendeloo, Viggo F I; Hobo, Willemijn; Lion, Eva

2018-01-01

Two decades of clinical cancer research with dendritic cell (DC)-based vaccination have proved that this type of personalized medicine is safe and has the capacity to improve survival, but monotherapy is unlikely to cure the cancer. Designed to empower the patient's antitumor immunity, huge research efforts are set to improve the efficacy of next-generation DC vaccines and to find synergistic combinations with existing cancer therapies. Immune checkpoint approaches, aiming to breach immune suppression and evasion to reinforce antitumor immunity, have been a revelation in the immunotherapy field. Early success of therapeutic antibodies blocking the programmed death-1 (PD-1) pathway has sparked the development of novel inhibitors and combination therapies. Hence, merging immunoregulatory tumor-specific DC strategies with PD-1-targeted approaches is a promising path to explore. In this review, we focus on the role of PD-1-signaling in DC-mediated antitumor immunity. In the quest of exploiting the full potential of DC therapy, different strategies to leverage DC immunopotency by impeding PD-1-mediated immune regulation are discussed, including the most advanced research on targeted therapeutic antibodies, lessons learned from chemotherapy-induced immune activation, and more recent developments with soluble molecules and gene-silencing techniques. An overview of DC/PD-1 immunotherapy combinations that are currently under preclinical and clinical investigation substantiates the clinical potential of such combination strategies.

Dendritic Cells and Programmed Death-1 Blockade: A Joint Venture to Combat Cancer

PubMed Central

Versteven, Maarten; Van den Bergh, Johan M. J.; Marcq, Elly; Smits, Evelien L. J.; Van Tendeloo, Viggo F. I.; Hobo, Willemijn; Lion, Eva

2018-01-01

Two decades of clinical cancer research with dendritic cell (DC)-based vaccination have proved that this type of personalized medicine is safe and has the capacity to improve survival, but monotherapy is unlikely to cure the cancer. Designed to empower the patient’s antitumor immunity, huge research efforts are set to improve the efficacy of next-generation DC vaccines and to find synergistic combinations with existing cancer therapies. Immune checkpoint approaches, aiming to breach immune suppression and evasion to reinforce antitumor immunity, have been a revelation in the immunotherapy field. Early success of therapeutic antibodies blocking the programmed death-1 (PD-1) pathway has sparked the development of novel inhibitors and combination therapies. Hence, merging immunoregulatory tumor-specific DC strategies with PD-1-targeted approaches is a promising path to explore. In this review, we focus on the role of PD-1-signaling in DC-mediated antitumor immunity. In the quest of exploiting the full potential of DC therapy, different strategies to leverage DC immunopotency by impeding PD-1-mediated immune regulation are discussed, including the most advanced research on targeted therapeutic antibodies, lessons learned from chemotherapy-induced immune activation, and more recent developments with soluble molecules and gene-silencing techniques. An overview of DC/PD-1 immunotherapy combinations that are currently under preclinical and clinical investigation substantiates the clinical potential of such combination strategies. PMID:29599770

Can patient navigation improve receipt of recommended breast cancer care? Evidence from the National Patient Navigation Research Program.

PubMed

Ko, Naomi Y; Darnell, Julie S; Calhoun, Elizabeth; Freund, Karen M; Wells, Kristin J; Shapiro, Charles L; Dudley, Donald J; Patierno, Steven R; Fiscella, Kevin; Raich, Peter; Battaglia, Tracy A

2014-09-01

Poor and underserved women face barriers in receiving timely and appropriate breast cancer care. Patient navigators help individuals overcome these barriers, but little is known about whether patient navigation improves quality of care. The purpose of this study is to examine whether navigated women with breast cancer are more likely to receive recommended standard breast cancer care. Women with breast cancer who participated in the national Patient Navigation Research Program were examined to determine whether the care they received included the following: initiation of antiestrogen therapy in patients with hormone receptor-positive breast cancer; initiation of postlumpectomy radiation therapy; and initiation of chemotherapy in women younger than age 70 years with triple-negative tumors more than 1 cm. This is a secondary analysis of a multicenter quasi-experimental study funded by the National Cancer Institute to evaluate patient navigation. Multiple logistic regression was performed to compare differences in receipt of care between navigated and non-navigated participants. Among participants eligible for antiestrogen therapy, navigated participants (n = 380) had a statistically significant higher likelihood of receiving antiestrogen therapy compared with non-navigated controls (n = 381; odds ratio [OR], 1.73; P = .004) in a multivariable analysis. Among the participants eligible for radiation therapy after lumpectomy, navigated participants (n = 255) were no more likely to receive radiation (OR, 1.42; P = .22) than control participants (n = 297). We demonstrate that navigated participants were more likely than non-navigated participants to receive antiestrogen therapy. Future studies are required to determine the full impact patient navigation may have on ensuring that vulnerable populations receive quality care. © 2014 by American Society of Clinical Oncology.

Can Patient Navigation Improve Receipt of Recommended Breast Cancer Care? Evidence From the National Patient Navigation Research Program

PubMed Central

Ko, Naomi Y.; Darnell, Julie S.; Calhoun, Elizabeth; Freund, Karen M.; Wells, Kristin J.; Shapiro, Charles L.; Dudley, Donald J.; Patierno, Steven R.; Fiscella, Kevin; Raich, Peter; Battaglia, Tracy A.

2014-01-01

Purpose Poor and underserved women face barriers in receiving timely and appropriate breast cancer care. Patient navigators help individuals overcome these barriers, but little is known about whether patient navigation improves quality of care. The purpose of this study is to examine whether navigated women with breast cancer are more likely to receive recommended standard breast cancer care. Patients and Methods Women with breast cancer who participated in the national Patient Navigation Research Program were examined to determine whether the care they received included the following: initiation of antiestrogen therapy in patients with hormone receptor–positive breast cancer; initiation of postlumpectomy radiation therapy; and initiation of chemotherapy in women younger than age 70 years with triple-negative tumors more than 1 cm. This is a secondary analysis of a multicenter quasi-experimental study funded by the National Cancer Institute to evaluate patient navigation. Multiple logistic regression was performed to compare differences in receipt of care between navigated and non-navigated participants. Results Among participants eligible for antiestrogen therapy, navigated participants (n = 380) had a statistically significant higher likelihood of receiving antiestrogen therapy compared with non-navigated controls (n = 381; odds ratio [OR], 1.73; P = .004) in a multivariable analysis. Among the participants eligible for radiation therapy after lumpectomy, navigated participants (n = 255) were no more likely to receive radiation (OR, 1.42; P = .22) than control participants (n = 297). Conclusion We demonstrate that navigated participants were more likely than non-navigated participants to receive antiestrogen therapy. Future studies are required to determine the full impact patient navigation may have on ensuring that vulnerable populations receive quality care. PMID:25071111

Opportunities for Regenerative Rehabilitation and Advanced Technologies in Physical Therapy: Perspective From Academia.

PubMed

Norland, Ryan; Muchnick, Matthew; Harmon, Zachary; Chin, Tiffany; Kakar, Rumit Singh

2016-04-01

As rehabilitation specialists, physical therapists must continue to stay current with advances in technologies to provide appropriate rehabilitation protocols, improve patient outcomes, and be the preferred clinician of choice. To accomplish this vision, the physical therapy profession must begin to develop a culture of lifelong learning at the early stages of education and clinical training in order to embrace cutting-edge advancements such as stem cell therapies, tissue engineering, and robotics, to name a few. The purposes of this article are: (1) to provide a current perspective on faculty and graduate student awareness of regenerative rehabilitation concepts and (2) to advocate for increased integration of these emerging technologies within the doctor of physical therapy (DPT) curriculum. An online survey was designed to gauge awareness of principles in regenerative rehabilitation and to determine whether the topic was included and assessed in doctoral curricula. The survey yielded 1,006 responses from 82 DPT programs nationwide and indicated a disconnect in familiarity with the term "regenerative rehabilitation" and awareness of the inclusion of this material in the curriculum. To resolve this disconnect, the framework of the curriculum can be used to integrate new material via guest lecturers, interdisciplinary partnerships, and research opportunities. Successfully mentoring a generation of clinicians and rehabilitation scientists who incorporate new medical knowledge and technology into their own clinical and research practice depends greatly on sharing the responsibility among graduate students, professors, the American Physical Therapy Association (APTA), and DPT programs. Creating an interdisciplinary culture and integrating regenerative medicine and rehabilitation concepts into the curriculum will cultivate individuals who will be advocates for interprofessional behaviors and will ensure that the profession meets the goals stated in APTA Vision 2020. © 2016 American Physical Therapy Association.

Sunflower therapy for children with specific learning difficulties (dyslexia): a randomised, controlled trial.

PubMed

Bull, Leona

2007-02-01

The aim of the study was to determine the clinical and perceived effectiveness of the Sunflower therapy in the treatment of childhood dyslexia. The Sunflower therapy includes applied kinesiology, physical manipulation, massage, homeopathy, herbal remedies and neuro-linguistic programming. A multi-centred, randomised controlled trial was undertaken with 70 dyslexic children aged 6-13 years. The research study aimed to test the research hypothesis that dyslexic children 'feel better' and 'perform better' as a result of treatment by the Sunflower therapy. Children in the treatment group and the control group were assessed using a battery of standardised cognitive, Literacy and self-esteem tests before and after the intervention. Parents of children in the treatment group gave feedback on their experience of the Sunflower therapy. Test scores were compared using the Mann Whitney, and Wilcoxon statistical tests. While both groups of children improved in some of their test scores over time, there were no statistically significant improvements in cognitive or Literacy test performance associated with the treatment. However, there were statistically significant improvements in academic self-esteem, and reading self-esteem, for the treatment group. The majority of parents (57.13%) felt that the Sunflower therapy was effective in the treatment of learning difficulties. Further research is required to verify these findings, and should include a control group receiving a dummy treatment to exclude placebo effects.

EEG Biofeedback as a Treatment for Substance Use Disorders: Review, Rating of Efficacy, and Recommendations for Further Research

PubMed Central

Cannon, Rex L.; Trudeau, David L.

2008-01-01

Electroencephalographic (EEG) biofeedback has been employed in substance use disorder (SUD) over the last three decades. The SUD is a complex series of disorders with frequent comorbidities and EEG abnormalities of several types. EEG biofeedback has been employed in conjunction with other therapies and may be useful in enhancing certain outcomes of therapy. Based on published clinical studies and employing efficacy criteria adapted by the Association for Applied Psychophysiology and Biofeedback and the International Society for Neurofeedback and Research, alpha theta training—either alone for alcoholism or in combination with beta training for stimulant and mixed substance abuse and combined with residential treatment programs, is probably efficacious. Considerations of further research design taking these factors into account are discussed and descriptions of contemporary research are given. PMID:18214670

Effect of Rational-Emotive Behavior Therapy Program on the Symptoms of Burnout Syndrome Among Undergraduate Electronics Work Students in Nigeria.

PubMed

Ogbuanya, Theresa C; Eseadi, Chiedu; Orji, Chibueze T; Omeje, Joachim C; Anyanwu, Joy I; Ugwoke, Samuel C; Edeh, Nkechinyere C

2018-01-01

This research aimed to investigate the effect that rational-emotive behavior therapy had on the symptoms of burnout among undergraduate electronics work students in Southeast Nigeria. This study utilized a pretest-posttest design involving a no-intervention group versus an intervention group. Participants were 124 undergraduate electronics work students who met the inclusion criteria of the study. The intervention consisted of 12 weeks of rational-emotive behavior therapy treatment and 2 weeks of follow-up meetings conducted at 6 months. Self-report questionnaire was used for data collection. Repeated measures analysis of variance and t test were used for data analysis. The results show that rational-emotive behavior therapy had a significant effect on the symptoms of burnout syndrome among the electronics work students in the treatment group compared to their counterparts in the no-intervention group. Finally, the positive gains were significantly maintained by the treatment group at the follow-up. The current study suggests that rational-emotive behavior therapy program can be effective for dealing with burnout syndrome among the population of undergraduates in Nigeria. Further clinical evaluation is needed.

Evidence-based psychosocial treatments for child and adolescent depression.

PubMed

David-Ferdon, Corinne; Kaslow, Nadine J

2008-01-01

The evidence-base of psychosocial treatment outcome studies for depressed youth conducted since 1998 is examined. All studies for depressed children meet Nathan and Gorman's (2002) criteria for Type 2 studies whereas the adolescent protocols meet criteria for both Type 1 and Type 2 studies. Based on the Task Force on the Promotion and Dissemination of Psychological Procedures guidelines, the cognitive-behavioral therapy (CBT) based specific programs of Penn Prevention Program, Self-Control Therapy, and Coping with Depression-Adolescent are probably efficacious. Interpersonal Therapy-Adolescent, which falls under the theoretical category of interpersonal therapy (IPT), also is a probably efficacious treatment. CBT provided through the modalities of child group only and child group plus parent components are well-established intervention approaches for depressed children. For adolescents, two modalities are well-established (CBT adolescent only group, IPT individual), and three are probably efficacious (CBT adolescent group plus parent component, CBT individual, CBT individual plus parent/family component). From the broad theoretical level, CBT has well-established efficacy and behavior therapy meets criteria for a probably efficacious intervention for childhood depression. For adolescent depression, both CBT and IPT have well-established efficacy. Future research directions and best practices are offered.

Juvenile delinquency treatment and prevention: a literature review.

PubMed

May, Jessica; Osmond, Kristina; Billick, Stephen

2014-09-01

In the last three decades there has been ample research to demonstrate that instituting Multisystemic Therapy for serious juvenile offenders, keeping them in the community with intensive intervention, can significantly reduce recidivism. When there is recidivism, it is less severe than in released incarcerated juveniles. Multisystemic Therapy provides 24 h available parental guidance, family therapy, individual therapy, group therapy, educational support and quite importantly a change of peer group. In New York City, there is the new mandate through the Juvenile Justice Initiative to implement interventions to keep juvenile offenders in the community rather than sending them to be incarcerated. However, this paper aims to examine how teaching prosocial values in early childhood can reduce the incidence of first-time juvenile delinquency. Programs such as the Perry School Project will be discussed to demonstrate that although somewhat expensive, these innovative programs nonetheless are quite cost-effective as the cost to society of adjudication, incarceration and victim damages are significantly greater. Along with teaching prosocial 0020 values, there has been renewed interest in early identification of youth at risk for developing Antisocial Personality Disorder. An update is given on the status of both promising approaches in early intervention to prevent serious juvenile delinquency and hence adult criminality.

Therapeutic mode preferences and associated factors among Norwegian undergraduate occupational therapy students: A cross-sectional exploratory study.

PubMed

Yazdani, Farzaneh; Carstensen, Tove; Bonsaksen, Tore

2017-03-01

The Intentional Relationship Model is specifically focused on the relational aspect of therapy. The model describes six therapeutic modes; these represent different types of interaction for the therapist. However, preferences for therapeutic mode use are under researched. This study aims to describe preferences for therapeutic modes in undergraduate occupational therapy students, as well as to explore factors associated to each of the therapeutic modes. A sample of 96 occupational therapy students, based at two different Norwegian universities, participated in the study. They completed the Norwegian Self-Assessment of Modes Questionnaire along with sociodemographic information. Descriptive analysis, bivariate correlation and linear regression analysis were employed. The problem-solving mode was most frequently endorsed. There were generally weak associations between the variables, but female sex and being a student in the education program in Trondheim were associated with higher preference for collaboration. There is diversity in students' preferences for the modes, but the problem-solving mode was the most preferred. Students need to be aware of the mode they feel more comfortable with and make sure they use modes that fit with the specific client. The occupational therapy education programs need to incorporate raising awareness about therapeutic modes.

Anti–PD-1/PD-L1 therapy of human cancer: past, present, and future

PubMed Central

Chen, Lieping; Han, Xue

2015-01-01

Major progress has been made toward our understanding of the programmed death-1/programmed death ligand-1 (PD-1/PD-L1) pathway (referred to as the PD pathway). mAbs are already being used to block the PD pathway to treat human cancers (anti-PD therapy), especially advanced solid tumors. This therapy is based on principles that were discovered through basic research more than a decade ago, but the great potential of this pathway to treat a broad spectrum of advanced human cancers is just now becoming apparent. In this Review, we will briefly review the history and development of anti-PD therapy, from the original benchwork to the most up-to-date clinical results. We will then focus the discussion on three basic principles that define this unique therapeutic approach and highlight how anti-PD therapy is distinct from other immunotherapeutic approaches, namely tumor site immune modulation, targeting tumor-induced immune defects, and repairing ongoing (rather than generating de novo) tumor immunity. We believe that these fundamental principles set the standard for future immunotherapies and will guide our efforts to develop more efficacious and less toxic immune therapeutics to treat human cancers. PMID:26325035

Developmental Scientist | Center for Cancer Research

Cancer.gov

PROGRAM DESCRIPTION Within the Leidos Biomedical Research Inc.’s Clinical Research Directorate, the Clinical Monitoring Research Program (CMRP) provides high-quality comprehensive and strategic operational support to the high-profile domestic and international clinical research initiatives of the National Cancer Institute (NCI), National Institute of Allergy and Infectious Diseases (NIAID), Clinical Center (CC), National Institute of Heart, Lung and Blood Institute (NHLBI), National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), National Center for Advancing Translational Sciences (NCATS), National Institute of Neurological Disorders and Stroke (NINDS), and the National Institute of Mental Health (NIMH). Since its inception in 2001, CMRP’s ability to provide rapid responses, high-quality solutions, and to recruit and retain experts with a variety of backgrounds to meet the growing research portfolios of NCI, NIAID, CC, NHLBI, NIAMS, NCATS, NINDS, and NIMH has led to the considerable expansion of the program and its repertoire of support services. CMRP’s support services are strategically aligned with the program’s mission to provide comprehensive, dedicated support to assist National Institutes of Health researchers in providing the highest quality of clinical research in compliance with applicable regulations and guidelines, maintaining data integrity, and protecting human subjects. For the scientific advancement of clinical research, CMRP services include comprehensive clinical trials, regulatory, pharmacovigilance, protocol navigation and development, and programmatic and project management support for facilitating the conduct of 400+ Phase I, II, and III domestic and international trials on a yearly basis. These trials investigate the prevention, diagnosis, treatment of, and therapies for cancer, influenza, HIV, and other infectious diseases and viruses such as hepatitis C, tuberculosis, malaria, and Ebola virus; heart, lung, and blood diseases and conditions; parasitic infections; rheumatic and inflammatory diseases; and rare and neglected diseases. CMRP’s collaborative approach to clinical research and the expertise and dedication of staff to the continuation and success of the program’s mission has contributed to improving the overall standards of public health on a global scale. The Clinical Monitoring Research Program (CMRP) provides quality assurance and regulatory compliance support to the National Cancer Institute’s (NCI’s), Center for Cancer Research (CCR), Surgery Branch (SB). KEY ROLES/RESPONSIBILITIES - THIS POSITION IS CONTINGENT UPON FUNDING APPROVAL The Developmental Scientist will: Provide support and advisement to the development of the T Cell receptor gene therapy protocols. Establishes, implements and maintains standardized processes and assesses performance to make recommendations for improvement. Provides support and guidance to the cellular therapy or vector production facilities at the NIH Clinical Center engaged in the manufacture of patient-specific therapies. Manufactures cellular therapy products for human use. Develops and manufactures lentiviral and/or retroviral vectors. Prepares technical reports, abstracts, presentations and program correspondence concerning assigned projects through research and analysis of information relevant to government policy, regulations and other relevant data and monitor all assigned programs for compliance. Provides project management support with planning and development of project schedules and deliverables, tracking project milestones, managing timelines, preparing status reports and monitoring progress ensuring adherence to deadlines. Facilitates communication through all levels of staff by functioning as a liaison between internal departments, senior management, and the customer. Serves as a leader/mentor to administrative staff and prepares employee performance evaluations. Develops and implements procedures/programs to ensure effective and efficient business and operational processes. Identifies potential bottlenecks in upcoming development processes and works with team members and senior management for resolution. Analyzes and tracks initiatives and contracts. Coordinates and reviews daily operations and logistics, including purchasing and shipping of miscellaneous equipment, laboratory and office supplies to ensure compliance with appropriate government regulations. Coordinates the administrative, fiscal, contractual, and quality aspects of all projects. Ensures that internal budgets, schedules and performance requirements are met. Monitors workflow and timelines to ensure production operations are on schedule and adequate raw materials and supplies are available. Ensures all activities are in compliance with applicable federal regulations and guidelines and proper testing/validation activities have been scheduled and conducted. Regularly interacts with senior or executive management both internally and externally, on matters concerning several functional areas such as operations, quality control and quality assurance. Participates in planning facility or operations modifications, upgrades and renovations. Performs technical audits of outsourced contractors in conjunction with Quality Assurance and or Quality Control. Assists in the evaluation and selection of staff, planning and coordination of training, assigning of tasks and scheduling workloads and evaluating overall performance. This position is located in Bethesda, Maryland.

Development and outcomes of a program to translate the evidence for spinal manipulation into physical therapy practice

PubMed Central

Kramer, Christopher D; Koch, William H; Fritz, Julie M

2013-01-01

Objectives: To describe a program to translate evidence into practice for the use of manipulation with a sub-group of patients with low back pain and report the program's outcomes following implementation. We compared outcomes based on appropriate inclusion in the program and compliance with the evidence being translated. Methods: The evidence translation program was based on evidence that patients meeting two criteria (duration of symptoms <16 days, no symptoms distal to knee) were likely to respond to a physical therapy that included manipulation in the first two visits. Implementation addressed potential barriers with referring physicians, physical therapists, and scheduling staff to this evidence. Outcomes for patients in the program were tracked following implementation. Process outcomes were appropriateness of inclusion (met both criteria), compliance with evidence for providing thrust manipulation in the first two visits, and number of physical therapy visits. Clinical outcomes were based on Oswestry scores from the first, interim (after two to three visits), and final visit. Results: A total of 577 patients entered the evidence translation program (mean age  =  43.0, 56.8% female); 79.5% were appropriate inclusions and 83.0% received manipulation. The use of manipulation was associated with fewer visits (mean difference  =  0.54 visits, 95% CI: 0.037, 1.04, P  =  0.035), and appropriate inclusion was associated with greater Oswestry change (mean difference at the final visit  =  6.6 points, 95% CI: 1.6, 11.6; P  =  0.010). Discussion: Implementing evidence into practice is difficult; however, barriers can be anticipated and overcome. Tracking the outcomes of an implementation program is critical to evaluating its benefit to patients. Additional research using experimental designs are necessary to evaluate the effectiveness of various treatments implemented in physical therapy practice. PMID:24421630

Evaluating Integrative Cancer Clinics With the Claim Assessment Profile: An Example With the InspireHealth Clinic.

PubMed

Hilton, Lara; Elfenbaum, Pamela; Jain, Shamini; Sprengel, Meredith; Jonas, Wayne B

2018-03-01

The evaluation of freestanding integrative cancer clinical programs is challenging and is rarely done. We have developed an approach called the Claim Assessment Profile (CAP) to identify whether evaluation of a practice is justified, feasible, and likely to provide useful information. A CAP was performed in order to (1) clarify the healing claims at InspireHealth, an integrative oncology treatment program, by defining the most important impacts on its clients; (2) gather information about current research capacity at the clinic; and (3) create a program theory and path model for use in prospective research. This case study design incorporates methods from a variety of rapid assessment approaches. Procedures included site visits to observe the program, structured qualitative interviews with 26 providers and staff, surveys to capture descriptive data about the program, and observational data on program implementation. The InspireHealth program is a well-established, multi-site, thriving integrative oncology clinical practice that focuses on patient support, motivation, and health behavior engagement. It delivers patient-centered care via a standardized treatment protocol. There arehigh levels of research interest from staff and resources by which to conduct research. This analysis provides the primary descriptive and claims clarification of an integrative oncology treatment program, an evaluation readiness report, a detailed logic model explicating program theory, and a clinical outcomes path model for conducting prospective research. Prospective evaluation of this program would be feasible and valuable, adding to our knowledge base of integrative cancer therapies.

How do eHealth Programs for Adolescents With Depression Work? A Realist Review of Persuasive System Design Components in Internet-Based Psychological Therapies.

PubMed

Wozney, Lori; Huguet, Anna; Bennett, Kathryn; Radomski, Ashley D; Hartling, Lisa; Dyson, Michele; McGrath, Patrick J; Newton, Amanda S

2017-08-09

Major depressive disorders are common among adolescents and can impact all aspects of their daily life. Traditional therapies, cognitive behavioral therapy (CBT), and interpersonal psychotherapy (IPT) have been delivered face-to-face. However, Internet-based (online) delivery of these therapies is emerging as an option for adolescents. Internet-based CBT and IPT involve therapeutic content, interaction between the user and the system, and different technological features embedded into the online program (eg, multimedia). Studies of Internet-based CBT and IPT for adolescent depression differ on all three aspects, and variable, positive therapy effects have been reported. A better understanding of the treatment conditions that influence therapy outcomes is important to designing and evaluating these novel therapies. Our aim was to examine the technological and program delivery features of Internet-based CBT and IPT for adolescent depression and to document their potential relation to treatment outcomes and program use. We performed a realist synthesis. We started with an extensive search of published and gray literature. We included intervention studies that evaluated Internet-based CBT or IPT for adolescent depression. We included mixed-methods and qualitative studies, theoretical papers, and policy/implementation documents if they included a focus on how Internet-based psychological therapy is proposed to work for adolescents with depression/depressive symptoms. We used the Mixed-Methods Appraisal Tool to assess the methodological quality of studies. We used the Persuasive System Design (PSD) model as a framework for data extraction and analysis to examine how Internet-based CBT and IPT, as technology-based systems, influence the attitudes and behaviors of system users. PSD components described for the therapies were linked to reported outcomes using a cross-case comparison method and thematic synthesis. We identified 19 Internet-based CBT programs in 59 documents. Of those, 71% (42/59) were of moderate to high quality. The PSD features surface credibility (competent "look and feel"), dialogue support (online program + in-person support), liking and similarity (esthetics and content appeal to adolescent users), the reduction and tunneling of therapeutic content (reducing online content into simple tasks, guiding users), and use of self-monitoring were present in therapies that resulted in improved therapy engagement, satisfaction, and adherence, as well as symptom and functional impairments. When incorporated into Internet-based CBT for adolescent depression, PSD features may improve adolescent adherence, satisfaction, and depression-related outcomes. Testing of these features using hypothesis-driven dismantling approaches is recommended to advance our understanding of how these features contribute to therapy effectiveness. ©Lori Wozney, Anna Huguet, Kathryn Bennett, Ashley D Radomski, Lisa Hartling, Michele Dyson, Patrick J McGrath, Amanda S Newton. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 09.08.2017.

Current Perspectives on Therapy Dog Welfare in Animal-Assisted Interventions

PubMed Central

Glenk, Lisa Maria

2017-01-01

Simple Summary In animal-assisted interventions (AAIs) animals are used as adjuncts to therapy to positively affect human health. The practice of implementing dogs into therapeutic environments is emerging and as a result, there has been a growing scientific interest on human health outcomes over the past decades. Research efforts into the canine perspective of AAIs have been scarce. Accordingly, there is little consensus on the impact of such interventions on the animals involved. This paper aimed to contribute to the limited body of knowledge by reviewing available studies on therapy dogs’ welfare during AAIs. Moreover, discussion of theoretical and methodological issues, implications for practice and suggestions for future research are provided. Abstract Research into the effects of animal-assisted interventions (AAIs) has primarily addressed human health outcomes. In contrast, only few publications deal with the therapy dog experience of AAIs. This paper provides an overview on potential welfare threats that therapy dogs may encounter and presents the results of a review of available studies on welfare indicators for therapy dogs during AAIs. Previous investigations used physiological and behavioral welfare indicators and dog handler surveys to identify work-related stress. Research outcomes are discussed in the light of strengths and weaknesses of the methods used. Study results suggest that frequency and duration of AAI sessions, novelty of the environment, controllability, age and familiarity of recipients modulate animal welfare indicators. However, this review reveals that currently, clear conclusions on how the well-being of dogs is influenced by the performance in AAIs are lacking due to the heterogeneity of programs, recipient and session characteristics, small dog sample sizes and methodological limitations. This paper further aimed to identify unresolved difficulties in previous research to pave the way for future investigations supporting the applicability of scientific findings in practice. PMID:28157145

[Role of psychoeducation in therapy of women with paranoid schizophrenia on the background of abdominal obesity].

PubMed

Sinayko, V; Korovina, L

2013-03-01

Sufficient information of patients and their relatives about essence of disease, principles of medicamental therapy, is one of major factors influencing on adherence of patients to therapy. Application of psychoeducation programs allows to activate a patient in partnership with a doctor, that assists the increase of compliance. Research aim - to improve quality of remission and readaptation of patients with paranoid schizophrenia by realization of the psychoeducation programs. 45 women in age of 18-60 being on treatment in the Kharkiv regional clinical psychiatric hospital №3, with a diagnosis paranoid schizophrenia were examined. Psychoeducation lessons were conducted in closed groups for 7-8 persons, 2 times per a week, by duration every lesson for 45 minutes. The psychoeducation module consisted of informative block and forming of practical skills. Realization of psychoeducation lesson in this contingent showed the efficiency. Communicative activity became better for all patients as well as their adherence to therapy, that gave possibility promptly expose and warn development of side effects, improve quality and level of social adaptation of patients life.

Counting the cost: estimating the economic benefit of pedophile treatment programs.

PubMed

Shanahan, M; Donato, R

2001-04-01

The principal objective of this paper is to identify the economic costs and benefits of pedophile treatment programs incorporating both the tangible and intangible cost of sexual abuse to victims. Cost estimates of cognitive behavioral therapy programs in Australian prisons are compared against the tangible and intangible costs to victims of being sexually abused. Estimates are prepared that take into account a number of problematic issues. These include the range of possible recidivism rates for treatment programs; the uncertainty surrounding the number of child sexual molestation offences committed by recidivists; and the methodological problems associated with estimating the intangible costs of sexual abuse on victims. Despite the variation in parameter estimates that impact on the cost-benefit analysis of pedophile treatment programs, it is found that potential range of economic costs from child sexual abuse are substantial and the economic benefits to be derived from appropriate and effective treatment programs are high. Based on a reasonable set of parameter estimates, in-prison, cognitive therapy treatment programs for pedophiles are likely to be of net benefit to society. Despite this, a critical area of future research must include further methodological developments in estimating the quantitative impact of child sexual abuse in the community.

Early Experience with a Brief, Multimodal, Multidisciplinary Treatment Program for Fibromyalgia

PubMed Central

Vincent, Ann; Whipple, Mary O.; Oh, Terry H.; Guderian, Janet A.; Barton, Debra L.; Luedtke, Connie A.

2014-01-01

Fibromyalgia is a complex, heterogeneous disorder for which a multidisciplinary individualized approach is currently advocated. We executed a 1 week multidisciplinary fibromyalgia clinical program with 7 patients, based on our previous experience with our existing 1.5 day multidisciplinary fibromyalgia program that has demonstrated both short- and long-term benefits. The current expanded program was not designed as a clinical study, but rather as a clinical feasibility assessment and was multidisciplinary in nature, with cognitive behavioral therapy, activity pacing and graded exercise therapy as major components. We assessed changes in individual patients at 1 week and 3 months following the program utilizing validated self-report measures of pain, fatigue, and self-efficacy. All patients indicated at least small improvements in pain and physical symptoms both at 1 week and 3 months and all but one patient showed improvement in self-efficacy at 1 week and 3 months. Similar trends were observed for fatigue. Based on our early clinical experience, we conclude that the 1 week multidisciplinary fibromyalgia program is logistically feasible and has potential for clinical efficacy. Further research is needed and is planned to test the clinical efficacy of this program and compare it with other interventions. PMID:24315246

Sexual Health Education in Massage Therapy Programs: A Survey of Program Directors

ERIC Educational Resources Information Center

Zamboni, Brian D.; Healey, Dale K.

2016-01-01

Massage therapy program directors completed an online survey to explore sexual education in massage therapy programs. The overall data suggest that program directors are supportive of sexual health education in the training of massage therapists and that such education is integrated into several aspects of their training programs. To enhance…

Music therapy in an integrated pediatric palliative care program.

PubMed

Knapp, Caprice; Madden, Vanessa; Wang, Hua; Curtis, Charlotte; Sloyer, Phyllis; Shenkman, Elizabeth

National experts have recommended that children with life-limiting illnesses receive integrated palliative and medical care. These programs offer a variety of services, including music therapy. Using survey data from parents whose were enrolled in Florida's Partners in Care: Together for Kids (PIC:TFK) program, this study investigates parents' experiences with music therapy. About 44% of children with life-limiting illnesses and 17% of their siblings used music therapy. For children who used music therapy, multivariate results suggest that their parents were 23 times as likely to report satisfaction with the overall PIC:TFK program (P < .05) versus parents whose children did not use music therapy. Pediatric palliative care programs should include music therapy, although recruiting licensed music therapists may be challenging.

Internet-Assisted Cognitive Behavioral Therapy.

PubMed

Andersson, Gerhard; Carlbring, Per

2017-12-01

Internet-assisted cognitive-behavioral therapy (ICBT) is a way to deliver cognitive-behavioral therapy (CBT) that has been found to generate similar effects as face-to-face CBT in some studies. Results have been replicated by different research groups. This article presents the treatment format and reviews evidence for mood and anxiety disorders. Future developments are discussed, including the lack of theories specific for the treatment format and ways to handle comorbidity. Although some programs have been implemented there is a need for further studies in clinical settings. Overall, clinician-assisted ICBT is becoming one of the most evidence-based forms of psychological treatment. Copyright © 2017 Elsevier Inc. All rights reserved.

Program Spotlight: Dana Farber/Harvard Cancer Center Partnership Receives $8 Million Grant

Cancer.gov

The UMass Boston and Dana Farber/Harvard Cancer Center PACHE Partnership received a grant to start-up a Center for Personalized Cancer Therapy on the UMass Boston campus. The center is deigned to train underrepresented students to work in cancer research.

Outdoor Education and Troubled Youth. ERIC Digest.

ERIC Educational Resources Information Center

Berman, Dene S.; Davis-Berman, Jennifer

This digest briefly summarizes the parallel development of outdoor education and outdoor therapeutic programs for troubled and adjudicated youth, describes the rationale supporting outdoor approaches, and reports related research and evaluation findings. First attempts to use the outdoors as a healing environment were "tent therapy"…

[Cognitive remediation therapy for children: literature data and clinical application in a child and adolescent psychiatry department].

PubMed

Doyen, C; Contejean, Y; Risler, V; Asch, M; Amado, I; Launay, C; Redon, P De Bois; Burnouf, I; Kaye, K

2015-04-01

The hypothesis of cerebral plasticity in psychiatric disorders has encouraged clinicians to develop cognitive remediation therapy (CRT), a new therapeutic approach based on attention, memory, planning, and mental flexibility tasks. The first cognitive remediation programs were developed and validated for adults with schizophrenia and were shown to have a positive impact on executive functions as well as on quality of life. In children and adolescents, researchers emphasized the existence of executive dysfunction in neurodevelopmental disorders such as autistic spectrum disorder, attention deficit disorder, and eating disorders. For these disorders, neuropsychological studies suggest that memory, planning, attention and mental flexibility are impaired. Despite the paucity of studies on cognitive remediation (CR) in children, preliminary results have suggested, as in adults with schizophrenia, good compliance and optimization of executive functioning. Consequently, programs dedicated to young subjects were developed in English-speaking countries, and the Department of Child and Adolescent Psychiatry of Sainte Anne Hospital (Paris) developed a new CR program for children with attention deficit disorder, academic problems, or eating disorders. These programs complete the field of CRT proposed by Sainte Anne Hospital's Remediation and Psychosocial Rehabilitation Reference Center, initially designed for adults with schizophrenia. Our team used and adapted validated tools such as Delahunty and Wykes's CRT program (translated and validated in French by Amado and Franck) and Lindvall and Lask's CRT Resource Pack. One program was developed for an adolescent with anorexia nervosa and applied to the subject and her family, but the purpose of this paper is to present a CR approach for children with attention deficit disorder or academic disorder, a 6-month program based on paper-pencil tasks and board and card games. The team was trained in different kinds of cognitive remediation, and the program was applied by a clinical nurse with the supervision of a child and adolescent psychiatrist and the department's neuropsychologists. Paper-pencil tasks were adapted from the CRT program for adults; the card and board games used were geometric figures, illusions, Rush Hour(®), Set(®), Jungle Speed(®), Color Addict(®), etc. These games are available in stores and the program can be applied at home, which helps families set aside their preoccupations with their child's academic performance. Diagnostic and neuropsychological evaluations were done before the beginning of the therapy and repeated at the end of the 6-month program. This program does not ignore the metapsychological impact of the therapy, and work on self-esteem is also done. The presence of the therapist is necessary, which seems better than a computer program, which cannot encourage the young subject in the same personalized and empathetic way. We therefore conducted the first clinical feasibility trial of cognitive remediation in young subjects and present a clinical case of a 6-year-old boy with attention deficit disorder and academic disorder. The results of neuropsychological evaluations before and after therapy suggest improvement in executive functions and better self-esteem. Satisfaction for the boy and his family was high. Even if these results need to be replicated, cognitive remediation appears to be a new therapeutic tool, complementary to classical approaches used in childhood psychiatric disorders. The Department of Child and Adolescent Psychiatry will submit this program to a research program conducted by the National Health Department to study the impact of this approach in a controlled study. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Controlling the Seedbeds of Tuberculosis: Diagnosis and Treatment of Tuberculosis Infection

PubMed Central

Rangaka, Molebogeng X.; Cavalcante, Solange C.; Marais, Ben J.; Thim, Sok; Martinson, Neil A.; Swaminathan, Soumya; Chaisson, Richard E.

2015-01-01

The billions of people with latent tuberculosis infection serve as the seedbeds for future cases of active tuberculosis. Virtually all episodes of tuberculosis disease are preceded by a period of asymptomatic Mycobacterium tuberculosis infection; therefore, identifying infected individuals most likely to progress to disease and treating such subclinical infections to prevent future disease provides a critical opportunity to interrupt tuberculosis transmission and reduce the global burden of tuberculosis disease. Programs focusing on single strategies rather than comprehensive programs that deliver an integrated arsenal for tuberculosis control may continue to struggle. Tuberculosis preventive therapy is a poorly utilized tool that is essential for controlling the reservoirs of disease that drive the current epidemic. Comprehensive control strategies that combine preventive therapy for the most high-risk populations and communities with improved case-finding and treatment, control of transmission and health systems strengthening could ultimately lead to worldwide tuberculosis elimination. This paper outlines challenges to implementation of preventive therapy and provides pragmatic suggestions for overcoming them. It further advocates for tuberculosis preventive therapy as the core of a renewed global focus to implement a comprehensive epidemic control strategy that would reduce new tuberculosis cases to elimination targets. This strategy would be underpinned by accelerated research to further understand the biology of subclinical tuberculosis infections, develop novel diagnostics, and drug regimens specifically for subclinical tuberculosis infection, strengthen health systems, community engagement, and enhance sustainable large scale implementation of preventive therapy programs. PMID:26515679

Comparison of manual therapy and exercise therapy in osteoarthritis of the hip: a randomized clinical trial.

PubMed

Hoeksma, Hugo L; Dekker, Joost; Ronday, H Karel; Heering, Annet; van der Lubbe, Nico; Vel, Cees; Breedveld, Ferdinand C; van den Ende, Cornelia H M

2004-10-15

To determine the effectiveness of a manual therapy program compared with an exercise therapy program in patients with osteoarthritis (OA) of the hip. A single-blind, randomized clinical trial of 109 hip OA patients was carried out in the outpatient clinic for physical therapy of a large hospital. The manual therapy program focused on specific manipulations and mobilization of the hip joint. The exercise therapy program focused on active exercises to improve muscle function and joint motion. The treatment period was 5 weeks (9 sessions). The primary outcome was general perceived improvement after treatment. Secondary outcomes included pain, hip function, walking speed, range of motion, and quality of life. Of 109 patients included in the study, 56 were allocated to manual therapy and 53 to exercise therapy. No major differences were found on baseline characteristics between groups. Success rates (primary outcome) after 5 weeks were 81% in the manual therapy group and 50% in the exercise group (odds ratio 1.92, 95% confidence interval 1.30, 2.60). Furthermore, patients in the manual therapy group had significantly better outcomes on pain, stiffness, hip function, and range of motion. Effects of manual therapy on the improvement of pain, hip function, and range of motion endured after 29 weeks. The effect of the manual therapy program on hip function is superior to the exercise therapy program in patients with OA of the hip.

Linking scientific discovery and better health for the nation: the first three years of the NIH's Clinical and Translational Science Awards.

PubMed

Califf, Robert M; Berglund, Lars

2010-03-01

A comprehensive system for translating basic biomedical research into useful and effectively implemented clinical diagnostic, preventive, and therapeutic practices is essential to the nation's health. The state of clinical and translational research (CTR) in the United States, however, has been characterized as fragmented, slow, expensive, and poorly coordinated. As part of its Roadmap Initiative, the National Institutes of Health instituted the Clinical and Translational Science Awards (CTSA), a sweeping and ambitious program designed to transform the conduct of biomedical research in the United States by speeding the translation of scientific discoveries into useful therapies and then developing methods to ensure that those therapies reach the patients who need them the most. The authors review the circumstances of the U.S. biomedical research enterprise that led to the creation of the CTSA and discuss the initial strategic plan of the CTSA, which was developed from the first three years of experience with the program and was designed to overcome organizational, methodological, and cultural barriers within and among research institutions. The authors also describe the challenges encountered during these efforts and discuss the promise of this vital national health care initiative, which is essential to creating a pipeline for the scientific workforce needed to conduct research that will, in turn, provide a rational evidence base for better health in the United States.

Linking Scientific Discovery and Better Health for the Nation: The First Three Years of the NIH’s Clinical and Translational Science Awards

PubMed Central

Califf, Robert M.; Berglund, Lars

2015-01-01

A comprehensive system for translating basic biomedical research into useful and effectively implemented clinical diagnostic, preventive, and therapeutic practices is essential to the nation’s health. The state of clinical and translational research (CTR) in the United States, however, has been characterized as fragmented, slow, expensive, and poorly coordinated. As part of its Roadmap Initiative, the National Institutes of Health instituted the Clinical and Translational Science Awards (CTSA), a sweeping and ambitious program designed to transform the conduct of biomedical research in the United States by speeding the translation of scientific discoveries into useful therapies and then developing methods to ensure that those therapies reach the patients who need them the most. The authors review the circumstances of the U.S. biomedical research enterprise that led to the creation of the CTSA and discuss the initial strategic plan of the CTSA, which was developed from the first 3 years of experience with the program and was designed to overcome organizational, methodological, and cultural barriers within and among research institutions. The authors also describe the challenges encountered during these efforts and discuss the promise of this vital national health care initiative, which is essential to creating a pipeline for the scientific workforce needed to conduct research that will in turn provide a rational evidence base for better health in the United States. PMID:20182118

Impact of educational outreach intervention on enhancing health care providers' knowledge about statin therapy prescribing in Malaysian patients with type 2 diabetes mellitus.

