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Physical therapy ethics

Pratima Murthy
While guidelines for psychosocial interventions in addictive disorders in India were earlier rooted in clinical experience and global empirical evidence, recently there have been efforts to develop guidelines for intervention based on the local needs assessments of specific populations and more appreciably, a testing of the effectiveness of the interventions. This supplement on psychosocial interventions for addictive disorders covers some of the important aspects of psychosocial interventions in five sections...
February 2018: Indian Journal of Psychiatry
Regina Wing Shan Sit, Keith Kwok Wai Chan, Benjamin Hon Kei Yip, Daisy Dexing Zhang, Kenneth Dean Reeves, Ying Ho Chan, Vincent Chi Ho Chung, Samuel Yeung Shan Wong
INTRODUCTION: Knee osteoarthritis (KOA) is a common, disabling and costly medical condition. The patellofemoral joint is a critical source of pain in individuals with KOA, and coexistence of patellofemoral osteoarthritis (PFOA) and tibiofemoral osteoarthritis (TFOA) is sometimes observed. The identification of subgroups with PFOA and customised interventions to correct underlying pathomechanics is beneficial for individuals with KOA. This study aims to evaluate whether a clinic-based patella mobilisation therapy (PMT) leads to significant improvement in pain, physical function and quality of life of individuals with KOA...
March 14, 2018: BMJ Open
Marlysa B Sullivan, Matt Erb, Laura Schmalzl, Steffany Moonaz, Jessica Noggle Taylor, Stephen W Porges
Yoga therapy is a newly emerging, self-regulating complementary and integrative healthcare (CIH) practice. It is growing in its professionalization, recognition and utilization with a demonstrated commitment to setting practice standards, educational and accreditation standards, and promoting research to support its efficacy for various populations and conditions. However, heterogeneity of practice, poor reporting standards, and lack of a broadly accepted understanding of the neurophysiological mechanisms involved in yoga therapy limits the structuring of testable hypotheses and clinical applications...
2018: Frontiers in Human Neuroscience
Federica Picariello, Rona Moss-Morris, Iain C Macdougall, Sam Norton, Maria Da Silva-Gane, Ken Farrington, Hope Clayton, Joseph Chilcot
INTRODUCTION: Fatigue is one of the most common and disabling symptoms in end-stage kidney disease, particularly among in-centre haemodialysis patients. This two-arm parallel group feasibility randomised controlled trial will determine whether a fully powered efficacy trial is achievable by examining the feasibility of recruitment, acceptability and potential benefits of a cognitive-behavioural therapy (CBT)-based intervention for fatigue among in-centre haemodialysis patients. METHODS: We aim to recruit 40 adult patients undergoing in-centre haemodialysis at secondary care outpatient dialysis units, who meet clinical levels of fatigue...
March 8, 2018: BMJ Open
Koen Bruynseels, Filippo Santoni de Sio, Jeroen van den Hoven
Personalized medicine uses fine grained information on individual persons, to pinpoint deviations from the normal. 'Digital Twins' in engineering provide a conceptual framework to analyze these emerging data-driven health care practices, as well as their conceptual and ethical implications for therapy, preventative care and human enhancement. Digital Twins stand for a specific engineering paradigm, where individual physical artifacts are paired with digital models that dynamically reflects the status of those artifacts...
2018: Frontiers in Genetics
Anne Hudon, Émilie Blackburn, Maude Laliberté, Kadija Perreault, Barbara Mazer, Debbie Ehrmann Feldman, Bryn Williams-Jones, Matthew Hunt
Ethics education is the cornerstone of professional practice, fostering knowledge and respect for core ethical values among healthcare professionals. Ethics is also a subject well-suited for interprofessional education and collaboration. However, there are few initiatives to gather experiences and share resources among ethics educators in rehabilitation. We thus undertook a knowledge exchange project to: 1) share knowledge about ethics training across Canadian occupational and physical therapy programs, and 2) build a community of educators dedicated to improving ethics education...