PubMed

Elnaem, Mohamed Hassan; Nik Mohamed, Mohamad Haniki; Zaman Huri, Hasniza; Azarisman, Shah M

2018-03-06

Previous research reported underutilization of statin therapy among patients with type 2 diabetes mellitus. Improving health care providers' awareness and understanding of the benefits and risks of statin treatment could be of assistance in optimizing the statin prescribing process. This study aimed to assess health care providers' knowledge related to statin therapy and the impact of educational outreach intervention based on the perceived knowledge. This was a cross-sectional study based on educational outreach intervention targeting physicians and pharmacists in 1 major tertiary hospital in the state of Pahang, Malaysia. Participants responded to a 12-item, validated questionnaire both prior to and after the outreach educational program. Two sessions were conducted separately for 2 cohorts of pharmacists and physicians. The knowledge scores prior to and after the educational intervention were calculated and compared using a paired-samples t-test. The response rate to both pre-and post-educational outreach questionnaires was 91% (40/44). Prior to the intervention, around 84% (n37) of the participants decided to initiate statin therapy for both pre-assessment clinical case scenarios; however, only 27% (n12) could state the clinical benefits of statin therapy. Forty-five percent (n20) could state the drug to drug interactions, and 52.3% (n23) could identify the statin therapy that can be given at any time day/evening. The educational outreach program increased participants' knowledge scores of 1.450 (95% CI, 0.918 to 1.982) point, P < .0005, which is statistically significant. Forty respondents (91%) were of the opinion that statin side effects are the most common cause of treatment discontinuation. This work demonstrated the impact of an educational outreach intervention on improving health care providers' knowledge and beliefs about statin therapy. This type of intervention is considered effective for short-term knowledge enhancement. Further research is needed to test the long-term efficacy of such intervention. © 2018 John Wiley & Sons, Ltd.

Predicting Treatment Success in Child and Parent Therapy Among Families in Poverty.

PubMed

Mattek, Ryan J; Harris, Sara E; Fox, Robert A

2016-01-01

Behavior problems are prevalent in young children and those living in poverty are at increased risk for stable, high-intensity behavioral problems. Research has demonstrated that participation in child and parent therapy (CPT) programs significantly reduces problematic child behaviors while increasing positive behaviors. However, CPT programs, particularly those implemented with low-income populations, frequently report high rates of attrition (over 50%). Parental attributional style has shown some promise as a contributing factor to treatment attendance and termination in previous research. The authors examined if parental attributional style could predict treatment success in a CPT program, specifically targeting low-income urban children with behavior problems. A hierarchical logistic regression was used with a sample of 425 families to assess if parent- and child-referent attributions variables predicted treatment success over and above demographic variables and symptom severity. Parent-referent attributions, child-referent attributions, and child symptom severity were found to be significant predictors of treatment success. Results indicated that caregivers who viewed themselves as a contributing factor for their child's behavior problems were significantly more likely to demonstrate treatment success. Alternatively, caregivers who viewed their child as more responsible for their own behavior problems were less likely to demonstrate treatment success. Additionally, more severe behavior problems were also predictive of treatment success. Clinical and research implications of these results are discussed.

[The program of Founding Research Centers for Emerging and Reemerging Infectious Diseases: the present status and future prospects].

PubMed

Okamoto, Yoshiko; Nagai, Yoshiyuki

2007-12-01

The program of Founding Research Centers for Emerging and Reemerging Infectious Diseases was commenced in 2005 with an outline for Japanese universities and research institutions to establish bilateral collaboration research bases in countries where emerging and reemerging infections are breaking out or will likely break out. So far, six universities and two institutions are participating in the program and ten collaboration bases have been established in six countries (five in Asia and one in Africa). Each research base aims to contribute to the security and safety of the partner and own countries by facilitating better understanding of infectious diseases, technology innovation in diagnosis, therapy and prevention, and human resources development. The experiences of the Reseau International des Instituts Pasteur (RIIP), France, and the Wellcome Trust Southeast Asian Tropical Medicine Research Units (Oxford Network), United Kingdom, which appear to share similar missions, suggest that infectious diseases research that is based on overseas research bases can produce first-time results through the building of long-term mutual trust with the counterparts. By referring to these networks as models, Japan's program should be implemented over the long run but not be based on a short-time perspective. Thus, secure funding is a major issue.

Animal Assisted Therapy (AAT) Program As a Useful Adjunct to Conventional Psychosocial Rehabilitation for Patients with Schizophrenia: Results of a Small-scale Randomized Controlled Trial

PubMed Central

Calvo, Paula; Fortuny, Joan R.; Guzmán, Sergio; Macías, Cristina; Bowen, Jonathan; García, María L.; Orejas, Olivia; Molins, Ferran; Tvarijonaviciute, Asta; Cerón, José J.; Bulbena, Antoni; Fatjó, Jaume

2016-01-01

Currently, one of the main objectives of human–animal interaction research is to demonstrate the benefits of animal assisted therapy (AAT) for specific profiles of patients or participants. The aim of this study is to assess the effect of an AAT program as an adjunct to a conventional 6–month psychosocial rehabilitation program for people with schizophrenia. Our hypothesis is that the inclusion of AAT into psychosocial rehabilitation would contribute positively to the impact of the overall program on symptomology and quality of life, and that AAT would be a positive experience for patients. To test these hypotheses, we compared pre–program with post–program scores for the Positive and Negative Syndrome Scale (PANSS) and the EuroQoL-5 dimensions questionnaire (EuroQol-5D), pre–session with post–session salivary cortisol and alpha–amylase for the last four AAT sessions, and adherence rates between different elements of the program. We conducted a randomized, controlled study in a psychiatric care center in Spain. Twenty–two institutionalized patients with chronic schizophrenia completed the 6–month rehabilitation program, which included individual psychotherapy, group therapy, a functional program (intended to improve daily functioning), a community program (intended to facilitate community reintegration) and a family program. Each member of the control group (n = 8) participated in one activity from a range of therapeutic activities that were part of the functional program. In place of this functional program activity, the AAT–treatment group (n = 14) participated in twice–weekly 1–h sessions of AAT. All participants received the same weekly total number of hours of rehabilitation. At the end of the program, both groups (control and AAT–treatment) showed significant improvements in positive and overall symptomatology, as measured with PANSS, but only the AAT–treatment group showed a significant improvement in negative symptomatology. Adherence to the AAT-treatment was significantly higher than overall adherence to the control group’s functional rehabilitation activities. Cortisol level was significantly reduced after participating in an AAT session, which could indicate that interaction with the therapy dogs reduced stress. In conclusion, the results of this small-scale RCT suggest that AAT could be considered a useful adjunct to conventional psychosocial rehabilitation for people with schizophrenia. PMID:27199859

Impact of programming strategies aimed at reducing nonessential implantable cardioverter defibrillator therapies on mortality: a systematic review and meta-analysis.

PubMed

Tan, Vern Hsen; Wilton, Stephen B; Kuriachan, Vikas; Sumner, Glen L; Exner, Derek V

2014-02-01

Patients who receive implantable cardioverter defibrillator therapies are at higher risk of death versus those who do not. Programmed settings to reduce nonessential implantable cardioverter defibrillator therapies (therapy reduction programming) have been developed but may have adverse effects. This systematic review and meta-analysis assessed the relationship between therapy reduction programming with the risks of death from any cause, implantable cardioverter defibrillator shocks, and syncope. MEDLINE, EMBASE, and clinicaltrials.gov databases were searched to identify relevant studies. Those that followed patients for ≥6 months and reported mortality were included. Six met the inclusion criteria; 4 randomized (Comparison of Empiric to Physician-Tailored Programming of ICDs [EMPIRIC], Multicenter Automatic Defibrillator Implantation Trial-Reduce Inappropriate Therapy [MADIT-RIT], Avoid Delivering Therapies for Non-sustained Arrhythmias in ICD Patients III [ADVANCE III], and Programming Implantable Cardioverter-Defibrillators in Patients with Primary Prevention Indication to Prolong Time to First Shock [PROVIDE]) and 2 prospective studies (Role of Long Detection Window Programming in Patients With Left Ventricular Dysfunction, Non-ischemic Etiology in Primary Prevention Treated with a Biventricular ICD [RELEVANT] and Primary Prevention Parameters Evaluation [PREPARE]). These 6 studies included 7687 (3598 conventional and 4089 therapy reduction programming) patients. Most (77%) participants were men, had a history of ischemic heart disease (56%), and were prescribed β-blockers (84%). Therapy reduction programming was associated with a 30% relative reduction in mortality (95% confidence interval, 16%-41%; P<0.001). No significant heterogeneity among studies was observed (P=0.6). A similar 26% reduction in mortality was observed when only the 4 randomized trials were included (95% confidence interval, 11%-40%; P=0.002). These results were not significantly altered after adjustment for baseline characteristics. No significant difference in the risk of syncope was observed with conventional versus therapy reduction programming (P=0.5). Therapy reduction programming results in a large, significant, and consistent reduction in mortality, with no apparent increase in the risk of syncope.

A new combined strategy to implement a community occupational therapy intervention: designing a cluster randomized controlled trial

PubMed Central

2011-01-01

Background Even effective interventions for people with dementia and their caregivers require specific implementation efforts. A pilot study showed that the highly effective community occupational therapy in dementia (COTiD) program was not implemented optimally due to various barriers. To decrease these barriers and make implementation of the program more effective a combined implementation (CI) strategy was developed. In our study we will compare the effectiveness of this CI strategy with the usual educational (ED) strategy. Methods In this cluster randomized, single-blinded, controlled trial, each cluster consists of at least two occupational therapists, a manager, and a physician working at Dutch healthcare organizations that deliver community occupational therapy. Forty-five clusters, stratified by healthcare setting (nursing home, hospital, mental health service), have been allocated randomly to either the intervention group (CI strategy) or the control group (ED strategy). The study population consists of the professionals included in each cluster and community-dwelling people with dementia and their caregivers. The primary outcome measures are the use of community OT, the adherence of OTs to the COTiD program, and the cost effectiveness of implementing the COTiD program in outpatient care. Secondary outcome measures are patient and caregiver outcomes and knowledge of managers, physicians and OTs about the COTiD program. Discussion Implementation research is fairly new in the field of occupational therapy, making this a unique study. This study does not only evaluate the effects of the CI-strategy on professionals, but also the effects of professionals' degree of implementation on client and caregiver outcomes. Clinical trials registration NCT01117285 PMID:21450063

Interprofessional Collaboration and Turf Wars How Prevalent Are Hidden Attitudes?*

PubMed Central

Chung, Chadwick L. R.; Manga, Jasmin; McGregor, Marion; Michailidis, Christos; Stavros, Demetrios; Woodhouse, Linda J.

2012-01-01

Purpose: Interprofessional collaboration in health care is believed to enhance patient outcomes. However, where professions have overlapping scopes of practice (eg, chiropractors and physical therapists), "turf wars" can hinder effective collaboration. Deep-rooted beliefs, identified as implicit attitudes, provide a potential explanation. Even with positive explicit attitudes toward a social group, negative stereotypes may be influential. Previous studies on interprofessional attitudes have mostly used qualitative research methodologies. This study used quantitative methods to evaluate explicit and implicit attitudes of physical therapy students toward chiropractic. Methods: A paper-and-pencil instrument was developed and administered to 49 individuals (students and faculty) associated with a Canadian University master's entry-level physical therapy program after approval by the Research Ethics Board. The instrument evaluated explicit and implicit attitudes toward the chiropractic profession. Implicit attitudes were determined by comparing response times of chiropractic paired with positive versus negative descriptors. Results: Mean time to complete a word association task was significantly longer (t = 4.75, p =.00) when chiropractic was associated with positive rather than negative words. Explicit and implicit attitudes were not correlated (r = 0.13, p =.38). Conclusions: While little explicit bias existed, individuals associated with a master's entry-level physical therapy program appeared to have a significant negative implicit bias toward chiropractic PMID:22778528

Interprofessional collaboration and turf wars how prevalent are hidden attitudes?

PubMed

Chung, Chadwick L R; Manga, Jasmin; McGregor, Marion; Michailidis, Christos; Stavros, Demetrios; Woodhouse, Linda J

2012-01-01

Interprofessional collaboration in health care is believed to enhance patient outcomes. However, where professions have overlapping scopes of practice (eg, chiropractors and physical therapists), "turf wars" can hinder effective collaboration. Deep-rooted beliefs, identified as implicit attitudes, provide a potential explanation. Even with positive explicit attitudes toward a social group, negative stereotypes may be influential. Previous studies on interprofessional attitudes have mostly used qualitative research methodologies. This study used quantitative methods to evaluate explicit and implicit attitudes of physical therapy students toward chiropractic. A paper-and-pencil instrument was developed and administered to 49 individuals (students and faculty) associated with a Canadian University master's entry-level physical therapy program after approval by the Research Ethics Board. The instrument evaluated explicit and implicit attitudes toward the chiropractic profession. Implicit attitudes were determined by comparing response times of chiropractic paired with positive versus negative descriptors. Mean time to complete a word association task was significantly longer (t = 4.75, p =.00) when chiropractic was associated with positive rather than negative words. Explicit and implicit attitudes were not correlated (r = 0.13, p =.38). While little explicit bias existed, individuals associated with a master's entry-level physical therapy program appeared to have a significant negative implicit bias toward chiropractic.

Building capacity for knowledge translation in occupational therapy: learning through participatory action research.

PubMed

Bennett, Sally; Whitehead, Mary; Eames, Sally; Fleming, Jennifer; Low, Shanling; Caldwell, Elizabeth

2016-10-01

There has been widespread acknowledgement of the need to build capacity in knowledge translation however much of the existing work focuses on building capacity amongst researchers rather than with clinicians directly. This paper's aim is to describe a research project for developing a knowledge translation capacity building program for occupational therapy clinicians. Participatory action research methods were used to both develop and evaluate the knowledge translation capacity-building program. Participants were occupational therapists from a large metropolitan hospital in Australia. Researchers and clinicians worked together to use the action cycle of the Knowledge to Action Framework to increase use of knowledge translation itself within the department in general, within their clinical teams, and to facilitate knowledge translation becoming part of the department's culture. Barriers and enablers to using knowledge translation were identified through a survey based on the Theoretical Domains Framework and through focus groups. Multiple interventions were used to develop a knowledge translation capacity-building program. Fifty-two occupational therapists participated initially, but only 20 across the first 18 months of the project. Barriers and enablers were identified across all domains of the Theoretical Domains Framework. Interventions selected to address these barriers or facilitate enablers were categorised into ten different categories: educational outreach; teams working on clinical knowledge translation case studies; identifying time blocks for knowledge translation; mentoring; leadership strategies; communication strategies; documentation and resources to support knowledge translation; funding a knowledge translation champion one day per week; setting goals for knowledge translation; and knowledge translation reporting strategies. Use of these strategies was, and continues to be monitored. Participants continue to be actively involved in learning and shaping the knowledge translation program across the department and within their specific clinical areas. To build capacity for knowledge translation, it is important to involve clinicians. The action cycle of the Knowledge to Action framework is a useful guide to introduce the knowledge translation process to clinicians. It may be used to engage the department as a whole, and facilitate the learning and application of knowledge translation within specific clinical areas. Research evaluating this knowledge translation program is being conducted.

Feasibility Study of an Interactive Multimedia Electronic Problem Solving Treatment Program for Depression: A Preliminary Uncontrolled Trial

PubMed Central

Berman, Margit I.; Jr., Jay C. Buckey; Hull, Jay G.; Linardatos, Eftihia; Song, Sueyoung L.; McLellan, Robert K.; Hegel, Mark T.

2014-01-01

Computer-based depression interventions lacking live therapist support have difficulty engaging users. This study evaluated the usability, acceptability, credibility, therapeutic alliance and efficacy of a stand-alone multimedia, interactive, computer-based Problem Solving Treatment program (ePST™) for depression. The program simulated live treatment from an expert PST therapist, and delivered 6 ePST™ sessions over 9 weeks. Twenty-nine participants with moderate-severe symptoms received the intervention; 23 completed a mini mally adequate dose of ePST™ (at least 4 sessions). Program usability, acceptability, credibility, and therapeutic alliance were assessed at treatment midpoint and endpoint. Depressive symptoms and health-related functioning were assessed at baseline, treatment midpoint (4 weeks), and study endpoint (10 weeks). Depression outcomes and therapeutic alliance ratings were also compared to previously published research on live PST and computer-based depression therapy. Participants rated the program as highly usable, acceptable, and credible, and reported a therapeutic alliance with the program comparable to that observed in live therapy. Depressive symptoms improved significantly over time. These findings also provide preliminary evidence that ePST™ may be effective as a depression treatment. Larger clinical trials with diverse samples are indicated. PMID:24680231

Learning together for effective collaboration in school-based occupational therapy practice.

PubMed

Villeneuve, Michelle A; Shulha, Lyn M

2012-12-01

School-based occupational therapy (SBOT) practice takes place within a complex system that includes service recipients, service providers, and program decision makers across health and education sectors. Despite the promotion of collaborative consultation at a policy level, there is little practical guidance about how to coordinate multi-agency service and interprofessional collaboration among these stakeholders. This paper reports on a process used to engage program administrators in an examination of SBOT collaborative consultation practice in one region of Ontario to provide an evidence-informed foundation for decision making about implementation of these services. Within an appreciative inquiry framework (Cooperrider, Whitney, & Stavros, 2008), Developmental Work Research methods (Engeström, 2000) were used to facilitate shared learning for improved SBOT collaborative consultation. Program administrators participated alongside program providers and service recipients in a series of facilitated workshops to develop principles that will guide future planning and decision making about the delivery of SBOT services. Facilitated discussion among stakeholders led to the articulation of 12 principles for effective collaborative practice. Program administrators used their shared understanding to propose a new model for delivering SBOT services. Horizontal and vertical learning across agency and professional boundaries led to the development of powerful solutions for program improvement.

Implementation science for the prevention and treatment of HIV/AIDS.

PubMed

Schackman, Bruce R

2010-12-01

Implementation science is the scientific study of methods to promote the integration of research findings and evidence-based interventions into health care policy and practice and hence to improve the quality and effectiveness of health services and care. Implementation science is distinguished from monitoring and evaluation by its emphasis on the use of the scientific method. The origins of implementation science include operations research, industrial engineering, and management science. Today, implementation science encompasses a broader range of methods and skills including decision science and operations research, health systems research, health outcomes research, health and behavioral economics, epidemiology, statistics, organization and management science, finance, policy analysis, anthropology, sociology, and ethics. Examples of implementation science research are presented for HIV prevention (prevention of mother-to-child transmission of HIV, male circumcision) and HIV and drug use (syringe distribution, treating drug users with antiretroviral therapy and opioid substitution therapy). For implementation science to become an established field in HIV/AIDS research, there needs to be better coordination between funders of research and funders of program delivery and greater consensus on scientific research approaches and standards of evidence.

The effect of ICD programming on inappropriate and appropriate ICD Therapies in ischemic and nonischemic cardiomyopathy: the MADIT-RIT trial.

PubMed

Sedláček, Kamil; Ruwald, Anne-Christine; Kutyifa, Valentina; McNitt, Scott; Thomsen, Poul Erik Bloch; Klein, Helmut; Stockburger, Martin; Wichterle, Dan; Merkely, Bela; DE LA Concha, Joaquin Fernandez; Swissa, Moshe; Zareba, Wojciech; Moss, Arthur J; Kautzner, Josef; Ruwald, Martin H

2015-04-01

The MADIT-RIT trial demonstrated reduction of inappropriate and appropriate ICD therapies and mortality by high-rate cut-off and 60-second-delayed VT therapy ICD programming in patients with a primary prophylactic ICD indication. The aim of this analysis was to study effects of MADIT-RIT ICD programming in patients with ischemic and nonischemic cardiomyopathy. First and total occurrences of both inappropriate and appropriate ICD therapies were analyzed by multivariate Cox models in 791 (53%) patients with ischemic and 707 (47%) patients with nonischemic cardiomyopathy. Patients with ischemic and nonischemic cardiomyopathy had similar incidence of first inappropriate (9% and 11%, P = 0.21) and first appropriate ICD therapy (11.6% and 14.1%, P = 0.15). Patients with ischemic cardiomyopathy had higher mortality rate (6.1% vs. 3.3%, P = 0.01). MADIT-RIT high-rate cut-off (arm B) and delayed VT therapy ICD programming (arm C) compared with conventional (arm A) ICD programming were associated with a significant risk reduction of first inappropriate and appropriate ICD therapy in patients with ischemic and nonischemic cardiomyopathy (HR range 0.11-0.34, P < 0.001 for all comparisons). Occurrence of total inappropriate and appropriate ICD therapies was significantly reduced by high-rate cut-off ICD programming and delayed VT therapy ICD programming in both ischemic and nonischemic cardiomyopathy patients. High-rate cut-off and delayed VT therapy ICD programming are associated with significant reduction in first and total inappropriate and appropriate ICD therapy in patients with ischemic and nonischemic cardiomyopathy. © 2014 Wiley Periodicals, Inc.

NCI Researchers Discover Exceptionally Potent Antibodies with Potential for Prophylaxis and Therapy of MERS-Coronavirus Infections | Poster

Cancer.gov

By Andrea Frydl, Contributing Writer In a recent article published in the Journal of Virology, Tianlei Ying, Ph.D., Dimiter Dimitrov, Ph.D., and their colleagues in the Laboratory of Experimental Immunology (LEI), Cancer and Inflammation Program, NCI Center for Cancer Research, reported the identification of three human monoclonal antibodies (m336, m337, and m338) that target

National survey of psychotherapy training in psychiatry, psychology, and social work.

PubMed

Weissman, Myrna M; Verdeli, Helen; Gameroff, Marc J; Bledsoe, Sarah E; Betts, Kathryn; Mufson, Laura; Fitterling, Heidi; Wickramaratne, Priya

2006-08-01

Approximately 3% of the US population receives psychotherapy each year from psychiatrists, psychologists, or social workers. A modest number of psychotherapies are evidence-based therapy (EBT) in that they have been defined in manuals and found efficacious in at least 2 controlled clinical trials with random assignment that include a control condition of psychotherapy, placebo, pill, or other treatment and samples of sufficient power with well-characterized patients. Few practitioners use EBT. To determine the amount of EBT taught in accredited training programs in psychiatry, psychology (PhD and PsyD), and social work and to note whether the training was elective or required and presented as a didactic (coursework) or clinical supervision. A cross-sectional survey of a probability sample of all accredited training programs in psychiatry, psychology, and social work in the United States. Responders included training directors (or their designates) from 221 programs (73 in psychiatry, 63 in PhD clinical psychology, 21 in PsyD psychology, and 64 in master's-level social work). The overall response rate was 73.7%. Main Outcome Measure Requiring both a didactic and clinical supervision in an EBT. Although programs offered electives in EBT and non-EBT, few required both a didactic and clinical supervision in EBT, and most required training was non-EBT. Psychiatry required coursework and clinical supervision in the largest percentage of EBT (28.1%). Cognitive behavioral therapy was the EBT most frequently offered and required as a didactic in all 3 disciplines. More than 90% of the psychiatry training programs were complying with the new cognitive behavior therapy requirement. The 2 disciplines with the largest number of students and emphasis on clinical training-professional clinical psychology (PsyD) and social work-had the largest percentage of programs (67.3% and 61.7%, respectively) not requiring a didactic and clinical supervision in any EBT. There is a considerable gap between research evidence for psychotherapy and clinical training. Until the training programs in the major disciplines providing psychotherapy increase training in EBT, the gap between research evidence and clinical practice will remain.

Treatment Retention Among Patients Participating in Coordinated Specialty Care for First-Episode Psychosis: a Mixed-Methods Analysis.

PubMed

Hamilton, Jane E; Srivastava, Devika; Womack, Danica; Brown, Ashlie; Schulz, Brian; Macakanja, April; Walker, April; Wu, Mon-Ju; Williamson, Mark; Cho, Raymond Y

2018-06-05

Young adults experiencing first-episode psychosis have historically been difficult to retain in mental health treatment. Communities across the United States are implementing Coordinated Specialty Care to improve outcomes for individuals experiencing first-episode psychosis. This mixed-methods research study examined the relationship between program services and treatment retention, operationalized as the likelihood of remaining in the program for 9 months or more. In the adjusted analysis, male gender and participation in home-based cognitive behavioral therapy were associated with an increased likelihood of remaining in treatment. The key informant interview findings suggest the shared decision-making process and the breadth, flexibility, and focus on functional recovery of the home-based cognitive behavioral therapy intervention may have positively influenced treatment retention. These findings suggest the use of shared decision-making and improved access to home-based cognitive behavioral therapy for first-episode psychosis patients may improve outcomes for this vulnerable population.

Using the Health Physics Student Volunteer Program for a Research Project Sponsored by the Medical Section of the Health Physics Society.

PubMed

Steiner, Joseph; Leinwander, Penny

2017-04-01

The Health Physics Society (HPS) Medical Health Physics Section (MHPS) received a request to research data on radiation safety guidance related to the death of patients who have recently received therapeutic doses of sealed or unsealed therapy sources. The MHPS elected to use student volunteers to perform this research. The purpose of this manuscript is to describe and provide a template for the process used by the MHPS to develop a student volunteer program. To implement the student volunteer program, the MHPS collaborated with the HPS Student Support Committee to develop a research proposal and a student volunteer selection process. The research proposal was sent to HPS student members in a call for volunteers. Two student volunteers were chosen based on predetermined qualifications to complete the work effort outlined in the research proposal. This project progressed with the use of milestones and culminated with the students presenting their findings at the annual HPS meeting. The students received HPS student travel awards to present at the conference. This work effort proved to be extremely beneficial to all parties involved.

Structure and Functions of Pediatric Aerodigestive Programs: A Consensus Statement.

PubMed

Boesch, R Paul; Balakrishnan, Karthik; Acra, Sari; Benscoter, Dan T; Cofer, Shelagh A; Collaco, Joseph M; Dahl, John P; Daines, Cori L; DeAlarcon, Alessandro; DeBoer, Emily M; Deterding, Robin R; Friedlander, Joel A; Gold, Benjamin D; Grothe, Rayna M; Hart, Catherine K; Kazachkov, Mikhail; Lefton-Greif, Maureen A; Miller, Claire Kane; Moore, Paul E; Pentiuk, Scott; Peterson-Carmichael, Stacey; Piccione, Joseph; Prager, Jeremy D; Putnam, Philip E; Rosen, Rachel; Rutter, Michael J; Ryan, Matthew J; Skinner, Margaret L; Torres-Silva, Cherie; Wootten, Christopher T; Zur, Karen B; Cotton, Robin T; Wood, Robert E

2018-02-07

Aerodigestive programs provide coordinated interdisciplinary care to pediatric patients with complex congenital or acquired conditions affecting breathing, swallowing, and growth. Although there has been a proliferation of programs, as well as national meetings, interest groups and early research activity, there is, as of yet, no consensus definition of an aerodigestive patient, standardized structure, and functions of an aerodigestive program or a blueprint for research prioritization. The Delphi method was used by a multidisciplinary and multi-institutional panel of aerodigestive providers to obtain consensus on 4 broad content areas related to aerodigestive care: (1) definition of an aerodigestive patient, (2) essential construct and functions of an aerodigestive program, (3) identification of aerodigestive research priorities, and (4) evaluation and recognition of aerodigestive programs and future directions. After 3 iterations of survey, consensus was obtained by either a supermajority of 75% or stability in median ranking on 33 of 36 items. This included a standard definition of an aerodigestive patient, level of participation of specific pediatric disciplines in a program, essential components of the care cycle and functions of the program, feeding and swallowing assessment and therapy, procedural scope and volume, research priorities and outcome measures, certification, coding, and funding. We propose the first consensus definition of the aerodigestive care model with specific recommendations regarding associated personnel, infrastructure, research, and outcome measures. We hope that this may provide an initial framework to further standardize care, develop clinical guidelines, and improve outcomes for aerodigestive patients. Copyright © 2018 by the American Academy of Pediatrics.

A Stage I Pilot Study of Acceptance and Commitment Therapy for Methadone Detoxification

PubMed Central

Stotts, Angela L.; Green, Charles; Masuda, Akihiko; Grabowski, John; Wilson, Kelly; Northrup, Thomas; Moeller, F. Gerard; Schmitz, Joy

2012-01-01

BACKGROUND While agonist replacement therapies are effective for managing opioid dependence, community treatment programs are increasingly choosing detoxification. Unfortunately, success rates for opioid detoxification are very low, in part, due to physical and psychological symptoms associated with opioid withdrawal. Few behavior therapies specifically address the distressing experiences specific to opioid withdrawal. A novel behavioral treatment, Acceptance and Commitment Therapy (ACT), works from the premise that the avoidance of unpleasant private experiences (thoughts, feelings, bodily sensations) is ubiquitous yet may be pathogenic, resulting in treatment drop-out and further drug use. METHODS This Stage I pilot study developed and tested an ACT-based opioid detoxification behavioral therapy. Opioid dependent patients (N = 56) who were attending a licensed methadone clinic were randomized to receive either 24 individual therapy sessions of ACT or Drug Counseling (DC) in the context of a 6-month methadone dose reduction program. RESULTS While no difference was found on opioid use during treatment, 37% of participants in the ACT condition were successfully detoxified at the end of treatment compared to 19% of those who received DC. Fear of detoxification was also reduced across time in the ACT condition relative to DC. CONCLUSION This first study of ACT to assist opioid detoxification indicates promise. Research is needed to refine specific treatment strategies for this population to further strengthen effects. PMID:22425411

Evaluating Integrative Cancer Clinics With the Claim Assessment Profile: An Example With the InspireHealth Clinic

PubMed Central

Hilton, Lara; Elfenbaum, Pamela; Jain, Shamini; Sprengel, Meredith; Jonas, Wayne B.

2016-01-01

Background: The evaluation of freestanding integrative cancer clinical programs is challenging and is rarely done. We have developed an approach called the Claim Assessment Profile (CAP) to identify whether evaluation of a practice is justified, feasible, and likely to provide useful information. Objectives: A CAP was performed in order to (1) clarify the healing claims at InspireHealth, an integrative oncology treatment program, by defining the most important impacts on its clients; (2) gather information about current research capacity at the clinic; and (3) create a program theory and path model for use in prospective research. Study Design/Methods: This case study design incorporates methods from a variety of rapid assessment approaches. Procedures included site visits to observe the program, structured qualitative interviews with 26 providers and staff, surveys to capture descriptive data about the program, and observational data on program implementation. Results: The InspireHealth program is a well-established, multi-site, thriving integrative oncology clinical practice that focuses on patient support, motivation, and health behavior engagement. It delivers patient-centered care via a standardized treatment protocol. There arehigh levels of research interest from staff and resources by which to conduct research. Conclusions: This analysis provides the primary descriptive and claims clarification of an integrative oncology treatment program, an evaluation readiness report, a detailed logic model explicating program theory, and a clinical outcomes path model for conducting prospective research. Prospective evaluation of this program would be feasible and valuable, adding to our knowledge base of integrative cancer therapies. PMID:29444602

A multimodal physical therapy approach to the management of a patient with temporomandibular dysfunction and head and neck lymphedema: a case report

PubMed Central

Crane, Patricia; Feinberg, Lauren; Morris, John

2015-01-01

Objective and importance: There is a paucity of research that investigates therapeutic interventions of patients with concurrent head and neck lymphedema and temporomandibular dysfunction (TMD). The purpose of this case report is to describe the management and outcomes of a patient with head and neck lymphedema and TMD using a multimodal physical therapy approach. Clinical presentation: A 74-year-old male with a past medical history of head and neck lymphedema and TMD was referred to physical therapy with chief complaints of inability to open his mouth in order to eat solid food, increased neck lymphedema, temporomadibular joint pain, and inability to speak for prolonged periods of time. Interventions: The patient was treated for three visits over 4 weeks. Treatment included complete decongestive therapy (CDT), manual therapy, therapeutic exercise, and a home exercise program. Upon discharge, the patient had improved mandibular depression, decreased head and neck lymphedema, improved deep neck flexor endurance, decreased pain, and improved function on the Patient Specific Functional Scale (PSFS). Conclusion: Utilization of a multimodal physical therapy approach to treat a patient with a complex presentation yielded positive outcomes. Further research on outcomes and treatment approaches in patients with TMD and head and neck lymphedema is warranted. PMID:26309380

A multimodal physical therapy approach to the management of a patient with temporomandibular dysfunction and head and neck lymphedema: a case report.

PubMed

Crane, Patricia; Feinberg, Lauren; Morris, John

2015-02-01

There is a paucity of research that investigates therapeutic interventions of patients with concurrent head and neck lymphedema and temporomandibular dysfunction (TMD). The purpose of this case report is to describe the management and outcomes of a patient with head and neck lymphedema and TMD using a multimodal physical therapy approach. A 74-year-old male with a past medical history of head and neck lymphedema and TMD was referred to physical therapy with chief complaints of inability to open his mouth in order to eat solid food, increased neck lymphedema, temporomadibular joint pain, and inability to speak for prolonged periods of time. The patient was treated for three visits over 4 weeks. Treatment included complete decongestive therapy (CDT), manual therapy, therapeutic exercise, and a home exercise program. Upon discharge, the patient had improved mandibular depression, decreased head and neck lymphedema, improved deep neck flexor endurance, decreased pain, and improved function on the Patient Specific Functional Scale (PSFS). Utilization of a multimodal physical therapy approach to treat a patient with a complex presentation yielded positive outcomes. Further research on outcomes and treatment approaches in patients with TMD and head and neck lymphedema is warranted.

Empirically supported psychosocial interventions for bipolar disorder: Current state of the research.

PubMed

Salcedo, Stephanie; Gold, Alexandra K; Sheikh, Sana; Marcus, Peter H; Nierenberg, Andrew A; Deckersbach, Thilo; Sylvia, Louisa G

2016-09-01

Bipolar disorder requires psychiatric medications, but even guideline-concordant treatment fails to bring many patients to remission or keep them euthymic. To address this gap, researchers have developed adjunctive psychotherapies. The purpose of this paper is to critically review the evidence for the efficacy of manualized psychosocial interventions for bipolar disorder. We conducted a search of the literature to examine recent (2007-present), randomized controlled studies of the following psychotherapy interventions for bipolar disorder: psychoeducation (PE), cognitive behavioral therapy (CBT), interpersonal and social rhythm therapy (IPSRT), dialectical behavior therapy (DBT), mindfulness-based cognitive therapy (MBCT), and family therapies such as family focused therapy (FFT). All of the psychotherapy interventions appear to be effective in reducing depressive symptoms. Psychoeducation and CBT are associated with increased time to mood episode relapse or recurrence. MBCT has demonstrated a particular effectiveness in improving depressive and anxiety symptoms. Online psychotherapy interventions, programs combining one or more psychotherapy interventions, and targeted interventions centering on particular symptoms have been the focus of recent, randomized controlled studies in bipolar disorder. Psychotherapy interventions for the treatment of bipolar disorder have substantial evidence for efficacy. The next challenge will to disseminate these psychotherapies into the community. Copyright © 2016 Elsevier B.V. All rights reserved.

Adaptation of an Evidence-Based Arthritis Program for Breast Cancer Survivors on Aromatase Inhibitor Therapy Who Experience Joint Pain

PubMed Central

Callahan, Leigh F.; Rini, Christine; Altpeter, Mary; Hackney, Betsy; Schecher, Arielle; Wilson, Anne; Muss, Hyman B.

2015-01-01

Adding aromatase inhibitors (AIs) to adjuvant treatment of postmenopausal women with hormone-receptor–positive breast cancer significantly reduces cancer recurrence. A common side effect of AIs is noninflammatory joint pain and stiffness (arthralgia) similar to arthritis symptoms. An evidence-based walking program developed by the Arthritis Foundation — Walk With Ease (WWE) — reduces arthritis-related joint symptoms. We hypothesized that WWE may also reduce AI-associated arthralgia. However, the potential for different barriers and facilitators to physical activity for these 2 patient populations suggested a need to adapt WWE before testing it with breast cancer survivors. We conducted qualitative research with 46 breast cancer survivors to explore program modification and inform the development of materials for an adapted program (Walk With Ease-Breast Cancer). Our process parallels the National Cancer Institute’s Research-Tested Intervention Programs (RTIPs) guidelines for adapting evidence-based programs for cancer populations. Findings resulted in a customized 8-page brochure to supplement existing WWE materials. PMID:26068412

Focused report : implantable cardioverter defibrillators (ICDs) and cardiac resynchronization therapy (CRT), implications for driving a commercial motor vehicle (CMV).

DOT National Transportation Integrated Search

2011-05-27

This report was prepared by MANILA Consulting Group, Inc. under Contract No. GS-10F-0177N; Order No. DTMC75-10-F-00013, entitled Medical Programs Research and Analysis Panels Project, with the Department of Transportations Federal Motor Carrier...

The Recovering Female Alcoholic: A Family Affair.

ERIC Educational Resources Information Center

Rolls, Judith A.

To ensure a positive prognosis, the recovering female alcoholic requires family therapy as an adjunct to her regular treatment program. Research indicates that the characteristics affecting a person's ability to secure and use treatment include (1) predisposing factors; (2) attitudes toward alcohol and health care; (3) personal enabling factors;…

Emotional foundations of music as a non-pharmacological pain management tool in modern medicine.

PubMed

Bernatzky, Guenther; Presch, Michaela; Anderson, Mary; Panksepp, Jaak

2011-10-01

This paper reviews the use of music as an adjuvant to the control of pain, especially in medical procedures. Surgery causes stress and anxiety that exacerbates the experience of pain. Self-report of and physiological measures on post-surgical patients indicate that music therapy or music stimulation reduces the perception of pain, both alone and when part of a multimodal pain management program, and can reduce the need for pharmaceutical interventions. However, multimodal pain therapy, including non-pharmacological interventions after surgery, is still rare in medical practice. We summarize how music can enhance medical therapies and can be used as an adjuvant with other pain-management programs to increase the effectiveness of those therapies. As summarized, we currently know that musical pieces chosen by the patient are commonly, but not always, more effective than pieces chosen by another person. Further research should focus both on finding the specific indications and contra-indications of music therapy and on the biological and neurological pathways responsible for those findings (related evidence has implicated brain opioid and oxytocin mechanisms in affective changes evoked by music). In turn, these findings will allow medical investigators and practitioners to design guidelines and reliable, standardized applications for this promising method of pain management in modern medicine. Copyright © 2011 Elsevier Ltd. All rights reserved.

Epidermolysis bullosa care in Germany.

PubMed

Bruckner-Tuderman, Leena

2010-04-01

Until 2003, no structures existed in Germany for special care of patients with rare diseases, such as epidermolysis bullosa (EB). At that point, the Federal Ministry of Education and Research announced a clinical research program-networks for rare diseases. The Network Epidermolysis Bullosa (EB Network), coordinated from the Department of Dermatology, University Medical Center Freiburg, has operated since October 2003 with the goal of improving diagnostics and clinical management, elucidating disease mechanisms, and development of novel therapies for EB (www.netzwerk-eb.de). Future goals of the EB Network include securing the clinical-diagnostic and IT structures established with grant support and focusing research on molecular disease mechanisms in EB and novel biologically valid therapies. Intensive collaborations with other networks for rare genetic diseases will generate durable structures in Germany and form a basis for future international consortia. Copyright 2010 Elsevier Inc. All rights reserved.

Assessment of the psychopathological effects of a horticultural therapy program in patients with schizophrenia.

PubMed

Oh, Yun-Ah; Park, Sin-Ae; Ahn, Byung-Eun

2018-02-01

This study assessed the psychopathological effects of participation in a 10-session horticultural therapy program in patients with schizophrenia. The study design was pre and post test design of experimental and control groups. Twenty-eight Korean patients with schizophrenia, recruited from a mental health clinic and two mental health rehabilitation centers in Suwon, South Korea, were voluntarily assigned to either a control group (average age: 33.4±9.4years) or a horticultural therapy group (average age: 42.1±13.0years). The participants in the horticultural therapy group participated in a 10-session horticultural therapy program designed around various plant cultivating activities. The horticultural therapy program involved sessions once a week from April 2017 to June 2017. A psychiatrist evaluated the psychopathological symptoms of schizophrenic patients in both groups. To assess the clinical psychopathological effects, the Korean version of the Positive and Negative Syndrome Scale (PANSS) and Brief Psychiatric Rating Scale (BPRS) were used. The horticultural therapy group significantly improved in terms of positive, negative, and general symptoms on the PANSS after the 10-session horticultural therapy program. Moreover, the horticultural therapy group significantly improved in terms of clinical symptoms of schizophrenia in BPRS after the 10-session horticultural therapy program. However, there was no change in the PANSS and BPRS scores in the control group. This study showed the potential of horticultural therapy in improving psychopathological symptoms in psychiatric patients. Future studies should investigate the effects of long-term horticultural therapy program on the chronic symptoms of patients with schizophrenia. Copyright © 2017 Elsevier Ltd. All rights reserved.

Call for Applications – Clinical Assay Development Program | Office of Cancer Clinical Proteomics Research

Cancer.gov

The NCI Clinical Assay Development Program (CADP) is requesting project applications from investigators seeking clinical assay validation resources.  These resources are designed to assist with the development of assays that may predict therapy response or prognostic behavior of a diagnosed cancer, primarily for use in clinical trials. Approved projects for the NCI CADP will be provided access to the Institute’s assay development and validation resources, including project management support.

Application of an artificial intelligence program to therapy of high-risk surgical patients.

PubMed

Patil, R S; Adibi, J; Shoemaker, W C

1996-11-01

We developed an artificial intelligence program from a large computerized database of hemodynamic and oxygen transport measurements together with prior studies defining survivors' values, outcome predictors, and a branched-chain decision tree. The artificial intelligence program was then tested on the data of 100 survivors and 100 nonsurvivors not used for the development of the program or other analyses. Using the predictor as a surrogate outcome measure, the therapy recommended by the program improved the predicted outcome 3.16% per therapeutic intervention while the actual therapy given increased outcome 1.86% in surviving patients; the artificial intelligence-recommended therapy improved outcome 7.9% in nonsurvivors, while the actual therapy given increased predicted outcome -0.29% in nonsurvivors (p < .05). There were fewer patients whose predicted outcome decreased after recommended treatment (14%) than after the actual therapy given (37%). Review of therapy recommended by the program did not reveal instances of inappropriate or potentially harmful recommendations.

Microwave resonance therapy in medical practice

NASA Astrophysics Data System (ADS)

Sumskoy, L. L.

1994-08-01

Consideration is being given to the problems of organizing treatment of patients with quantum medicine methods by Prof. S.P. Sit'ko at 660 hospitals of Ukraine and Russia. Analyzed are teaching of doctors and treatment of 250,000 patients for 82 nozologic cases in 1990 through 1993. In the State of Ukraine, the Government has adopted a State Target-oriented Program of Large- scale Promotion of Microwave Resonance Therapy Into Medical Practice as presented by the Ministry of Health care in 1989. According to the Program, it was planned, during the three year period, to provide MRT rooms in 325 medical institutions. The Program was based on a discovery by Prof. S.P. Sit'ko DSc (Physics & Mathematics), of a new non-morphological structure of man, i.e. an electromagnetic framework that is manifested by eigenfrequencies in the millimeter range and disturbance of which results in disease while repair returns the organism to health. This idea was subjected to national and international expert evaluation. This evaluation was done by a panel of 12 universally acknowledged scientists headed by the founder of the theory of superconductivity, professor of the Liverpool University (Great Britain) h. Frohlich and director of the Madrid medical center Prof. Alzina. The USA was represented by Dr. W. Rogers, chief of the Center of Radiation, Institute of Bioinformation Research. The stated that Professor S.P. Sit'ko and his coworkers had established a new line of inquiry in medicine, i.e. microwave resonance therapy. To implement the State Target-oriented Program, the Government chose the Interbranch Scientific and Engineering Center on Physics of the Alive and Microwave Resonance Therapy 'Vidhuk'.

Teleconsultation with a developing country: student reported outcomes of learning.