February 22, 2018: Journal of Interprofessional Care
Massimo Negro, Natale Marzullo, Francesca Caso, Luca Calanni, Giuseppe D'Antona
The term doping is generally used to indicate practices based on the use of performance-enhancing drugs (PEDs) or the abuse of medical therapies. Mostly analysed by doctors and officials, doping nevertheless also requires a philosophical consideration to avoid being simplistically portrayed as an isolated practice. To do this, we need to pay attention to the contradictions and paradoxes in the modern approach to doping in sport. In this context, doping is not only relevant to the health of an individual involved in the violation of World Anti-Doping Agency (WADA) criteria, but it actually represents a double-edged phenomenon containing ethical and legal points of view...
February 9, 2018: European Journal of Applied Physiology
Rowan W Johnson, Sian A Williams, Daniel F Gucciardi, Natasha Bear, Noula Gibson
INTRODUCTION: Children with cerebral palsy (CP) and other neurodevelopmental disabilities often receive a home programme of exercises to assist in reaching their therapy goals. Adherence to exercise programmes is necessary to attain the level of practice required to achieve goals; however, adherence can be difficult to accomplish. In this paper, we describe the protocol for a randomised controlled trial to evaluate the effectiveness of delivering a home exercise programme to school-age children with disabilities using Physitrack, an online exercise prescription tool with a website or app interface...
January 23, 2018: BMJ Open
Gunn Pettersen, Jan H Rosenvinge, Maria Bakland, Rolf Wynn, Therese Fostervold Mathisen, Jorunn Sundgot-Borgen
INTRODUCTION: Women with bulimia nervosa and binge eating disorder often suffer for many years before they seek professional help. Evidence-based treatments like cognitive-behavioural therapy (CBT) might be poorly accessible, and about 50% of those who receive CBT respond to it. Such outcome may reflect the heterogeneous nature of eating disorders, and addressing this heterogeneity calls for expanding the portfolio of treatment options. In particular, it is important to explore such options' acceptability, tolerability and affordability expressed through experiences with the treatment...
January 8, 2018: BMJ Open
M Isabel González-Méndez, Luís López-Rodríguez
The decrease in potential donation after brain death has resulted in a need to evaluate alternative sources. Donation after cardiac death is a good option. The objectives of this article were to describe the Maastricht type iii controlled organ donation characteristics and to determine end-of-life care and the role of nurses in the donation process. In this type of donation, cardiocirculatory arrest is predictable after the limitation of life sustaining treatments. These are patients for whom there are no effective therapy options and, in the context of an organised and planned practice involving all the professionals involved in the care of the patient, the decision is made, in consultation with the family, to withdraw life support measures...
December 11, 2017: Enfermería Clínica
Luigi Santacroce, Lucrezia Bottalico, Ioannis Alexandros Charitos
Background: In the pre-Hellenistic period, the concept of medicine was not well-defined. Usually, a disease was considered as a divine punishment and its treatment was devolved to the priests who asked for healing from the divinities. The only job that could be compared to medical practice was a kind of itinerant medicine, derived from the Egyptian therapeutic tradition based only on practical experience and performed by people that knew a number of remedies, mostly vegetable, but without any theoretical bases about the possible mechanisms of action...
December 12, 2017: Medicines (Basel, Switzerland)
Emmylou Beekman, Susy M Braun, Darcy Ummels, Kim van Vijven, Albine Moser, Anna J Beurskens
Background: For older people and people with a chronic disease, physical activity provides health benefits. Patients and healthcare professionals can use commercially available activity trackers to objectively monitor (alterations in) activity levels and patterns and to support physical activity. However, insight in the validity, reliability, and feasibility of these trackers in people with a chronic disease is needed. In this article, a study protocol is described in which the validity, reliability (part A), and feasibility from a patient and therapist's point of view (part B) of commercially available activity trackers in daily life and health care is investigated...
2017: Pilot and Feasibility Studies
Hélène Laurent, Géraud Galvaing, Emilie Thivat, Emmanuel Coudeyre, Sylvie Aubreton, Ruddy Richard, Fabrice Kwiatkowski, Frederic Costes, Marc Filaire
INTRODUCTION: Surgery is the standard curative treatment for lung cancer but is only possible in patients with local tumour and preserved exercise capacity. Improving fitness before surgery can reduce postoperative complications and mortality. However, preoperative rehabilitation remains difficult to implement for several reasons. We aim to investigate the effectiveness of an intensive 3-week home-based preoperative exercise training programme on hospital discharge ability, postoperative complications and physical performance in patients with chronic obstructive pulmonary disease (COPD) who are eligible for lung cancer surgery...