PubMed

Foti, Megan K; Eleazar, Crystal; Furphy, Kimberly A

2014-01-01

This qualitative study explored the benefits of implementing (international) teleconsultation in a Master of Science in Occupational Therapy (MSOT) curriculum. Twenty-one students provided supervised teleconsultative services to individuals with disabilities in Guatemala and were responsible for completing assessments, setting goals, and providing resources to address goals and improve quality of life. Data were collected through student presentations and coded for relevant themes. Analysis revealed new learning in the areas of the occupational therapy process, cultural awareness, and technology. Three themes emerged: Increased Understanding of Awareness of and Challenges to Working with People of a Different Culture; Need for Adaptability and Flexibility as Practicing Clinicians; Emerging Role of Technology in Occupational Therapy. Based on results from this study, occupational therapy academicians should consider implementing similar programs into curricula and conduct related research in order to promote not only student learning, but also to advance the use of telehealth technology in occupational therapy practice.

Improving Quality and Access to Radiation Therapy-An IAEA Perspective.

PubMed

Abdel-Wahab, May; Zubizarreta, Eduardo; Polo, Alfredo; Meghzifene, Ahmed

2017-04-01

The International Atomic Energy Agency (IAEA) has been involved in radiation therapy since soon after its creation in 1957. In response to the demands of Member States, the IAEA׳s activities relating to radiation therapy have focused on supporting low- and middle-income countries to set up radiation therapy facilities, expand the scope of treatments, or gradually transition to new technologies. In addition, the IAEA has been very active in providing internationally harmonized guidelines on clinical, dosimetry, medical physics, and safety aspects of radiation therapy. IAEA clinical research has provided evidence for treatment improvement as well as highly effective resource-sparing interventions. In the process, training of researchers occurs through this program. To provide this support, the IAEA works with its Member States and multiple partners worldwide through several mechanisms. In this article, we review the main activities conducted by the IAEA in support to radiation therapy. IAEA support has been crucial for achieving tangible results in many low- and middle-income countries. However, long-term sustainability of projects can present a challenge, especially when considering health budget constraints and the brain drain of skilled professionals. The need for support remains, with more than 90% of patients in low-income countries lacking access to radiotherapy. Thus, the IAEA is expected to continue its support and strengthen quality radiation therapy treatment of patients with cancer. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Cellular Therapies in Trauma and Critical Care Medicine: Forging New Frontiers

PubMed Central

Pati, Shibani; Pilia, Marcello; Grimsley, Juanita M.; Karanikas, Alexia T.; Oyeniyi, Blessing; Holcomb, John B.; Cap, Andrew P.; Rasmussen, Todd E.

2015-01-01

ABSTRACT Trauma is a leading cause of death in both military and civilian populations worldwide. Although medical advances have improved the overall morbidity and mortality often associated with trauma, additional research and innovative advancements in therapeutic interventions are needed to optimize patient outcomes. Cell-based therapies present a novel opportunity to improve trauma and critical care at both the acute and chronic phases that often follow injury. Although this field is still in its infancy, animal and human studies suggest that stem cells may hold great promise for the treatment of brain and spinal cord injuries, organ injuries, and extremity injuries such as those caused by orthopedic trauma, burns, and critical limb ischemia. However, barriers in the translation of cell therapies that include regulatory obstacles, challenges in manufacturing and clinical trial design, and a lack of funding are critical areas in need of development. In 2015, the Department of Defense Combat Casualty Care Research Program held a joint military–civilian meeting as part of its effort to inform the research community about this field and allow for effective planning and programmatic decisions regarding research and development. The objective of this article is to provide a “state of the science” review regarding cellular therapies in trauma and critical care, and to provide a foundation from which the potential of this emerging field can be harnessed to mitigate outcomes in critically ill trauma patients. PMID:26428845

Cellular Therapies in Trauma and Critical Care Medicine: Forging New Frontiers.

PubMed

Pati, Shibani; Pilia, Marcello; Grimsley, Juanita M; Karanikas, Alexia T; Oyeniyi, Blessing; Holcomb, John B; Cap, Andrew P; Rasmussen, Todd E

2015-12-01

Trauma is a leading cause of death in both military and civilian populations worldwide. Although medical advances have improved the overall morbidity and mortality often associated with trauma, additional research and innovative advancements in therapeutic interventions are needed to optimize patient outcomes. Cell-based therapies present a novel opportunity to improve trauma and critical care at both the acute and chronic phases that often follow injury. Although this field is still in its infancy, animal and human studies suggest that stem cells may hold great promise for the treatment of brain and spinal cord injuries, organ injuries, and extremity injuries such as those caused by orthopedic trauma, burns, and critical limb ischemia. However, barriers in the translation of cell therapies that include regulatory obstacles, challenges in manufacturing and clinical trial design, and a lack of funding are critical areas in need of development. In 2015, the Department of Defense Combat Casualty Care Research Program held a joint military-civilian meeting as part of its effort to inform the research community about this field and allow for effective planning and programmatic decisions regarding research and development. The objective of this article is to provide a "state of the science" review regarding cellular therapies in trauma and critical care, and to provide a foundation from which the potential of this emerging field can be harnessed to mitigate outcomes in critically ill trauma patients.

Pharmacists' interventions on intravenous to oral conversion for potassium.

PubMed

Charpiat, B; Bedouch, P; Conort, O; Juste, M; Rose, F X; Roubille, R; Allenet, B

2014-06-01

Guidelines recommend use of the oral route whenever possible to treat or prevent hypokalemia. Although a myriad of papers have been published regarding intravenous to oral (IV to PO) therapy conversion programs and about clinical pharmacy services provided in hospitals, little is known on the role of hospital pharmacists in promoting the oral route for potassium administration. The aim of this work was to describe the frequency of interventions related to IV to PO potassium therapy conversions performed by hospital pharmacists. Setting French hospitals recording pharmacist's interventions on the website tool of the French Society of Clinical Pharmacy. From the pharmacist's interventions (PI) dataset recorded we extracted all interventions related to potassium IV to PO conversion. We assessed the acceptance rate of these PI by prescribers. Additional free text information in the dataset was analysed. IV to PO potassium therapy conversions related to potassium chloride. From January 2007 to December 2010, 87 hospitals recorded 1,868 PIs concerning IV to PO therapy conversion. Among these, 16 (<1 %) concerned potassium chloride. They were recorded by four hospitals (4.6 %) with respectively 12, 2, 1 and 1 PIs. Six PIs were accepted by physicians and the prescriptions were modified. PIs to promote the administration of potassium by the oral route are extremely rare. Our results and scarce previously published data reveal that this field of practice remains almost unexplored. These findings highlight an important gap in the field of intravenous to oral therapy programs. This situation must be regarded as unsatisfactory and should lead to setting up more education and research programs.

A Nationally Scaled Telebehavioral Health Program for Chronic Pain: Characteristics, Goals, and Psychological Outcomes.

PubMed

Mochari-Greenberger, Heidi; Peters, Aimee; Vue, Lee; Pande, Reena L

2017-08-01

Millions of U.S. adults suffer from chronic pain with a high prevalence of comorbid mental health issues. Telehealth-delivered behavioral therapy for chronic pain has been evaluated in the research setting. The purpose of this study was 1) to describe a nationally scaled, standardized, telebehavioral therapy program for patients with chronic pain and behavioral comorbidities, and 2) evaluate characteristics, goals, and psychosocial outcomes among program participants. This was mixed-methods retrospective cohort analysis among consecutive program graduates (mean age 53y; 24% male). The 8-week program was delivered by a licensed therapist and a behavior coach through telephone/secure video and tailored to each participant's behavioral health needs and goals. Participant chief complaints, behavioral goals, and mood triggers were abstracted by deidentified clinical record review using structured qualitative research methods. Depression, anxiety, and stress symptom data were collected at baseline and program graduation using the validated Depression Anxiety Stress Scales 21. Back pain (42%) and hip/leg/knee pain (28%) comprised the most common chief complaints. Pain management (44%) and weight loss (43%) were the most frequently cited goals. At baseline, approximately half of participants had elevated depression (59%), anxiety (54%), and/or stress (48%) scores. Triggers for depressed, anxious, or stressed mood included severe pain (47%), health concerns (46%), and interpersonal relationship challenges (45%). At graduation, significant improvement in median depression (-54%), anxiety (-50%), and stress (-33%) symptom scores was observed among those with non-normal baseline values (p < 0.001); degree of improvement did not vary by participant age or sex. Participants in a nationally scaled telebehavioral health program for chronic pain experienced significant improvement in depression, anxiety, and stress symptoms and shared several complaints, goals, and mood triggers.

Low level laser therapy (photobiomodulation) for the management of breast cancer-related lymphedema: an update

NASA Astrophysics Data System (ADS)

Baxter, G. David; Liu, Lizhou; Chapple, Cathy; Petrich, Simone; Anders, Juanita J.; Tumilty, Steve

2018-04-01

Breast cancer related lymphedema (BCRL) is prevalent among breast cancer survivors, and may be painful and disfiguring with associated psychological impact. Previous research shows increasing use of low level laser therapy (LLLT), now commonly referred to as photobiomodulation (PBM) therapy for managing BCRL, in countries including the United States and Australia. However, conclusions were limited by the paucity, heterogeneity, and poor quality of previous studies. LLLT (PBM) has been barely used in clinical practice in New Zealand, and no clinical studies on LLLT (PBM) for BCRL have been conducted in this country. In order to promote this potentially useful treatment modality for BCRL patients, the Laser Lymphedema Trial Team at the University of Otago conducted a program to assess the effectiveness of LLLT (PBM) in management of BCRL. The program comprises three phases including a systematic review (completed), a feasibility study (completed), and a full-scale randomized controlled trial (proposed). This current paper provides an update on the program. Based upon the systematic review, LLLT (PBM) is considered a potentially effective treatment approach for women with BCRL; the review also indicated the need for further research including exploration of the relevance of dosage and other LLLT (PBM) parameters. The feasibility study demonstrated that it is feasible to conduct a fully powered RCT to definitively test the effectiveness of the additional use of LLLT (PBM) in the management of BCRL, and 114 participants will be needed at baseline in the main study. Currently, the full-scale RCT is under preparation.

Clinical Effectiveness of Statin Therapy After Ischemic Stroke: Primary Results From the Statin Therapeutic Area of the Patient-Centered Research Into Outcomes Stroke Patients Prefer and Effectiveness Research (PROSPER) Study.

PubMed

O'Brien, Emily C; Greiner, Melissa A; Xian, Ying; Fonarow, Gregg C; Olson, DaiWai M; Schwamm, Lee H; Bhatt, Deepak L; Smith, Eric E; Maisch, Lesley; Hannah, Deidre; Lindholm, Brianna; Peterson, Eric D; Pencina, Michael J; Hernandez, Adrian F

2015-10-13

In patients with ischemic stroke, data on the real-world effectiveness of statin therapy for clinical and patient-centered outcomes are needed to better inform shared decision making. Patient-Centered Research Into Outcomes Stroke Patients Prefer and Effectiveness Research (PROSPER) is a Patient-Centered Outcomes Research Institute-funded research program designed with stroke survivors to evaluate the effectiveness of poststroke therapies. We linked data on patients ≥65 years of age enrolled in the Get With The Guidelines-Stroke Registry to Medicare claims. Two-year to postdischarge outcomes of those discharged on a statin versus not on a statin were adjusted through inverse probability weighting. Our coprimary outcomes were major adverse cardiovascular events and home time (days alive and out of a hospital or skilled nursing facility). Secondary outcomes included all-cause mortality, all-cause readmission, cardiovascular readmission, and hemorrhagic stroke. From 2007 to 2011, 77 468 patients who were not taking statins at the time of admission were hospitalized with ischemic stroke; of these, 71% were discharged on statin therapy. After adjustment, statin therapy at discharge was associated with a lower hazard of major adverse cardiovascular events (hazard ratio, 0.91; 95% confidence interval, 0.87-0.94), 28 more home-time days after discharge (P<0.001), and lower all-cause mortality and readmission. Statin therapy at discharge was not associated with increased risk of hemorrhagic stroke (hazard ratio, 0.94; 95% confidence interval, 0.72-1.23). Among statin-treated patients, 31% received a high-intensity dose; after risk adjustment, these patients had outcomes similar to those of recipients of moderate-intensity statin. In older ischemic stroke patients who were not taking statins at the time of admission, discharge statin therapy was associated with lower risk of major adverse cardiovascular events and nearly 1 month more home time during the 2-year period after hospitalization. © 2015 American Heart Association, Inc.

A conceptual framework for international service-learning course planning: promoting a foundation for ethical practice in the physical therapy and occupational therapy professions.

PubMed

Lattanzi, Jill Black; Pechak, Celia

2011-01-01

As physical therapy (PT) and occupational therapy (OT) educational programs endeavor to foster core values of social responsibility, justice, and altruism in an increasingly global community, the incorporation of local and international service-learning (ISL) into the curriculum is growing. Much of the research has focused on the measurement of student learning, with little written about the impact on the host community. Proponents of global health initiatives are calling for consideration of all stakeholders to ensure ethical practice. This paper explores the current literature related to PT and OT ISL and builds a conceptual framework for ISL course planning. The essential phases in the framework include: 1) pre-experience planning/preparation stage, 2) field immersion experience stage, and 3) postexperience stage. The essential elements are: 1) cultural competency training, 2) communication and coordination with community, 3) comprehensive assessment, and 4) strategic planning. The authors suggest this framework as a practical tool to structure ISL courses with an explicit emphasis on ethical concerns. Additionally, they seek to foster more dialogue and action related to the promotion of ethical practices in ISL in PT and OT education programs.

Bone Analyzer

NASA Technical Reports Server (NTRS)

1985-01-01

The danger of disuse osteoporosis under weightless condition in space led to extensive research into measurements of bone stiffness and mass by the Biomedical Research Division of Ames and Stanford University. Through its Technology Utilization Program, NASA funded an advanced SOBSA, a microprocessor-controlled bone probe system. SOBSA determines bone stiffness by measuring responses to an electromagnetic shaker. With this information, a physician can identify bone disease, measure deterioration and prescribe necessary therapy. The system is now undergoing further testing.

Maximizing the Impact of e-Therapy and Serious Gaming: Time for a Paradigm Shift.

PubMed

Fleming, Theresa M; de Beurs, Derek; Khazaal, Yasser; Gaggioli, Andrea; Riva, Giuseppe; Botella, Cristina; Baños, Rosa M; Aschieri, Filippo; Bavin, Lynda M; Kleiboer, Annet; Merry, Sally; Lau, Ho Ming; Riper, Heleen

2016-01-01

Internet interventions for mental health, including serious games, online programs, and apps, hold promise for increasing access to evidence-based treatments and prevention. Many such interventions have been shown to be effective and acceptable in trials; however, uptake and adherence outside of trials is seldom reported, and where it is, adherence at least, generally appears to be underwhelming. In response, an international Collaboration On Maximizing the impact of E-Therapy and Serious Gaming (COMETS) was formed. In this perspectives' paper, we call for a paradigm shift to increase the impact of internet interventions toward the ultimate goal of improved population mental health. We propose four pillars for change: (1) increased focus on user-centered approaches, including both user-centered design of programs and greater individualization within programs, with the latter perhaps utilizing increased modularization; (2) Increased emphasis on engagement utilizing processes such as gaming, gamification, telepresence, and persuasive technology; (3) Increased collaboration in program development, testing, and data sharing, across both sectors and regions, in order to achieve higher quality, more sustainable outcomes with greater reach; and (4) Rapid testing and implementation, including the measurement of reach, engagement, and effectiveness, and timely implementation. We suggest it is time for researchers, clinicians, developers, and end-users to collaborate on these aspects in order to maximize the impact of e-therapies and serious gaming.

Maximizing the Impact of e-Therapy and Serious Gaming: Time for a Paradigm Shift

PubMed Central

Fleming, Theresa M.; de Beurs, Derek; Khazaal, Yasser; Gaggioli, Andrea; Riva, Giuseppe; Botella, Cristina; Baños, Rosa M.; Aschieri, Filippo; Bavin, Lynda M.; Kleiboer, Annet; Merry, Sally; Lau, Ho Ming; Riper, Heleen

2016-01-01

Internet interventions for mental health, including serious games, online programs, and apps, hold promise for increasing access to evidence-based treatments and prevention. Many such interventions have been shown to be effective and acceptable in trials; however, uptake and adherence outside of trials is seldom reported, and where it is, adherence at least, generally appears to be underwhelming. In response, an international Collaboration On Maximizing the impact of E-Therapy and Serious Gaming (COMETS) was formed. In this perspectives’ paper, we call for a paradigm shift to increase the impact of internet interventions toward the ultimate goal of improved population mental health. We propose four pillars for change: (1) increased focus on user-centered approaches, including both user-centered design of programs and greater individualization within programs, with the latter perhaps utilizing increased modularization; (2) Increased emphasis on engagement utilizing processes such as gaming, gamification, telepresence, and persuasive technology; (3) Increased collaboration in program development, testing, and data sharing, across both sectors and regions, in order to achieve higher quality, more sustainable outcomes with greater reach; and (4) Rapid testing and implementation, including the measurement of reach, engagement, and effectiveness, and timely implementation. We suggest it is time for researchers, clinicians, developers, and end-users to collaborate on these aspects in order to maximize the impact of e-therapies and serious gaming. PMID:27148094

Connecting students to institutions: the relationship between program resources and student retention in respiratory care education programs.

PubMed

Ari, Arzu

2009-09-01

Respiratory care education programs are being held accountable for student retention. Increasing student retention is necessary for the respiratory therapy profession, which suffers from a shortage of qualified therapists needed to meet the increased demand. The present study investigated the relationship between student retention rate and program resources, in order to understand which and to what extent the different components of program resources predict student retention rate. The target population of this study was baccalaureate of science degree respiratory care education programs. After utilizing a survey research method, Pearson correlations and multiple regression analysis were used for data analysis. With a 63% response rate (n = 36), this study found a statistically significant relationship between program resources and student retention rate. Financial and personnel resources had a statistically significant positive relationship with student retention. The mean financial resources per student was responsible for 33% of the variance in student retention, while the mean personnel resources per student accounted for 12% of the variance in student retention. Program financial resources available to students was the single best predictor of program performance on student retention. Respiratory care education programs spending more money per student and utilizing more personnel in the program have higher mean performance in student retention. Therefore, respiratory care education programs must devote sufficient resources to retaining students so that they can produce more respiratory therapists and thereby make the respiratory therapy profession stronger.

Family therapy: critique from a feminist perspective.

PubMed

Penfold, P S

1989-05-01

Family therapy is a powerful modality which, all too often, is used without awareness of its possible constricting, or even crippling, effects. Textbooks and articles about family therapy focus soley or mainly on the family system alone, thus obscuring the influence of school, workplace, neighborhood, peer group, class, race and sex. Theorists, who are predominantly male, have developed rigid and mechanical concepts which encourage formulations encompassing the family system alone. Power inequalities between men and women are ignored and socially programmed sex roles are reflected and reinforced by theory and practice. Thus family therapy may function to locate and contain, within the family, difficulties and distress derived from stresses outside the family. The negative effects of traditional sex roles on emotional growth, sexuality and the development of mutually gratifying male-female relationships are never dealt with. As a result, family therapy may contribute to men's straitjacketing and women's oppression. To fulfill its promise, family therapy research and teaching must move beyond shortsighted and narrowly conceptualized theories which could damage, rather than heal, families who are suffering.

Use of evidence-based treatments in substance abuse treatment programs serving American Indian and Alaska Native communities.

PubMed

Novins, Douglas K; Croy, Calvin D; Moore, Laurie A; Rieckmann, Traci

2016-04-01

Research and health surveillance activities continue to document the substantial disparities in the impacts of substance abuse on the health of American Indian and Alaska Native (AI/AN) people. While Evidence-Based Treatments (EBTs) hold substantial promise for improving treatment for AI/ANs with substance use problems (as they do for non-AI/ANs), anecdotal reports suggest that their use is limited. In this study, we examine the awareness of, attitudes toward, and use of EBTs in substance abuse treatment programs serving AI/AN communities. Data are drawn from the first national survey of tribal substance abuse treatment programs. Clinicians or clinical administrators from 192 programs completed the survey. Participants were queried about their awareness of, attitudes toward, and use of 9 psychosocial and 3 medication EBTs. Cognitive Behavioral Therapy (82.2%), Motivational Interviewing (68.6%), and Relapse Prevention Therapy (66.8%) were the most commonly implemented psychosocial EBTs; medications for psychiatric comorbidity was the most commonly implemented medication treatment (43.2%). Greater EBT knowledge and use were associated with both program (e.g., funding) and staff (e.g., educational attainment) characteristics. Only two of the commonly implemented psychosocial EBTs (Motivational Interviewing and Relapse Prevention Therapy) were endorsed as culturally appropriate by a majority of programs that had implemented them (55.9% and 58.1%, respectively). EBT knowledge and use is higher in substance abuse treatment programs serving AI/AN communities than has been previously estimated. However, many users of these EBTs continue to have concerns about their cultural appropriateness, which likely limits their further dissemination. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Together - a couples' program to improve communication, coping, and financial management skills: development and initial pilot-testing.

PubMed

Falconier, Mariana K

2015-04-01

The accumulated knowledge about the negative impact of financial strain on couple's relationship functioning and the magnitude of the latest economic downturn have brought together the fields of financial counseling and couples' therapy. This article describes the development of a new interdisciplinary program that aims at helping couples under financial strain improve their financial management, communication, and dyadic coping skills. The article also reports the results from its initial pilot-testing with data collected from 18 financially distressed couples before and after participation in the program and 3 months later. Results from repeated measures ANOVAs suggest that the program may help reduce both partners' financial strain and the male negative communication and improve both partners' financial management skills and strategies to cope together with financial strain, and the male relationship satisfaction. These findings together with the high satisfaction reported by participants regarding the structure and content of the sessions and homework suggest that this program may be a promising approach to help couples experiencing financial strain. Gender differences, clinical implications, and possibilities for further research are also discussed. © 2014 American Association for Marriage and Family Therapy.

Novel ICD Programming and Inappropriate ICD Therapy in CRT-D Versus ICD Patients: A MADIT-RIT Sub-Study.

PubMed

Kutyifa, Valentina; Daubert, James P; Schuger, Claudio; Goldenberg, Ilan; Klein, Helmut; Aktas, Mehmet K; McNitt, Scott; Stockburger, Martin; Merkely, Bela; Zareba, Wojciech; Moss, Arthur J

2016-01-01

The Multicenter Automatic Defibrillator Implantation Trial-Reduce Inappropriate therapy (MADIT-RIT) trial showed a significant reduction in inappropriate implantable cardioverter defibrillator (ICD) therapy in patients programmed to high-rate cut-off (Arm B) or delayed ventricular tachycardia therapy (Arm C), compared with conventional programming (Arm A). There is limited data on the effect of cardiac resynchronization therapy with a cardioverter defibrillator (CRT-D) on the effect of ICD programming. We aimed to elucidate the effect of CRT-D on ICD programming to reduce inappropriate ICD therapy in patients implanted with CRT-D or an ICD, enrolled in MADIT-RIT. The primary end point of this study was the first inappropriate ICD therapy. Secondary end points were inappropriate anti-tachycardia pacing and inappropriate ICD shock. The study enrolled 742 (49%) patients with an ICD and 757 (51%) patients with a CRT-D. Patients implanted with a CRT-D had 62% lower risk of inappropriate ICD therapy than those with an ICD only (hazard ratio [HR] =0.38, 95% confidence interval: 0.25-0.57; P<0.001). High-rate cut-off or delayed ventricular tachycardia therapy programming significantly reduced the risk of inappropriate ICD therapy compared with conventional ICD programming in ICD (HR=0.14 [B versus A]; HR=0.21 [C versus A]) and CRT-D patients (HR=0.15 [B versus A]; HR=0.23 [C versus A]; P<0.001 for all). There was a significant reduction in inappropriate anti-tachycardia pacings in both group and a significant reduction in inappropriate ICD shock in CRT-D patients. Patients implanted with a CRT-D have lower risk of inappropriate ICD therapy than those with an ICD. Innovative ICD programming significantly reduces the risk of inappropriate ICD therapy in both ICD and CRT-D patients. http://clinicaltrials.gov; Unique identifier: NCT00947310. © 2016 American Heart Association, Inc.

ihear[R] Internet Therapy Program: A Program by St. Joseph Institute for the Deaf

ERIC Educational Resources Information Center

Broekelmann, Cheryl

2012-01-01

The ihear[R] Internet Therapy Program (ihear) provides effective, individualized, and interactive therapy that is tailored to each child's specific needs through a secure, high-quality Internet connection. The program brings listening and spoken language services directly to schools and families. The foundation for ihear is based on the St. Joseph…

Animal-Assisted Therapy with Female Inmates with Mental Illness: A Case Example from a Pilot Program

ERIC Educational Resources Information Center

Jasperson, Rachael A.

2010-01-01

Female offenders' mental health needs have consistently been shown to exceed those of male offenders. Incarcerated women report higher rates of violent victimization, major depression, post-traumatic stress disorder, mood disorders, substance use disorders, and personality disorders. For years, researchers have examined the human-animal…

Correction of School Disadaptation of Teenagers by Art Therapy Methods

ERIC Educational Resources Information Center

Nigmatullina, Irina A.; Gerasimenko, Julia A.

2016-01-01

Relevance of research is caused by growth of number of pupils with school disadaptation that is expressed in problems of development of the school program, socialization problems, and the general trouble. In this regard, this article is directed to identification or disclosure of opportunities of assistance to teenagers with this problem, to take…

Families and Schools Together: Building Relationships. Juvenile Justice Bulletin.

ERIC Educational Resources Information Center

McDonald, Lynn; Frey, Heather E.

This bulletin profiles a program, Families and Schools Together (FAST), that brings at-risk children and their families together in multifamily groups to strengthen families and increase the likelihood that children will succeed at home, at school, and in the community. Drawing on research and family therapy, FAST builds protective factors for…

For Nicotine, Dose Matters | Center for Cancer Research

Cancer.gov

Nicotine replacement therapy (NRT) is frequently part of a person’s regimen for smoking cessation. The U.S. Food and Drug Administration has approved use of this approach for 12 weeks in supervised quitting programs. Unfortunately for some patients, though, this length of time is not long enough to break their addiction to tobacco. 

78 FR 40271 - Medicare and Medicaid Programs; Home Health Prospective Payment System Rate Update for CY 2014...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-03

... care hospital length of stay. ADL Activities of daily living. AHRQ Agency for Healthcare Research and.... DHHS Department of Health and Human Services. DM Diabetes mellitus. DME Durable medical equipment. DRA... payment [Adjustment]. POC Plan of care. PRRB Provider Reimbursement Review Board. PT Physical therapy. QAP...

Evaluating scholarship productivity in COAMFTE-accredited PhD programs.

PubMed

Jared DuPree, W; White, Mark B; Meredith, William H; Ruddick, Lindsay; Anderson, Michael P

2009-04-01

Due to an increasing trend among states to cut higher education funds, many universities are relying more on private donations and federal funding to keep programs afloat. Scholarship productivity in general has become an integral factor in terms of universities granting tenure to faculty, allocating resources, and supporting program goals due to the fact that more research in a particular area tends to increase the likelihood that one will obtain funding from federal, state, and private sources. In the past, ranking systems have also been used to evaluate programs. However, most ranking systems use methodologies that do not quantify research productivity or evaluate factors that match current university trends. The purpose of this article is to explore current scholarship productivity trends among COAMFTE-accredited doctoral programs through the use of several evaluation methods. Specifically, productivity was examined in regard to the following areas: (a) family therapy journal publications; (b) family science journal publications; (c) historic journal publication trends; and (d) recent journal publication trends.

A Qualitative Investigation into Why the Motivation of Massage Therapy Students Changes over the Course of Their Professional Education.

PubMed

Finch, Paul

2009-03-19

In previous research, the motivation of massage therapy students was observed to change between commencement of their professional studies and entry into practice. The change involved a decrease in intrinsic motivation (associated with altruism) and an increase in extrinsic motivation (associated with the prospect of external rewards). This paper reports on the influences underlying those changes. The research used a qualitative design in which data were collected during a series of individual in-depth semi-structured interviews with massage therapy graduates, just after completion of a 2-year (2200-hour) full-time program. After informed consent was obtained, interviews were taped, transcribed, and analyzed, resulting in identification of a number of themes and subthemes. Previously noted changes in student motivation involved an increase in the influence of extrinsic rewards and a decrease in motivation related to helping and working with people. The findings of the present study suggest that these changes are explained by two main themes, each with a number of subthemes. The first theme, The Reality of Life in Practice, is associated with two subthemes: Debt Load, and Effectiveness in Achieving Positive Health Outcomes. The second theme, An Evolving Self-Image As a Health Care Professional, is associated with three sub-themes: Rigor/Intensity of the Educational Program, Developing Perspective of Massage Therapy As a Career, and Interaction with Faculty. The data suggest that the change in motivation noted in previous work (increased extrinsic motivation and decreased intrinsic motivation) is influenced in different ways by each identified theme. Although schools must be vigilant in ensuring that their programs support the humanistic mission of health care, the present study indicates that the change in motivation noted in earlier work is not sinister. Rather, it appears to be related to the development of a realistic perspective of life as a health care practitioner, which departs from the more naïve expectations of students when they commence their professional studies.

Is the Nintendo Wii Fit really acceptable to older people?: a discrete choice experiment

PubMed Central

2011-01-01

Background Interactive video games such as the Nintendo Wii Fit are increasingly used as a therapeutic tool in health and aged care settings however, their acceptability to older people is unclear. The aim of this study was to determine the acceptability of the Nintendo Wii Fit as a therapy tool for hospitalised older people using a discrete choice experiment (DCE) before and after exposure to the intervention. Methods A DCE was administered to 21 participants in an interview style format prior to, and following several sessions of using the Wii Fit in physiotherapy. The physiotherapist prescribed the Wii Fit activities, supervised and supported the patient during the therapy sessions. Attributes included in the DCE were: mode of therapy (traditional or using the Wii Fit), amount of therapy, cost of therapy program and percentage of recovery made. Data was analysed using conditional (fixed-effects) logistic regression. Results Prior to commencing the therapy program participants were most concerned about therapy time (avoiding programs that were too intensive), and the amount of recovery they would make. Following the therapy program, participants were more concerned with the mode of therapy and preferred traditional therapy programs over programs using the Wii Fit. Conclusions The usefulness of the Wii Fit as a therapy tool with hospitalised older people is limited not only by the small proportion of older people who are able to use it, but by older people's preferences for traditional approaches to therapy. Mainstream media portrayals of the popularity of the Wii Fit with older people may not reflect the true acceptability in the older hospitalised population. PMID:22011360

Characterization and predictors of first and subsequent inappropriate ICD therapy by heart rate ranges: Result of the MADIT-RIT efficacy analysis.

PubMed

Kutyifa, Valentina; Daubert, James P; Olshansky, Brian; Huang, David T; Zhang, Claire; Ruwald, Anne-Christine H; McNitt, Scott; Zareba, Wojciech; Moss, Arthur J; Schuger, Claudio

2015-09-01

Data on inappropriate implantable cardioverter-defibrillator (ICD) therapy and effects of programming by heart rate are lacking. We aimed to characterize inappropriate ICD therapy and assess the effects of novel programming by heart rate. Incidence and causes of inappropriate therapy by heart rate range (below or above 200 bpm) were assessed. Predictors of inappropriate therapy and effects of programming by heart rate were evaluated with multivariate Cox regression models. Crossovers were excluded. Inappropriate therapy occurred in 9.2% of the total patient population, with 19% of patients randomized to study arm A, 3.6% in arm B, and 4.7% in arm C. Inappropriate therapies <200 bpm were attributable to supraventricular tachycardia (SVT)/sinus tachycardia (78%) or atrial fibrillation/flutter (20%). Inappropriate therapy ≥200 bpm occurred because of SVT (47%), atrial fibrillation/flutter (41%), or electromagnetic interference (13%). Conventional ICD programming was associated with more inappropriate therapy <200 bpm than high-rate or delayed therapy, as were younger age, history of atrial arrhythmia, advanced New York Heart Association functional class, ICD versus cardiac resynchronization therapy with defibrillator, and absence of diabetes. High-rate and long-delay therapy significantly reduced the risk of inappropriate therapy in the <200 bpm range. Long delay was associated with further reduction of fast (≥200 bpm) inappropriate therapy (P = .032) and a reduction in subsequent inappropriate episodes (P = .006). In MADIT-RIT, inappropriate ICD therapy is most frequent at rates below 200 bpm and can be predicted, and effectively prevented, with high-rate cutoff programming. Long-delay therapy effectively reduces fast inappropriate therapy ≥200 bpm and subsequent events. [ http://clinicaltrials.gov/ct2/show/NCT00947310]. Copyright © 2015 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

The Enhancement of Resilience via a Wilderness Therapy Program. A Preliminary Investigation

ERIC Educational Resources Information Center

Gillespie, E.; Allen-Craig, Sandy

2009-01-01

This paper presents the findings of a recent preliminary study into the effects of a wilderness therapy program on the resilience of male youth at-risk. The study focused on participants who completed a wilderness therapy program at Typo Station. The residential program involved a five-week stay at the Typo Station property in north east Victoria,…

No surgery required: the future of feline sterilization: An overview of the Michelson Prize & Grants in Reproductive Biology.

PubMed

Johnston, Shirley; Rhodes, Linda

2015-09-01

For many years, researchers have been studying reproduction of cats and dogs, including approaches to non-surgical sterilization, but scant funding has been available for this work. Recognizing the need to fund research and to attract researchers from the biomedical community to apply their expertise to this area, the Michelson Prize & Grants (MPG) in Reproductive Biology program was founded. Since 2009, it has funded 34 research projects in seven countries toward discovery of a safe single-administration lifetime non-surgical sterilant in male and female cats and dogs. The goal of the MPG program is the reduction or elimination of the approximately 2.7 million deaths of healthy shelter cats and dogs in the US every year. The successful product is expected to be a single-dose injectable product approved by the US Food and Drug Administration as a veterinary prescription item. The most optimistic prediction is that such a product will reach the hands of practicing veterinarians within the next decade. Active research is in progress using approaches such as immunocontraception with a single-administration vaccine against gonadotropin releasing hormone (GnRH). Long-term therapy with GnRH agonists such as deslorelin administered in controlled-release devices is also being studied. Other scientists are targeting cells in the brain or gonads with cytotoxins, such as are used in cancer chemotherapy. Gene therapy expressing proteins that suppress reproduction and gene silencing of peptides essential to reproduction are further avenues of research. Findings are available at www.michelsonprizeandgrants.org/michelson-grants/research-findings. © The Author(s) 2015.

Advances in boron neutron capture therapy (BNCT) at kyoto university - From reactor-based BNCT to accelerator-based BNCT

NASA Astrophysics Data System (ADS)

Sakurai, Yoshinori; Tanaka, Hiroki; Takata, Takushi; Fujimoto, Nozomi; Suzuki, Minoru; Masunaga, Shinichiro; Kinashi, Yuko; Kondo, Natsuko; Narabayashi, Masaru; Nakagawa, Yosuke; Watanabe, Tsubasa; Ono, Koji; Maruhashi, Akira

2015-07-01

At the Kyoto University Research Reactor Institute (KURRI), a clinical study of boron neutron capture therapy (BNCT) using a neutron irradiation facility installed at the research nuclear reactor has been regularly performed since February 1990. As of November 2014, 510 clinical irradiations were carried out using the reactor-based system. The world's first accelerator-based neutron irradiation system for BNCT clinical irradiation was completed at this institute in early 2009, and the clinical trial using this system was started in 2012. A shift of BCNT from special particle therapy to a general one is now in progress. To promote and support this shift, improvements to the irradiation system, as well as its preparation, and improvements in the physical engineering and the medical physics processes, such as dosimetry systems and quality assurance programs, must be considered. The recent advances in BNCT at KURRI are reported here with a focus on physical engineering and medical physics topics.

Wilderness adventure therapy effects on the mental health of youth participants.

PubMed

Bowen, Daniel J; Neill, James T; Crisp, Simon J R

2016-10-01

Adventure therapy offers a prevention, early intervention, and treatment modality for people with behavioural, psychological, and psychosocial issues. It can appeal to youth-at-risk who are often less responsive to traditional psychotherapeutic interventions. This study evaluated Wilderness Adventure Therapy (WAT) outcomes based on participants' pre-program, post-program, and follow-up responses to self-report questionnaires. The sample consisted of 36 adolescent out-patients with mixed mental health issues who completed a 10-week, manualised WAT intervention. The overall short-term standardised mean effect size was small, positive, and statistically significant (0.26), with moderate, statistically significant improvements in psychological resilience and social self-esteem. Total short-term effects were within age-based adventure therapy meta-analytic benchmark 90% confidence intervals, except for the change in suicidality which was lower than the comparable benchmark. The short-term changes were retained at the three-month follow-up, except for family functioning (significant reduction) and suicidality (significant improvement). For participants in clinical ranges pre-program, there was a large, statistically significant reduction in depressive symptomology, and large to very large, statistically significant improvements in behavioural and emotional functioning. These changes were retained at the three-month follow-up. These findings indicate that WAT is as effective as traditional psychotherapy techniques for clinically symptomatic people. Future research utilising a comparison or wait-list control group, multiple sources of data, and a larger sample, could help to qualify and extend these findings. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

The Influence of Drug Testing and Benefit-Based Distribution of Opioid Substitution Therapy on Drug Abstinence.

PubMed

Gabrovec, Branko

2015-01-01

The objective of our research was to discover whether the new approach to urine drug testing has a positive effect on users' abstinence, users' treatment, and their cooperation, while remaining user-friendly, and whether this approach is more cost-effective. The centers are focused on providing high-quality treatment within a cost-efficient program. In this study, we focus on the influence of drug testing and benefit-based distribution of opioid substitution therapy (BBDOST) on drug abstinence. The purpose of this study was to find any possible positive effect of modified distribution of the therapy and illicit drug testing on the number of users who are abstinent from illicit drugs and users who are not abstinent from illicit drugs as well as the users' opinion on BBDOST and testing. We are also interested in a difference in abstinence rates between those on BBDOST and those not receiving BBDOST. In 2010, the method of drug testing at the center was changed (less frequent and random drug testing) to enable its users faster access to BBDOST (take-home therapy). It was found that the number of drug-abstinent program participants has increased from initial 44.5% (2010) to 54.1% (2014). According to the program participants, the new method allows them to achieve and maintain abstinence from drugs more easily. In addition, they are also satisfied with the modified way of drug testing. This opinion does not change with age, gender, and acquired benefits.

Effectiveness of Sleep-Based Interventions for Children with Autism Spectrum Disorder: A Meta-Synthesis.

PubMed

Cuomo, Belinda M; Vaz, Sharmila; Lee, Elinda Ai Lim; Thompson, Craig; Rogerson, Jessica M; Falkmer, Torbjorn

2017-05-01

Sleep problems are common in children with autism spectrum disorder (ASD). This meta-synthesis collated eight previously published systematic reviews examining the efficacy of sleep interventions in children with ASD in an attempt to present a clear analysis of trialed interventions. The collated reviews consider five major groups of sleep interventions for children with ASD: melatonin therapy, pharmacologic treatments other than melatonin, behavioral interventions, parent education/education programs, and alternative therapies (massage therapy, aromatherapy, and multivitamin and iron supplementation). These eight reviews were based on 38 original studies and address the efficacy of interventions across 17 sleep problem domains. The results of this meta-synthesis suggest that no single intervention is effective across all sleep problems in children with ASD. However, melatonin, behavioral interventions, and parent education/education program interventions appear the most effective at ameliorating multiple domains of sleep problems compared with other interventions. Due to the heterogeneous causative factors and presentations of disordered sleep, further research into the effectiveness of sleep interventions may target specific phenotypic subgroups rather than a broad analysis across the general ASD population. Similarly, future research needs to consider the efficacy of different polytherapeutic approaches in order to provide clinicians with evidence to inform best practice. In the meantime, this review supports clinicians' decision making for a majority of the identified sleep problems in the ASD population. © 2017 Pharmacotherapy Publications, Inc.

The addition of upper cervical manipulative therapy in the treatment of patients with fibromyalgia: a randomized controlled trial.

PubMed

Moustafa, Ibrahim M; Diab, Aliaa A

2015-07-01

The aim of this study was to investigate the immediate and long-term effects of a one-year multimodal program, with the addition of upper cervical manipulative therapy, on fibromyalgia management outcomes in addition to three-dimensional (3D) postural measures. This randomized clinical trial with one-year follow-up was completed at the research laboratory of our university. A total of 120 (52 female) patients with fibromyalgia syndrome (FMS) and definite C1-2 joint dysfunction were randomly assigned to the control or an experimental group. Both groups received a multimodal program; additionally, the experimental group received upper cervical manipulative therapy. Primary outcomes were the Fibromyalgia Impact Questionnaire (FIQ), whereas secondary outcomes included Pain Catastrophizing Scale (PCS), algometric score, Pittsburgh Sleep Quality Index (PSQI), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), and 3D postural measures. Measures were assessed at three time intervals: baseline, 12 weeks, and 1 year after the 12-week follow-up. The general linear model with repeated measures indicated a significant group × time effect in favor of the experimental group on the measures of 3D postural parameters (P < .0005), FIQ (P < .0005), PCS (P < .0005), algometric score (F = P < .0005), PSQI (P < .0005), BAI (P < .0005), and BDI (P < .0005). The addition of the upper cervical manipulative therapy to a multimodal program is beneficial in treating patients with FMS.

Systematic review of the effects of mirror therapy in children with cerebral palsy.

PubMed

Park, Eom-Ji; Baek, Soon-Hyung; Park, Soohee

2016-11-01

[Purpose] To provide data for systematic intervention plans in occupational therapy practice by objectivity showing the value of mirror therapy interventions in children with cerebral palsy. [Subjects and Methods] Medline and EMBASE databases were searched for the key words "cerebral palsy," "mirror movement," "mirror therapy," and "mirror visual feedback." Nine studies that met the inclusion and exclusion criteria were identified. The qualitatively determined level of evidence, period of research, comparisons and interventions, tools used to measure the intervention, and the effects were analyzed. [Results] According to the results analyzed, one (1/9, 11.1%) study showed the same result as the control group, one (1/9, 11.1%) showed a negative effect, and seven (7/9, 77.8%) showed positive effects of mirror-mediated therapy, with meaningful improvement in function, such as hand strength, movement speed, muscle activity, and accuracy of hand matching. [Conclusion] Through this study, the value of mirror-mediated therapeutic interventions in occupational therapy practice targeting cerebral palsy was confirmed. It is expected that this result will be useful in establishing mirror therapy as an interventional program.

Evaluation of the effectiveness of robotic gait training and gait-focused physical therapy programs for children and youth with cerebral palsy: a mixed methods RCT.

PubMed

Wiart, Lesley; Rosychuk, Rhonda J; Wright, F Virginia

2016-06-02

Robot assisted gait training (RAGT) is considered to be a promising approach for improving gait-related gross motor function of children and youth with cerebral palsy. However, RAGT has yet to be empirically demonstrated to be effective. This knowledge gap is particularly salient given the strong interest in this intensive therapy, the high cost of the technology, and the requirement for specialized rehabilitation centre resources. This is a research protocol describing a prospective, multi-centre, concurrent mixed methods study comprised of a randomized controlled trial (RCT) and an interpretive descriptive qualitative design. It is a mixed methods study designed to determine the relative effectiveness of three physical therapy treatment conditions (i.e., RAGT, a functional physical therapy program conducted over-ground (fPT), and RAGT + fPT) on gait related motor skills of ambulatory children with cerebral palsy. Children with cerebral palsy aged 5-18 years who are ambulatory (Gross Motor Function Classification System Levels II and III) will be randomly allocated to one of four treatment conditions: 1) RAGT, 2) fPT, 3) RAGT and fPT combined, or 4) a maintenance therapy only control group. The qualitative component will explicate child and parent experiences with the interventions, provide insight into the values that underlie their therapy goals, and assist with interpretation of the results of the RCT. n/a. NCT02391324 Registered March 12, 2015.

Implementation of Motivational Interviewing in Substance Use Disorder Treatment: Research Network Participation and Organizational Compatibility.

PubMed

Rieckmann, Traci R; Abraham, Amanda J; Bride, Brian E

Despite considerable empirical evidence that psychosocial interventions improve addiction treatment outcomes across populations, implementation remains problematic. A small body of research points to the importance of research network participation as a facilitator of implementation; however, studies examined limited numbers of evidence-based practices. To address this gap, the present study examined factors impacting implementation of motivational interviewing (MI). This study used data from a national sample of privately funded treatment programs (n = 345) and programs participating in the National Drug Abuse Treatment Clinical Trials Network (CTN) (n = 156). Data were collected via face-to-face interviews with program administrators and clinical directors (2007-2009). Analysis included bivariate t tests and chi-square tests to compare private and CTN programs, and multivariable logistic regression of MI implementation. A majority (68.0%) of treatment programs reported use of MI. Treatment programs participating in the CTN (88.9%) were significantly more likely to report use of MI compared with non-CTN programs (58.5%; P < 0.01). CTN programs (82.1%) also were more likely to use trainers from the Motivational Interviewing Network of Trainers as compared with private programs (56.1%; P < 0.05). Multivariable logistic regression models reveal that CTN-affiliated programs and programs with a psychiatrist on staff were more likely to use MI. Programs that used the Stages of Change Readiness and Treatment Eagerness Scale assessment tool were more likely to use MI, whereas programs placing greater emphasis on confrontational group therapy were less likely to use MI. Findings suggest the critical role of research network participation, access to psychiatrists, and organizational compatibility in adoption and sustained use of MI.

Enhancing Supportive-Educative Nursing Systems to Reduce Risk of Post-Breast Cancer Lymphedema.

PubMed

Armer, Jane M; Shook, Robin P; Schneider, Melanie K; Brooks, Constance W; Peterson, Julie; Stewart, Bob R

2009-10-01

This study describes the use of data regarding self-care agency to enhance a supportive-educative nursing system for breast cancer survivors to reduce the risk of developing lymphedema post surgery. Impetus for this study came from the analysis of participant feedback from a parent study (Lance Armstrong Foundation pilot study) that sought to plan an educational program for nurses that will improve their supportive-educative nursing system when working with breast cancer survivors. The goal is to enable these women to reduce the risk of lymphedema post surgery. The parent study examined a bundled behavioral-educative intervention, which included standard lymphedema education coupled with Modified Manual Lymph Drainage (MMLD) to reduce the risk of developing lymphedema in newly-diagnosed breast cancer survivors. Based upon the feedback received from the parent study, the research team recognized that many of the participants were not fully following the recommendations of the intervention protocol. In order for nurses to help patients develop self-care agency (SCA) (Orem, 2001) to engage in actions that addressed the self-care requisites associated with post-breast cancer surgery, these nurses needed to refine their intervention skills. Prior to the development of a program for the nurses, the research team conducted a study to explore the state of power related to SCA of the study participants. The information obtained from this was then used in the development of an educational program for bundled intervention. Both motivational interviewing (Miller & Rollnick, 2002) and solution-focused therapy (Berg & DeJong, 1996) were incorporated into the educational program for the research nurse team to strengthen and improve supportive-educative nursing systems. Supportive-educative systems of care that integrate self-care deficit nursing theory, motivational interviewing, and solution-focused therapy can assist patients to develop and sustain self-care agency.

How do we value a cure?

PubMed

Husereau, Don

2015-01-01

Future perceptions of the value of curative therapies will likely reflect debates happening today about preferences for funding of preventive versus treatment programs, as well as funding orphan drugs. Little is known about how society will value curative therapies versus standard treatments, and the significant role of a host of psychological factors compared to overarching concerns about opportunity costs will likely lead to significant tension between payers and the public. More research to clarify societal preferences and healthcare goals in regards to curative therapies and in light of the potential for significant opportunity costs will be required. Given what we know about preferences for the funding of prevention and treatment measures, we should expect that cures will not be held to a different measure.

Ovarian Failure and the Menopause

PubMed Central

McEwen, Donald C.

1965-01-01

Long-term replacement therapy for ovarian deficiency or failure, including the menopause, has been widely debated. In the past, treatment, if indicated, was reassurance, sedation, and occasionally short-term estrogen therapy. Today, because of recent advances in steroid synthesis, the consequences of ovarian deficiency may be preventable. Ovarian function and failure are discussed, the apparent physiological renaissance of nine patients documented, and the methods of treatment detailed. Thirty-three patients, who took part in this program during the past two years, have continued treatment with enthusiasm, without major problems in management, and have shown evidence of improved physical and emotional well-being. Further unbiased long-term research, possibly using modern computer technique, is needed to decide between traditional and replacement therapy for the menopause. ImagesFig. 1 PMID:14289145

Scientific Production about the Adherence to Antiretroviral Therapy

PubMed Central

de Oliveira, Regina Célia; de Andrade Moraes, Danielle Chianca; Santos, Cleytiane Stephany Silva; da Silva Monteiro, Gicely Regina Sobral; da Rocha Cabral, Juliana; Beltrão, Roberta Andrade; da Silva, Calos Roberto Lyra

2017-01-01

Objective To identify the elite of authors about the subject adherence to antiretroviral therapy; to identify the journals turned to publishing articles about adherence to antiretroviral therapy; and to identify and analyze the most commonly used words in abstracts of articles about adherence to antiretroviral therapy. Method A bibliometric study conducted through the Scopus base. We used articles published between 1996 and 2014, after application of the eligibility criteria, there were composed the sample with 24 articles. The data were analyzed descriptively. Were used the laws of bibliometric (Lotka, Bradford and Zipf) and the conceptual cloud map of words, through the program Cmap tools. Results Lotka’s Law identified the 5 authors more productive (46% of the total published). Bradford is impaired in this study. Concerning Zipf, 3 zones were determined, 31.47% of the words with in the first zone, 26.46% in the second and 42.06% in the third. In the conceptual map, the words/factors that positively and negatively influence adherence were emphasized, among them the need for more research in the health services. Conclusion There are few publications about the accession to antiretroviral therapy, and the scientific production is in the process of maturation. One can infer that the theme researched is not yet an obsolete topic. It should be noted that the Bibliometric was a relevant statistic tool to generate information about the publications about the antiretroviral therapy. PMID:28979571

Development of a Hampton University Program for Novel Breast Cancer Imaging and Therapy Research

DTIC Science & Technology

2015-06-01

student ( Nanda Karthik) involved…. Should be able to give you some text!]. Aim 2 Develop and test a practical method for application of a magnetic field ...a Department of Energy (DOE) nuclear physics research facility operated by Jefferson Science Associates LLC. Jefferson Lab resources for this...minimally affected by breast density because of the higher energy photons of 99mTc. In a recent study that included patients who had inconclusive

Academic Facility Utilization and Survival Outcomes in Adult Head and Neck Sarcomas: An NCDB Analysis.

PubMed

Cannon, Richard B; Carpenter, Patrick S; Boothe, Dustin; Buchmann, Luke O; Hunt, Jason P; Lloyd, Shane; Hitchcock, Ying J; Houlton, Jeffrey J; Weis, John R; Shepherd, Hailey M; Monroe, Marcus M

2018-04-01

Objectives To investigate clinicopathologic and treatment factors associated with survival in adult head and neck sarcomas in the National Cancer Database (NCDB). To analyze whether treatment settings and therapies received influence survival outcomes and to compare trends in utilization via an aggregated national data set. Study Design Prospectively gathered data. Setting NCDB. Subjects and Methods The study comprised a total of 6944 adult patients treated for a head and neck sarcoma from January 2004 to December 2013. Overall survival (OS) was the primary outcome. Results Increased age and tumor size, nodal involvement, and poorly differentiated histology had significantly reduced OS ( P < .001). Angiosarcoma, malignant nerve sheath tumor, malignant fibrous histiocytoma, osteosarcoma, and rhabdomyosarcoma histologic subtypes had significantly reduced OS, while liposarcoma, chondrosarcoma, and chordoma had improved OS ( P < .001). Utilization of surgical therapy was associated with improved OS, while positive surgical margins were associated with treatment at a community-based cancer program and had reduced OS ( P < .001). On multivariate analysis, treatment with radiation and/or chemotherapy was not significantly associated with OS; however, primary treatment with definitive chemoradiotherapy had significantly reduced OS. Patients treated at academic/research cancer programs (n = 3874) had significantly improved 5- and 10-year OS (65% and 54%, respectively) when compared with patients treated at community-based cancer programs (n = 3027; 49% and 29%; P < .001). The percentage utilization of these programs (56% vs 44%) did not change over the study period. Conclusion For adult head and neck sarcomas, treatment at an academic/research cancer program was associated with improved survival; however, despite increasing medical specialization, the percentage utilization of these programs for this rare tumor remains constant.

SPORTS PHYSICAL THERAPY CURRICULA IN PHYSICAL THERAPIST PROFESSIONAL DEGREE PROGRAMS.

PubMed

Mulligan, Edward P; DeVahl, Julie

2017-10-01

The specialty niche of sports physical therapy has grown at a significant rate over the past 40 years. Despite this growth there is little information or direction from the physical therapy education accreditation body or professional association to guide academic programs on the interest or necessity of this type of practice content in physical therapy professional degree programs. The purpose of this survey study is to report on the prevalence, attitudes, barriers, resources, and faculty expertise in providing required or elective sports physical therapy course work. Cross-sectional descriptive survey. A 57-item questionnaire with branching logic was distributed via a web-based electronic data capture tool to survey all Commission on Accreditation for Physical Therapy Education (CAPTE) accredited and candidate schools in the United States. Response data was analyzed to describe typical educational program profiles, faculty demographics, and correlational factors consistent with the presence or absence of specific sports physical therapy curricular content. Thirty one percent of the schools responded to the survey and the program demographics were consistent with all currently accredited schools in regards to their geography, Carnegie classification, and faculty and student size. Forty three percent of programs offered a required or elective course distinct to the practice of sports physical therapy. Descriptive information regarding the sequencing, curricular make-up, resources, and assessment of content competence is reported. The odds of providing this content nearly doubles for programs that have faculty with sports clinical specialist credentials, accredited sports residency curriculums, or state practice acts that allow sports venue coverage. This survey provides an initial overview of sports physical therapy educational efforts in professional physical therapy degree programs. The data can used to spur further discussion on the necessity, structure, and implementation of education content that is inherent to a growing specialty practice in the physical therapy profession. 4, Cross-sectional descriptive survey design.

Family Therapy Training in Child and Adolescent Psychiatry Fellowship Programs

ERIC Educational Resources Information Center

Rait, Douglas Samuel

2012-01-01

Objective: This study describes the current state of family therapy training in a sample of child and adolescent psychiatry fellowship programs. Method: Child and adolescent psychiatry fellows (N = 66) from seven training programs completed a questionnaire assessing demographics, family therapy training experiences, common models of treatment and…

Description of an Intensive Dialectical Behavior Therapy Program for Multidiagnostic Clients with Eating Disorders

ERIC Educational Resources Information Center

Federici, Anita; Wisniewski, Lucene; Ben-Porath, Denise

2012-01-01

The authors describe an intensive outpatient dialectical behavior therapy (DBT) program for multidiagnostic clients with eating disorders who had not responded adequately to standard, empirically supported treatments for eating disorders. The program integrates DBT with empirically supported cognitive behavior therapy approaches that are well…

Cyclotron Provides Neutron Therapy for Cancer Patients

NASA Image and Video Library

1978-01-21

A cancer patient undergoes treatment in the Neutron Therapy Treatment Facility, or Cylotron, at the National Aeronautics and Space Administration (NASA) Lewis Research Center. After World War II Lewis researchers became interested in nuclear energy for propulsion. The focused their efforts on thermodynamics and strength of materials after radiation. In 1950 an 80-person Nuclear Reactor Division was created, and a cyclotron was built behind the Materials and Structures Laboratory. An in-house nuclear school was established to train these researchers in their new field. NASA cancelled its entire nuclear program in January 1973, just as the cyclotron was about to resume operations after a major upgrade. In 1975 the Cleveland Clinic Foundation partnered with NASA Lewis to use the cyclotron for a new type of radiation treatment for cancer patients. The cyclotron split beryllium atoms which caused neutrons to be released. The neutrons were streamed directly at the patient’s tumor. The facility had a dual-beam system that could target the tumor both vertically and horizontally. Over the course of five years, the cyclotron was used to treat 1200 patients. It was found to be particularly effective on salivary gland, prostrate, and other tumors. It was not as successful with tumors of the central nervous system. The program was terminated in 1980 as the Clinic began concentrating on non-radiation treatments.

Mirror therapy enhances lower-extremity motor recovery and motor functioning after stroke: a randomized controlled trial.

PubMed

Sütbeyaz, Serap; Yavuzer, Gunes; Sezer, Nebahat; Koseoglu, B Füsun

2007-05-01

To evaluate the effects of mirror therapy, using motor imagery training, on lower-extremity motor recovery and motor functioning of patients with subacute stroke. Randomized, controlled, assessor-blinded, 4-week trial, with follow-up at 6 months. Rehabilitation education and research hospital. A total of 40 inpatients with stroke (mean age, 63.5 y), all within 12 months poststroke and without volitional ankle dorsiflexion. Thirty minutes per day of the mirror therapy program, consisting of nonparetic ankle dorsiflexion movements or sham therapy, in addition to a conventional stroke rehabilitation program, 5 days a week, 2 to 5 hours a day, for 4 weeks. The Brunnstrom stages of motor recovery, spasticity assessed by the Modified Ashworth Scale (MAS), walking ability (Functional Ambulation Categories [FAC]), and motor functioning (motor items of the FIM instrument). The mean change score and 95% confidence interval (CI) of the Brunnstrom stages (mean, 1.7; 95% CI, 1.2-2.1; vs mean, 0.8; 95% CI, 0.5-1.2; P=.002), as well as the FIM motor score (mean, 21.4; 95% CI, 18.2-24.7; vs mean, 12.5; 95% CI, 9.6-14.8; P=.001) showed significantly more improvement at follow-up in the mirror group compared with the control group. Neither MAS (mean, 0.8; 95% CI, 0.4-1.2; vs mean, 0.3; 95% CI, 0.1-0.7; P=.102) nor FAC (mean, 1.7; 95% CI, 1.2-2.1; vs mean, 1.5; 95% CI, 1.1-1.9; P=.610) showed a significant difference between the groups. Mirror therapy combined with a conventional stroke rehabilitation program enhances lower-extremity motor recovery and motor functioning in subacute stroke patients.

Exercise programming and counseling preferences of breast cancer survivors during or after radiation therapy.

PubMed

Karvinen, Kristina H; Raedeke, Thomas D; Arastu, Hyder; Allison, Ron R

2011-09-01

To explore exercise programming and counseling preferences and exercise-related beliefs in breast cancer survivors during and after radiation therapy, and to compare differences based on treatment and insurance status. Cross-sectional survey. Ambulatory cancer center in a rural community in eastern North Carolina. 91 breast cancer survivors during or after radiation therapy. The researchers administered the questionnaire to participants. Exercise programming and counseling preferences and exercise beliefs moderated by treatment status (on-treatment, early, and late survivors) and insurance status (Medicaid, non-Medicaid). Chi-square analyses indicated that fewer Medicaid users were physically active and reported health benefits as an advantage of exercise compared to non-Medicaid users (p < 0.05). In addition, more Medicaid users preferred exercise programming at their cancer center compared to non-Medicaid users (p < 0.05). More on-treatment and early survivors listed health benefits as advantages to exercise, but fewer indicated weight control as an advantage compared to late survivors (p < 0.05). Early survivors were more likely than on-treatment survivors to indicate that accessible facilities would make exercising easier for them (p < 0.05). Medicaid users are less active, less likely to identify health benefits as an advantage for exercising, and more likely to prefer cancer center-based exercise programming compared to non-Medicaid users. In addition, on-treatment and early survivors are more likely to list health benefits and less likely to indicate weight control as advantages of exercising compared to late survivors. The low activity levels of Medicaid users may be best targeted by providing cancer center-based exercise programming. Exercise interventions may be most effective if tailored to the unique needs of treatment status.

Internet-Based Cognitive Behavioral Therapy for Adults With ADHD in Outpatient Psychiatric Care.

PubMed

Pettersson, Richard; Söderström, Staffan; Edlund-Söderström, Kerstin; Nilsson, Kent W

2017-04-01

The purpose of the study was to evaluate an Internet-based cognitive behavioral therapy (iCBT) program targeting difficulties and impairments associated with adult ADHD. Forty-five adults diagnosed with ADHD were randomized to either self-help (iCBT self-help format [iCBT-S]), self-help with weekly group sessions (iCBT group-therapy format [iCBT-G]), or a waiting-list control group. Treatment efficacy was measured at pre- and posttreatment and at 6-month follow-up. Intention-to-treat (ITT) analysis showed a significant reduction in ADHD symptoms for the iCBT-S group in comparison with the waiting-list controls at posttreatment, with a between-group effect size of d = 1.07. The result was maintained at 6-month follow-up. No significant difference was found at posttreatment or 6-month follow-up between the iCBT-S and iCBT-G groups. The findings show that a CBT treatment program administered through the Internet can be a promising treatment for adult ADHD. Limitations of the study design and directions for future research are discussed.

The PEREGRINETM program: using physics and computer simulation to improve radiation therapy for cancer

NASA Astrophysics Data System (ADS)

Hartmann Siantar, Christine L.; Moses, Edward I.

1998-11-01

When using radiation to treat cancer, doctors rely on physics and computer technology to predict where the radiation dose will be deposited in the patient. The accuracy of computerized treatment planning plays a critical role in the ultimate success or failure of the radiation treatment. Inaccurate dose calculations can result in either insufficient radiation for cure, or excessive radiation to nearby healthy tissue, which can reduce the patient's quality of life. This paper describes how advanced physics, computer, and engineering techniques originally developed for nuclear weapons and high-energy physics research are being used to predict radiation dose in cancer patients. Results for radiation therapy planning, achieved in the Lawrence Livermore National Laboratory (LLNL) 0143-0807/19/6/005/img2 program show that these tools can give doctors new insights into their patients' treatments by providing substantially more accurate dose distributions than have been available in the past. It is believed that greater accuracy in radiation therapy treatment planning will save lives by improving doctors' ability to target radiation to the tumour and reduce suffering by reducing the incidence of radiation-induced complications.

[Multiprofessional inpatient psychotherapy of depression in old age].

PubMed

Cabanel, N; Kundermann, B; Franz, M; Müller, M J

2017-11-01

Depression is common in old age but is often underdiagnosed and inadequately treated. Although psychotherapy is considered effective for treating elderly patients with depression, it is rarely applied in inpatient settings. Furthermore, treatment on inpatient units specialized for elderly patients and implementation of a psychotherapeutic treatment approach are currently more the exception. From this background, a multiprofessional inpatient behavioral treatment program (MVT) for elderly depressed patients was developed at a specialized unit of a university-affiliated regional psychiatric hospital. The MVT is based on specific and modularized group therapies accompanied by individual therapeutic interventions. While the provision of group therapies (such as psychotherapy, social skills training, relaxation training, euthymic and mindfulness-based methods, exercise and occupational therapy as well as psychoeducational sessions for relatives) is assigned to specific professional groups, a joint multiprofessional treatment planning is of central relevance. First evaluations of different treatment components support the high acceptability of the MVT and highlight that psychotherapeutic inpatient treatment programs for the elderly are feasible. Further research is required to investigate the clinical efficacy of psychotherapy in elderly depressive inpatients.

Planting hope in loss and grief: self-care applications of horticultural therapy for grief caregivers in Taiwan.

PubMed

Lin, Yeh-Jen; Lin, Chi Yun; Li, Yu-Chan

2014-01-01

In 2008, the Taiwan Association for Care and Counseling for Loss organized a workshop about Horticultural Therapy, conducted as a participatory action research (PAR). Nineteen grief caregivers participated. Specific goals were designed according to a survey of participant expectations and focus-group discussions. The workshop content included lectures and interactive activities. Results demonstrated that most participants displayed an increased awareness of personal loss and meaning in grief, indicating that horticulture and nature appreciation might relieve individual grief and stress. The report introduces the rationale, evolution, execution, and results of the program development.

Emerging Non-Cancer Applications of Therapeutic Ultrasound

PubMed Central

O’Reilly, Meaghan A.; Hynynen, Kullervo

2015-01-01

Ultrasound therapy has been investigated for over half a century. Ultrasound can act on tissue through a variety of mechanisms, including thermal, shockwave and cavitation mechanisms, and through these can elicit different responses. Ultrasound therapy can provide a non-invasive or minimally invasive treatment option, and ultrasound technology has advanced to the point where devices can be developed to investigate a wide range of applications. This review focuses on non-cancer, clinical applications of therapeutic ultrasound, with an emphasis on treatments that have recently reached clinical investigations, and preclinical research programs that have great potential to impact patient care. PMID:25792225

Production Assistance for Cellular Therapies (PACT): four-year experience from the United States National Heart, Lung, and Blood Institute (NHLBI) contract research program in cell and tissue therapies.

PubMed

Reed, William; Noga, Stephen J; Gee, Adrian P; Rooney, Cliona M; Wagner, John E; McCullough, Jeffrey; McKenna, David H; Whiteside, Theresa L; Donnenberg, Albert D; Baker, Acacia K; Lindblad, Robert W; Wagner, Elizabeth L; Mondoro, Traci Heath

2009-04-01

In 2002, the US National Heart, Lung, and Blood Institute (NHLBI) conducted a workshop to determine needs of the cell therapy community. A consensus emerged that improved access to cGMP facilities, regulatory assistance, and training would foster the advancement of cellular therapy. A 2003 NHLBI request for proposals resulted in four contracts being awarded to three cell-manufacturing facilities (Baylor College of Medicine, University of Minnesota, and University of Pittsburgh) and one administrative center (The EMMES Corporation). As a result, Production Assistance for Cellular Therapies (PACT) was formed. As of October 1, 2008, PACT has received 65 preliminary applications of which 45 have been approved for product manufacture. A variety of cell therapies are represented including T-regulatory cells, natural killer cells, adipose-derived stem cells, cardiac progenitor cells for cardiac disease, hematopoietic progenitor cells (HPCs) for central nervous system applications, cytotoxic T lymphocytes, and dendritic cells. A total of 169 products have been administered under 12 applications and 2 reagents were manufactured and delivered. Fourteen peer-reviewed publications and 15 abstracts have resulted from the PACT project to date. A cell therapy textbook is nearly complete. PACT technical projects have addressed assay development, rapid endotoxin testing, shipping of cell products, and CD34+ HPC isolation from low-volume marrow. Educational Web seminars and on-site training through workshops have been conducted. PACT is an active and successful cell therapy manufacturing resource in the United States, addressing research and training while forging relationships among academia, industry, and participating institutions.

The importance of international collaboration for rare diseases research: a European perspective

PubMed Central

Julkowska, D; Austin, C P; Cutillo, C M; Gancberg, D; Hager, C; Halftermeyer, J; Jonker, A H; Lau, L P L; Norstedt, I; Rath, A; Schuster, R; Simelyte, E; van Weely, S

2017-01-01

Over the last two decades, important contributions were made at national, European and international levels to foster collaboration into rare diseases research. The European Union (EU) has put much effort into funding rare diseases research, encouraging national funding organizations to collaborate together in the E-Rare program, setting up European Reference Networks for rare diseases and complex conditions, and initiating the International Rare Diseases Research Consortium (IRDiRC) together with the National Institutes of Health in the USA. Co-ordination of the activities of funding agencies, academic researchers, companies, regulatory bodies, and patient advocacy organizations and partnerships with, for example, the European Research Infrastructures maximizes the collective impact of global investments in rare diseases research. This contributes to accelerating progress, for example, in faster diagnosis through enhanced discovery of causative genes, better understanding of natural history of rare diseases through creation of common registries and databases and boosting of innovative therapeutic approaches. Several examples of funded pre-clinical and clinical gene therapy projects show that integration of multinational and multidisciplinary expertize generates new knowledge and can result in multicentre gene therapy trials. International collaboration in rare diseases research is key to improve the life of people living with a rare disease. PMID:28440796

The importance of international collaboration for rare diseases research: a European perspective.

PubMed

Julkowska, D; Austin, C P; Cutillo, C M; Gancberg, D; Hager, C; Halftermeyer, J; Jonker, A H; Lau, L P L; Norstedt, I; Rath, A; Schuster, R; Simelyte, E; van Weely, S

2017-09-01

Over the last two decades, important contributions were made at national, European and international levels to foster collaboration into rare diseases research. The European Union (EU) has put much effort into funding rare diseases research, encouraging national funding organizations to collaborate together in the E-Rare program, setting up European Reference Networks for rare diseases and complex conditions, and initiating the International Rare Diseases Research Consortium (IRDiRC) together with the National Institutes of Health in the USA. Co-ordination of the activities of funding agencies, academic researchers, companies, regulatory bodies, and patient advocacy organizations and partnerships with, for example, the European Research Infrastructures maximizes the collective impact of global investments in rare diseases research. This contributes to accelerating progress, for example, in faster diagnosis through enhanced discovery of causative genes, better understanding of natural history of rare diseases through creation of common registries and databases and boosting of innovative therapeutic approaches. Several examples of funded pre-clinical and clinical gene therapy projects show that integration of multinational and multidisciplinary expertize generates new knowledge and can result in multicentre gene therapy trials. International collaboration in rare diseases research is key to improve the life of people living with a rare disease.

Reduced stress and improved physical functional ability in elderly with mental health problems following a horticultural therapy program.

PubMed

Han, Ah-Reum; Park, Sin-Ae; Ahn, Byung-Eun

2018-06-01

This study aimed to determine the effects of a plant cultivation-based horticultural therapy program for elderly people with mental health problems. Pre- and post-test design with experimental and control groups. Twenty-eight elderly Korean people with mental health problems participated from April to June 2017 at a farm located in Suwon, South Korea. The participants were randomly assigned to either the control (n = 14) or horticultural therapy group (n = 14); the latter participated in once-weekly sessions of a previously designed 10-session horticultural therapy program. The pre-test occurred 1 week before starting the horticultural therapy program. The post-test was completed within 1 week after finishing the final program session. Cortisol levels were measured in saliva samples collected from both groups. The Senior Fitness Test was used to assess physical functional ability in both groups. In the horticultural therapy group, the cortisol levels decreased significantly from before to after the horticultural therapy program, and the post-test scores for six subtests of the Senior Fitness Test improved significantly. No significant improvements were seen in either measure in the control group. This study demonstrates the potential ability of horticultural therapy to improve the stress levels and physical functional abilities of elderly people with mental health problems. In future studies, it would be interesting to verify the long-term effects of this horticultural therapy program and to compare its effects with regard to sex, age, and various mental symptoms. Copyright © 2018 Elsevier Ltd. All rights reserved.

Empirical application of empathy enhancing program based on movement concept for married couples in conflict

PubMed Central

Kim, Soo-Yeon; Kang, Hye-Won; Chung, Yong-Chul; Park, Seungha

2013-01-01

In the field of marital therapy, it is known that couple movement program helps married couples faced with conflict situation to rebuild the relationship and to maintain a family homeostasis. The purpose of this study was to configure and apply the kinesthetic empathy program and to assess the effectiveness for married couples in conflict. To achieve the research aims, qualitative research method has been conducted, subjecting three couples, 6 people, who are participating in expressive movement program for this study. The study used focus group interview method for collecting date and employed for the interview method by mixing the semi-structured and unstructured questionnaire. The results were followings. First, through kinesthetic empathy enhancing program, one could develop self-awareness and emotional attunement. Second, the result showed the relationship between intention and empathy. It shows that “knowing spouse’s hidden intention” is significant factors to understand others. Third, kinesthetic empathy program could complement general marriage counseling program. The results of this study provide empirical evidence that movement program functions as an empathy enhancer through the process of perceiving, feeling, thinking, and interacting with others. PMID:24278896

Influence of antiretroviral therapy on programmed death-1 (CD279) expression on T cells in lymph nodes of human immunodeficiency virus-infected individuals.

PubMed

Ehrhard, Simone; Wernli, Marion; Dürmüller, Ursula; Battegay, Manuel; Gudat, Fred; Erb, Peter

2009-10-01

Human immunodeficiency virus infection leads to T-cell exhaustion and involution of lymphoid tissue. Recently, the programmed death-1 pathway was found to be crucial for virus-specific T-cell exhaustion during human immunodeficiency virus infection. Programmed death-1 expression was elevated on human immunodeficiency virus-specific peripheral blood CD8+ and CD4+ T cells and correlated with disease severity. During human immunodeficiency infection, lymphoid tissue acts as a major viral reservoir and is an important site for viral replication, but it is also essential for regulatory processes important for immune recovery. We compared programmed death-1 expression in 2 consecutive inguinal lymph nodes of 14 patients, excised before antiretroviral therapy (antiretroviral therapy as of 1997-1999) and 16 to 20 months under antiretroviral therapy. In analogy to lymph nodes of human immunodeficiency virus-negative individuals, in all treated patients, the germinal center area decreased, whereas the number of germinal centers did not significantly change. Programmed death-1 expression was mostly found in germinal centers. The absolute extent of programmed death 1 expression per section was not significantly altered after antiretroviral therapy resulting in a significant-relative increase of programmed death 1 per shrunken germinal center. In colocalization studies, CD45R0+ cells that include helper/inducer T cells strongly expressed programmed death-1 before and during therapy, whereas CD8+ T cells, fewer in numbers, showed a weak expression for programmed death-1. Thus, although antiretroviral therapy seems to reduce the number of programmed death-1-positive CD8+ T lymphocytes within germinal centers, it does not down-regulate programmed death-1 expression on the helper/inducer T-cell subset that may remain exhausted and therefore unable to trigger immune recovery.

Let Me Wipe My Tears So I Can Help with Yours.

ERIC Educational Resources Information Center

Elkinson-Griff, Audrey

1995-01-01

Recounts experiences with art therapy as utilized by the staff of an AIDS and HIV-infection research clinic in Birmingham, Alabama, to deal with their own anxiety and depression about dealing with the disease. The staff art program began due to the efforts of the director's sensitivity to the possibility of burnout among the staff. (JPS)

NRC/AMRMC Resident Research Associateship Program

DTIC Science & Technology

2015-03-01

antimicrobials (and antiseptics) as well as to evaluate the effectiveness of various biofilm dispersal agents utilizing a number of bacterial species as...combat related wounds. 3 Demonstrated the utility of combinations of biofilm dispersal agents and antimicrobials as an alternate therapy for...alone or in combination with antimicrobials ) to reduce infection in contaminated femoral segmental defects. 5 Characterized host responses of

Behavioral Activation Therapy for Depressed Cancer Patients: Factors Associated with Treatment Outcome and Attrition

ERIC Educational Resources Information Center

Hopko, D. R.; Robertson, S. M. C.; Colman, L.

2008-01-01

In recent years there has been increased focus on evaluating the efficacy of psychosocial interventions for cancer patients. Among the several limitations inherent to these programs of research, few studies have targeted patients with well-diagnosed clinical depression and little is known about factors that best predict treatment outcome and…

Connecting to the Good Life through Outdoor Adventure Leadership Experiences Designed for Indigenous Youth

ERIC Educational Resources Information Center

Ritchie, Stephen D.; Wabano, Mary Jo; Corbiere, Rita G.; Restoule, Brenda M.; Russell, Keith C.; Young, Nancy L.

2015-01-01

Indigenous voices are largely silent in the outdoor education and adventure therapy literature. The purpose of this research collaboration was to understand how a 10-day outdoor adventure leadership experience (OALE) may promote resilience and well-being for Indigenous youth through their participation in the program. The process was examined…

Brief Report of Preliminary Outcomes of an Emotion Regulation Intervention for Children with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Thomson, Kendra; Burnham Riosa, Priscilla; Weiss, Jonathan A.

2015-01-01

Children with autism spectrum disorder (ASD) often present with comorbid psychopathology including problems with emotion regulation. The goal of the present research was to investigate the feasibility of a multicomponent manualized cognitive behavior therapy treatment program for improving emotion regulation in youth with ASD 8-12 years of age.…

Effects of Weighted Vests on the Engagement of Children with Developmental Delays and Autism

ERIC Educational Resources Information Center

Reichow, Brian; Barton, Erin E.; Sewell, Joanna Neely; Good, Leslie; Wolery, Mark

2010-01-01

The use of weighted vests for children with autism spectrum disorders and developmental disabilities is a common practice as part of sensory integration therapy programs. The purpose of the current investigation was to extend the research on the use of weighted vests for children with autism and developmental delays in a methodologically rigorous…

An Independent Evaluation of Mode Deactivation Therapy for Juvenile Offenders

ERIC Educational Resources Information Center

Thoder, Vincent J.; Cautilli, Joseph D.

2011-01-01

Juveniles who commit crimes are likely to exhibit conduct problems in their youth. Persistent and long-term antisocial behavior can be seen in very young children. To treat these children, programs must be designed to meet the needs of them on an individualized basis. Residential treatment, typically, is the answer, but research has shown its…

Development and Preliminary Evaluation of a One-Week Summer Treatment Program for Separation Anxiety Disorder

ERIC Educational Resources Information Center

Santucci, Lauren C.; Ehrenreich, Jill T.; Trosper, Sarah E.; Bennett, Shannon M.; Pincus, Donna B.

2009-01-01

Numerous clinical trials have demonstrated the efficacy of cognitive behavior therapy (CBT) for the treatment of childhood Separation Anxiety Disorder (SAD) and other anxiety disorders yet additional research may still be needed to better access and engage anxious youth. In this study, we investigated the acceptability and preliminary utility of a…

Predictors of Treatment Response in Depressed Mothers Receiving In-Home Cognitive-Behavioral Therapy and Concurrent Home Visiting

ERIC Educational Resources Information Center

Ammerman, Robert T.; Peugh, James L.; Putnam, Frank W.; Van Ginkel, Judith B.

2012-01-01

Home visiting is a child abuse prevention strategy that seeks to optimize child development by providing mothers with support, training, and parenting information. Research has consistently found high rates of depression in mothers participating in home visiting programs and low levels of obtaining mental health treatment in the community.…

Effectiveness of cognitive behavioral therapy integrated with systematic desensitization, cognitive behavioral therapy combined with eye movement desensitization and reprocessing therapy, and cognitive behavioral therapy combined with virtual reality exposure therapy methods in the treatment of flight anxiety: a randomized trial.

PubMed

Triscari, Maria Teresa; Faraci, Palmira; Catalisano, Dario; D'Angelo, Valerio; Urso, Viviana

2015-01-01

The purpose of the research was to compare the effectiveness of the following treatment methods for fear of flying: cognitive behavioral therapy (CBT) integrated with systematic desensitization, CBT combined with eye movement desensitization and reprocessing therapy, and CBT combined with virtual reality exposure therapy. Overall, our findings have proven the efficacy of all interventions in reducing fear of flying in a pre- to post-treatment comparison. All groups showed a decrease in flight anxiety, suggesting the efficiency of all three treatments in reducing self-report measures of fear of flying. In particular, our results indicated significant improvements for the treated patients using all the treatment programs, as shown not only by test scores but also by participation in the post-treatment flight. Nevertheless, outcome measures maintained a significant effect at a 1-year follow-up. In conclusion, combining CBT with both the application of eye movement desensitization and reprocessing treatment and the virtual stimuli used to expose patients with aerophobia seemed as efficient as traditional cognitive behavioral treatments integrated with systematic desensitization.

Effectiveness of cognitive behavioral therapy integrated with systematic desensitization, cognitive behavioral therapy combined with eye movement desensitization and reprocessing therapy, and cognitive behavioral therapy combined with virtual reality exposure therapy methods in the treatment of flight anxiety: a randomized trial

PubMed Central

Triscari, Maria Teresa; Faraci, Palmira; Catalisano, Dario; D’Angelo, Valerio; Urso, Viviana

2015-01-01

The purpose of the research was to compare the effectiveness of the following treatment methods for fear of flying: cognitive behavioral therapy (CBT) integrated with systematic desensitization, CBT combined with eye movement desensitization and reprocessing therapy, and CBT combined with virtual reality exposure therapy. Overall, our findings have proven the efficacy of all interventions in reducing fear of flying in a pre- to post-treatment comparison. All groups showed a decrease in flight anxiety, suggesting the efficiency of all three treatments in reducing self-report measures of fear of flying. In particular, our results indicated significant improvements for the treated patients using all the treatment programs, as shown not only by test scores but also by participation in the post-treatment flight. Nevertheless, outcome measures maintained a significant effect at a 1-year follow-up. In conclusion, combining CBT with both the application of eye movement desensitization and reprocessing treatment and the virtual stimuli used to expose patients with aerophobia seemed as efficient as traditional cognitive behavioral treatments integrated with systematic desensitization. PMID:26504391

Management of transfusional iron overload – differential properties and efficacy of iron chelating agents

PubMed Central

Kwiatkowski, Janet L

2011-01-01

Regular red cell transfusion therapy ameliorates disease-related morbidity and can be lifesaving in patients with various hematological disorders. Transfusion therapy, however, causes progressive iron loading, which, if untreated, results in endocrinopathies, cardiac arrhythmias and congestive heart failure, hepatic fibrosis, and premature death. Iron chelation therapy is used to prevent iron loading, remove excess accumulated iron, detoxify iron, and reverse some of the iron-related complications. Three chelators have undergone extensive testing to date: deferoxamine, deferasirox, and deferiprone (although the latter drug is not currently licensed for use in North America where it is available only through compassionate use programs and research protocols). These chelators differ in their modes of administration, pharmacokinetics, efficacy with regard to organ-specific iron removal, and adverse-effect profiles. These differential properties influence acceptability, tolerability and adherence to therapy, and, ultimately, the effectiveness of treatment. Chelation therapy, therefore, must be individualized, taking into account patient preferences, toxicities, ongoing transfusional iron intake, and the degree of cardiac and hepatic iron loading. PMID:22287873

Management of transfusional iron overload - differential properties and efficacy of iron chelating agents.

PubMed

Kwiatkowski, Janet L

2011-01-01

Regular red cell transfusion therapy ameliorates disease-related morbidity and can be lifesaving in patients with various hematological disorders. Transfusion therapy, however, causes progressive iron loading, which, if untreated, results in endocrinopathies, cardiac arrhythmias and congestive heart failure, hepatic fibrosis, and premature death. Iron chelation therapy is used to prevent iron loading, remove excess accumulated iron, detoxify iron, and reverse some of the iron-related complications. Three chelators have undergone extensive testing to date: deferoxamine, deferasirox, and deferiprone (although the latter drug is not currently licensed for use in North America where it is available only through compassionate use programs and research protocols). These chelators differ in their modes of administration, pharmacokinetics, efficacy with regard to organ-specific iron removal, and adverse-effect profiles. These differential properties influence acceptability, tolerability and adherence to therapy, and, ultimately, the effectiveness of treatment. Chelation therapy, therefore, must be individualized, taking into account patient preferences, toxicities, ongoing transfusional iron intake, and the degree of cardiac and hepatic iron loading.

Supporting our military families: a case for a larger role for occupational therapy in prevention and mental health care.

PubMed

Cogan, Alison M

2014-01-01

More than 2 million U.S. military servicemembers have deployed to Afghanistan or Iraq since September 11, 2001. Unlike during prior conflicts, many servicemembers leave spouses and children behind. Long, multiple deployments cause strain on family at home, with new challenges arising when servicemembers return from combat and reintegrate into family and civilian life. In World Wars I and II, occupational therapy practitioners played a significant role in supporting servicemember reintegration. However, their presence in program delivery in this practice area is limited. Occupational therapy researchers and practitioners can make a valuable contribution by helping families tailor daily activities and routines to address challenges and optimize health and wellness. However, barriers such as reimbursement for services, workforce availability, and access to military families have limited the profession's full engagement. Advocacy is needed to help establish occupational therapy as a key component of the mental and preventive health care teams serving military servicemembers. Copyright © 2014 by the American Occupational Therapy Association, Inc.

Mortality reduction in relation to implantable cardioverter defibrillator programming in the Multicenter Automatic Defibrillator Implantation Trial-Reduce Inappropriate Therapy (MADIT-RIT).

PubMed

Ruwald, Anne-Christine; Schuger, Claudio; Moss, Arthur J; Kutyifa, Valentina; Olshansky, Brian; Greenberg, Henry; Cannom, David S; Estes, N A Mark; Ruwald, Martin H; Huang, David T; Klein, Helmut; McNitt, Scott; Beck, Christopher A; Goldstein, Robert; Brown, Mary W; Kautzner, Josef; Shoda, Morio; Wilber, David; Zareba, Wojciech; Daubert, James P

2014-10-01

The benefit of novel implantable cardioverter defibrillator (ICD) programming in reducing inappropriate ICD therapy and mortality was demonstrated in Multicenter Automatic Defibrillator Implantation Trial-Reduce Inappropriate Therapy (MADIT-RIT). However, the cause of mortality reduction remains incompletely evaluated. We aimed to identify factors associated with mortality, with focus on ICD therapy and programming in the MADIT-RIT population. In MADIT-RIT, 1500 patients with a primary prophylactic indication for ICD or cardiac resynchronization therapy with defibrillator were randomized to 1 of 3 different ICD programming arms: conventional programming (ventricular tachycardia zone ≥170 beats per minute), high-rate programming (ventricular tachycardia zone ≥200 beats per minute), and delayed programming (60-second delay before therapy ≥170 beats per minute). Multivariate Cox models were used to assess the influence of time-dependent appropriate and inappropriate ICD therapy (shock and antitachycardia pacing) and randomized programming arm on all-cause mortality. During an average follow-up of 1.4±0.6 years, 71 of 1500 (5%) patients died: cardiac in 40 patients (56.3%), noncardiac in 23 patients (32.4%), and unknown in 8 patients (11.3%). Appropriate shocks (hazard ratio, 6.32; 95% confidence interval, 3.13-12.75; P<0.001) and inappropriate therapy (hazard ratio, 2.61; 95% confidence interval, 1.28-5.31; P=0.01) were significantly associated with an increased mortality risk. There was no evidence of increased mortality risk in patients who experienced appropriate antitachycardia pacing only (hazard ratio, 1.02; 95% confidence interval, 0.36-2.88; P=0.98). Randomization to conventional programming was identified as an independent predictor of death when compared with patients randomized to high-rate programming (hazard ratio, 2.0; 95% confidence interval, 1.06-3.71; P=0.03). In MADIT-RIT, appropriate shocks, inappropriate ICD therapy, and randomization to conventional ICD programming were independently associated with an increased mortality risk. Appropriate antitachycardia pacing was not related to an adverse outcome. clinicaltrials.gov Unique identifier: NCT00947310. © 2014 American Heart Association, Inc.

Brief Strategic Family Therapy: twenty-five years of interplay among theory, research and practice in adolescent behavior problems and drug abuse.

PubMed

Szapocznik, J; Williams, R A

2000-06-01

This article describes a systematic program of research that focuses on Brief Strategic Family Therapy (BSFT) and the adaptations that were developed based on BSFT principles. The culture-specific origins of BSFT are reviewed, as well as its broader applications to the field of family therapy. Research is reviewed demonstrating that BSFT is a promising family-based approach to treating Hispanic youth behavior problems and drug abuse. Treatment innovations are described that address the combination of intergenerational and cultural differences that occur among youths and their Hispanic parents. Programmatic work is described that challenges basic principles of family therapy by expanding BSFT to a One Person modality and a strategic engagement procedure. Both of these novel approaches are intended to add tools to therapists' repertoire in working with difficult-to-engage families. A preview discussion of results is presented from a randomized clinical trial that is an application of an ecosystemic prevention version of BSFT. The implications of the work of the Center for Family Studies are discussed in the context of the broader service system. Ultimately, this article articulates a way of thinking about adolescent problem behavior, its social interactional determinants, and a range of theoretically consistent family-centered strategies that attempt to change social ecological processes that impact adolescent developmental trajectories.

The changing motivation of massage therapy students.

PubMed

Finch, P

2007-05-01

The study was conducted in order to determine whether the level of motivation related to intrinsic (people-oriented) and extrinsic (external reward) value complexes in a class of massage therapy students changed during their professional education. The research was a quasi-experimental within-subject design, in which survey data was collected from students on their first day in the massage therapy program and again towards the end of their final term. The data were collated and summarized, and the differences in motivation scores were assessed using Fisher's Least Significant Difference procedure. The results support the hypothesis that massage therapy students are motivated more strongly by intrinsic than extrinsic rewards both at the commencement of their studies and as they approach entry to practice. Also evident from the data is the fact that the students' motivation changed during their professional studies. This change involved a significant decrease in the level of intrinsic motivation and significant increase in the level of extrinsic motivation. Thus, although intrinsic motivation reduced while extrinsic motivation increased, the former remained the more powerful influence. Professional programs should consider the balance between intrinsic and extrinsic student motivation and attempt to control influences that might shift this such that the humanistic / altruistic mission of health care is undermined.

Combination therapy with PD-1/PD-L1 blockade: An overview of ongoing clinical trials.

PubMed

Johnson, C Bryce; Win, Shwe Y

2018-01-01

Monoclonal antibodies (mAbs) that block the programmed death 1 (PD-1) or programmed death-ligand 1 (PD-L1) receptors are the most clinically advanced tumor immunotherapies. Given the broad antitumor efficacy and novel mechanism of action, numerous combinatorial approaches incorporating PD-1/PD-L1 blockade have been suggested; herein we present a comprehensive analysis of these clinical trials. We queried clinicaltrials.gov for all PD-1/PD-L1 mAbs administered for cancer therapy with an end date of 4/30/2017. A total of 1,218 clinical trials met our search criteria. These trials have a planned enrollment of 227,190 patients, and approximately half (493) were initiated in 2016 alone. Of these over 1,200 trials, 916 combine PD-1/PD-L1 blockade with at least one additional therapy, ranging from traditional treatment modalities like surgery and chemoradiation to newer therapies like small molecule inhibitors and other immunotherapies. The staggering proliferation of clinical trials combining PD-1/PD-L1 blockade with disparate treatments necessitates careful accounting to maximize efficiency and highlight areas of unmet needs. We believe our analysis provides this data and expect it will facilitate the design of future clinical trials in this burgeoning area of oncology research.

Effectiveness of progressive muscle relaxation therapy as a worksite health promotion program in the automobile assembly line

PubMed Central

SUNDRAM, Bala Murali; DAHLUI, Maznah; CHINNA, Karuthan

2015-01-01

The aim of this study was to examine the effectiveness of Progressive Muscle Relaxation (PMR) as part of a Worksite Health Promotion Program on self-perceived stress, anxiety and depression among male automotive assembly-line workers through a quasi-experimental trial. Two assembly plants were chosen with one receiving PMR therapy and the other Pamphlets. Intention-to-treat analysis was conducted to test the effectiveness of the relaxation therapy. Stress, Depression and Anxiety levels were measured using the shortened DASS-21 questionnaire. Data were analyzed using Chi-square, Independent sample t test and Repeated-measures analysis of variance to test the significance of the effects of intervention (time * group) for the measures of Stress, Depression and Anxiety. Significant favourable intervention effects on stress were found in the PMR group (Effect size=0.6) as compared to the Pamphlet group (Effect size=0.2). There was a significant group *time interaction effect (p<0.001) on Stress levels. Depression and Anxiety levels were minimal at baseline in both the groups with mild or no reduction in levels. The improvement in stress levels showed the potential of PMR therapy as a coping strategy at the workplace. Further research in this field is necessary to examine the beneficial effects of coping strategies in the workplace. PMID:26726829

Cognitive behavioral therapy for compulsive buying behavior: Predictors of treatment outcome.

PubMed

Granero, R; Fernández-Aranda, F; Mestre-Bach, G; Steward, T; Baño, M; Agüera, Z; Mallorquí-Bagué, N; Aymamí, N; Gómez-Peña, M; Sancho, M; Sánchez, I; Menchón, J M; Martín-Romera, V; Jiménez-Murcia, S

2017-01-01

Compulsive buying behavior (CBB) is receiving increasing consideration in both consumer and psychiatric-epidemiological research, yet empirical evidence on treatment interventions is scarce and mostly from small homogeneous clinical samples. To estimate the short-term effectiveness of a standardized, individual cognitive behavioral therapy intervention (CBT) in a sample of n=97 treatment-seeking patients diagnosed with CBB, and to identify the most relevant predictors of therapy outcome. The intervention consisted of 12 individual CBT weekly sessions, lasting approximately 45minutes each. Data on patients' personality traits, psychopathology, sociodemographic factors, and compulsive buying behavior were used in our analysis. The risk (cumulative incidence) of poor adherence to the CBT program was 27.8%. The presence of relapses during the CBT program was 47.4% and the dropout rate was 46.4%. Significant predictors of poor therapy adherence were being male, high levels of depression and obsessive-compulsive symptoms, low anxiety levels, high persistence, high harm avoidance and low self-transcendence. Cognitive behavioral models show promise in treating CBB, however future interventions for CBB should be designed via a multidimensional approach in which patients' sex, comorbid symptom levels and the personality-trait profiles play a central role. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Effectiveness of progressive muscle relaxation therapy as a worksite health promotion program in the automobile assembly line.

PubMed

Sundram, Bala Murali; Dahlui, Maznah; Chinna, Karuthan

2016-06-10

The aim of this study was to examine the effectiveness of Progressive Muscle Relaxation (PMR) as part of a Worksite Health Promotion Program on self-perceived stress, anxiety and depression among male automotive assembly-line workers through a quasi-experimental trial. Two assembly plants were chosen with one receiving PMR therapy and the other Pamphlets. Intention-to-treat analysis was conducted to test the effectiveness of the relaxation therapy. Stress, Depression and Anxiety levels were measured using the shortened DASS-21 questionnaire. Data were analyzed using Chi-square, Independent sample t test and Repeated-measures analysis of variance to test the significance of the effects of intervention (time * group) for the measures of Stress, Depression and Anxiety. Significant favourable intervention effects on stress were found in the PMR group (Effect size=0.6) as compared to the Pamphlet group (Effect size=0.2). There was a significant group *time interaction effect (p<0.001) on Stress levels. Depression and Anxiety levels were minimal at baseline in both the groups with mild or no reduction in levels. The improvement in stress levels showed the potential of PMR therapy as a coping strategy at the workplace. Further research in this field is necessary to examine the beneficial effects of coping strategies in the workplace.

Approaches to the study of gender in marriage and family therapy curricula.

PubMed

Filkowski, M B; Storm, C L; York, C D; Brandon, A D

2001-01-01

This study compares two accredited marriage and family therapy programs: One includes a separate course on gender, and the other integrates gender throughout the curriculum. Students from the two programs rated their own and their peers' experience of how gender education effects therapy, program culture, and personal life. Results indicate that students from the integrated program view their peers as incorporating gender ideas in therapy to a significantly greater extent (t = 2.83, p < .05) than do students in the gender course program. However, students from the program that has a gender course leaned more toward agreement with feminist concepts than did students from the integrated program. Overall, students appear to be learning about gender and integrating these concepts into their work as therapists. Discussion is included on how to choose a gender curriculum.

Applying Principles from Complex Systems to Studying the Efficacy of CAM Therapies

PubMed Central

Nahin, Richard L.; Calabrese, Carlo; Folkman, Susan; Kimbrough, Elizabeth; Shoham, Jacob; Haramati, Aviad

2010-01-01

Abstract In October 2007, a National Center for Complementary and Alternative Medicine (NCCAM)–sponsored workshop, entitled “Applying Principles from Complex Systems to Studying the Efficacy of CAM Therapies,” was held at Georgetown University in Washington, DC. Over a 2-day period, the workshop engaged a small group of experts from the fields of complementary and alternative medicine (CAM) research and complexity science to discuss and examine ways in which complexity science can be applied to CAM research. After didactic presentations and small-group discussions, a number of salient themes and ideas emerged. This paper article describes the workshop program and summarizes these emergent ideas, which are divided into five broad categories: (1) introduction to complexity; (2) challenges to CAM research; (3) applications of complexity science to CAM; (4) CAM as a model of complexity applied to medicine; and (5) future directions. This discusses possible benefits and challenges associated with applying complexity science to CAM research. By providing an introductory framework for this collaboration and exchange, it is hoped that this article may stimulate further inquiry into this largely unexplored area of research. PMID:20715978

Effects of Evidence-Based Fall Reduction Programing on the Functional Wellness of Older Adults in a Senior Living Community: A Clinical Case Study.

PubMed

Harnish, Andrew; Dieter, William; Crawford, Albert; Shubert, Tiffany E

2016-01-01

Older adults at a high risk of falls may be referred to a physical therapist. A physical therapy episode of care is designed for the transition of an older adult from a high fall risk to a moderate to low fall risk. However, these episodes of care are limited in time and duration. There is compelling evidence for the efficacy of group-based exercise classes to address risk, and transitioning an older adult from physical therapy to a group-based program may be an effective way to manage risk through the continuum of care. The purpose of this study was to translate research findings into a "real world" setting, and demonstrate the efficacy of integrating evidence-based fall prevention exercises into pre-existing exercise classes at a senior living facility as a "proof of concept" model for future programing. Twenty-four participants aged 65 years and older living in a senior living community and the community were stratified into group-based exercise classes. Cutoff scores from functional outcome measures were used to stratify participants. Exercises from The Otago Exercise Program were implemented into the classes. Functional outcome measures collected included the 10-Meter Walk Test, 30-Second Sit to Stand, and Timed Up and Go (TUG). Number of falls, hospitalizations, and physical therapy episodes of care were also tracked. Data were compared to a control group in a different senior living community that offered classes with similar exercises aimed at improving strength and mobility. The classes were taught by an exercise physiologist and were of equal duration and frequency. Participants demonstrated significant improvements in all functional outcome measures. TUG mean improved from 13.5 to 10.4 s ( p  = 0.034). The 30-Second Sit to Stand mean improved from 10.5 to 13.4 ( p  = 0.002). The 10-Meter Walk Test improved from 0.81 to 0.98 m/s ( p  < 0.0001). Participants did not experience any falls or hospitalizations, and two participants required physical therapy episodes of care. Implementing an evidence-based fall reduction program into a senior living program has a positive effect on strength, balance, fall risk, gait speed, fall rate, hospitalizations, and amount of physical therapy intervention.

Approaches to the Study of Gender in Marriage and Family Therapy Curricula.

ERIC Educational Resources Information Center

Brown-Filkowski, Melissa; Storm, Cheryl L.; York, Charles D.; Brandon, Antonius D.

2001-01-01

Compares two accredited marriage and family therapy programs: one includes a separate course on gender, and the other integrates gender through the curriculum. Results indicate that students from the integrated program view their peers as incorporating gender ideas in therapy to a significantly greater extent. Students from the program that has a…

Strategies For Clinical Implementation: Precision Oncology At Three Distinct Institutions.

PubMed

Nadauld, Lincoln D; Ford, James M; Pritchard, Daryl; Brown, Thomas

2018-05-01

Despite rapid advances in molecular diagnostics and targeted therapeutics, the adoption of precision medicine into clinical oncology workflows has been slow. Questions about clinical utility, inconsistent reimbursement for molecular diagnostics, and limited access to targeted therapies are some of the major hurdles that have hampered clinical adoption. Despite these challenges, providers have invested in precision medicine programs in an ongoing search for innovative care models to deliver improved patient outcomes and achieve economic gains. We describe the precision oncology medicine programs implemented by an integrated delivery system, a community care center, and an academic medical center, to demonstrate the approaches and challenges associated with clinical implementation efforts designed to advance this treatment paradigm. Payer policies that include coverage for broad genomic testing panels would support the broader application of precision medicine, deepen research benefits, and bring targeted therapies to more patients with advanced cancer.

Strengthening Healthcare Capacity Through a Responsive, Country-Specific, Training Standard: The KITSO AIDS Training Program’s Sup-port of Botswana’s National Antiretroviral Therapy Rollout

PubMed Central

Bussmann, Christine; Rotz, Philip; Ndwapi, Ndwapi; Baxter, Daniel; Bussmann, Hermann; Wester, C. William; Ncube, Patricia; Avalos, Ava; Mine, Madisa; Mabe, Elang; Burns, Patricia; Cardiello, Peter; Makhema, Joseph; Marlink, Richard

2008-01-01

In parallel with the rollout of Botswana’s national antiretroviral therapy (ART) program, the Botswana Ministry of Health established the KITSO AIDS Training Program by entering into long-term partnerships with the Botswana–Harvard AIDS Institute Partnership for HIV Research and Education and others to provide standardized, country-specific training in HIV/AIDS care. The KITSO training model has strengthened human capacity within Botswana’s health sector and been indispensable to successful ART rollout. Through core and advanced training courses and clinical mentoring, different cadres of health care workers have been trained to provide high-quality HIV/AIDS care at all ART sites in the country. Continuous and standardized clinical education will be crucial to sustain the present level of care and successfully address future treatment challenges. PMID:18923699

Implementation fidelity of Multidimensional Family Therapy in an international trial.

PubMed

Rowe, Cynthia; Rigter, Henk; Henderson, Craig; Gantner, Andreas; Mos, Kees; Nielsen, Philip; Phan, Olivier

2013-04-01

Implementation fidelity, a critical aspect of clinical trials research that establishes adequate delivery of the treatment as prescribed in treatment manuals and protocols, is also essential to the successful implementation of effective programs into new practice settings. Although infrequently studied in the drug abuse field, stronger implementation fidelity has been linked to better outcomes in practice but appears to be more difficult to achieve with greater distance from model developers. In the INternational CAnnabis Need for Treatment (INCANT) multi-national randomized clinical trial, investigators tested the effectiveness of Multidimensional Family Therapy (MDFT) in comparison to individual psychotherapy (IP) in Brussels, Berlin, Paris, The Hague, and Geneva with 450 adolescents with a cannabis use disorder and their parents. This study reports on the implementation fidelity of MDFT across these five Western European sites in terms of treatment adherence, dose and program differentiation, and discusses possible implications for international implementation efforts. Copyright © 2013 Elsevier Inc. All rights reserved.

National Institute on Drug Abuse International Program: improving opioid use disorder treatment through international research training.

PubMed

Gust, Steven W; McCormally, Judy

2018-07-01

For more than 25 years, the National Institute on Drug Abuse (NIDA) has supported research-training programs, establishing a global research network and expanding the knowledge base on substance use disorders. International research to inform approaches to opioid addiction is particularly important and relevant to the United States, where opioid misuse, addiction, and overdose constitute an emerging public health crisis. This article summarizes the NIDA International Program and illustrates its impact by reviewing recent articles about treatment approaches for opioid use disorders (OUD). Studies in several countries have demonstrated the effectiveness of physician office-based opioid substitution therapies. Other research has demonstrated the effectiveness of different formulations and doses of the opioid antagonist naltrexone, as well as different approaches to providing naloxone to treat opioid overdose. Continuing research into implementation of evidence-based treatment in international settings with limited resources is applicable to US regions that face similar structural, legal, and fiscal constraints. The current review describes international research on OUD treatment and opioid overdose, most coauthored by former NIDA fellows. The findings from outside the United States have important implications for best practices domestically and in other countries that are experiencing increases in OUD prevalence and related overdose deaths.

STEERing an IDeA in Undergraduate Research at a Rural Research Intensive University

PubMed Central

Sens, Donald A.; Cisek, Karen L.; Garrett, Scott H.; Somji, Seema; Dunlevy, Jane R.; Sens, Mary Ann; Conway, Pat; Doze, Van A.

2017-01-01

This study documents outcomes, including student career choices, of the North Dakota Institutional Development Award Networks of Biomedical Research Excellence program that provides 10-week, summer undergraduate research experiences at the University of North Dakota School of Medicine and Health Sciences. Program evaluation initiated in 2008 and, to date, 335 students have completed the program. Of the 335, 214 students have successfully completed their bachelor’s degree, 102 are still undergraduates, and 19 either did not complete a bachelor’s degree or were lost to follow-up. The program was able to track 200 of the 214 students for education and career choices following graduation. Of these 200, 76% continued in postgraduate health-related education; 34.0% and 20.5% are enrolled in or have completed MD or PhD programs, respectively. Other postbaccalaureate pursuits included careers in pharmacy, optometry, dentistry, public health, physical therapy, nurse practitioner, and physician’s assistant, accounting for an additional 21.5%. Most students electing to stop formal education at the bachelor’s degree also entered fields related to health care or science, technology, engineering, and mathematics (19.5%), with only a small number of the 200 students tracked going into service or industries which lacked an association with the health-care workforce (4.5%). These student outcomes support the concept that participation in summer undergraduate research boosts efforts to populate the pipeline of future researchers and health professionals. It is also an indication that future researchers and health professionals will be able to communicate the value of research in their professional and social associations. The report also discusses best practices and issues in summer undergraduate research for students originating from rural environments. PMID:29057317

STEERing an IDeA in Undergraduate Research at a Rural Research Intensive University.

PubMed

Sens, Donald A; Cisek, Karen L; Garrett, Scott H; Somji, Seema; Dunlevy, Jane R; Sens, Mary Ann; Conway, Pat; Doze, Van A

2017-01-01

This study documents outcomes, including student career choices, of the North Dakota Institutional Development Award Networks of Biomedical Research Excellence program that provides 10-week, summer undergraduate research experiences at the University of North Dakota School of Medicine and Health Sciences. Program evaluation initiated in 2008 and, to date, 335 students have completed the program. Of the 335, 214 students have successfully completed their bachelor's degree, 102 are still undergraduates, and 19 either did not complete a bachelor's degree or were lost to follow-up. The program was able to track 200 of the 214 students for education and career choices following graduation. Of these 200, 76% continued in postgraduate health-related education; 34.0% and 20.5% are enrolled in or have completed MD or PhD programs, respectively. Other postbaccalaureate pursuits included careers in pharmacy, optometry, dentistry, public health, physical therapy, nurse practitioner, and physician's assistant, accounting for an additional 21.5%. Most students electing to stop formal education at the bachelor's degree also entered fields related to health care or science, technology, engineering, and mathematics (19.5%), with only a small number of the 200 students tracked going into service or industries which lacked an association with the health-care workforce (4.5%). These student outcomes support the concept that participation in summer undergraduate research boosts efforts to populate the pipeline of future researchers and health professionals. It is also an indication that future researchers and health professionals will be able to communicate the value of research in their professional and social associations. The report also discusses best practices and issues in summer undergraduate research for students originating from rural environments.

Effects of a live educational music therapy intervention on acute psychiatric inpatients' perceived social support and trust in the therapist: a four-group randomized effectiveness study.

PubMed

Silverman, Michael J

2014-01-01

Social support is associated with enhanced illness management and recovery in persons with mental illness, making it an important topic addressed through acute inpatient psychoeducational programs. In addition, trust in the therapist may mediate clinical outcomes in this patient population. To date, few studies have examined the effect of music-based psychoeducational programs on these variables. The purpose of this study was to isolate and examine the component parts of a live educational music therapy intervention, and its effect on acute psychiatric inpatients' perceived social support from significant others, family, and friends and trust in the therapist. This study also explored whether trust in therapist varied across conditions, but did not examine it as a mediator for social support. Participants (N = 96) were cluster-randomized in a single-session posttest-only design to one of four conditions: live educational music therapy, recorded educational music therapy, education without music, or recreational music therapy without education. Conditions were designed to isolate the following intervention components: live vs. recorded music, educational vs. non-educational content, and music vs. nonmusic modality. Dependent measures were assessed post intervention via established self-report instruments evaluating perceived social support and trust in the therapist. There were no significant between-group differences for social support or trust in therapist total scores. However, subscale score analyses revealed two significant between-group differences: (a) participants in the Live Educational Music Therapy condition reported significantly higher perceived therapist competence compared with the Recorded Educational Music Therapy condition; (b) participants in the Live Educational Music Therapy condition reported significantly higher perceived support from friends compared with the Recreational Music Therapy condition. Live educational music therapy may be a way to heighten psychiatric inpatients' perceived social support concerning friends and perceptions of the therapist's competence. The current results demonstrated differences between live and recorded music therapy in psychiatric music therapy and provide empirical support for competent musicianship. Implications for clinical practice, limitations, and suggestions for future research are included. © the American Music Therapy Association 2014. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

[E-health within the Dutch mental health services: what is the current situation?].

PubMed

Smeets, Odile; Martin Abello, Katherina; Zijlstra-Vlasveld, Moniek; Boon, Brigitte

2014-01-01

The 'e-mental health' currently available, which also covers m-health and i-health, varies from psycho-education and self-tests to self-help, treatment and contact with fellow sufferers. Many programs are based on cognitive behavioural therapy, but other types of therapy are also used. Research shows that online programs for depression, alcohol problems and anxiety can reduce these symptoms and can be cost effective. This applies to both self-help and treatment programs. Many e-programs in the Netherlands have been developed for the Dutch Association of Mental Health and Addiction Care (GGZ) and for treatment of addiction problems. One problem with e-mental-health is that provision is fragmented, and there is no national overview, while insight into quality is important for patients and professionals. The quality hallmark 'Onlinehulpstempel.nl' ('Online help hallmark') provides this insight. The use of e-mental-health within Dutch healthcare services is still in its infancy. New financing methods are stimulating general practitioners to use it. The consolidation of online and face-to-face care ('blended e-health') provides an opportunity for patients and GGZ support personnel within general practice to start to use e-health.

Interventions for treating obesity in children.

PubMed

Summerbell, C D; Ashton, V; Campbell, K J; Edmunds, L; Kelly, S; Waters, E

2003-01-01

The prevalence of overweight and obesity is increasing in child populations throughout the world. Obesity in children has significant short and long term health consequences. To assess the effects of a range of lifestyle interventions designed to treat obesity in childhood. We searched CCTR, MEDLINE, EMBASE, CINAHL, PsychLIT, Science Citation Index, Social Science Citation Index. Each database was searched from 1985 to July 2001. We also contacted experts in child obesity treatment. We selected randomised controlled trials of lifestyle interventions for treating obesity in children with a minimum of six months duration. Examples of lifestyle interventions include dietary, physical activity and/or behavioural therapy interventions, with or without the support of associated family members. Interventions from any setting and delivered by any professional were considered. However, interventions that specifically dealt with the treatment of eating disorders were excluded. Two of our research team independently assessed trial quality and extracted data. Authors of the included studies were contacted for additional information where this was appropriate. We included 18 randomised controlled trials with 975 participants. Many studies were run from a specialist obesity clinic within a hospital setting. Five studies (n=245 participants) investigated changes in physical activity and sedentary behaviour. Two studies (n=107 participants) compared problem-solving with usual care or behavioural therapy. Nine studies (n=399 participants) compared behavioural therapy at varying degrees of family involvement with no treatment or usual care or mastery criteria and contingent reinforcement. Two studies (n=224 participants) compared cognitive behavioural therapy with relaxation.Most of the studies included in this review were too small to have the power to detect the effects of the treatment. We did not conduct a meta-analysis since so few of the trials included the same comparisons and outcomes. Therefore, we synthesised the results in a narrative format. Although 18 research studies were found, most of these were very small studies drawn from homogenous, motivated groups in hospital settings and so generalisable evidence from them is limited. In conclusion, there is a limited amount of quality data on the components of programs to treat childhood obesity that favour one program over another. Further research that considers psychosocial determinants for behaviour change, strategies to improve clinician-family interaction, and cost-effective programs for primary and community care is required. We conclude that no direct conclusions can be drawn from this review with confidence.

WE-B-BRD-00: MRI for Radiation Oncology

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

The use of MRI in radiation therapy is rapidly increasing. Applications vary from the MRI simulator, to the MRI fused with CT, and to the integrated MRI+RT system. Compared with the standard MRI QA, a broader scope of QA features has to be defined in order to maximize the benefits of using MRI in radiation therapy. These QA features include geometric fidelity, image registration, motion management, cross-system alignment, and hardware interference. Advanced MRI techniques require a specific type of QA, as they are being widely used in radiation therapy planning, dose calculations, post-implant dosimetry, and prognoses. A vigorous and adaptivemore » QA program is crucial to defining the responsibility of the entire radiation therapy group and detecting deviations from the performance of high-quality treatment. As a drastic departure from CT simulation, MRI simulation requires changes in the work flow of treatment planning and image guidance. MRI guided radiotherapy platforms are being developed and commercialized to take the advantage of the advance in knowledge, technology and clinical experience. This symposium will from an educational perspective discuss the scope and specific issues related to MRI guided radiotherapy. Learning Objectives: Understand the difference between a standard and a radiotherapy-specific MRI QA program. Understand the effects of MRI artifacts (geometric distortion and motion) on radiotherapy. Understand advanced MRI techniques (ultrashort echo, fast MRI including dynamic MRI and 4DMRI, diffusion, perfusion, and MRS) and related QA. Understand the methods to prepare MRI for treatment planning (electron density assignment, multimodality image registration, segmentation and motion management). Current status of MRI guided treatment platforms. Dr. Jihong Wang has a research grant with Elekta-MRL project. Dr. Ke Sheng receives research grants from Varian Medical systems.« less

Dance program for physical rehabilitation and participation in children with cerebral palsy.

PubMed

López-Ortiz, Citlali; Gladden, Kim; Deon, Laura; Schmidt, Jennifer; Girolami, Gay; Gaebler-Spira, Deborah

2012-02-01

Objective : This pilot study aimed to examine a classical ballet program created for children with cerebral palsy (CP) as an emerging physical rehabilitation modality. The main program goals were to promote participation and to provide an artistic, physically therapeutic activity. Methods : The study was conducted in collaboration with a tertiary rehabilitation hospital, one outpatient physical therapy clinic, and one community center. As a pilot exploratory study, the research design included questionnaires to assess the participants' (children ( n  = 16), parents ( n  = 16), and therapists ( n  = 13)) perceptions on the therapeutic benefit of the dance program. A binomial statistical model was adopted for the analysis of the results. Results : Main results were that the children reported high enjoyment level ( p  < .0001) and desire for more classes (.0001); the parents reported perceived therapeutic benefit ( p  < .0001); and the therapists viewed the class as a positive adjunct to therapy ( p  < .0001). Conclusions : The main limitation of this work was the utilization of subjective outcome measures. However, this is the first step toward the development of objective measures of an intervention that, to our knowledge, has not been analyzed in the past. We conclude that the program has the potential of developing into an evidence based rehabilitation resource for children with CP.

[SOPHO-NET - a research network on psychotherapy for social phobia].

PubMed

Leichsenring, Falk; Salzer, Simone; Beutel, Manfred E; von Consbruch, Katrin; Herpertz, Stephan; Hiller, Wolfgang; Hoyer, Jürgen; Hüsing, Johannes; Irle, Eva; Joraschky, Peter; Konnopka, Alexander; König, Hans-Helmut; de Liz, Therese; Nolting, Björn; Pöhlmann, Karin; Ruhleder, Mirjana; Schauenburg, Henning; Stangier, Ulrich; Strauss, Bernhard; Subic-Wrana, Claudia; Vormfelde, Stefan V; Weniger, Godehard; Willutzki, Ulrike; Wiltink, Jörg; Leibing, Eric

2009-01-01

This paper presents the Social Phobia Psychotherapy Research Network (SOPHO-NET). SOPHO-NET is among the five research networks on psychotherapy funded by "Bundesministerium für Bildung und Forschung". The research program encompasses a coordinated group of studies of social phobia. In the central project (Study A), a multi-center randomized controlled trial, refined models of manualized cognitive-behavioral therapy (CBT) and manualized short-term psychodynamic psychotherapy (STPP) are compared in the treatment of social phobia. A sample of n=512 outpatients will be randomized to either CBT, STPP or wait list. For quality assurance and treatment integrity, a specific project has been established (Project Q). Study A is complemented by four interrelated projects focusing on attachment style (Study B1), cost-effectiveness (Study B2), polymorphisms in the serotonin transporter gene (Study C1) and on structural and functional deviations of hippocampus and amygdala (Study C2). Thus, the SOPHO-NET program allows for a highly interdisciplinary research of psychotherapy in social phobia.

INEL BNCT Research Program, March/April 1992

DOE Office of Scientific and Technical Information (OSTI.GOV)

Venhuizen, J.R.

1992-09-01

This report presents summaries for two months of current research for the Idaho National Engineering Laboratory (INEL) Boron Neutron Capture Therapy (BNCT) Program. Information is presented on development and murino screening experiments of low-density lipoprotein, carboranyl alanine, and liposome boron containing compounds. Pituitary tumor call culture studies are described. Drug stability, pharmacology and toxicity evaluation of borocaptate sodium (BSH) and boronopheoylalanine (BPA) are described. Treatment protocol development via the large animal (canine) model studies and physiological response evaluation in rats are discussed. Supporting technology development and technical support activities for boron drug biochemistry and purity, analytical and measurement dosimetry, andmore » noninvasive boron quantification activities are included for the current time period. Current publications for the two months are listed.« less

Treatment Programs in the National Drug Abuse Treatment Clinical Trials Network

PubMed Central

McCarty, Dennis; Fuller, Bret; Kaskutas, Lee Ann; Wendt, William W.; Nunes, Edward V.; Miller, Michael; Forman, Robert; Magruder, Kathryn M.; Arfken, Cynthia; Copersino, Marc; Floyd, Anthony; Sindelar, Jody; Edmundson, Eldon

2008-01-01

Drug abuse treatment programs and university-based research centers collaborate to test emerging therapies for alcohol and drug disorders in the National Drug Abuse Treatment Clinical Trials Network (CTN). Programs participating in the CTN completed organizational (n = 106 of 112; 95% response rate) and treatment unit surveys (n = 348 of 384; 91% response rate) to describe the levels of care, ancillary services, patient demographics, patient drug use and co-occurring conditions. Analyses describe the corporations participating in the CTN and provide an exploratory assessment of variation in treatment philosophies. A diversity of treatment centers participate in the CTN; not for profit organizations with a primary mission of treating alcohol and drug disorders dominate. Compared to N-SSATS (National Survey of Substance Abuse Treatment Services), programs located in medical settings are over-represented and centers that are mental health clinics are under-represented. Outpatient, methadone, long-term residential and inpatient treatment units differed on patients served and services proved. Larger programs with higher counselor caseloads in residential settings reported more social model characteristics. Programs with higher social model scores were more likely to offer self-help meetings, vocational services and specialized services for women. Conversely, programs with accreditation had less social model influence. The CTN is an ambitious effort to engage community-based treatment organizations into research and more fully integrate research and practice. PMID:17875368

Perceived Needs for Support Program for Family With Child Sexual Abuse Victim in South Korea: Focus Group Interview With Therapists and Mothers.

PubMed

Han, Suejung; Kim, Jinsook

2016-10-01

This study assessed perceived needs for psychological support program for family with victim of child sexual abuse in South Korea. We conducted two separate focus group interviews with five therapists who served child sexual abuse victims and families as well as four mothers of a child sexual abuse victim. Consensual qualitative research analysis revealed four domains: Emotional support for parents, psychoeducation, family therapy, and tailored and flexible service delivery. Core ideas of the four domains were identified. The results were consistent with the family support program contents developed in Western countries and suggested culture-specific contents and culturally sensitive service delivery. Clinical implications for developing family support program in South Korea were discussed.

German national femtosecond technology project (FST)

NASA Astrophysics Data System (ADS)

Dausinger, Friedrich

2002-06-01

The German federal government started the funding of a national project intended to exploit the potential of femtosecond technology. In a forgoing competition five research consortia had been successful and have started now together with an adjoin research consortium their investigations in the following fields: (i) micro-machining of technical materials for microstructuring and drilling, (ii) medical therapy in: ophthalmology, dentistry, neurology and ear surgery, (iii) metrology, (iv) laser safety, (v) x- ray generation. Lasers, systems and technologies required in these potential fields of applications will be investigated. The program aims at industrial success and is dominated by industrial partners, therefore. The more fundamental research is done in university institutes and research centers.

An analysis of music therapy program goals and outcomes for clients with diagnoses on the autism spectrum.

PubMed

Kaplan, Ronna S; Steele, Anita Louise

2005-01-01

The researchers analyzed data related to goals and outcomes over 2 program years for 40 music therapy clients, ranging in age from 2-49 years, with diagnoses on the autism spectrum. They investigated music therapy interventions, session types, and formats most frequently used; goals most frequently addressed; assessed level of difficulty of clients and their situations; and generalization of skills attained in music therapy to other settings. The most common session type was individual, followed by partner, small or large groups, peer model, or a combination. Primary goal areas were ranked from language/communication (41%), behavioral/psychosocial (39%), cognitive (8%), and musical (7%), to perceptual/motor (5%). One hundred percent of subjects reached their initial objectives in these goal areas within one year or less, regardless of session type, level of difficulty, or goal area. Seventy-seven percent of intermediate objectives were reached within that time. The most frequently utilized interventions were interactive instrument playing, musical instrument instruction, interactive singing, instrument choices, and song choices. Specific interventions chosen did not affect accomplishment of initial objectives. However, there was more variation among interventions in terms of achievement of intermediate objectives. Session formats were ranked from activity-based as most frequent to lesson-based, client-led/"shadow," and ensemble format. All formats were successful when addressing initial objectives, with lesson-based format being most effective in reaching intermediate objectives. Lastly, 100% of parents and caregivers surveyed indicated subjects generalized skills/responses acquired in music therapy to non-music therapy environments.

Creative Art Therapy Groups: A Treatment Modality for Psychiatric Outpatients

ERIC Educational Resources Information Center

Drapeau, Marie-Celine; Kronish, Neomi

2007-01-01

This brief report examines the benefits of a creative art therapy group program for outpatients suffering from psychiatric disorders. Included is a review of relevant treatment outcomes literature on the effectiveness of group art therapy. The authors describe the Creative Art Therapy Group Program offered to adult psychiatric outpatients that is…

Stem cell hype: media portrayal of therapy translation.

PubMed

Kamenova, Kalina; Caulfield, Timothy

2015-03-11

In this Perspective, we examine the portrayal of translational stem cell research in major daily newspapers in Canada, the United States, and the United Kingdom between 2010 and 2013, focusing on how timelines for stem cell therapies were represented before and after Geron terminated its pioneering stem cell program. Our content analysis reveals that press coverage has shifted from ethical, legal, and social issues to clinical translation issues, and highly optimistic timelines were provided with no substantial change in representation over time. Scientists were the dominant voice with respect to translation timelines. The findings raise questions about the degree to which the media's overly optimistic slant fosters unrealistic expectations regarding the speed of clinical translation and highlight the ethical responsibility of stem cell researchers as public communicators. Copyright © 2015, American Association for the Advancement of Science.

Process and Outcome Evaluation of an Art Therapy Program for People Living with HIV/AIDS

ERIC Educational Resources Information Center

Feldman, Matthew B.; Betts, Donna J.; Blausey, Daniel

2014-01-01

Program evaluation offers an opportunity for improving the implementation and impact of art therapy. This article describes a process and outcomes evaluation of an art therapy program within the mental health services unit of a community-based organization for people living with HIV/AIDS. The aims were to assess utilization patterns and program…

NRC/AMRMC Resident Research Associateship Program

DTIC Science & Technology

2015-03-01

antimicrobials (and antiseptics) as well as to evaluate the effectiveness of various biofilm dispersal agents utilizing a number of bacterial species as well...combat related wounds. 3 Demonstrated the utility of combinations of biofilm dispersal agents and antimicrobials as an alternate therapy for targeting...alone or in combination with antimicrobials ) to reduce infection in contaminated femoral segmental defects. 5 Characterized host responses of

NRC/AMRMC Resident Research Associateship Program

DTIC Science & Technology

2015-05-01

2011-9/6/2014 1 Developed in vitrobiofilm assays to test susceptibility to various antimicrobials (and antiseptics) as well as to evaluate the...combinations of biofilm dispersal agents and antimicrobials as an alternate therapy for targeting bacterial biofilms. 4 Through collaborative efforts...contributed to the development of biomaterials capable of delivering biofilm dispersal agents (alone or in combination with antimicrobials ) to reduce

NRC/AMRMC Resident Research Associateship Program

DTIC Science & Technology

2015-04-01

Sanchez, Carlos 9/7/2011-9/6/2014 1 Developed in vitrobiofilm assays to test susceptibility to various antimicrobials (and antiseptics) as well as to...utility of combinations of biofilm dispersal agents and antimicrobials as an alternate therapy for targeting bacterial biofilms. 4 Through...collaborative efforts contributed to the development of biomaterials capable of delivering biofilm dispersal agents (alone or in combination with antimicrobials

Development of a Hampton University Program for Novel Breast Cancer Imaging and Therapy Research

DTIC Science & Technology

2013-04-01

intracavitary brachytherapy procedures during laboratory pre-clinical imaging and dosimetry equipment testing, calibration and data processing, in collaboration... electronics and detector instrumentation development; 4) breast phantom construction and implantation; 5) laboratory pre-clinical device testing...such as the ionization chamber, diode, radiographic verification 6 films and thermoluminescent dosimeters ( TLD ) but the scintillator fiber detectors

Promoting the Implementation of an Evidence-Based Intervention for Adolescent Marijuana Abuse in Community Settings: Testing the Use of Intensive Quality Assurance

ERIC Educational Resources Information Center

Henggeler, Scott W.; Sheidow, Ashli J.; Cunningham, Phillippe B.; Donohue, Bradley C.; Ford, Julian D.

2008-01-01

The development and evaluation of effective strategies for transporting evidence-based practices to community-based clinicians has become a research and policy priority. Using multisystemic therapy programs as a platform, an experimental design examined the capacity of an Intensive Quality Assurance (IQA) system to promote therapist implementation…

Online Cognitive-Restructuring Self-Help: www.SelfHelpSocialAnxiety.com a New Application for Social Anxiety Disorder

ERIC Educational Resources Information Center

Egan, Julia

2010-01-01

The primary purpose of the present study was to develop an online self-help treatment program for Social Anxiety Disorder, focused on cognitive restructuring. It can be difficult getting socially anxious individuals to commit to treatment since therapy is typically a face to face social interaction (the feared stimulus). Recent research suggests…

Targeting Heterogeneity and Comorbidity in Children with Autism Spectrum Disorder through the Resilience Builder Group Therapy Program

ERIC Educational Resources Information Center

Habayeb, Serene; Rich, Brendan; Alvord, Mary K.

2017-01-01

Background: Children with autism spectrum disorders (ASD) often carry co-morbid diagnoses and present with impairing heterogeneous symptomatology (Leyfer et al. in "J Autism Dev Disord" 36(7): 849-861, 2006. doi:10.1007/s10803-006-0123-0). However, research from controlled laboratory settings often fails to examine the vast number of…

Funding a Health Disparities Research Agenda: The Case of Medicare Home Health Care

ERIC Educational Resources Information Center

Davitt, Joan K.

2014-01-01

Medicare home health care provides critical skilled nursing and therapy services to patients in their homes, generally after a period in an inpatient facility or nursing home. Disparities in access to, or outcomes of, home health care can result in patient deterioration and increased cost to the Medicare program if patient care needs intensify.…

Interprofessional clinical education for occupational therapy and psychology students: a social skills training program for children with autism spectrum disorders.

PubMed

Howell, Dana M; Wittman, Peggy; Bundy, Myra Beth

2012-01-01

An interprofessional clinical learning experience was developed for pre-licensure occupational therapy (OT) and psychology graduate students. Students worked in interprofessional teams to plan and implement a social skills training program for children with autism spectrum disorders (ASD). The objectives were to provide a hands-on, student-led clinical experience; facilitate interprofessional collaborative learning through leadership partnerships and teach children with ASD to engage in appropriate social skill behaviors. Concurrently, faculty performed qualitative research to explore how the students worked together to provide intervention to the children. Data were collected via interview, direct observation of student planning sessions and student interprofessional interactions, and collection of posts from an online social network site used for session planning. There were six student participants and two faculty participants. Four themes emerged: learning who I am as a professional, learning to appreciate our professional differences, learning to communicate with each other and figuring it out, for the benefit of the kids. This interprofessional clinical learning experience and research helps ensure that students are adequately prepared to represent their profession as part of a diverse interprofessional health care team.

Making a measurable difference in advanced Huntington disease care.

PubMed

Moskowitz, Carol Brown; Rao, Ashwini K

2017-01-01

Neurologists' role in the care of people with advanced Huntington disease (HD) (total functional capacity <7), often limited by a lack of clinical research to support good practice, includes the following: (1) provide comprehensive health records to an interdisciplinary care staff before admission to a more intense care setting (home health services, day program, assisted living, group home, long-term skilled nursing facility, palliative care); (2) consult with and refer to rehabilitation (occupational therapy, physical therapy, speech and language pathology), behavioral and psychiatric professionals for problem-solving strategies, which must be reviewed with direct care staff before implementation; (3) encourage and support qualitative and quantitative interdisciplinary research studies, and randomized controlled studies of nonpharmacologic interventions; and (4) assist in the development of meaningful measures to further document what works to provide a good quality of life for the patient and family and a comfortable thoughtful approach to a good death. Collaborative models of care depend on: (1) clear communication; (2) ongoing education and support programs; with (3) pharmacologic and rehabilitation interventions, always in the context of respect for the person with HD, a preservation of the individuals' dignity, autonomy, and individual preferences. Copyright © 2017 Elsevier B.V. All rights reserved.

Immune checkpoint inhibitors in lung cancer: current status and future directions.

PubMed

Fan, Yun; Mao, Weimin

2017-04-01

Recently, the immune checkpoint inhibitors that target programmed death 1 (PD-1)/programmed death ligand 1 (PD-L1) have made a breakthrough in treating advanced non-small cell lung cancer (NSCLC) with the efficacy of approximately 20%; among which, nivolumab has acquired treatment indications in lung squamous cell carcinoma. The inhibitors targeting cytotoxic T lymphocyte associated antigen 4 (CTLA-4) are also undergoing clinical trials. Researches on immune checkpoint inhibitors have been rapidly implemented in a variety of different types of lung cancer, such as small cell lung cancer (SCLC) and locally advanced NSCLC, and these inhibitors began to be applied in combination with some established treatments, including chemotherapy, targeting therapy and radiotherapy. Undoubtedly, the immune checkpoint inhibitors have become a hot spot in the research and treatment of lung cancer. However, many problems wait to be solved, such as searching for ideal biomarkers, constituting the best criteria for curative effect evaluation, exploring different combination treatment models, and clearly understanding the mechanisms of primary or secondary drug resistance. Along with these problems to be successfully solved, the immune checkpoint inhibitors will have more broad applications in lung cancer therapy.

Education and Training Needs in Radiation Oncology in India: Opportunities for Indo–US Collaborations

DOE Office of Scientific and Technical Information (OSTI.GOV)

Grover, Surbhi, E-mail: Surbhi.grover@uphs.upenn.edu; Chadha, Manjeet; Rengan, Ramesh

Purpose: To conduct a survey of radiation oncologists in India, to better understand specific educational needs of radiation oncology in India and define areas of collaboration with US institutions. Methods and Materials: A 20-question survey was distributed to members of the Association of Indian Radiation Oncologists and the Indian Brachytherapy Society between November 2013 and May 2014. Results: We received a total of 132 responses. Over 50% of the physicians treat more than 200 patients per day, use 2-dimensional or 3-dimensional treatment planning techniques, and approximately 50% use image guided techniques. For education needs, most respondents agreed that further education inmore » intensity modulated radiation therapy, image guided radiation therapy, stereotactic radiation therapy, biostatistics, and research methods for medical residents would be useful areas of collaboration with institutions in the United States. Other areas of collaboration include developing a structured training module for nursing, physics training, and developing a second-opinion clinic for difficult cases with faculty in the United States. Conclusion: Various areas of potential collaboration in radiation oncology education were identified through this survey. These include the following: establishing education programs focused on current technology, facilitating exchange programs for trainees in India to the United States, promoting training in research methods, establishing training modules for physicists and oncology nurses, and creating an Indo–US. Tumor Board. It would require collaboration between the Association of Indian Radiation Oncologists and the American Society for Radiation Oncology to develop these educational initiatives.« less

Education and Training Needs in Radiation Oncology in India: Opportunities for Indo-US Collaborations.

PubMed

Grover, Surbhi; Chadha, Manjeet; Rengan, Ramesh; Williams, Tim R; Morris, Zachary S; Morgan, David A L; Tripuraneni, Prabhakar; Hu, Kenneth; Viswanathan, Akila N

2015-12-01

To conduct a survey of radiation oncologists in India, to better understand specific educational needs of radiation oncology in India and define areas of collaboration with US institutions. A 20-question survey was distributed to members of the Association of Indian Radiation Oncologists and the Indian Brachytherapy Society between November 2013 and May 2014. We received a total of 132 responses. Over 50% of the physicians treat more than 200 patients per day, use 2-dimensional or 3-dimensional treatment planning techniques, and approximately 50% use image guided techniques. For education needs, most respondents agreed that further education in intensity modulated radiation therapy, image guided radiation therapy, stereotactic radiation therapy, biostatistics, and research methods for medical residents would be useful areas of collaboration with institutions in the United States. Other areas of collaboration include developing a structured training module for nursing, physics training, and developing a second-opinion clinic for difficult cases with faculty in the United States. Various areas of potential collaboration in radiation oncology education were identified through this survey. These include the following: establishing education programs focused on current technology, facilitating exchange programs for trainees in India to the United States, promoting training in research methods, establishing training modules for physicists and oncology nurses, and creating an Indo-US. Tumor Board. It would require collaboration between the Association of Indian Radiation Oncologists and the American Society for Radiation Oncology to develop these educational initiatives. Copyright © 2015 Elsevier Inc. All rights reserved.

Wearable Therapy - Detecting Information from Wearables and Mobiles that are Relevant to Clinical and Self-directed Therapy.

PubMed

Arnrich, Bert; Ersoy, Cem; Mayora, Oscar; Dey, Anind; Berthouze, Nadia; Kunze, Kai

2017-01-09

This accompanying editorial provides a brief introduction into the focus theme "Wearable Therapy". The focus theme "Wearable Therapy" aims to present contributions which target wearable and mobile technologies to support clinical and self-directed therapy. A call for papers was announced to all participants of the "9th International Conference on Pervasive Computing Technologies for Healthcare" and was published in November 2015. A peer review process was conducted to select the papers for the focus theme. Six papers were selected to be included in this focus theme. The paper topics cover a broad range including an approach to build a health informatics research program, a comprehensive literature review of self-quantification for health self-management, methods for affective state detection of informal care givers, social-aware handling of falls, smart shoes for supporting self-directed therapy of alcohol addicts, and reference information model for pervasive health systems. More empirical evidence is needed that confirms sustainable effects of employing wearable and mobile technology for clinical and self-directed therapy. Inconsistencies between different conceptual approaches need to be revealed in order to enable more systematic investigations and comparisons.

Systematic review of the effects of mirror therapy in children with cerebral palsy

PubMed Central

Park, Eom-ji; Baek, Soon-hyung; Park, Soohee

2016-01-01

[Purpose] To provide data for systematic intervention plans in occupational therapy practice by objectivity showing the value of mirror therapy interventions in children with cerebral palsy. [Subjects and Methods] Medline and EMBASE databases were searched for the key words “cerebral palsy,” “mirror movement,” “mirror therapy,” and “mirror visual feedback.” Nine studies that met the inclusion and exclusion criteria were identified. The qualitatively determined level of evidence, period of research, comparisons and interventions, tools used to measure the intervention, and the effects were analyzed. [Results] According to the results analyzed, one (1/9, 11.1%) study showed the same result as the control group, one (1/9, 11.1%) showed a negative effect, and seven (7/9, 77.8%) showed positive effects of mirror-mediated therapy, with meaningful improvement in function, such as hand strength, movement speed, muscle activity, and accuracy of hand matching. [Conclusion] Through this study, the value of mirror-mediated therapeutic interventions in occupational therapy practice targeting cerebral palsy was confirmed. It is expected that this result will be useful in establishing mirror therapy as an interventional program. PMID:27942154

Physical and Occupational Therapy for a Teenager with Acute Flaccid Myelitis: A Case Report.

PubMed

Kornafel, Tracy; Tsao, Elaine Y; Sabelhaus, Emily; Surges, Lori; Apkon, Susan D

2017-10-20

The purpose of this case report is to describe the inpatient rehabilitation program of a 13-year-old boy with acute flaccid myelitis (AFM), specific to physical and occupational therapy examination, treatment, and outcomes. AFM is a rare, acute neurologic illness in children and young adults who present with weakness and/or paralysis of unknown etiology. The teenager was admitted to the program, dependent for all mobility and self-care. Interventions focused on range of motion, transfer training, self-care, power wheelchair mobility, and environmental adaptations. Weekly re-evaluations and the WeeFIM were used at admission and discharge to measure the teenager's progress. At discharge, the teenager had made small gains in his passive and active range of motion. He was independent in directing his care and able to drive his power wheelchair with supervision. Due to the scarcity of published data describing AFM, this report describes an individual's response to a rehabilitation program and will hopefully add to future research in order to provide patients and families with expectations for their recovery and ultimate level of function.

An Assessment of an Outpatient Antimicrobial Therapy Program in a Rural Medical Center : A Retrospective Chart Review.

PubMed

Burkett, Matthew Shawn; Macci Bires, Angela; Cline, Thomas W; Knight, Anthony

Current literature supports outpatient parenteral antimicrobial therapy (OPAT). This article presents results from a research study that evaluated an OPAT program that treated community-acquired pneumonia. If patients had the opportunity to receive outpatient intravenous antibiotics for community-acquired pneumonia, would this prevent future hospitalization? Was there a decrease in hospital admissions? An informal cost-benefit analysis comparing OPAT with inpatient hospital admissions for the same disease was also reviewed to provide evidence whether there was a change. What was the overall health care cost savings? The medical charts of 50 patients with confirmed pneumonia who had received OPAT in a 3-month period were reviewed. A retrospective medical record review was performed. All patients were evaluated by the in-house OPAT team. The resulting analysis provided evidence that an estimated savings of approximately $2100 per day would be achieved by decreasing hospital readmissions for patient who had been treated with OPAT. The conclusion of this study provides evidence that the implement of an OPAT program was, and is, essential for patient care and evidence-based best practice adherence.

The assessment and treatment of performance anxiety in musicians.

PubMed

Clark, D B; Agras, W S

1991-05-01

Performance anxiety in musicians may be severe enough to require intervention but has been the subject of relatively little clinical research. The authors' objectives were to describe the results of a comprehensive clinical and laboratory assessment and to perform a double-blind, placebo-controlled study comparing buspirone, cognitive-behavior therapy, and the combination of these treatments for performance anxiety. Ninety-four subjects were recruited by mass media announcements and were seen in a university-based outpatient psychiatric clinic. Assessments were 1) questionnaires for all 94 subjects, 2) diagnostic interview of 50 subjects, and 3) laboratory performance of 34 subjects. Treatment conditions were 1) 6 weeks of buspirone, 2) 6 weeks of placebo, 3) a five-session, group cognitive-behavior therapy program with buspirone, or 4) the cognitive-behavior therapy program with placebo. Treatment outcome measures included subjective anxiety ratings and heart rate measures during a laboratory performance, a questionnaire measure of performance confidence, and a blind rating of musical performance quality. All subjects fulfilled criteria for DSM-III-R social phobia. Of the 15 full-time professional musicians, ten had tried propranolol and three had stopped performing. Most of the subjects had substantial anxiety and heart rate increases during laboratory speech and musical performances. Cognitive-behavior therapy resulted in statistically significant reductions in subjective anxiety, improved quality of musical performance, and improved performance confidence. Buspirone was not an effective treatment. Cognitive-behavior therapy is a viable treatment approach for performance anxiety in musicians.

SU-E-J-02: 4D Digital Tomosynthesis Based On Algebraic Image Reconstruction and Total-Variation Minimization for the Improvement of Image Quality

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kim, D; Kang, S; Kim, T

2014-06-01

Purpose: In this paper, we implemented the four-dimensional (4D) digital tomosynthesis (DTS) imaging based on algebraic image reconstruction technique and total-variation minimization method in order to compensate the undersampled projection data and improve the image quality. Methods: The projection data were acquired as supposed the cone-beam computed tomography system in linear accelerator by the Monte Carlo simulation and the in-house 4D digital phantom generation program. We performed 4D DTS based upon simultaneous algebraic reconstruction technique (SART) among the iterative image reconstruction technique and total-variation minimization method (TVMM). To verify the effectiveness of this reconstruction algorithm, we performed systematic simulation studiesmore » to investigate the imaging performance. Results: The 4D DTS algorithm based upon the SART and TVMM seems to give better results than that based upon the existing method, or filtered-backprojection. Conclusion: The advanced image reconstruction algorithm for the 4D DTS would be useful to validate each intra-fraction motion during radiation therapy. In addition, it will be possible to give advantage to real-time imaging for the adaptive radiation therapy. This research was supported by Leading Foreign Research Institute Recruitment Program (Grant No.2009-00420) and Basic Atomic Energy Research Institute (BAERI); (Grant No. 2009-0078390) through the National Research Foundation of Korea(NRF) funded by the Ministry of Science, ICT and Future Planning (MSIP)« less

Production Assistance for Cellular Therapies (PACT): five-year experience from the United States National Heart, Lung, and Blood Institute (NHLBI) contract research program in cell and tissue therapies

PubMed Central

Reed, William; Noga, Stephen J.; Gee, Adrian P.; Rooney, Cliona M.; Wagner, John E.; McCullough, Jeffrey; McKenna, David H.; Whiteside, Theresa L.; Donnenberg, Albert D.; Baker, Acacia K.; Lindblad, Robert W.; Wagner, Elizabeth L.; Mondoro, Traci Heath

2014-01-01

BACKGROUND In 2002, the US National Heart, Lung, and Blood Institute (NHLBI) conducted a workshop to determine needs of the cell therapy community. A consensus emerged that improved access to cGMP facilities, regulatory assistance, and training would foster the advancement of cellular therapy. STUDY DESIGN AND METHODS A 2003 NHLBI request for proposals resulted in four contracts being awarded to three cell-manufacturing facilities (Baylor College of Medicine, University of Minnesota, and University of Pittsburgh) and one administrative center (The EMMES Corporation). As a result, Production Assistance for Cellular Therapies (PACT) was formed. RESULTS As of October 1, 2008, PACT has received 65 preliminary applications of which 45 have been approved for product manufacture. A variety of cell therapies are represented including T-regulatory cells, natural killer cells, adipose-derived stem cells, cardiac progenitor cells for cardiac disease, hematopoietic progenitor cells (HPCs) for central nervous system applications, cytotoxic T lymphocytes, and dendritic cells. A total of 169 products have been administered under 12 applications and 2 reagents were manufactured and delivered. Fourteen peer-reviewed publications and 15 abstracts have resulted from the PACT project to date. A cell therapy textbook is nearly complete. PACT technical projects have addressed assay development, rapid endotoxin testing, shipping of cell products, and CD34+ HPC isolation from low-volume marrow. Educational Web seminars and onsite training through workshops have been conducted. CONCLUSIONS PACT is an active and successful cell therapy manufacturing resource in the United States, addressing research and training while forging relationships among academia, industry, and participating institutions. PMID:19170985

Multidimensional Patient Impression of Change Following Interdisciplinary Pain Management.

PubMed

Gagnon, Christine M; Scholten, Paul; Atchison, James

2018-04-20

To assess patient impression of change following interdisciplinary pain management utilizing a newly developed Multidimensional Patient Impression of Change (MPIC) questionnaire. A heterogeneous group of chronic pain patients (N = 601) participated in an interdisciplinary treatment program. Programs included individual and group therapies (pain psychology, physical therapy, occupational therapy, relaxation training/biofeedback, aerobic conditioning, patient education and medical management). Patients completed measures of pain, mood, coping, physical functioning and pain acceptance both prior to and at completion of their treatment programs. The newly developed MPIC is an expansion to the Patient Global Impression of Change (PGIC) including seven additional domains (Pain, Mood, Sleep, Physical Functioning, Cope with Pain, Manage Pain Flare-ups, and Medication Effectiveness). The MPIC was administered to the patients post-treatment. There were statistically significant pre- to post-treatment improvements found on all outcome measures. The majority of these improvements were significantly correlated with all domains of the MPIC. The original PGIC item was significantly associated with all of the new MPIC domains and the domains were significantly associated with each other; but there were variations in the distribution of responses highlighting variation of perceived improvements among the domains. Our results support the use of the MPIC as a quick and easy post-treatment assessment screening tool. Future research is needed to examine relevant correlates to Medication Effectiveness. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

The efficacy of self-directed modules for clinical learning: advanced competencies in entry-level physical therapy education.

PubMed

Peck, Kirk; Paschal, Karen; Black, Lisa; Nelson, Kelly

2014-01-01

Prior to graduation, students often express an interest to advance clinical and professional skills in teaching, research, administration, and various niche practice areas. The acquisition of advanced education in selected areas of practice is believed to improve employment opportunities, accelerate career advancement including eligibility for professional certifications, and contribute to personal satisfaction in the profession. The purpose of this paper is to (1) describe an innovative model of education, the Directed Practice Experience (DPE) elective, that incorporates a student-initiated learning process designed to achieve student-identified professional goals, and (2) report the outcomes for graduates who have completed the DPE in an entry-level program in physical therapy education. Students who met select criteria were eligible to complete a DPE. Applicants designed a 4- to 6-week clinical education experience consisting of stated rationale for personal and professional growth, examples of leadership and service, and self-directed objectives that are beyond entry-level expectations as measured by the revised Physical Therapist Clinical Performance Instrument, version 2006. Twenty-six students have completed DPEs since 2005. Fifty percent resulted in new academic partnerships. At least 25% of graduates now serve as clinical instructors for the entry-level program. Those who participated in DPEs have also completed post-graduate residencies, attained ABPTS Board certifications, authored peer-reviewed publications, and taught in both PT and residency programs. The DPE model allows qualified students to acquire advanced personal skills and knowledge prior to graduation in areas of professional practice that exceed entry-level expectations. The model is applicable to all CAPTE accredited physical therapy education programs and is especially beneficial for academic programs desiring to form new community partnerships for student clinical education.

The home stroke rehabilitation and monitoring system trial: a randomized controlled trial.

PubMed

Linder, Susan M; Rosenfeldt, Anson B; Reiss, Aimee; Buchanan, Sharon; Sahu, Komal; Bay, Curtis R; Wolf, Steven L; Alberts, Jay L

2013-01-01

Because many individuals poststroke lack access to the quality and intensity of rehabilitation to improve upper extremity motor function, a home-based robotic-assisted upper extremity rehabilitation device is being paired with an individualized home exercise program. The primary aim of this project is to determine the effectiveness of robotic-assisted home therapy compared with a home exercise program on upper extremity motor recovery and health-related quality of life for stroke survivors in rural and underserved locations. The secondary aim is to explore whether initial degree of motor function of the upper limb may be a factor in predicting the extent to which patients with stroke may be responsive to a home therapy approach. We hypothesize that the home exercise program intervention, when enhanced with robotic-assisted therapy, will result in significantly better outcomes in motor function and quality of life. A total of 96 participants within six-months of a single, unilateral ischemic, or hemorrhagic stroke will be recruited in this prospective, single-blind, multisite randomized clinical trial. The primary outcome is the change in upper extremity function using the Action Research Arm Test. Secondary outcomes include changes in: upper extremity function (Wolf Motor Function Test), upper extremity impairment (upper extremity portion of the Fugl-Meyer Test), self-reported quality of life (Stroke Impact Scale), and affect (Centers for Epidemiologic Studies Depression Scale). Similar or greater improvements in upper extremity function using the combined robotic home exercise program intervention compared with home exercise program alone will be interpreted as evidence that supports the introduction of in-home technology to augment the recovery of function poststroke. © 2012 The Authors. International Journal of Stroke © 2012 World Stroke Organization.

Research productivity of doctor of physical therapy faculty promoted in the southeastern United States

PubMed Central

Littman, Marissa A.; Sonne, James W.; Smith, Gerald V.

2017-01-01

ABSTRACT Background: Little information exists on the research productivity of successfully promoted tenure-track Doctor of Physical Therapy (DPT) faculty. Objective: To determine the research productivity that typically results in successful promotion. Design: We collected publicly available curriculum vitae (CVs) from faculty currently in accredited DPT programs and who had been successfully promoted from an institution in the southeastern USA from 2000 through 2016. Total publication count, journal impact factor, funding, citations, and other metrics were analysed from 45 subjects of 22 of the 64 CAPTE-accredited DPT programs in the southeast. Results: None of the studied metrics were normally distributed with time to promotion as determined by a Shapiro-Wilk test. These faculty exhibited a median publication count of 4, range 0 to 43; median of average citation count of 12.4, range 0 to 87.25; median of average journal impact factor of 2.866, range 0 to 6.280; median external funding received of $9910, range $0.00 to $19 543 198; and median author h-index of 3, range 0 to 17. The median number of years before promotion was 6, ranging from 3 to 13 years. Linear regression analysis indicates a poor fit with no significant correlation between years before promotion and any of the studied metrics. No correlation between journal impact factor and number of citations was observed (m = −0.22, p = 0.728, R2 = 0.0003). Prior to promotion 31% (14 of 45) did not receive external funding and 24% (11 of 45) had a 0 h-index. The Carnegie Classification of the institution did not significantly correlate with research productivity metrics in this dataset (p = 0.213). Conclusion: While faculty unsuccessful in promotion were not identifiable using this method, this research can be used by faculty and committees to evaluate research productivity against regional data and promote competitive standards with peer institutions. Abbreviations: CAPTE: Commission on Accreditation in Physical Therapist Education; DPT: Doctor of Physical Therapy PMID:28835200

Research productivity of doctor of physical therapy faculty promoted in the southeastern United States.

PubMed

Littman, Marissa A; Sonne, James W; Smith, Gerald V

2017-01-01

Little information exists on the research productivity of successfully promoted tenure-track Doctor of Physical Therapy (DPT) faculty. To determine the research productivity that typically results in successful promotion. We collected publicly available curriculum vitae (CVs) from faculty currently in accredited DPT programs and who had been successfully promoted from an institution in the southeastern USA from 2000 through 2016. Total publication count, journal impact factor, funding, citations, and other metrics were analysed from 45 subjects of 22 of the 64 CAPTE-accredited DPT programs in the southeast. None of the studied metrics were normally distributed with time to promotion as determined by a Shapiro-Wilk test. These faculty exhibited a median publication count of 4, range 0 to 43; median of average citation count of 12.4, range 0 to 87.25; median of average journal impact factor of 2.866, range 0 to 6.280; median external funding received of $9910, range $0.00 to $19 543 198; and median author h-index of 3, range 0 to 17. The median number of years before promotion was 6, ranging from 3 to 13 years. Linear regression analysis indicates a poor fit with no significant correlation between years before promotion and any of the studied metrics. No correlation between journal impact factor and number of citations was observed (m = -0.22, p = 0.728, R 2  = 0.0003). Prior to promotion 31% (14 of 45) did not receive external funding and 24% (11 of 45) had a 0 h-index. The Carnegie Classification of the institution did not significantly correlate with research productivity metrics in this dataset (p = 0.213). While faculty unsuccessful in promotion were not identifiable using this method, this research can be used by faculty and committees to evaluate research productivity against regional data and promote competitive standards with peer institutions. CAPTE: Commission on Accreditation in Physical Therapist Education; DPT: Doctor of Physical Therapy.

A Pilot Evaluation of an Art Therapy Program for Refugee Youth from Burma

ERIC Educational Resources Information Center

Kowitt, Sarah Dorothy; Emmerling, Dane; Gavarkavich, Diane; Mershon, Claire-Helene; Linton, Kristin; Rubesin, Hillary; Agnew-Brune, Christine; Eng, Eugenia

2016-01-01

Art therapy is a promising form of therapy to address mental health concerns for refugee youth. This article describes the development and implementation of a pilot evaluation of an art therapy program for refugee adolescents from Burma currently living in the United States. Evaluation activities were based on the Centers for Disease Control and…

The Use of Art Therapy in Treatment Programs to Promote Spiritual Recovery from Addiction.

ERIC Educational Resources Information Center

Feen-Calligan, Holly

1995-01-01

Illustrates the relationship between art therapy, spirituality, and recovery supported by the philosophy of Alcoholic Anonymous, and offers a model in which art therapy can be used in treatment programs to facilitate spiritual recovery from addiction. Discusses personal experiences related to the use of art therapy for assisting in addiction…

[Fingolimod compassionate use program: case study on the concept of a therapy option for multiple sclerosis prior to marketing approval].

PubMed

Haas, J; Linker, R A; Hartung, H P; Meergans, M; Ortler, S; Tracik, F

2012-12-01

In order to meet the needs of therapy of multiple sclerosis (MS) new immune therapies with a user-friendly application and better effectiveness together with good tolerability are necessary. With respect to its potential to improve MS therapy, patients with a high medical need were given access to Fingolimod even before marketing approval. Therefore, a compassionate use program unique in the field of MS was initiated. In total 137 centers participated (75 % outpatient neurologists and 25 % hospitals). Within 19 weeks 135 patients were enrolled to receive Fingolimod. The patients in the compassionate use program can be representatively described as showing hardly controllable disease activity and progression with currently available, often poorly tolerated therapy. The compassionate use program for these patients offered better control of the disease with Fingolimod. The adverse events were as expected. The Fingolimod compassionate use program demonstrated the need for this new therapeutic option. Patients who were not yet sufficiently treated were provided with an effective therapy with a good safety profile and a user-friendly administration form.

Readiness to change and therapy outcomes of an innovative psychotherapy program for surgical patients: results from a randomized controlled trial.

PubMed

Krampe, Henning; Salz, Anna-Lena; Kerper, Léonie F; Krannich, Alexander; Schnell, Tatjana; Wernecke, Klaus-Dieter; Spies, Claudia D

2017-12-29

Readiness to change is a pivotal construct for psychotherapy research and a major target of motivational interventions. Our primary objective was to examine whether pre-treatment readiness to change moderated therapy effects of Bridging Intervention in Anesthesiology (BRIA), an innovative psychotherapy approach for surgical patients. This stepped care program aims at motivating and supporting surgical patients with mental disorders to engage in psychosocial mental health care. The major steps of BRIA are two motivational interventions with different intensity. The first step of the program consists of preoperative computer-assisted psychosocial self-assessment including screening for psychological distress and automatically composed computerized brief written advice (BWA). In the second step, patients participate in postoperative psychotherapy sessions combining motivational interviewing with cognitive behavioural therapy (BRIA psychotherapy sessions). We performed regression-based moderator analyses on data from a recent randomized controlled trial published by our research group. The sample comprised 220 surgical patients with diverse comorbid mental disorders according to ICD-10. The most frequent disorders were mood, anxiety, substance use and adjustment disorders. The patients had a mean age of 43.31 years, and 60.90% were women. In a regression model adjusted for pre-treatment psychological distress, we investigated whether readiness to change moderated outcome differences between (1) the BRIA psychotherapy sessions and (2) no psychotherapy / BWA only. Multiple regression analyses showed that readiness to change moderated treatment effects regarding the primary outcomes "Participation in psychosocial mental health care options at month 6" (p = 0.03) and "Having approached psychosocial mental health care options at month 6" (p = 0.048) but not regarding the secondary outcome "Change of general psychological distress between baseline assessment and month 6" (p = 0.329). Probing the moderation effect with the Johnson-Neyman technique revealed that BRIA psychotherapy sessions were superior to BWA in patients with low to moderate readiness, but not in those with high readiness. Readiness to change may act as moderator of the efficacy of psychosocial therapy. Combinations of motivational interviewing and cognitive behavioural therapy may be effective particularly in patients with a variety of mental disorders and low readiness to change. clinicaltrials.gov Identifier: NCT01357694.

Models of interinstitutional partnerships between research intensive universities and minority serving institutions (MSI) across the Clinical Translational Science Award (CTSA) consortium.

PubMed

Ofili, Elizabeth O; Fair, Alecia; Norris, Keith; Verbalis, Joseph G; Poland, Russell; Bernard, Gordon; Stephens, David S; Dubinett, Steven M; Imperato-McGinley, Julianne; Dottin, Robert P; Pulley, Jill; West, Andrew; Brown, Arleen; Mellman, Thomas A

2013-12-01

Health disparities are an immense challenge to American society. Clinical and Translational Science Awards (CTSAs) housed within the National Center for Advancing Translational Science (NCATS) are designed to accelerate the translation of experimental findings into clinically meaningful practices and bring new therapies to the doorsteps of all patients. Research Centers at Minority Institutions (RCMI) program at the National Institute on Minority Health and Health Disparities (NIMHD) are designed to build capacity for biomedical research and training at minority serving institutions. The CTSA created a mechanism fostering formal collaborations between research intensive universities and minority serving institutions (MSI) supported by the RCMI program. These consortium-level collaborations activate unique translational research approaches to reduce health disparities with credence to each academic institutions history and unique characteristics. Five formal partnerships between research intensive universities and MSI have formed as a result of the CTSA and RCMI programs. These partnerships present a multifocal approach; shifting cultural change and consciousness toward addressing health disparities, and training the next generation of minority scientists. This collaborative model is based on the respective strengths and contributions of the partnering institutions, allowing bidirectional interchange and leveraging NIH and institutional investments providing measurable benchmarks toward the elimination of health disparities. © 2013 Wiley Periodicals, Inc.

Models of Interinstitutional Partnerships between Research Intensive Universities and Minority Serving Institutions (MSI) across the Clinical Translational Science Award (CTSA) Consortium

PubMed Central

Fair, Alecia; Norris, Keith; Verbalis, Joseph G.; Poland, Russell; Bernard, Gordon; Stephens, David S.; Dubinett, Steven M.; Imperato‐McGinley, Julianne; Dottin, Robert P.; Pulley, Jill; West, Andrew; Brown, Arleen; Mellman, Thomas A.

2013-01-01

Abstract Health disparities are an immense challenge to American society. Clinical and Translational Science Awards (CTSAs) housed within the National Center for Advancing Translational Science (NCATS) are designed to accelerate the translation of experimental findings into clinically meaningful practices and bring new therapies to the doorsteps of all patients. Research Centers at Minority Institutions (RCMI) program at the National Institute on Minority Health and Health Disparities (NIMHD) are designed to build capacity for biomedical research and training at minority serving institutions. The CTSA created a mechanism fostering formal collaborations between research intensive universities and minority serving institutions (MSI) supported by the RCMI program. These consortium‐level collaborations activate unique translational research approaches to reduce health disparities with credence to each academic institutions history and unique characteristics. Five formal partnerships between research intensive universities and MSI have formed as a result of the CTSA and RCMI programs. These partnerships present a multifocal approach; shifting cultural change and consciousness toward addressing health disparities, and training the next generation of minority scientists. This collaborative model is based on the respective strengths and contributions of the partnering institutions, allowing bidirectional interchange and leveraging NIH and institutional investments providing measurable benchmarks toward the elimination of health disparities. PMID:24119157

Client Accounts of Corrective Experiences in Psychotherapy: Implications for Clinical Practice.

PubMed

Angus, Lynne; Constantino, Michael J

2017-02-01

The Patient Perceptions of Corrective Experiences in Individual Therapy (PPCEIT; Constantino, Angus, Friedlander, Messer, & Moertl, 2011) posttreatment interview guide was developed to provide clinical researchers with an effective mode of inquiry to identify and further explore clients' firsthand accounts of corrective and transformative therapy experiences and their determinants. Not only do findings from the analysis of client corrective experience (CE) accounts help identify what and how CEs happen in or as a result of psychotherapy, but the measure itself may also provide therapists with an effective tool to further enhance clients' awareness, understanding, and integration of transformative change experiences. Accordingly, we discuss in this afterword to the series the implications for clinical practice arising from (a) the thematic analysis of client CE accounts, drawn from a range of clinical samples and international research programs and (b) the clinical effect of completing the PPCEIT posttreatment interview inquiry. We also identify directions for future clinical training and research. © 2016 Wiley Periodicals, Inc.

Optimal Implantable Cardioverter Defibrillator Programming.

PubMed

Shah, Bindi K

Optimal programming of implantable cardioverter defibrillators (ICDs) is essential to appropriately treat ventricular tachyarrhythmias and to avoid unnecessary and inappropriate shocks. There have been a series of large clinical trials evaluating tailored programming of ICDs. We reviewed the clinical trials evaluating ICD therapies and detection, and the consensus statement on ICD programming. In doing so, we found that prolonged ICD detection times, higher rate cutoffs, and antitachycardia pacing (ATP) programming decreases inappropriate and painful therapies in a primary prevention population. The use of supraventricular tachyarrhythmia discriminators can also decrease inappropriate shocks. Tailored ICD programming using the knowledge gained from recent ICD trials can decrease inappropriate and unnecessary ICD therapies and decrease mortality.

Relationships, environment, and the brain: how emerging research is changing what we know about the impact of families on human development.

PubMed

Patterson, Jo Ellen; Vakili, Susanna

2014-03-01

Recent research is providing family therapists with new information about the complex interaction between an individual's biological makeup and his/her social and physical environment. Family and social relationships, particularly during sensitive periods early in life, can affect a child's biological foundation. Additionally, stress during the early years can have a lasting effect on an individual's physical and mental health and contribute to the onset of severe mental illness. Community programs have been developed to intervene early with families who have an at-risk child to prevent or minimize the onset of mental illness including providing partnerships with at-risk mothers of infants to shape attachment relationships. Programs are also developing individual and family interventions to prevent the onset of psychosis. Practicing family therapists can incorporate emerging neuroscience and early intervention research and leverage the growing base of community programs to enhance the effectiveness and sustainability of mental health outcomes for clients. Additionally, family therapy education programs should broaden student training to incorporate the growing body of information about how family relationships affect individual mental health development. © 2013 FPI, Inc.

Forced Migration as Public Relations Process? Lothar B. Kalinowsky and the Trans-Atlantic Transfer of Electroconvulsive Therapy.

PubMed

Stahnisch, Frank W

2016-01-01

Research in biological psychiatry during the first half of the 20 th century was based upon a wide range of interrelated disciplines, including neurology, neuroanatomy, neuropathology, and experimental biology. The work of German-American psychiatrist and neurologist Lothar B. Kalinowsky (1899-1992) is taken here as an example of how such fields could be combined to produce a highly innovative and multidimensional research program in clinical neuroscience. Kalinowsky functioned exceptionally well in both scientific and clinical cultures despite the marked contextual differences between the Charité in Berlin and his later workplace in New York's Columbia Medical School. The innovative ideas exemplified by Kalinowsky's efforts, however, sometimes amounted to a dubious advantage for émigré clinical neuroscientists: they easily led to incommensurable scientific views, and sometimes even resulted in the marginalization of the innovator from existing research programs.

Relationship between age and inappropriate implantable cardioverter-defibrillator therapy in MADIT-RIT (Multicenter Automatic Defibrillator Implantation Trial-Reduce Inappropriate Therapy).

PubMed

Biton, Yitschak; Huang, David T; Goldenberg, Ilan; Rosero, Spencer; Moss, Arthur J; Kutyifa, Valentina; McNitt, Scott; Strasberg, Boris; Zareba, Wojciech; Barsheshet, Alon

2016-04-01

There is limited data regarding the relationship between age and inappropriate therapy among patients with an implantable cardioverter-defibrillator (ICD) and resynchronization therapy. We aimed to investigate this relationship and the effect of ICD programming on inappropriate therapy by age. In the Multicenter Automatic Defibrillator Implantation Trial-Reduce Inappropriate Therapy (MADIT-RIT) 1500 patients were randomized to 3 ICD programming arms: (A) conventional with ventricular tachycardia (VT) therapy ≥170; (B) high-rate cutoff with VT therapy ≥200, and (C) prolonged 60-second delay for VT therapy ≥170. We investigated the relationship between age, the risk of inappropriate ICD therapy (including antitachycardia pacing [ATP] or shock), and ICD programming. Cumulative incidence function Kaplan-Meier graphs showed an inverse relationship between increasing quartiles of age (Q1: ≤55, Q2: 56-64, Q3: 65-71, and Q4: ≥72 years) and the risk for inappropriate therapy. Multivariate analyses showed that each increasing decade of life was associated with 34% (P < .001), 27% (P < .001), and 26% (P < .001) reduction in the risk of inappropriate shock, inappropriate ATP, and any inappropriate therapy, respectively. Treatment arms B and C as compared with arm A were associated with a significant reduction in the risk of inappropriate therapies across all age quartiles (P < .001 for all). Among patients with a primary prevention indication for an ICD, there is an inverse relationship between age and inappropriate ICD therapy. Innovative ICD programming of high-rate cutoff or prolonged delay for VT therapy is associated with significant reductions in inappropriate therapy among all age groups. Copyright © 2016 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

Benefits and challenges of a QSP approach through case study: Evaluation of a hypothetical GLP-1/GIP dual agonist therapy.

PubMed

Rieger, Theodore R; Musante, Cynthia J

2016-10-30

Quantitative Systems Pharmacology (QSP) is an emerging science with increasing application to pharmaceutical research and development paradigms. Through case study we provide an overview of the benefits and challenges of applying QSP approaches to inform program decisions in the early stages of drug discovery and development. Specifically, we describe the use of a type 2 diabetes systems model to inform a No-Go decision prior to lead development for a potential GLP-1/GIP dual agonist program, enabling prioritization of exploratory programs with higher probability of clinical success. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

42 CFR 485.58 - Condition of participation: Comprehensive rehabilitation program.

Code of Federal Regulations, 2011 CFR

2011-10-01

... the services on its premises. (2) Exceptions. Physical therapy, occupational therapy, and speech... rehabilitation program that includes, at a minimum, physicians' services, physical therapy services, and social... patient and the physical therapist, occupational therapist, or speech-language pathologist, as appropriate...

42 CFR 485.58 - Condition of participation: Comprehensive rehabilitation program.

Code of Federal Regulations, 2010 CFR

2010-10-01

... rehabilitation program that includes, at a minimum, physicians' services, physical therapy services, and social or psychological services. These services must be furnished by personnel that meet the qualifications... the services on its premises. (2) Exceptions. Physical therapy, occupational therapy, and speech...

Relationship between Admission Criteria and Program Completion in a Radiation Therapy Program

ERIC Educational Resources Information Center

Dougherty, Adrienne M.

2017-01-01

Poor completion rates in the radiation therapy associate's degree program offered through a community college did not meet the standards set by the college and damaged the program's reputation. The relationship between admission criteria and program completion was not known. The purpose of this study was to determine if there were any…

CARL: a LabVIEW 3 computer program for conducting exposure therapy for the treatment of dental injection fear.

PubMed

Coldwell, S E; Getz, T; Milgrom, P; Prall, C W; Spadafora, A; Ramsay, D S

1998-04-01

This paper describes CARL (Computer Assisted Relaxation Learning), a computerized, exposure-based therapy program for the treatment of dental injection fear. The CARL program operates primarily in two different modes; in vitro, which presents a video-taped exposure hierarchy, and in vivo, which presents scripts for a dentist or hygienist to use while working with a subject. Two additional modes are used to train subjects to use the program and to administer behavioral assessment tests. The program contains five different modules, which function to register a subject, train subjects to use physical and cognitive relaxation techniques, deliver an exposure hierarchy, question subjects about the helpfulness of each of the therapy components, and test for memory effects of anxiolytic medication. Nine subjects have completed the CARL therapy program and 1-yr follow-up as participants in a placebo-controlled clinical trial examining the effects of alprazolam on exposure therapy for dental injection phobia. All nine subjects were able to receive two dental injections, and all reduced their general fear of dental injections. Initial results therefore indicate that the CARL program successfully reduces dental injection fear.

A Qualitative Investigation into Why the Motivation of Massage Therapy Students Changes over the Course of Their Professional Education

PubMed Central

Finch, Paul

2009-01-01

Purpose: In previous research, the motivation of massage therapy students was observed to change between commencement of their professional studies and entry into practice. The change involved a decrease in intrinsic motivation (associated with altruism) and an increase in extrinsic motivation (associated with the prospect of external rewards). This paper reports on the influences underlying those changes. Methods: The research used a qualitative design in which data were collected during a series of individual in-depth semi-structured interviews with massage therapy graduates, just after completion of a 2-year (2200-hour) full-time program. After informed consent was obtained, interviews were taped, transcribed, and analyzed, resulting in identification of a number of themes and subthemes. Results: Previously noted changes in student motivation involved an increase in the influence of extrinsic rewards and a decrease in motivation related to helping and working with people. The findings of the present study suggest that these changes are explained by two main themes, each with a number of subthemes. The first theme, The Reality of Life in Practice, is associated with two subthemes: Debt Load, and Effectiveness in Achieving Positive Health Outcomes. The second theme, An Evolving Self-Image As a Health Care Professional, is associated with three sub-themes: Rigor/Intensity of the Educational Program, Developing Perspective of Massage Therapy As a Career, and Interaction with Faculty. Conclusions: The data suggest that the change in motivation noted in previous work (increased extrinsic motivation and decreased intrinsic motivation) is influenced in different ways by each identified theme. Although schools must be vigilant in ensuring that their programs support the humanistic mission of health care, the present study indicates that the change in motivation noted in earlier work is not sinister. Rather, it appears to be related to the development of a realistic perspective of life as a health care practitioner, which departs from the more naïve expectations of students when they commence their professional studies. PMID:21589720

A Call for Diversity: The Need to Recruit and Retain Ethnic Minority Students in Art Therapy

ERIC Educational Resources Information Center

Awais, Yasmine J.; Yali, Ann Marie

2013-01-01

There is a clear need for greater diversity in the field of art therapy with particular attention to increasing the representation of students of color in art therapy training programs. However, little to no data exists on how art therapy programs are actively recruiting for diversity. Diversity in the classroom can offer novel perspectives on…

Dosimetric investigation of proton therapy on CT-based patient data using Monte Carlo simulation

NASA Astrophysics Data System (ADS)

Chongsan, T.; Liamsuwan, T.; Tangboonduangjit, P.

2016-03-01

The aim of radiotherapy is to deliver high radiation dose to the tumor with low radiation dose to healthy tissues. Protons have Bragg peaks that give high radiation dose to the tumor but low exit dose or dose tail. Therefore, proton therapy is promising for treating deep- seated tumors and tumors locating close to organs at risk. Moreover, the physical characteristic of protons is suitable for treating cancer in pediatric patients. This work developed a computational platform for calculating proton dose distribution using the Monte Carlo (MC) technique and patient's anatomical data. The studied case is a pediatric patient with a primary brain tumor. PHITS will be used for MC simulation. Therefore, patient-specific CT-DICOM files were converted to the PHITS input. A MATLAB optimization program was developed to create a beam delivery control file for this study. The optimization program requires the proton beam data. All these data were calculated in this work using analytical formulas and the calculation accuracy was tested, before the beam delivery control file is used for MC simulation. This study will be useful for researchers aiming to investigate proton dose distribution in patients but do not have access to proton therapy machines.

76 FR 48563 - Medicare and Medicaid Programs; Quarterly Listing of Program Issuances-January Through March 2011...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-08

...-7205 Ventricular Assist Device (Destination Therapy) Facilities. XIII Medicare-Approved Lung JoAnna...-Approved Ventricular Assist Device (Destination Therapy) Facilities, Addendum XIII: Lung Volume Reduction...-Approved Ventricular Assist Device (Destination Therapy) Facilities (January Through March 2011) Addendum...

The Perceived Value and Efficacy of Traditional Face-to-Face versus Hybrid Methods of Clinical Instruction among Physical Therapy Educators and Students in Doctoral Level Programs: A Qualitative Case Study

ERIC Educational Resources Information Center

Eddow, Christine

2017-01-01

Physical therapy is a branch of healthcare that has advanced from an ancillary support role to an autonomous doctoral level profession in only two decades. Enrollment in physical therapy programs is increasing while resources and program length remain limited, leaving academic leaders challenged to identify instructional methods to manage…

Multicenter Cell Processing for Cardiovascular Regenerative Medicine Applications - The Cardiovascular Cell Therapy Research Network (CCTRN) Experience

PubMed Central

Gee, Adrian P.; Richman, Sara; Durett, April; McKenna, David; Traverse, Jay; Henry, Timothy; Fisk, Diann; Pepine, Carl; Bloom, Jeannette; Willerson, James; Prater, Karen; Zhao, David; Koç, Jane Reese; Ellis, Steven; Taylor, Doris; Cogle, Christopher; Moyé, Lemuel; Simari, Robert; Skarlatos, Sonia

2013-01-01

Background Aims Multi-center cellular therapy clinical trials require the establishment and implementation of standardized cell processing protocols and associated quality control mechanisms. The aims here were to develop such an infrastructure in support of the Cardiovascular Cell Therapy Research Network (CCTRN) and to report on the results of processing for the first 60 patients. Methods Standardized cell preparations, consisting of autologous bone marrow mononuclear cells, prepared using the Sepax device were manufactured at each of the five processing facilities that supported the clinical treatment centers. Processing staff underwent centralized training that included proficiency evaluation. Quality was subsequently monitored by a central quality control program that included product evaluation by the CCTRN biorepositories. Results Data from the first 60 procedures demonstrate that uniform products, that met all release criteria, could be manufactured at all five sites within 7 hours of receipt of the bone marrow. Uniformity was facilitated by use of the automated systems (the Sepax for processing and the Endosafe device for endotoxin testing), standardized procedures and centralized quality control. Conclusions Complex multicenter cell therapy and regenerative medicine protocols can, where necessary, successfully utilize local processing facilities once an effective infrastructure is in place to provide training, and quality control. PMID:20524773

Re-imagining occupational therapy clients as communities: Presenting the community-centred practice framework.

PubMed

Hyett, Nerida; Kenny, Amanda; Dickson-Swift, Virginia

2018-01-09

Occupational therapists' are increasingly working with communities and providing services at the community level. There is, however, a lack of conceptual frameworks to guide this work. The aim of this article is to present a new conceptual framework for community-centered practice in occupational therapy. The conceptual framework was developed from qualitative multi-case research on exemplars of community participation. The first was, a network of Canadian food security programs, and the second, a rural Australian community banking initiative. Key themes were identified from across the case studies, and cross-case findings interpreted using occupational therapy and occupational science knowledge, and relevant social theory. The outcome is a four-stage, occupation-focused, community-centered practice framework. The Community-Centred Practice Framework can be used by occupational therapists to understand and apply a community-centered practice approach. The four stages are: (1) Community Identity, (2) Community Occupations, (3) Community Resources and Barriers, and (4) Participation Enablement. Further research is needed to trial and critically evaluate the framework, to assess its usefulness as a robust, occupation-focused, frame of reference to guide community-centered practice in occupational therapy. The proposed framework should assist occupational therapists to conceptualize community-centered practice, and to utilize and apply theory.

[Effects of heat therapy using a far infrared rays heating element for dysmenorrhea in high school girls].

PubMed

Hong, Yeon Ran

2011-02-01

The purpose of this study was designed to identify the effects of heat therapy on dysmenorrhea, heat being provided using a far infrared rays heating element. The research design for the study was a non-equivalent control group quasi-experimental design. Participants were 22 students for the experimental group, and 26 students for the control group. Data were analyzed using SAS WIN 9.1 program. The experimental group had significantly lower mean scores for menstrual pain, dysmenorrhea, and blood pressure than those in the control group. However, no significant differences were found between two groups for pulse, respiration, and temperature. These findings show that thermotherapy was effective for reduction of menstrual pain, dysmenorrhea, and B/P. Therefore, this therapy could be used as a nursing intervention for students with dysmenorrhea.

Medical ultrasound education for bioengineers

NASA Astrophysics Data System (ADS)

Vaezy, Shahram

2005-04-01

The widespread adoption of ultrasound technologies in medicine has necessitated the development of educational programs to address the growing demand for trained expertise in both academia and industry. The demand has been especially great in the field of therapeutic ultrasound that has experienced a significant level of research and development activities in the past decade. The applications cover a wide range including cancer treatment, hemorrhage control, cardiac ablation, gene therapy, and cosmetic surgery. A comprehensive educational program in ultrasound is well suited for bioengineering departments at colleges and universities. Our educational program for students in Bioengineering at the University of Washington includes a year-long coursework covering theory and practice of ultrasound, conducting research projects, attending and presenting at weekly seminars on literature survey, presentations at scientific meetings, and attending specialized workshops offered by various institutions for specific topics. An important aspect of this training is its multi-disciplinary approach, encompassing science, engineering, and medicine. The students are required to build teams with expertise in these disciplines. Our experience shows that these students are well prepared for careers in academia, conducting cutting edge research, as well as industry, being involved in the transformation of research end-products to commercially viable technology.

Engineering excellence in breakthrough biomedical technologies: bioengineering at the University of California, Riverside.

PubMed

Schultz, Jane S; Rodgers, V G J

2012-07-01

The Department of Bioengineering at the University of California, Riverside (UCR), was established in 2006 and is the youngest department in the Bourns College of Engineering. It is an interdisciplinary research engine that builds strength from highly recognized experts in biochemistry, biophysics, biology, and engineering, focusing on common critical themes. The range of faculty research interests is notable for its diversity, from the basic cell biology through cell function to the physiology of the whole organism, each directed at breakthroughs in biomedical devices for measurement and therapy. The department forges future leaders in bioengineering, mirroring the field in being energetic, interdisciplinary, and fast moving at the frontiers of biomedical discoveries. Our educational programs combine a solid foundation in bio logical sciences and engineering, diverse communication skills, and training in the most advanced quantitative bioengineering research. Bioengineering at UCR also includes the Bioengineering Interdepartmental Graduate (BIG) program. With its slogan Start-Grow-Be-BIG, it is already recognized for its many accomplishments, including being third in the nation in 2011 for bioengineering students receiving National Science Foundation graduate research fellowships as well as being one of the most ethnically inclusive programs in the nation.

Development of the compact proton beam therapy system dedicated to spot scanning with real-time tumor-tracking technology

NASA Astrophysics Data System (ADS)

Umezawa, Masumi; Fujimoto, Rintaro; Umekawa, Tooru; Fujii, Yuusuke; Takayanagi, Taisuke; Ebina, Futaro; Aoki, Takamichi; Nagamine, Yoshihiko; Matsuda, Koji; Hiramoto, Kazuo; Matsuura, Taeko; Miyamoto, Naoki; Nihongi, Hideaki; Umegaki, Kikuo; Shirato, Hiroki

2013-04-01

Hokkaido University and Hitachi Ltd. have started joint development of the Gated Spot Scanning Proton Therapy with Real-Time Tumor-Tracking System by integrating real-time tumor tracking technology (RTRT) and the proton therapy system dedicated to discrete spot scanning techniques under the "Funding Program for World-Leading Innovative R&D on Science and Technology (FIRST Program)". In this development, we have designed the synchrotron-based accelerator system by using the advantages of the spot scanning technique in order to realize a more compact and lower cost proton therapy system than the conventional system. In the gated irradiation, we have focused on the issues to maximize irradiation efficiency and minimize the dose errors caused by organ motion. In order to understand the interplay effect between scanning beam delivery and target motion, we conducted a simulation study. The newly designed system consists of the synchrotron, beam transport system, one compact rotating gantry treatment room with robotic couch, and one experimental room for future research. To improve the irradiation efficiency, the new control function which enables multiple gated irradiations per synchrotron cycle has been applied and its efficacy was confirmed by the irradiation time estimation. As for the interplay effect, we confirmed that the selection of a strict gating width and scan direction enables formation of the uniform dose distribution.

Accepted Common Interest Community (CIC) Proposals.

PubMed

These are the 18 accepted proposals for the three Common Interest Community (CIC) sessions at IAYT's Symposium on Yoga Therapy and Research (SYTAR), June 5-8, 2014, in Austin, Texas and published in the Final Program Guide and CIC Works for SYTAR 2014. The sessions were CIC#1 Rehab Professionals: Bridging the Past with the Future and CIC#2a & CIC#2b Mental, Emotional and Spiritual Health.

Fox Chase Cancer Center's Genitourinary Division: a national resource for research, innovation and patient care.

PubMed

Uzzo, Robert G; Horwitz, Eric M; Plimack, Elizabeth R

2016-04-01

Founded in 1904, Fox Chase Cancer Center remains committed to its mission. It is one of 41 centers in the country designated as a Comprehensive Cancer Center by the National Cancer Institute, is a founding member of the National Comprehensive Cancer Network, holds the magnet designation for nursing excellence, is one of the first to establish a family cancer risk assessment program, and has achieved national distinction because of the scientific discoveries made there that have advanced clinical care. Two of its researchers have won Nobel prizes. The Genitourinary Division is nationally recognized and viewed as one of the top driving forces behind the growth of Fox Chase due to its commitment to initiating and participating in clinical trials, its prolific contributions to peer-reviewed publications and presentations at scientific meetings, its innovations in therapies and treatment strategies, and its commitment to bringing cutting-edge therapies to patients.

[The effects of a multi agent obesity control program in obese school children].

PubMed

Ahn, Hye Young; Im, Sook Bin; Hong, Kyung Ja; Hur, Myung Haeng

2007-02-01

The purpose of this study was to identify the effects of a multi agent obesity control program in obese school children. This program was composed of strategies to modify diet and exercise habits and to change cognitive behavior variables(stress, coping, and self-efficacy). The subjects were 40 obese school children who participated in our project voluntarily via homepage, TV, newspaper, public paper and school official documents. The program was implemented daily for 4 sessions per day for ten days from August 16 to 26, 2004. The daily program consisted of exercise therapy, dance therapy, cognitive behavior therapy and aroma therapy. The data was analyzed by paired t-test using the SPSSWIN program. There was a significant decrease in children's waist-hip ratio (p=.04) and in children's stress (p=.00) after the program. There was a significant increase in children's self-confidence after the program(p=.02) and a significant decrease in children's diet habit after the program(p=.02). This study provides evidence that a multiagent obese control program is effective in changing waist-hip ratio, stress, self-confidence, and diet habits in obese school children.

The Daily Events and Emotions of Master's-Level Family Therapy Trainees in Off-Campus Practicum Settings

ERIC Educational Resources Information Center

Edwards, Todd M.; Patterson, Jo Ellen

2012-01-01

The Day Reconstruction Method (DRM) was used to assess the daily events and emotions of one program's master's-level family therapy trainees in off-campus practicum settings. This study examines the DRM reports of 35 family therapy trainees in the second year of their master's program in marriage and family therapy. Four themes emerged from the…

Outcomes research in cancer clinical trial cooperative groups: the RTOG model.

PubMed

Bruner, D W; Movsas, B; Konski, A; Roach, M; Bondy, M; Scarintino, C; Scott, C; Curran, W

2004-08-01

The Radiation Therapy Oncology Group (RTOG), a National Cancer Institute sponsored cancer clinical trials research cooperative, has recently formed an Outcomes Committee to assess a comprehensive array of clinical trial endpoints and factors impacting the net effect of therapy. To study outcomes in a consistent, comprehensive and coordinated manner, the RTOG Outcomes Committee developed a model to assess clinical, humanistic, and economic outcomes important in clinical trials. This paper reviews how the RTOG incorporates outcomes research into cancer clinical trials, and demonstrates utilization of the RTOG Outcomes Model to test hypotheses related to non-small-cell lung cancer (NSCLC). In this example, the clinical component of the model indicates that the addition of chemotherapy to radiotherapy (RT) improves survival but increases the risk of toxicity. The humanistic component indicates that esophagitis is the symptom impacting quality of life the greatest and may outweigh the benefits in elderly (> or =70 years) patients. The economic component of the model indicates that accounting for quality-adjusted survival, concurrent chemoRT for the treatment of NSCLC is within the range of economically acceptable recommendations. The RTOG Outcomes Model guides a comprehensive program of research that systematically measures a triad of endpoints considered important to clinical trials research.

Cognitive behavioral therapy and physical exercise for climacteric symptoms in breast cancer patients experiencing treatment-induced menopause: design of a multicenter trial.

PubMed

Duijts, Saskia F A; Oldenburg, Hester S A; van Beurden, Marc; Aaronson, Neil K

2009-06-06

Premature menopause is a major concern of younger women undergoing adjuvant therapy for breast cancer. Hormone replacement therapy is contraindicated in women with a history of breast cancer. Non-hormonal medications show a range of bothersome side-effects. There is growing evidence that cognitive behavioral therapy (CBT) and physical exercise can have a positive impact on symptoms in naturally occurring menopause. The objective of this study is to investigate the efficacy of these interventions among women with breast cancer experiencing treatment-induced menopause. In a randomized, controlled, multicenter trial, we are evaluating the effectiveness of CBT/relaxation, of physical exercise and of these two program elements combined, in reducing menopausal symptoms, improving sexual functioning, reducing emotional distress, and in improving the health-related quality of life of younger breast cancer patients who experience treatment-induced menopause. 325 breast cancer patients (aged < 50) are being recruited from hospitals in the Amsterdam region, and randomly allocated to one of the three treatment groups or a 'waiting list' control group. Self-administered questionnaires are completed by the patients at baseline, and at 12 weeks (T1) and 6 months (T2) post-study entry. Upon completion of the study, women assigned to the control group will be given the choice of undergoing either the CBT or physical exercise program. Cognitive behavioral therapy and physical exercise are potentially useful treatments among women with breast cancer undergoing treatment-induced, premature menopause. For these patients, hormonal and non-hormonal therapies are contraindicated or have a range of bothersome side-effects. Hence, research into these interventions is needed, before dissemination and implementation in the current health care system can take place.

Psychotherapy Training: Residents' Perceptions and Experiences.

PubMed

Kovach, Jessica G; Dubin, William R; Combs, Christopher J

2015-10-01

This survey examined actual training hours in psychotherapy modalities as reported by residents, residents' perceptions of training needs, and residents' perceptions of the importance of different aspects of psychotherapy training. A brief, voluntary, anonymous, Internet-based survey was developed. All 14 program directors for Accreditation Council for Graduate Medical Education accredited programs in Pennsylvania, New Jersey, and Delaware provided email addresses for current categorical residents. The survey inquired about hours of time spent in various aspects of training, value assigned to aspects of training, residents' involvement in their own psychotherapy, and overall resident wellness. The survey was e-mailed to 328 residents. Of the 328 residents contacted, 133 (40.5%) responded. Median reported number of PGY 3 and 4 performed versus perceived ideal hours of supportive therapy, cognitive behavioral therapy (CBT), and psychodynamic therapy did not differ. Answers for clinical time utilizing these modalities ranged from "none or less than 1 h" per month to 20+ h per month. PGY 3 and 4 residents reported a median of "none or less than 1 h" per month performed of interpersonal, dialectical behavior therapy, couples/family/group, and child therapies but preferred more time using these therapies. Residents in all years of training preferred more hours of didactic instruction for all psychotherapies and for medication management. Residents ranked teaching modalities in the following order of importance: supervision, hours of psychotherapy performed, personal psychotherapy, readings, and didactic instruction. Residents engaged in their own psychotherapy were significantly more likely to rank the experiential aspects of psychotherapy training (personal psychotherapy, supervision, and hours performed) higher than residents not in psychotherapy. Current psychotherapy training for psychiatry residents is highly variable, but overall, residents want more psychotherapy education than they are receiving. Further research and discussion about how much psychotherapy training is feasible in an evolving field is required.

Play Therapy Training among School Psychology, Social Work, and School Counseling Graduate Training Programs

ERIC Educational Resources Information Center

Pascarella, Christina Bechle

2012-01-01

This study examined play therapy training across the nation among school psychology, social work, and school counseling graduate training programs. It also compared current training to previous training among school psychology and school counseling programs. A random sample of trainers was selected from lists of graduate programs provided by…

Action observation and motor imagery for rehabilitation in Parkinson's disease: A systematic review and an integrative hypothesis.

PubMed

Caligiore, Daniele; Mustile, Magda; Spalletta, Gianfranco; Baldassarre, Gianluca

2017-01-01

This article discusses recent evidence supporting the use of action observation therapy and motor imagery practice for rehabilitation of Parkinson's disease. A main question that emerges from the review regards the different effectiveness of these approaches and the possibility of integrating them into a single method to enhance motor behaviour in subjects with Parkinson's disease. In particular, the reviewed studies suggest that action observation therapy can have a positive effect on motor facilitation of patients and that a long-term rehabilitation program based on action observation therapy or motor imagery practice can bring some benefit on their motor recovery. Moreover, the paper discusses how the research on the combined use of action observation and motor imagery for motor improvements in healthy subjects may encourage the combined use of action observation therapy and motor imagery practice for therapeutic aims in Parkinson's disease. To date, this hypothesis has never been experimented. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

[Advanced radiation therapy project for cancer treatment--from Hokkaido to the world, the world access to Hokkaido].

PubMed

Shimizu, Shinichi; Tsuchiya, Kazuhiko; Takao, Seishin; Shirato, Hiroki

2014-05-01

Cancer is the most major cause of death in Japan recently. In this symposium, we explained advanced treatment technology for cancer treatment, now used and that will be used in near future at the Hokkaido University Hospital. Intensity Moderated Radiation Therapy (IMRT) and Proton Beam Therapy (PBT) are considered to be the most promising and advanced technologies for cancer treatment. Various kinds of radiation treatment equipment and methods have been developed and constructed at the Hokkaido University. One of the most worlds wide famous one is the real time tumor tracking radiotherapy system. The FIRST (Funding for World-Leading Innovative R&D on Science and Technology) Program has been supporting us to produce cutting-edge technology. We hope that this symposium would help the audience to understand the latest technology for cancer treatment especially in the field of radiation therapy and also we wish the audience would recognize the importance of the research aspect that have been performed at Hokkaido University and its Hospital.

Enhancing Supportive-Educative Nursing Systems to Reduce Risk of Post-Breast Cancer Lymphedema

PubMed Central

Armer, Jane M.; Shook, Robin P.; Schneider, Melanie K; Brooks, Constance W.; Peterson, Julie; Stewart, Bob R

2010-01-01

This study describes the use of data regarding self-care agency to enhance a supportive-educative nursing system for breast cancer survivors to reduce the risk of developing lymphedema post surgery. Impetus for this study came from the analysis of participant feedback from a parent study (Lance Armstrong Foundation pilot study) that sought to plan an educational program for nurses that will improve their supportive-educative nursing system when working with breast cancer survivors. The goal is to enable these women to reduce the risk of lymphedema post surgery. The parent study examined a bundled behavioral-educative intervention, which included standard lymphedema education coupled with Modified Manual Lymph Drainage (MMLD) to reduce the risk of developing lymphedema in newly-diagnosed breast cancer survivors. Based upon the feedback received from the parent study, the research team recognized that many of the participants were not fully following the recommendations of the intervention protocol. In order for nurses to help patients develop self-care agency (SCA) (Orem, 2001) to engage in actions that addressed the self-care requisites associated with post-breast cancer surgery, these nurses needed to refine their intervention skills. Prior to the development of a program for the nurses, the research team conducted a study to explore the state of power related to SCA of the study participants. The information obtained from this was then used in the development of an educational program for bundled intervention. Both motivational interviewing (Miller & Rollnick, 2002) and solution-focused therapy (Berg & DeJong, 1996) were incorporated into the educational program for the research nurse team to strengthen and improve supportive-educative nursing systems. Supportive-educative systems of care that integrate self-care deficit nursing theory, motivational interviewing, and solution-focused therapy can assist patients to develop and sustain self-care agency. PMID:22872189

Postdoctoral Fellow | Center for Cancer Research

Cancer.gov

The Laboratory of Tumor Immunology and Biology (LTIB) functions as a multidisciplinary and interdisciplinary translational research programmatic effort with the goal of developing novel immunotherapies for cancer. The LTIB strategic plan focuses on the development of novel immunotherapeutics for human cancer, not only as monotherapies, but more importantly, in combination with other immune-mediating modalities, and other conventional or experimental therapies, as part of an immuno-oncology programmatic effort. Within this effort are several research groups, a clinical trials group, and multiple collaborations with intramural and extramural scientific and clinical investigators and with investigators in the private sector. The program takes advantage of the uniqueness of the NCI intramural program in that it spans high-risk basic discovery research in immunology, genomics and tumor biology, through preclinical translational research, to paradigm-shifting clinical trials. Focus is placed on the design and development of novel "off-the-shelf" recombinant immunotherapeutics that can be used in clinical studies at numerous institutions. A major strength of the program is the rapid translation of preclinical studies to hypothesis-generating clinical trials. We are looking for postdoctoral fellows interested in learning immunology and immunotherapy, as well as those postdoctoral fellows with a background and/or interest in experimental pathology.  The position is available immediately. The appointment duration is up to 5 years. Stipends are commensurate with education and experience.

Dance program for physical rehabilitation and participation in children with cerebral palsy

PubMed Central

López-Ortiz, Citlali; Gladden, Kim; Deon, Laura; Schmidt, Jennifer; Girolami, Gay; Gaebler-Spira, Deborah

2012-01-01

Objective: This pilot study aimed to examine a classical ballet program created for children with cerebral palsy (CP) as an emerging physical rehabilitation modality. The main program goals were to promote participation and to provide an artistic, physically therapeutic activity. Methods: The study was conducted in collaboration with a tertiary rehabilitation hospital, one outpatient physical therapy clinic, and one community center. As a pilot exploratory study, the research design included questionnaires to assess the participants' (children (n = 16), parents (n = 16), and therapists (n = 13)) perceptions on the therapeutic benefit of the dance program. A binomial statistical model was adopted for the analysis of the results. Results: Main results were that the children reported high enjoyment level (p < .0001) and desire for more classes (.0001); the parents reported perceived therapeutic benefit (p < .0001); and the therapists viewed the class as a positive adjunct to therapy (p < .0001). Conclusions: The main limitation of this work was the utilization of subjective outcome measures. However, this is the first step toward the development of objective measures of an intervention that, to our knowledge, has not been analyzed in the past. We conclude that the program has the potential of developing into an evidence based rehabilitation resource for children with CP. PMID:25431617

Gene therapy for prostate cancer: where are we now?

PubMed

Steiner, M S; Gingrich, J R

2000-10-01

The ability to recombine specifically and alter DNA sequences followed by techniques to transfer these sequences or even whole genes into normal and diseased cells has revolutionized medical research and ushered the clinicians of today into the age of gene therapy. We provide urologists a review of relevant background information, outline current treatment strategies and clinical trials, and delineate current challenges facing the field of gene therapy for advanced prostate cancer. We comprehensively reviewed the literature, including PubMed and recent abstract proceedings from national meetings, relevant to gene therapy and advanced prostate cancer. We selected for review literature representative of the principal scientific background for current gene therapy strategies and National Institutes of Health Recombinant DNA Advisory Committee approved clinical trials. Current prostate cancer gene therapy strategies include correcting aberrant gene expression, exploiting programmed cell death pathways, targeting critical cell biological functions, introducing toxic or cell lytic suicide genes, enhancing the immune system antitumor response and combining treatment with conventional cytotoxic chemotherapy or radiation therapy. Many challenges lie ahead for gene therapy, including improving DNA transfer efficiency to cells locally and at distant sites, enhancing levels of gene expression and overcoming immune responses that limit the time that genes are expressed. Nevertheless, despite these current challenges it is almost certain that gene therapy will be part of the urological armamentarium against prostate cancer in this century.

Delivery of the Wilbarger Protocol: A Survey of Pediatric Occupational Therapy Practitioners

ERIC Educational Resources Information Center

Lancaster, Stephanie; Zachry, Anne; Duck, Ashleigh; Harris, Alexandria; Page, Ellen; Sanders, Jordan

2016-01-01

The Wilbarger Therapressure Program is a commonly used treatment approach utilized by occupational therapy professionals for the treatment of sensory defensiveness. The purpose of the current study was to investigate occupational therapy practitioners' sources of training in the administration of Wilbarger Therapressure Program, the uniformity of…

76 FR 17870 - Medicare and Medicaid Programs; Quarterly Listing of Program Issuances-October Through December 2010

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-31

... Registry (NOPR) Sites. Addendum XIII: Medicare-approved Ventricular Assist Device (Destination Therapy... Therapy) Facilities (October Through December 2010) On October 1, 2003, we issued our decision memorandum on ventricular assist devices (VADs) for the clinical indication of destination therapy. We...

Occupational Therapy Assistants Program. Demonstration Project.

ERIC Educational Resources Information Center

Wisconsin State Board of Health, Madison.

Between November 1964 and June 1967, 85 women and five men completed a 4-month course held in several Wisconsin locations to prepare them as Certified Occupational Therapy Assistants to (1) plan and direct a general activity or supportive program of occupational therapy, (2) train individual patients in independent performance of activities of…

The Family Therapy Institute: A State-Wide Deinstitutionalization Program.

ERIC Educational Resources Information Center

Family Therapy Inst., Rugby, ND.

The report--over half of which consists of appendixes--describes the Family Therapy Institute, a statewide program in Rugby, North Dakota devoted to the deinstitutionalization of juvenile delinquent status offenders by means of short term intensive family therapy treatment. Among the aspects covered are a history of the philosophical approach…

38 CFR 17.48 - Compensated Work Therapy/Transitional Residences program.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false Compensated Work Therapy/Transitional Residences program. 17.48 Section 17.48 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Hospital, Domiciliary and Nursing Home Care § 17.48 Compensated Work Therapy...

38 CFR 17.48 - Compensated Work Therapy/Transitional Residences program.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false Compensated Work Therapy/Transitional Residences program. 17.48 Section 17.48 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Hospital, Domiciliary and Nursing Home Care § 17.48 Compensated Work Therapy...

38 CFR 17.48 - Compensated Work Therapy/Transitional Residences program.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Compensated Work Therapy/Transitional Residences program. 17.48 Section 17.48 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Hospital, Domiciliary and Nursing Home Care § 17.48 Compensated Work Therapy...

38 CFR 17.48 - Compensated Work Therapy/Transitional Residences program.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Compensated Work Therapy/Transitional Residences program. 17.48 Section 17.48 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Hospital, Domiciliary and Nursing Home Care § 17.48 Compensated Work Therapy...

38 CFR 17.48 - Compensated Work Therapy/Transitional Residences program.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Compensated Work Therapy/Transitional Residences program. 17.48 Section 17.48 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Hospital, Domiciliary and Nursing Home Care § 17.48 Compensated Work Therapy...

Exercise, education, manual-therapy and taping compared to education for patellofemoral osteoarthritis: a blinded, randomised clinical trial.

PubMed

Crossley, K M; Vicenzino, B; Lentzos, J; Schache, A G; Pandy, M G; Ozturk, H; Hinman, R S

2015-09-01

Patellofemoral joint osteoarthritis (PFJ OA) contributes considerably to knee OA symptoms. This study aimed to determine the efficacy of a PFJ-targeted exercise, education manual-therapy and taping program compared to OA education alone, in participants with PFJ OA. A randomised, participant-blinded and assessor-blinded clinical trial was conducted in primary-care physiotherapy. 92 people aged ≥40 years with symptomatic and radiographic PFJ OA participated. Physiotherapists delivered the PFJ-targeted exercise, education, manual-therapy and taping program, or the OA-education (control condition) in eight sessions over 12 weeks. Primary outcomes at 3-month (primary) and 9-month follow-up: (1) patient-perceived global rating of change (2) pain visual analogue scale (VAS) (100 mm); and (3) activities of daily living (ADL) subscale of the Knee injury and Osteoarthritis Outcome Score (KOOS). 81 people (88%) completed the 3-month follow-up and data analysed on an intention-to-treat basis. Between-group baseline similarity for participant characteristics was observed. The exercise, education, manual-therapy and taping program resulted in more people reporting much improvement (20/44) than the OA-education group (5/48) (number needed to treat 3 (95% confidence interval (CI) 2 to 5)) and greater pain reduction (mean difference: -15.2 mm, 95% CI -27.0 to -3.4). No significant effects on ADL were observed (5.8; 95% CI -0.6 to 12.1). At 9 months there were no significant effects for self-report of improvement, pain (-10.5 mm, 95% CI -22.7 to 1.8) or ADL (3.0, 95% CI -3.7 to 9.7). Exercise, education, manual-therapy and taping can be recommended to improve short-term patient rating of change and pain severity. However over 9-months, both options were equivalent. Australian New Zealand Clinical Trials Registry (ACTRN12608000288325): https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=82878. Copyright © 2015 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

National Heart, Lung, and Blood Institute and the translation of cardiovascular discoveries into therapeutic approaches.

PubMed

Galis, Zorina S; Black, Jodi B; Skarlatos, Sonia I

2013-04-26

The molecular causes of ≈4000 medical conditions have been described, yet only 5% have associated therapies. For decades, the average time for drug development through approval has taken 10 to 20 years. In recent years, the serious challenges that confront the private sector have made it difficult to capitalize on new opportunities presented by advances in genomics and cellular therapies. Current trends are disturbing. Pharmaceutical companies are reducing their investments in research, and biotechnology companies are struggling to obtain venture funds. To support early-stage translation of the discoveries in basic science, the National Institutes of Health and the National Heart, Lung, and Blood Institute have developed new approaches to facilitating the translation of basic discoveries into clinical applications and will continue to develop a variety of programs that create teams of academic investigators and industry partners. The goal of these programs is to maximize the public benefit of investment of taxpayer dollars in biomedical research and to lessen the risk required for industry partners to make substantial investments. This article highlights several examples of National Heart, Lung, and Blood Institute-initiated translational programs and National Institutes of Health translational resources designed to catalyze and enable the earliest stages of the biomedical product development process. The translation of latest discoveries into therapeutic approaches depends on continued federal funding to enhance the early stages of the product development process and to stimulate and catalyze partnerships between academia, industry, and other sources of capital.

Using internet enabled mobile devices and social networking technologies to promote exercise as an intervention for young first episode psychosis patients.

PubMed

Killackey, Eoin; Anda, Anna Lee; Gibbs, Martin; Alvarez-Jimenez, Mario; Thompson, Andrew; Sun, Pamela; Baksheev, Gennady N

2011-05-12

Young people with first episode psychosis are at an increased risk for a range of poor health outcomes. In contrast to the growing body of evidence that suggests that exercise therapy may benefit the physical and mental health of people diagnosed with schizophrenia, there are no studies to date that have sought to extend the use of exercise therapy among patients with first episode psychosis. The aim of the study is to test the feasibility and acceptability of an exercise program that will be delivered via internet enabled mobile devices and social networking technologies among young people with first episode psychosis. This study is a qualitative pilot study being conducted at Orygen Youth Health Research Centre in Melbourne, Australia. Participants are young people aged 15-24 who are receiving clinical care at a specialist first episode psychosis treatment centre. Participants will also comprise young people from the general population. The exercise intervention is a 9-week running program, designed to gradually build a person's level of fitness to be able to run 5 kilometres (3 miles) towards the end of the program. The program will be delivered via an internet enabled mobile device. Participants will be asked to post messages about their running experiences on the social networking website, and will also be asked to attend three face-to-face interviews. This paper describes the development of a qualitative study to pilot a running program coupled with the use of internet enabled mobile devices among young people with first episode psychosis. If the program is found to be feasible and acceptable to patients, it is hoped that further rigorous evaluations will ultimately lead to the introduction of exercise therapy as part of an evidence-based, multidisciplinary approach in routine clinical care.

Physical conditioning and mental stress reduction - a randomised trial in patients undergoing cardiac surgery

PubMed Central

2011-01-01

Background Preoperative anxiety and physical unfitness have been shown to have adverse effects on recovery from cardiac surgery. This study involving cardiac surgery patients was primarily aimed at assessing the feasibility of delivering physical conditioning and stress reduction programs within the public hospital setting. Secondary aims were to evaluate the effect of these programs on quality of life (QOL), rates of postoperative atrial fibrillation (AF) and length of stay (LOS) in hospital. Methods Elective patients scheduled for coronary artery bypass graft and/or valve surgery at a public hospital in Melbourne, Australia were enrolled. Patients were randomized to receive either holistic therapy (HT) or usual care (UC). HT consisted of a series of light physical exercise sessions together with a mental stress reduction program administered in an outpatient setting for the first two weeks after placement on the waiting list for surgery. A self-administered SF-36 questionnaire was used to measure QOL and hospital records to collect data on LOS and rate of postoperative AF. Results The study population comprised 117 patients of whom 60 received HT and 57 received UC. Both programs were able to be delivered within the hospital setting but ongoing therapy beyond the two week duration of the program was not carried out due to long waiting periods and insufficient resources. HT, as delivered in this study, compared to UC did not result in significant changes in QOL, LOS or AF incidence. Conclusions Preoperative holistic therapy can be delivered in the hospital setting, although two weeks is insufficient to provide benefits beyond usual care on QOL, LOS or postoperative AF. Further research is now required to determine whether a similar program of longer duration, or targeted to high risk patients can provide measurable benefits. Trial registration This trial was conducted as part of a larger study and according to the principles contained in the CONSORT statement 2001. PMID:21385466

Who let the dogs out? Infection control did: utility of dogs in health care settings and infection control aspects.

PubMed

DiSalvo, Heidi; Haiduven, Donna; Johnson, Nancy; Reyes, Valentine V; Hench, Carmen P; Shaw, Rosemary; Stevens, David A

2006-06-01

Research has substantiated that animals improve human health, both psychologically and physiologically. Therefore, healthcare facilities have begun to implement programs, such as the "Furry Friends Foundation," that bring animals into the facility to improve the quality of life of patients. When implementing these programs, consideration must be given to potential adverse events such as phobias, allergies, and particularly the possibility of zoonotic disease transmission. Santa Clara Valley Medical Centre (SCVMC), a 600-bed county teaching hospital with specialized units (e.g., for burns, rehabilitation, and pediatric care), has implemented programs that incorporate animals into the healthcare setting. This facility allows three categories of dogs to interact with their patients: service dogs, therapy dogs, and pet visitation dogs by the "Furry Friends Foundation." A blurring of the roles of the three categories of dogs occurred when these programs were put into place at SCVMC. The American with Disabilities Act (ADA) states that service animals cannot be prohibited from any area. For example, a "no pet allowed" policy could not apply to these animals. Proof of a person's disability or proof of the service animal's health or training cannot be required. The purpose of this project was to maintain these programs by clarifying the policies regarding animals, specifically dogs, in the healthcare setting. This had to take place to provide a safe and enjoyable environment for the patients and the staff. A comprehensive table was developed to delineate the three categories of dogs and the corresponding policies. Therapy dogs and the visitation animals are more restricted than service dogs. Both therapy dogs and visitation dogs require identification and certification of health and are excluded from certain areas of the facility, including intensive care units and isolation rooms. By complying with the current policies and regulations, the risks from these programs can be minimized. Staff should be educated on the proper terminology and procedures to prevent a blurring of the categories and roles of these animals.

The utility of the FIM+FAM for assessing traumatic brain injury day program outcomes.

PubMed

Seel, Ronald T; Wright, Greg; Wallace, Tracey; Newman, Sary; Dennis, Leanne

2007-01-01

To evaluate the effectiveness of the FIM+FAM as a primary outcome measure for traumatic brain injury (TBI) comprehensive day programs. Retrospective data analysis. Single center, TBI comprehensive day program facility. A demographically and regionally diverse sample of 105 persons with moderate or severe TBI admitted to the Shepherd Pathways comprehensive TBI day rehabilitation program. Functional Independence Measure + Functional Assessment Measure (FIM+FAM). Twenty-eight percent or fewer of participants reached ceiling effects on 25 of the 30 FIM+FAM items at day program admission with only 2% of clients rated above ceiling score levels on the FIM+FAM total score. The criteria of Guyatt et al showed that 20 of the 30 FIM+FAM items showed clinically meaningful improvements in 60% or more of clients. On average, clients with TBI improved over 27 points on the FIM+FAM total score. Fifteen of 30 items showed ceiling effects of 33% or less at discharge where only 25% of clients exceeded the FIM+FAM total score ceiling threshold. Discharge FIM+FAM motor scale was a very good predictor of the need for additional single service physical therapy. However, reaching ceiling rating on the FIM+FAM cognitive scale demonstrated poor specificity (0.28) and negative predictive power (0.42) for the need for additional speech/cognitive therapy services. The FIM+FAM demonstrated utility as an outcome measure for TBI comprehensive day program treatment in the current milieu. Future research is required to replicate and extend the current findings.

A combined treatment approach emphasizing impairment-based manual physical therapy for plantar heel pain: a case series.

PubMed

Young, Brian; Walker, Michael J; Strunce, Joseph; Boyles, Robert

2004-11-01

Case series. To describe an impairment-based physical therapy treatment approach for 4 patients with plantar heel pain. There is limited evidence from clinical trials on which to base treatment decision making for plantar heel pain. Four patients completed a course of physical therapy based on an impairment-based model. All patients received manual physical therapy and stretching. Two patients were also treated with custom orthoses, and 1 patient received an additional strengthening program. Outcome measures included a numeric pain rating scale (NPRS) and self-reported functional status. Symptom duration ranged from 6 to 52 weeks (mean duration+/-SD, 33+/-19 weeks). Treatment duration ranged from 8 to 49 days (mean duration+/-SD, 23+/-18 days), with number of treatment sessions ranging from 2 to 7 (mode, 3). All 4 patients reported a decrease in NPRS scores from an average (+/-SD) of 5.8+/-2.2 to 0 (out of 10) during previously painful activities. Additionally, all patients returned to prior activity levels. In this case series, patients with plantar heel pain treated with an impairment-based physical therapy approach emphasizing manual therapy demonstrated complete pain relief and full return to activities. Further research is necessary to determine the effectiveness of impairment-based physical therapy interventions for patients with plantar heel pain/plantar fasciitis.

Mental health consumer participation in undergraduate occupational therapy student assessment: No negative impact.

PubMed

Logan, Alexandra; Yule, Elisa; Taylor, Michael; Imms, Christine

2018-05-28

Australian accreditation standards for occupational therapy courses require consumer participation in the design, delivery and evaluation of programs. This study investigated whether a mental health consumer - as one of two assessors for an oral assessment in a mental health unit - impacted engagement, anxiety states and academic performance of undergraduate occupational therapy students. Students (n = 131 eligible) self-selected into two groups but were blinded to the group differences (assessor panel composition) until shortly prior to the oral assessment. Control group assessors were two occupational therapy educators, while consumer group assessors included an occupational therapy educator and a mental health consumer. Pre- and post-assessment data were successfully matched for 79 students (overall response rate = 73.1%). No evidence was found of significant differences between the two groups for engagement, anxiety or academic performance (all P values >0.05). Including mental health consumers as assessors did not negatively impact student engagement and academic performance, nor increase student anxiety beyond that typically observed in oral assessment tasks. The findings provide support for expanding the role of mental health consumers in the education and assessment of occupational therapy students. Development of methods to determine the efficacy of consumer involvement remains an area for future research. © 2018 Occupational Therapy Australia.

Art Enrichment: Evaluating a Collaboration between Head Start and a Graduate Art Therapy Program

ERIC Educational Resources Information Center

Klorer, P. Gussie; Robb, Megan

2012-01-01

Head Start, a U.S. federally funded program, prepares children for school through early childhood intervention in social-emotional and cognitive arenas. This article describes program evaluation survey results from the past 5 years of an 18-year collaboration between a university graduate art therapy program and 8 Head Start centers. Graduate art…

New Mexico Center for Isotopes in Medicine

DOE Office of Scientific and Technical Information (OSTI.GOV)

Burchiel, Scott W.

2012-12-13

The purpose of the New Mexico Center for Isotopes in Medicine (NMCIM) is to support research, education and service missions of the UNM College of Pharmacy Radiopharmaceutical Sciences Program (COP RSP) and the Cancer Research and Treatment Center (CRTC). NMCIM developed and coordinated unique translational research in cancer radioimaging and radiotherapy agents based on novel molecules developed at UNM and elsewhere. NMCIM was the primary interface for novel radioisotopes and radiochemistries developed at the Los Alamos National Laboratory (LANL) for SPECT/PET imaging and therapy. NMCIM coordinated the use of the small animal imaging facility with the CRTC provided support servicesmore » to assist investigators in their studies. NMCIM developed education and training programs that benefited professional, graduate, and postdoctoral students that utilized its unique facilities and technologies. UNM COP RSP has been active in writing research and training grants, as well as supporting contract research with industrial partners. The ultimate goal of NMCIM is to bring new radiopharmaceutical imaging and therapeutic agents into clinical trials that will benefit the health and well being of cancer and other patients in New Mexico and the U.S.« less

The use of misclassification costs to learn rule-based decision support models for cost-effective hospital admission strategies.

PubMed

Ambrosino, R; Buchanan, B G; Cooper, G F; Fine, M J

1995-01-01

Cost-effective health care is at the forefront of today's important health-related issues. A research team at the University of Pittsburgh has been interested in lowering the cost of medical care by attempting to define a subset of patients with community-acquire pneumonia for whom outpatient therapy is appropriate and safe. Sensitivity and specificity requirements for this domain make it difficult to use rule-based learning algorithms with standard measures of performance based on accuracy. This paper describes the use of misclassification costs to assist a rule-based machine-learning program in deriving a decision-support aid for choosing outpatient therapy for patients with community-acquired pneumonia.

Nursing issues in renal replacement therapy: organization, manpower assessment, competency evaluation and quality improvement processes.

PubMed

Graham, Patricia; Lischer, Eileen

2011-01-01

For the patient with acute kidney injury, continuous renal replacement therapy (CRRT) is a treatment option that has application for the hemodynamically unstable critically ill patient. The decision to initiate a continuous renal replacement modality depends not only on the physician, either the nephrologist or intensivist, but also on the availability of specially trained nursing resources. This article will explore the nursing collaborative model of care at a large university-based research and teaching Medical Center in Southern California. The focus will be on nursing issues in CRRT including organization of educational programs, manpower assessment, competency evaluation, and quality improvement processes. © 2011 Wiley Periodicals, Inc.

Recent developments in family psychoeducation as an evidence-based practice.

PubMed

Lucksted, Alicia; McFarlane, William; Downing, Donna; Dixon, Lisa

2012-01-01

Among potential resources for people with serious mental illnesses (SMI) and their families, professionally delivered family psychoeducation (FPE) is designed to engage, inform, and educate family members, so that they can assist the person with SMI in managing their illness. In this article, we review research regarding FPE outcomes and implementation since 2001, updating the previous review in this journal (McFarlane, Dixon, Lukens, & Lucksted, Journal of Marital and Family Therapy 2003; 29, 223). Research on a range of FPE variations continues to return mostly positive effects for adults with schizophrenia and increasingly, bipolar disorder. More recent studies include functional outcomes as well as the more common relapse and hospitalization. FPE research involving adults with other diagnoses is increasing, as is FPE research outside the United States In both cases, uneven methodologies and multiple FPE variations make drawing conclusions difficult, although the core utility of access to information, skill building, problem solving, and social support often shines though. Since the previous review, several FPE programs for parents of children or youth with mood disorders have also been developed, with limited research showing more positive than null results. Similarly, we review the developing inquiry into early intervention and FPE, short-form FPE, and cost studies involving FPE. The second half of the article updates the paradox of FPE's evidence base versus its persistently low use, via recent implementation efforts. Multiple challenges and facilitating factors across healthcare systems and financing, individual programs and providers, family members, and consumers shape this issue, and we conclude with discussion of the need for empirical evaluation of implementation strategies and models. © 2011 American Association for Marriage and Family Therapy.

Pelvic Floor Muscle Training: Underutilization in the USA.

PubMed

Lamin, Eliza; Parrillo, Lisa M; Newman, Diane K; Smith, Ariana L

2016-02-01

Pelvic floor disorders are highly prevalent in women of all ages and can greatly impair quality of life. Pelvic floor muscle training (PFMT) is a viable treatment option for several pelvic floor conditions including urinary incontinence and pelvic organ prolapse. PFMT is a program of therapy initiated by an experienced clinician (e.g., women's health or urology nurse practitioner (NP), physical therapist (PT)) that involves exercises for women with stress urinary incontinence (UI) and exercises combined with behavioral or conservative treatments (lifestyle changes, bladder training with urge suppression) for women with urgency or mixed UI. These exercise programs are more comprehensive than simple Kegel exercises. Despite evidence-based research indicating the efficacy and cost-effectiveness for treatment of urinary incontinence, PFMT is not commonly used as a first-line treatment in clinical practice in the USA (Abrams et al., 2012). This article will review PFMT for the treatment of UI and pelvic organ prolapse (POP) and theorize how this conservative therapy can be utilized more effectively in the USA.

Laboratory Directed Research and Development Program: Annual report to the Department of Energy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ogeka, G.J.; Romano, A.J.

1994-12-01

Project program summaries are presented for: effect of bacterial spore protein on mutagenesis; cellular toxicity of coaine and cocaethylene; calcinfication in marine alga (global carbon cycling); advanced permanent magnet materials; a high flux neutron source; genetics of drug addiction; microdialysis; analysis of powder diffraction data; accelerator technology; nucleic acids and proteins and their interactions, by small-angle XRD; enhancement of microplanar beam radiation therapy of gliosarcoma; relaxographic and functional MRI; low-temperature infrared laser absorption spectroscopy; photodesorption of H{sub 2}; helical magnet for RHIC; novel microporous solids; chemistry and physics of stratospheric aerosols (ozone depletion); rf source for linear colliders; resonance Ramanmore » detection of VOCs; synthesis of plant fatty acids with unusual double bond positions; outer surface proteins of the Lyme disease spirochete; multiwire proportional chambers for collider muons; self-organized criticality; PCR-SSCP detection of genetic changes at single cell level; proton facility for cancer therapy; and visible free-electron laser experiment.« less

Accessible high-throughput virtual screening molecular docking software for students and educators.

PubMed

Jacob, Reed B; Andersen, Tim; McDougal, Owen M

2012-05-01

We survey low cost high-throughput virtual screening (HTVS) computer programs for instructors who wish to demonstrate molecular docking in their courses. Since HTVS programs are a useful adjunct to the time consuming and expensive wet bench experiments necessary to discover new drug therapies, the topic of molecular docking is core to the instruction of biochemistry and molecular biology. The availability of HTVS programs coupled with decreasing costs and advances in computer hardware have made computational approaches to drug discovery possible at institutional and non-profit budgets. This paper focuses on HTVS programs with graphical user interfaces (GUIs) that use either DOCK or AutoDock for the prediction of DockoMatic, PyRx, DockingServer, and MOLA since their utility has been proven by the research community, they are free or affordable, and the programs operate on a range of computer platforms.

Improving patient care through implementation of an antimicrobial stewardship program.

PubMed

Palmer, Hannah R; Weston, Jaye; Gentry, Layne; Salazar, Miguel; Putney, Kimberly; Frost, Craig; Tipton, Joyce A; Cottreau, Jessica; Tam, Vincent H; Garey, Kevin W

2011-11-15

The implementation of an antimicrobial stewardship program at a health system is described. In 2008, the Center for Antimicrobial Stewardship and Epidemiology (CASE) was formed at St. Luke's Episcopal Hospital (SLEH) to improve the quality of care for patients as it related to antimicrobial therapy. The charter of CASE contained specific aims for improving patient care, furthering clinical research, and training the next generation of clinical infectious diseases pharmacists. The CASE team consists of at least two infectious diseases pharmacists and one physician (the medical director) who provide direct oversight for antimicrobial utilization within the hospital. The CASE medical director, an infectious diseases physician, is responsible for overseeing the activities of the center. With the oversight of the CASE advisory board, the medical director develops and implements the antimicrobial stewardship and management policies for SLEH. Another key innovative feature of CASE is its extensive involvement in training new infectious diseases pharmacists and conducting research. CASE uses a model in which a clinical scenario or problem is identified, a research project is undertaken to further elucidate the problem, and policy changes are made to improve patient outcomes. The CASE team is supported by a CASE advisory board, a CASE research collaborative including university faculty, and a dedicated training program for pharmacy fellows, residents, and students. Implementation of an antimicrobial stewardship program at a health system helped decrease the inappropriate use of antibiotics, improve patient care and outcomes, further clinical research, and increase training opportunities for future clinical infectious diseases pharmacists.

Family Therapy Training at the Ackerman Institute: Thoughts of Form and Substance.

ERIC Educational Resources Information Center

LaPerriere, Kitty

1979-01-01

Presents the history, philosophy, and form of training at the Ackerman Institute for Family Therapy, and attempts to capture the spirit and atmosphere of the program rather than enumerate details. The program teaches family therapy and a systems perspective on human behavior to professionals who have completed basic professional training. (Author)

Meeting the Needs of Urban Students: Creative Arts Therapy in Jersey City Public Schools

ERIC Educational Resources Information Center

Nelson, Cindy Lou

2010-01-01

This paper describes the history and development of the Jersey City Public Schools creative arts therapy program. Creative arts therapists contributed examples of their work throughout the district that provide a window into their respective school settings. Examples include technology-based art therapy, an extended school year program,…

The Wilderness Therapy Prevention Program: A Prevention Model for At-Risk Children and Adolescents

ERIC Educational Resources Information Center

Butler, Meghan

2008-01-01

Wilderness Therapy Programs have recently become a formal alternative treatment for adolescents with emotional and behavioral disorders (Hinkle, 1999; Russell & Hendee, 1999; Russell, Hendee, & Phillips-Miller, 2000; Russell, 2003a, 2003b). Adolescent populations are unique in that traditional forms of psychotherapy, including "talk-therapies,"…

Highly effective cystic fibrosis clinical research teams: critical success factors.

PubMed

Retsch-Bogart, George Z; Van Dalfsen, Jill M; Marshall, Bruce C; George, Cynthia; Pilewski, Joseph M; Nelson, Eugene C; Goss, Christopher H; Ramsey, Bonnie W

2014-08-01

Bringing new therapies to patients with rare diseases depends in part on optimizing clinical trial conduct through efficient study start-up processes and rapid enrollment. Suboptimal execution of clinical trials in academic medical centers not only results in high cost to institutions and sponsors, but also delays the availability of new therapies. Addressing the factors that contribute to poor outcomes requires novel, systematic approaches tailored to the institution and disease under study. To use clinical trial performance metrics data analysis to select high-performing cystic fibrosis (CF) clinical research teams and then identify factors contributing to their success. Mixed-methods research, including semi-structured qualitative interviews of high-performing research teams. CF research teams at nine clinical centers from the CF Foundation Therapeutics Development Network. Survey of site characteristics, direct observation of team meetings and facilities, and semi-structured interviews with clinical research team members and institutional program managers and leaders in clinical research. Critical success factors noted at all nine high-performing centers were: 1) strong leadership, 2) established and effective communication within the research team and with the clinical care team, and 3) adequate staff. Other frequent characteristics included a mature culture of research, customer service orientation in interactions with study participants, shared efficient processes, continuous process improvement activities, and a businesslike approach to clinical research. Clinical research metrics allowed identification of high-performing clinical research teams. Site visits identified several critical factors leading to highly successful teams that may help other clinical research teams improve clinical trial performance.

A randomized, single-blind cross-over design evaluating the effectiveness of an individually defined, targeted physical therapy approach in treatment of children with cerebral palsy.

PubMed

Franki, Inge; Van den Broeck, Christine; De Cat, Josse; Tijhuis, Wieke; Molenaers, Guy; Vanderstraeten, Guy; Desloovere, Kaat

2014-10-01

A pilot study to compare the effectiveness of an individual therapy program with the effects of a general physical therapy program. A randomized, single-blind cross-over design. Ten ambulant children with bilateral spastic cerebral palsy, age four to nine years. Participants were randomly assigned into a ten-week individually defined, targeted or a general program, followed by a cross-over. Evaluation was performed using the Gross Motor Function Measure-88 and three-dimensional gait analysis. General outcome parameters were Gross Motor Function Measure-88 scores, time and distance parameters, gait profile score and movement analysis profiles. Individual goal achievement was evaluated using z-scores for gait parameters and Goal Attainment Scale for gross motor function. No significant changes were observed regarding gross motor function. Only after individualized therapy, step- and stride-length increased significantly (p = 0.022; p = 0.017). Change in step-length was higher after the individualized program (p = 0.045). Within-group effects were found for the pelvis in transversal plane after the individualized program (p = 0.047) and in coronal plane after the general program (p = 0.047). Between-program differences were found for changes in the knee in sagittal plane, in the advantage of the individual program (p = 0.047). A median difference in z-score of 0.279 and 0.419 was measured after the general and individualized program, respectively. Functional goal attainment was higher after the individual therapy program compared with the general program (48 to 43.5). The results indicate slightly favorable effects towards the individualized program. To detect clinically significant changes, future studies require a minimal sample size of 72 to 90 participants. © The Author(s) 2014.

Centering the voices of international students in family studies and family therapy graduate programs.

PubMed

McDowell, Teresa; Fang, Shi-Ruei; Kosutic, Iva; Griggs, Julie

2012-06-01

In this article, we report the results of a survey that accessed the perceptions of family studies and family therapy international master's and doctoral students across the United States. Our goals included giving collective voice to the experience of international students and gathering their suggestions for improving programs. Themes that emerged from responses to open- and closed-ended questions included feeling (mis)understood and (de)valued; forming personal connections and experiencing marginalization; the importance of including international perspectives in curricula; considering the relevance/transferability of knowledge; and attending to barriers to learning. Based on the results, we share suggestions for improving family studies and family therapy graduate programs relative to program planning, curricula revision, teaching strategies, and faculty development. © 2012 American Association for Marriage and Family Therapy.

Morris B. Parloff (1918-2011).

PubMed

Elkin, Irene; Wolfe, Barry E

2012-04-01

Morris B. Parloff was considered an elder statesman in the field of psychotherapy research, and his wisdom and stewardship were of enormous benefit to several generations of psychotherapy researchers. Parloff received his bachelor's degree from Western Reserve University (1940), a degree in psychiatric social work from the University of Chicago (1942), and a doctorate in psychology from Western Reserve University (1953). Parloff spent most of his career (from 1953 until his retirement in 1983) as a researcher and administrator at the National Institute of Mental Health (NIMH). He was also on the senior faculty of the Washington School of Psychiatry, taught or consulted at a number of universities, and maintained a private practice of psychotherapy. In the NIMH intramural program, Parloff was chief of the Section on Personality in the Laboratory of Psychology. There he conducted a major longitudinal study on the personality characteristics of adolescent and adult scientists. In the NIMH extramural program, he served as chief of the Psychotherapy and Behavioral Intervention Section in the Clinical Research Branch (1972-1980), after which he became chief of the new Psychosocial Treatments Research Branch. Throughout his career, from his pioneering teaching and research on group psychotherapy through his 30 years at NIMH, Parloff provided researchers and practitioners with a broad understanding of the field of psychotherapy research, the complexity of its subject matter, and its relationship to the "real world." Often ahead of others in the field, Parloff dealt with many topics that retain their importance today, including the need to carefully define criteria for improvement in psychotherapy, the transmission of values in psychotherapy, the concepts of the placebo and of common factors in psychotherapy research, and the role of the patient-therapist relationship (in both individual and group therapy) and its impact on the outcome of therapy. Starting with a 1979 article in the American Psychologist ("Can Psychotherapy Research Guide the Policymaker? Vol. 34, pp. 296-306), Parloff wrote extensively about the relationship among practitioners, psychotherapy researchers, and policymakers. To promote the systematic use of clinical trials and address methodological issues in the field, Parloff obtained support to fund the first NIMH multisite collaborative outcome study in the field of psychotherapy. He and the first author (I. E.) then designed and launched the NIMH Treatment of Depression Collaborative Research Program. This study would serve as a model for future collaborative research by independent investigators. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

Depressive Rumination: Investigating Mechanisms to Improve Cognitive Behavioural Treatments

PubMed Central

Watkins, Edward R.

2009-01-01

Rumination has been identified as a core process in the development and maintenance of depression. Treatments targeting ruminative processes may, therefore, be particularly helpful for treating chronic and recurrent depression. The development of such treatments requires translational research that marries clinical trials, process–outcome research, and basic experimental research that investigates the mechanisms underpinning pathological rumination. For example, a program of experimental research has demonstrated that there are distinct processing modes during rumination that have distinct functional effects for the consequences of rumination on a range of clinically relevant cognitive and emotional processes: an adaptive style characterized by more concrete, specific processing and a maladaptive style characterized by abstract, overgeneral processing. Based on this experimental work, two new treatments for depression have been developed and evaluated: (a) rumination-focused cognitive therapy, an individual-based face-to-face therapy, which has encouraging results in the treatment of residual depression in an extended case series and a pilot randomized controlled trial; and (b) concreteness training, a facilitated self-help intervention intended to increase specificity of processing in patients with depression, which has beneficial findings in a proof-of-principle study in a dysphoric population. These findings indicate the potential value of process–outcome research (a) explicitly targeting identified vulnerability processes and (b) developing interventions informed by research into basic mechanisms. PMID:19697180

The Comparison Study of Quadratic Infinite Beam Program on Optimization Instensity Modulated Radiation Therapy Treatment Planning (IMRTP) between Threshold and Exponential Scatter Method with CERR® In The Case of Lung Cancer

NASA Astrophysics Data System (ADS)

Hardiyanti, Y.; Haekal, M.; Waris, A.; Haryanto, F.

2016-08-01

This research compares the quadratic optimization program on Intensity Modulated Radiation Therapy Treatment Planning (IMRTP) with the Computational Environment for Radiotherapy Research (CERR) software. We assumed that the number of beams used for the treatment planner was about 9 and 13 beams. The case used the energy of 6 MV with Source Skin Distance (SSD) of 100 cm from target volume. Dose calculation used Quadratic Infinite beam (QIB) from CERR. CERR was used in the comparison study between Gauss Primary threshold method and Gauss Primary exponential method. In the case of lung cancer, the threshold variation of 0.01, and 0.004 was used. The output of the dose was distributed using an analysis in the form of DVH from CERR. The maximum dose distributions obtained were on the target volume (PTV) Planning Target Volume, (CTV) Clinical Target Volume, (GTV) Gross Tumor Volume, liver, and skin. It was obtained that if the dose calculation method used exponential and the number of beam 9. When the dose calculation method used the threshold and the number of beam 13, the maximum dose distributions obtained were on the target volume PTV, GTV, heart, and skin.

Impact of the introduction of a standardised ICD programming protocol: real-world data from a single centre.

PubMed

Sunderland, Nicholas; Kaura, Amit; Li, Anthony; Kamdar, Ravi; Petzer, Ed; Dhillon, Para; Murgatroyd, Francis; Scott, Paul A

2016-09-01

Randomised trials have shown that empiric ICD programming, using long detection times and high detection zones, reduces device therapy in ICD recipients. However, there is less data on its effectiveness in a "real-world" setting, especially secondary prevention patients. Our aim was to evaluate the introduction of a standardised programming protocol in a real-world setting of unselected ICD recipients. We analysed 270 consecutive ICD recipients implanted in a single centre-135 implanted prior to protocol implementation (physician-led group) and 135 after (standardised group). The protocol included long arrhythmia detection times (30/40 or equivalent) and high rate detection zones (primary prevention lower treatment zone 200 bpm). Programming in the physician-led group was at the discretion of the implanter. The primary endpoint was time-to-any therapy (ATP or shocks). Secondary endpoints were time-to-inappropriate therapy and time-to-appropriate therapy. The safety endpoints were syncopal episodes, hospital admissions and death. At 12 months follow-up, 47 patients had received any ICD therapy (physician-led group, n = 31 vs. standardised group, n = 16). There was a 47 % risk reduction in any device therapy (p = 0.04) and an 86 % risk reduction in inappropriate therapy (p = 0.009) in the standardised compared to the physician-led group. There was a non-significant 30 % risk reduction in appropriate therapy (p = 0.32). Results were consistent across primary and secondary prevention patients. There were no significant differences in the rates of syncope, hospitalisation, and death. In unselected patients in a real-world setting, introduction of a standardised programming protocol, using long detection times and high detection zones, significantly reduces the burden of ICD therapy without an increase in adverse outcomes.

[Psychological Effects of Forest Therapy Program on Workers].

PubMed

Ikei, Harumi; Koizumi, Haruka; Song, Chorong; Kouzuki, Mitsunori; Teratani, Seiichiro; Sakuma, Takahiro; Miyazaki, Yoshifumi

2015-01-01

To examine the psychological effects of forest therapy program on workers. The subjective symptoms index, a shortened version of the profile of mood states (POMS), and a semantic differential (SD) method were used to measure the psychological effects. The evaluations were performed 3 days before, during, and 1, 3, and 5 days after the forest therapy. The following results were obtained: (1) the subjective symptoms improved before breakfast and continued for 5 days; (2) the mood evaluated using POMS improved before breakfast and continued for 3 days; and (3) “comfortable,” “relaxed,” and “natural” feelings evaluated using the SD method were enhanced before breakfast, lunch, and dinner during forest therapy. These results provided scientific evidence of the psychological effects of forest therapy program on workers.

Lab and Imaging Tests

MedlinePlus

... Grant Grant Finder Therapy Acceleration Program Academic Concierge Biotechnology Accelerator Clinical Trials Division Resources for HCPs Continuing ... Grant Grant Finder Therapy Acceleration Program Academic Concierge Biotechnology Accelerator Clinical Trials Division Resources for HCPs Continuing ...

Response of Psychiatrically Impaired Inmates to Activity Therapy.

ERIC Educational Resources Information Center

Siberski, James

2001-01-01

This paper describes the results of activity therapy programs with psychiatrically impaired inmates at a maximum security prison. Results include the programs which were felt to be of benefit and enjoyable, and those which prepared them for the future. Recommendations for initiation of a similar program are offered. (Author)

Family Adventure Programming for Troubled Adolescents.

ERIC Educational Resources Information Center

Gerstein, Jaclyn S.

The family adventure program merges traditional family therapy and adventure therapy to provide a more effective therapeutic process for the troubled adolescent. Family adventure programming is based on the assumption that the family has the skills and resources for positive change and growth. The stressful nature of adventure activities removes…

Nursing and therapy: partnering for successful niche programs.

PubMed

Samson, Barbara; Anderson, Lisa

2007-02-01

Changing market environment, increased patient expectations, and emphasis on improving functional outcomes led to the development of orthopedic and cardiac niche programs at one agency. Through these programs, it was learned how to best utilize the strengths of nursing and therapy to achieve maximum success for both patients and the organization.

The Effectiveness of Community-Based Occupational Therapy Education and Functional Training Programs for Older Adults: A Critical Literature Review.

ERIC Educational Resources Information Center

Wilkins, Seanne; Jung, Bonny; Wishart, Laurie; Edwards, Mary; Norton, Shelley Gamble

2003-01-01

Results of a literature review describing the provision of education and occupational therapy training programs for older adults indicate that programs are effective in three areas: prevention of functional decline and falls, stroke, and rheumatoid arthritis. (Contains 37 references.) (JOW)

Developmental Programming of Adult Disease: Reprogramming by Melatonin?

PubMed

Tain, You-Lin; Huang, Li-Tung; Hsu, Chien-Ning

2017-02-16

Adult-onset chronic non-communicable diseases (NCDs) can originate from early life through so-called the "developmental origins of health and disease" (DOHaD) or "developmental programming". The DOHaD concept offers the "reprogramming" strategy to shift the treatment from adulthood to early life, before clinical disease is apparent. Melatonin, an endogenous indoleamine produced by the pineal gland, has pleiotropic bioactivities those are beneficial in a variety of human diseases. Emerging evidence support that melatonin is closely inter-related to other proposed mechanisms contributing to the developmental programming of a variety of chronic NCDs. Recent animal studies have begun to unravel the multifunctional roles of melatonin in many experimental models of developmental programming. Even though some progress has been made in research on melatonin as a reprogramming strategy to prevent DOHaD-related NCDs, future human studies should aim at filling the translational gap between animal models and clinical trials. Here, we review several key themes on the reprogramming effects of melatonin in DOHaD research. We have particularly focused on the following areas: mechanisms of developmental programming; the interrelationship between melatonin and mechanisms underlying developmental programming; pathophysiological roles of melatonin in pregnancy and fetal development; and insight provided by animal models to support melatonin as a reprogramming therapy. Rates of NCDs are increasing faster than anticipated all over the world. Hence, there is an urgent need to understand reprogramming mechanisms of melatonin and to translate experimental research into clinical practice for halting a growing list of DOHaD-related NCDs.

Reimbursement of Drugs for Rare Diseases through the Public Healthcare System in Canada: Where Are We Now?

PubMed

Menon, Devidas; Clark, Derek; Stafinski, Tania

2015-08-01

Over the past 20 years, the number of therapies developed for rare diseases has rapidly increased. Often, these therapies represent the only active treatment for debilitating and/or life-threatening conditions. However, they create significant challenges for public and private payers. Because they target small patient populations, clinical evidence of efficacy/effectiveness is typically limited, while the cost per patient is high. In Canada, each province/territory establishes its own mechanisms for determining which drugs for rare diseases (DRDs) to provide. To compare current mechanisms across provinces and territories, and explore their impact on access. A systematic review of relevant published and unpublished documents was performed. Electronic bibliographic databases, the internet, and government websites were scanned using structured search strategies. Information was extracted independently by two researchers, and included aspects such as program type, condition/patient/therapy eligibility criteria, role of health technology assessment (HTA), decision options, ethical assumptions, and stakeholder input. It was validated through member-checking with provincial/territorial policy experts and tabulated to facilitate qualitative analyses. Impact on access was assessed through a cross-province/territory comparison of the coverage status of all non-cancer therapies reviewed by the Common Drug Review for indications affecting <1/2,000 Canadians using the Kappa statistic. Reasons for variations were explored using qualitative techniques. Each province/territory has formal and informal mechanisms through which such therapies may be accessed. In most cases, formal mechanisms constitute the centralized HTA processes that also apply to common therapies. While several provinces have established dedicated processes/programs, whether they have affected access is not clear. Despite broadly comparable approaches, there is less than perfect agreement on publicly funded DRDs across jurisdictions. Individual jurisdictions have developed different approaches to providing access to these therapies. However, as the number increases, a more systematic approach to decision-making may be needed. Copyright © 2015 Longwoods Publishing.

Mastitis therapy and antimicrobial susceptibility: a multispecies review with a focus on antibiotic treatment of mastitis in dairy cattle.

PubMed

Barlow, John

2011-12-01

Mastitis occurs in numerous species. Antimicrobial agents are used for treatment of infectious mastitis in dairy cattle, other livestock, companion animals, and humans. Mastitis is an economically important disease of dairy cattle and most mastitis research has focused on epidemiology and control of bovine mastitis. Antibiotic treatment of clinical and subclinical mastitis in dairy cattle is an established component of mastitis control programs. Research on the treatment of clinical and subclinical mastitis in other dairy species such as sheep and goats has been less frequent, although the general principles of mastitis therapy in small ruminants are similar to those of dairy cattle. Research on treatment of clinical mastitis in humans is limited and as for other species empirical treatment of mastitis appears to be common. While antimicrobial susceptibility testing is recommended to direct treatment decisions in many clinical settings, the use of susceptibility testing for antibiotic selection for mastitis treatments of dairy cattle has been challenged in a number of publications. The principle objective of this review is to summarize the literature evaluating the question, "Does antimicrobial susceptibility predict treatment outcome for intramammary infections caused by common bacterial pathogens?" This review also addresses current issues related to antimicrobial use and treatment decisions for mastitis in dairy cattle. Information on treatment of mastitis in other species, including humans, is included although research appears to be limited. Issues related to study design, gaps in current knowledge and opportunities for future research are identified for bovine mastitis therapy.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chang, Joe Y., E-mail: jychang@mdanderson.org; Jabbour, Salma K.; De Ruysscher, Dirk

Radiation dose escalation has been shown to improve local control and survival in patients with non–small cell lung cancer in some studies, but randomized data have not supported this premise, possibly owing to adverse effects. Because of the physical characteristics of the Bragg peak, proton therapy (PT) delivers minimal exit dose distal to the target volume, resulting in better sparing of normal tissues in comparison to photon-based radiation therapy. This is particularly important for lung cancer given the proximity of the lung, heart, esophagus, major airways, large blood vessels, and spinal cord. However, PT is associated with more uncertainty becausemore » of the finite range of the proton beam and motion for thoracic cancers. PT is more costly than traditional photon therapy but may reduce side effects and toxicity-related hospitalization, which has its own associated cost. The cost of PT is decreasing over time because of reduced prices for the building, machine, maintenance, and overhead, as well as newer, shorter treatment programs. PT is improving rapidly as more research is performed particularly with the implementation of 4-dimensional computed tomography–based motion management and intensity modulated PT. Given these controversies, there is much debate in the oncology community about which patients with lung cancer benefit significantly from PT. The Particle Therapy Co-operative Group (PTCOG) Thoracic Subcommittee task group intends to address the issues of PT indications, advantages and limitations, cost-effectiveness, technology improvement, clinical trials, and future research directions. This consensus report can be used to guide clinical practice and indications for PT, insurance approval, and clinical or translational research directions.« less

Stem cell transplantation for treating stroke: status, trends and development.

PubMed

Huo, Wenxin; Liu, Xiaoyang; Tan, Cheng; Han, Yingying; Kang, Chunyang; Quan, Wei; Chen, Jiajun

2014-09-01

The developing approaches of thrombolytic therapy, endovascular treatment, neuroprotective therapy, and stem cell therapy have enabled breakthroughs in stroke treatment. In this study, we summarize and analyze trends and progress in stem cell transplantation for stroke treatment by retrieval of literature from Thomson Reuters Web of Science database, the NIH Clinical Trial Planning Grant Program, and Clinical Trials Registration Center in North America. In the last 10 years, there has been an increasing number of published articles on stem cell transplantation for stroke treatment. In particular, research from the USA and China has focused on stem cell transplantation. A total of 2,167 articles addressing stem cell transplantation for stroke treatment from 2004 to 2013 were retrieved from the Thomson Reuters Web of Science database. The majority of these articles were from the USA (854, 39.4%), with the journal Stroke publishing the most articles (145, 6.7%). Of the published articles, 143 were funded by the National Institutes of Health (accounting for 6.6% of total publications), and 91 by the National Natural Science Foundation of China. Between 2013 and 2014, the National Institutes of Health provided financial support ($130 million subsidy) for 329 research projects on stroke therapy using stem cell transplantation. In 2014, 215 new projects were approved, receiving grants of up to $70,440,000. Ninety clinical trials focusing on stem cell transplantation for stroke were registered in the Clinical Trial Registration Center in North America, with 40 trials registered in the USA (ranked first place). China had the maximum number of registered research or clinical trials (10 projects).

Anxiety Online—A Virtual Clinic: Preliminary Outcomes Following Completion of Five Fully Automated Treatment Programs for Anxiety Disorders and Symptoms

PubMed Central

Meyer, Denny; Austin, David William; Kyrios, Michael

2011-01-01

Background The development of e-mental health interventions to treat or prevent mental illness and to enhance wellbeing has risen rapidly over the past decade. This development assists the public in sidestepping some of the obstacles that are often encountered when trying to access traditional face-to-face mental health care services. Objective The objective of our study was to investigate the posttreatment effectiveness of five fully automated self-help cognitive behavior e-therapy programs for generalized anxiety disorder (GAD), panic disorder with or without agoraphobia (PD/A), obsessive–compulsive disorder (OCD), posttraumatic stress disorder (PTSD), and social anxiety disorder (SAD) offered to the international public via Anxiety Online, an open-access full-service virtual psychology clinic for anxiety disorders. Methods We used a naturalistic participant choice, quasi-experimental design to evaluate each of the five Anxiety Online fully automated self-help e-therapy programs. Participants were required to have at least subclinical levels of one of the anxiety disorders to be offered the associated disorder-specific fully automated self-help e-therapy program. These programs are offered free of charge via Anxiety Online. Results A total of 225 people self-selected one of the five e-therapy programs (GAD, n = 88; SAD, n = 50; PD/A, n = 40; PTSD, n = 30; OCD, n = 17) and completed their 12-week posttreatment assessment. Significant improvements were found on 21/25 measures across the five fully automated self-help programs. At postassessment we observed significant reductions on all five anxiety disorder clinical disorder severity ratings (Cohen d range 0.72–1.22), increased confidence in managing one’s own mental health care (Cohen d range 0.70–1.17), and decreases in the total number of clinical diagnoses (except for the PD/A program, where a positive trend was found) (Cohen d range 0.45–1.08). In addition, we found significant improvements in quality of life for the GAD, OCD, PTSD, and SAD e-therapy programs (Cohen d range 0.11–0.96) and significant reductions relating to general psychological distress levels for the GAD, PD/A, and PTSD e-therapy programs (Cohen d range 0.23–1.16). Overall, treatment satisfaction was good across all five e-therapy programs, and posttreatment assessment completers reported using their e-therapy program an average of 395.60 (SD 272.2) minutes over the 12-week treatment period. Conclusions Overall, all five fully automated self-help e-therapy programs appear to be delivering promising high-quality outcomes; however, the results require replication. Trial Registration Australian and New Zealand Clinical Trials Registry ACTRN121611000704998; http://www.anzctr.org.au/trial_view.aspx?ID=336143 (Archived by WebCite at http://www.webcitation.org/618r3wvOG) PMID:22057287

A Randomized Controlled Trial of a Mindfulness and Acceptance Group Therapy for Residential Substance Use Patients.

PubMed

Shorey, Ryan C; Elmquist, Joanna; Gawrysiak, Michael J; Strauss, Catherine; Haynes, Ellen; Anderson, Scott; Stuart, Gregory L

2017-09-19

Substance use disorders are understood as a chronically relapsing condition that is difficult to treat. However, in recent years there have been promising developments in the treatment of substance use disorders, specifically with interventions based on mindfulness and acceptance and commitment therapy. Little research has examined whether these types of interventions may positively impact residential substance use treatment outcomes. Thus, in the current study we developed and examined, in a randomized controlled trial, a 4-week, eight-session, adjunctive mindfulness and acceptance group therapy for patients in residential substance use treatment. Our primary outcomes were substance use cravings, psychological flexibility, and dispositional mindfulness at treatment discharge. Patients (N = 117) from a private residential substance use facility were randomized to receive the adjunctive mindfulness and acceptance group or treatment-as-usual. Patients were assessed at treatment intake and at discharge from a 28-30-day residential program. Although treatment groups did not statistically differ at discharge on any primary outcome, small effect sizes favored the mindfulness and acceptance group on cravings and psychological flexibility. Conclusions/Importance: Continued research is needed to determine whether the addition of mindfulness and acceptance-based interventions improve outcomes long term following residential substance use treatment.

Pilot Study of Community-Based Cognitive Behavioral Group Therapy for Adolescents with Social Phobia.

ERIC Educational Resources Information Center

Baer, Susan; Garland, E. Jane

2005-01-01

Objective: A pilot study to evaluate the efficacy of a cognitive-behavioral group therapy program for adolescents with social phobia, simplified both in terms of time and labor intensity from a previously studied program (Social Effectiveness Therapy for Children and Adolescents) to be more appropriate for a community outpatient psychiatric…

Predicting Success: A Study of Admission Processes and Passing the National Physical Therapy Examination for Physical Therapist Assistants

ERIC Educational Resources Information Center

Shaab, Kathryn R.

2013-01-01

In order to practice physical therapy, physical therapist assistants (PTAs) must graduate from an accredited academic program and pass the National Physical Therapy Examination for Physical Therapist Assistants (PTA-NPTE). The primary objective of academic programs is to prepare students to successfully complete these two milestones to become…

Integrating Therapy Dog Teams in a Physical Activity Program for Children with Autism Spectrum Disorders

ERIC Educational Resources Information Center

Obrusnikova, Iva; Bibik, Janice M.; Cavalier, Albert R.; Manley, Kyle

2012-01-01

The use of therapy-dog teams in programs for children with disabilities is becoming increasingly popular in school and therapeutic settings and has been shown to provide physical, social, and emotional benefits for the children. This article describes the basic steps for implementing therapy dog-assisted activities in physical activity programs…

Take a Paws: Fostering Student Wellness with a Therapy Dog Program at Your University Library

ERIC Educational Resources Information Center

Lannon, Amber; Harrison, Pamela

2015-01-01

Therapy dogs are trained and socialized to provide comfort to individuals who are ill or experiencing stress. The following article explores therapy dog outreach programs in academic libraries by describing a successful venture at McGill University Library. Background, planning advice, assessment results, and recommendations are presented with an…

Integrating Multimodal Radiation Therapy Data into i2b2.

PubMed

Zapletal, Eric; Bibault, Jean-Emmanuel; Giraud, Philippe; Burgun, Anita

2018-04-01

 Clinical data warehouses are now widely used to foster clinical and translational research and the Informatics for Integrating Biology and the Bedside (i2b2) platform has become a de facto standard for storing clinical data in many projects. However, to design predictive models and assist in personalized treatment planning in cancer or radiation oncology, all available patient data need to be integrated into i2b2, including radiation therapy data that are currently not addressed in many existing i2b2 sites.  To use radiation therapy data in projects related to rectal cancer patients, we assessed the feasibility of integrating radiation oncology data into the i2b2 platform.  The Georges Pompidou European Hospital, a hospital from the Assistance Publique - Hôpitaux de Paris group, has developed an i2b2-based clinical data warehouse of various structured and unstructured clinical data for research since 2008. To store and reuse various radiation therapy data-dose details, activities scheduling, and dose-volume histogram (DVH) curves-in this repository, we first extracted raw data by using some reverse engineering techniques and a vendor's application programming interface. Then, we implemented a hybrid storage approach by combining the standard i2b2 "Entity-Attribute-Value" storage mechanism with a "JavaScript Object Notation (JSON) document-based" storage mechanism without modifying the i2b2 core tables. Validation was performed using (1) the Business Objects framework for replicating vendor's application screens showing dose details and activities scheduling data and (2) the R software for displaying the DVH curves.  We developed a pipeline to integrate the radiation therapy data into the Georges Pompidou European Hospital i2b2 instance and evaluated it on a cohort of 262 patients. We were able to use the radiation therapy data on a preliminary use case by fetching the DVH curve data from the clinical data warehouse and displaying them in a R chart.  By adding radiation therapy data into the clinical data warehouse, we were able to analyze radiation therapy response in cancer patients and we have leveraged the i2b2 platform to store radiation therapy data, including detailed information such as the DVH to create new ontology-based modules that provides research investigators with a wider spectrum of clinical data. Schattauer GmbH Stuttgart.

"Music Therapy Helped Me Get Back Doing": Perspectives of Music Therapy Participants in Mental Health Services.

PubMed

McCaffrey, Tríona; Edwards, Jane

2016-01-01

Mental health service development internationally is increasingly informed by the collaborative ethos of recovery. Service user evaluation of experiences within music therapy programs allows new phenomena about participation in services to be revealed that might otherwise remain unnoticed. The aim of this study was to demonstrate how asking service users about their experience of music therapy can generate useful information, and to reflect upon the feedback elicited from such processes in order to gain a deeper understanding of how music therapy is received among service users in mental health. Six mental health service users described their experiences of music therapy in one or two individual interviews. Transcripts of interviews were analyzed using the procedures and techniques of Interpretative Phenomenological Analysis. Interviews with mental health service users provided rich, in-depth accounts reflecting the complex nature of music therapy participation. Super-ordinate themes refer to the context in which music therapy was offered, the rich sound world of music in music therapy, the humanity of music therapy, and the strengths enhancing opportunities experienced by service users. Participants indicated that they each experienced music therapy in unique ways. Opinions about the value of music therapy were revealed through an interview process in which the researcher holds an open attitude, welcoming all narrative contributions respectfully. These findings can remind practitioners of the importance of closely tuning into the perspectives and understandings of those who have valuable expertise to share about their experience of music therapy services in mental health. © the American Music Therapy Association 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

United Kingdom: Medical Laboratory Science, Occupational Therapy, Physiotherapy. A Study of These Programs and a Guide to the Academic Placement of Students from These Programs in Educational Institutions of the United States.

ERIC Educational Resources Information Center

Margolis, Alan M.; Monahan, Thomas J.

Medical laboratory science, occupational therapy, and physiotherapy programs in the United Kingdom (U.K.) are described, and guidelines concerning the academic placement of students from these programs who wish to study in U.S. institutions are provided. For each of the programs, attention is directed to the relevant professional bodies, career…

Effects of dance therapy on the selected hematological and rheological indicators in older women.

PubMed

Filar-Mierzwa, Katarzyna; Marchewka, Anna; Bac, Aneta; Kulis, Aleksandra; Dąbrowski, Zbigniew; Teległów, Aneta

2017-01-01

The aim of this study was to analyze the effects of dance therapy on selected hematological and rheological indicators in older women. The study included 30 women (aged 71.8±7.4), and the control group comprised of 10 women of corresponding age. Women from the experimental group were subjected to a five-month dance therapy program (three 45-minute sessions per week); women from the control group were not involved in any regular physical activity. Blood samples from all the women were examined for hematological, rheological, and biochemical parameters prior to the study and five months thereafter. The dance therapy program was reflected by a significant improvement of erythrocyte count and hematocrit. Furthermore, the dance therapy resulted in a significant increase in the plasma viscosity, while no significant changes in glucose and fibrinogen levels were noted. Dance therapy modulates selected hematological parameters of older women; it leads to increase in erythrocyte count and hematocrit level. Dance therapy is reflected by higher plasma viscosity. Concentrations of fibrinogen and glucose are not affected by the dance therapy in older women, suggesting maintenance of homeostasis. Those findings advocate implementation of dance therapy programs in older women.

An integrative review of attention biases and their contribution to treatment for anxiety disorders

PubMed Central

Barry, Tom J.; Vervliet, Bram; Hermans, Dirk

2015-01-01

Models of exposure therapy, one of the key components of cognitive behavioral therapy for anxiety disorders, suggest that attention may play an important role in the extinction of fear and anxiety. Evidence from cognitive research suggests that individual differences may play a causal role in the onset and maintenance of anxiety disorders and so it is also likely to influence treatment. We review the evidence concerning attention and treatment outcomes in anxiety disorders. The evidence reviewed here suggests that that attention biases assessed at pre-treatment might actually predict improved response to treatment, and in particular that prolonged engagement with threat as measured in tasks such as the dot probe is associated with greater reductions in anxious symptoms following treatment. We examine this research within a fear learning framework, considering the possible role of individual differences in attention in the extinction of fear during exposure. Theoretical, experimental and clinical implications are discussed, particularly with reference to the potential for attention bias modification programs in augmenting treatment, and also with reference to how existing research in this area might inform best practice for clinicians. PMID:26217284

[Obstacles and perspectives of new antimicrobial concepts within research and development].

PubMed

Kloß, Florian; Gerbach, Sina

2018-05-01

Antimicrobial resistance (AMR) has developed into a serious problem for the healthcare sector worldwide. Research on fundamentally novel antibiotics has been insufficient for decades and only a few new compounds have reached the market. Thus, the pressure to implement novel and effective concepts for the reduction of infections through problematic pathogens has dramatically increased. This demand has been recognized by politicians and comprehensive national and international funding programs have been launched. A major role of many funding lines is the investigation and development of therapeutics exerting a novel mechanism of action and/or minimizing the frequency of resistance. In addition to the actual clinical pipeline, this article lists selected examples from research and early development with a special focus on antibiotics. Moreover, alternative approaches like antivirulence and phage therapy as well as immunomodulation are summarized. AMR is no longer solely a healthcare policy, but is of societal significance as a whole. A consolidation of infrastructures and public-private partnerships, a reduction of regulatory obstacles and a continuous pursuit of innovations for antimicrobial therapy are urgently needed.

Distance art groups for women with breast cancer: guidelines and recommendations.

PubMed

Collie, Kate; Bottorff, Joan L; Long, Bonita C; Conati, Cristina

2006-08-01

To overcome barriers that prevent women with breast cancer from attending support groups, innovative formats and modes of delivery both need to be considered. The present study was part of an interdisciplinary program of research in which researchers from counseling psychology, psycho-oncology, nursing, computer science, and fine arts have explored art making as an innovative format and telehealth as a mode of delivery. For this study, we conducted focus groups and interviews with 25 people with expertise about breast cancer, art, art therapy, and distance delivery of mental health services to generate guidelines for distance art-based psychosocial support services to women with breast cancer. A qualitative analysis of the focus group and interview data yielded guidelines for developers and facilitators of distance art groups for women with breast cancer pertaining to (a) emotional expression, (b) emotional support, (c) emotional safety, and (d) accommodating individual differences, plus special considerations for art therapy groups. Further research is needed pertaining to the use of computers, involvement of art therapists, and screening out vulnerable clients.

Brief virtual reality therapy for public speaking anxiety.

PubMed

Harris, Sandra R; Kemmerling, Robert L; North, Max M

2002-12-01

The primary goal of this research program was to investigate the effectiveness of virtual reality therapy (VRT) in reducing public speaking anxiety of university students. The prevalence and impact of public speaking anxiety as a type of Social Phobia are discussed. Studies of VRT as an emerging treatment for psychological problems are reviewed. In the present study, eight students completed VRT individual treatment and post-testing, and six students in a Wait-List control group completed post-testing. Assessment measures included four self-report inventories, self-report of Subjective Units of Discomfort during exposure to VRT and physiological measurements of heart rate during speaking tasks. Four weekly individual exposure treatment sessions of approximately 15 min each were conducted by the author serving as therapist. Results on self-report and physiological measures appear to indicate that four virtual reality treatment sessions were effective in reducing public speaking anxiety in university students, corroborating earlier studies of VRT's effectiveness as a psychotherapeutic modality. Future research directions are discussed, primarily the need for research on younger populations, to assess the effectiveness of VRT for earlier intervention with public speaking anxiety.

Evidence-based design and development of a VR-based treadmill system for gait research and rehabilitation of patients with Parkinson's disease.

PubMed

Pérez-Sanpablo, Alberto Isaac; González-Mendoza, Arturo; Quiñones-Uriostegui, Ivett; Rodríguez-Reyes, Gerardo; Núñez-Carrera, Lidia; Hernández-Arenas, Claudia; Boll-Woehrlen, Marie Catherine; Alessi Montero, Aldo

2014-07-01

Virtual reality (VR) in neurorehabilitation allows to reduce patient's risk and allows him to learn on a faster way. Up to now VR has been used in patients with Parkinson disease (PD) as a research tool and none of the developed systems are used in clinical practice. The goal of this project is to develop a VR-based system for gait therapy, and gait research of patients with PD designed based on published evidence. The developed system uses a digital camera to measure spatiotemporal gait parameters. The software was developed in C#, using Open-Source libraries that facilitates VR programming. The system has potential uses in clinical and research settings.

WE-FG-BRB-00: The Challenges of Predicting RBE Effects in Particle Therapy and Opportunities for Improving Cancer Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

The physical pattern of energy deposition and the enhanced relative biological effectiveness (RBE) of protons and carbon ions compared to photons offer unique and not fully understood or exploited opportunities to improve the efficacy of radiation therapy. Variations in RBE within a pristine or spread out Bragg peak and between particle types may be exploited to enhance cell killing in target regions without a corresponding increase in damage to normal tissue structures. In addition, the decreased sensitivity of hypoxic tumors to photon-based therapies may be partially overcome through the use of more densely ionizing radiations. These and other differences betweenmore » particle and photon beams may be used to generate biologically optimized treatments that reduce normal tissue complications. In this symposium, speakers will examine the impact of the RBE of charged particles on measurable biological endpoints, treatment plan optimization, and the prediction or retrospective assessment of treatment outcomes. In particular, an AAPM task group was formed to critically examine the evidence for a spatially-variant RBE in proton therapy. Current knowledge of proton RBE variation with respect to dose, biological endpoint, and physics parameters will be reviewed. Further, the clinical relevance of these variations will be discussed. Recent work focused on improving simulations of radiation physics and biological response in proton and carbon ion therapy will also be presented. Finally, relevant biology research and areas of research needs will be highlighted, including the dependence of RBE on genetic factors including status of DNA repair pathways, the sensitivity of cancer stem-like cells to charged particles, the role of charged particles in hypoxic tumors, and the importance of fractionation effects. In addition to the physical advantages of protons and more massive ions over photons, the future application of biologically optimized treatment plans and their potential to provide higher levels of local tumor control and improved normal tissue sparing will be discussed. Learning Objectives: To assess whether the current practice of a constant RBE of 1.1 should be revised or maintained in proton therapy and to evaluate the potential clinical consequences of delivering RBE-weighted dose distributions based on variable RBE To review current research on biological models used to predict the increased biological effectiveness of proton and carbon ions to help move towards a practical understanding and implementation of biological optimization in particle therapy To discuss potential differences in biological mechanisms between photons and charged particles (light and heavy ions) that could impact clinical cancer therapy H. Paganetti, NCI U19 CA21239D. Grosshans, Our research is supported by the NCIK. Held, Funding Support: National Cancer Institute of the National Institutes of Health, USA, under Award Number R21CA182259 and Federal Share of Program Income Earned by Massachusetts General Hospital on C06CA059267, Proton Therapy Research and Treatment Center.« less

The Emerging Role of PD-1/PD-L1-Targeting Immunotherapy in the Treatment of Metastatic Urothelial Carcinoma.

PubMed

Gwynn, Morgan E; DeRemer, David L

2018-01-01

To summarize and evaluate immunotherapy agents targeting programmed cell death protein-1 (PD-1) and programmed death ligand-1 (PD-L1) recently approved for the treatment of metastatic urothelial carcinomas (UC). A literature review was performed using PubMed (2012 to June 2017), the American Society of Clinical Oncology abstract databases (2012 to June 2017 Annual Meetings/symposia), and the America Association for Cancer Research symposia (2012 to June 2017). A search using clinicaltrials.gov was conducted to identify studies for atezolizumab, avelumab, durvalumab, nivolumab, and pembrolizumab. English language phase I to III studies assessing PD-1 and PD-L1 in UC were incorporated. Atezolizumab, avelumab, durvalumab, nivolumab, and pembrolizumab have demonstrated clinical efficacy with tolerable toxicities in patients with metastatic UC with disease progression following platinum-based chemotherapy. Anti-PD-1/PD-L1 therapies may provide overall survival advantage; these are currently being evaluated in ongoing phase 3 studies. Greater objective response rates seem to be observed in PD-L1-positive patients versus PD-L1-negative patients, but methodologies in this assessment differ among clinical trials. The identification of biomarkers that provide greater insight into patients who positively respond to PD-1/PD-L1 therapies are needed. Treatment options for metastatic UC have expanded to include PD-1/PD-L1 therapies. These agents should be strongly considered as second-line therapy over single-agent chemotherapy for patients who fail or progress after platinum-based treatment.