November 12, 2017: BMJ Open
D Zilles, M Koller, I Methfessel, S Trost, A Simon
BACKGROUND: Severe affective and psychotic disorders may be accompanied by legal incapacity. If in this case the patient refuses treatment and in parallel there is a risk of serious damage to health, treatment can be carried out against the patient's non-autonomous will under defined prerequisites. Due to its good and partly superior effectiveness in the treatment of severe and pharmacotherapy-resistant affective and psychotic disorders, electroconvulsive therapy (ECT) is an important treatment option in such constellations...
October 27, 2017: Der Nervenarzt
Maude Laliberté, Bryn Williams-Jones, Debbie E Feldman, Matthew Hunt
Demographic change and changing population needs are important drivers of increased demand for rehabilitation. These developments place significant stress on access to physical therapy services, as current resources are insufficient to meet the growing demand. This situation presents ethical challenges for physical therapists and others involved in managing wait lists and prioritizing access to services. The purpose of this study is to explore how outpatient physical therapy department (OPD) staff experience ethical issues relating to access to physical therapy services...
2017: Narrative Inquiry in Bioethics
Regine Klinger, Maxie Blasini, Julia Schmitz, Luana Colloca
INTRODUCTION: Nocebo-induced algesic responses occurring within clinical contexts present a challenge for health care practitioners working in the field of pain medicine. OBJECTIVES: Following the recent research on algesic nocebo effects, the scope of this review is to develop ethically acceptable strategies to help avoid, or at least reduce, nocebo responses within clinical settings. METHODS: We reviewed relevant clinical studies that depict how patient-practitioner interactions may contribute to the reduction of nocebo responses...
March 2017: Pain Reports (Baltimore, Md.)
Matheus Oliveira Almeida, Bruno T Saragiotto, Chris G Maher, Leonardo Oliveira Pena Costa
INTRODUCTION: Meta-epidemiological studies examining the influence of methodological characteristics, such as allocation concealment and intention-to-treat analysis have been performed in a large number of healthcare areas. However, there are no studies investigating these characteristics in physical therapy interventions for patients with low back pain. The aim of this study is to investigate the influence of allocation concealment and the use of intention-to-treat analysis on estimates of treatment effects of physical therapy interventions in low back pain clinical trials...
September 27, 2017: BMJ Open
Rana Abu Farha, Akram Saleh, Salah Aburuz
BACKGROUND: Hypertension is a major cause of cardiovascular diseases with a high prevalence in Jordan. No previous studies have been carried out to determine the effect of the presence of drug-related problems (DRPs) on the health-related quality of life (HRQOL) among hypertensive patients. OBJECTIVES: The purpose of this study was to identify the influence of different types of DRPs on the HRQOL of hypertensive patients. METHODS: A total of 200 hypertensive patients were recruited in this cross-sectional correlation study that was conducted across the cardiac outpatient clinic at Jordan University Hospital...
July 2017: Pharmacy Practice
Brittany J Harrison, Tara N Hilton, Raphaël N Rivière, Zachary M Ferraro, Raywat Deonandan, Mark C Walker
OBJECTIVES: This review explores the ethical and medical challenges faced by women of advanced maternal age who decide to have children. Assisted reproductive technologies (ARTs) make post-menopausal pregnancy physiologically plausible, however, one must consider the associated physical, psychological, and sociological factors involved. METHODS: A quasi-systematic review was conducted in PubMed and Ovid using the key terms post-menopause, pregnancy + MeSH terms [donations, hormone replacement therapy, assisted reproductive technologies, embryo donation, donor artificial insemination, cryopreservation]...
2017: International Journal of Women's Health
Thomas D Steensma, S Annelijn Wensing-Kruger, Daniel T Klink
Counseling and treatment of transgender youth can be challenging for mental health practitioners, as increased availability of gender-affirming treatments in recent years raises ethical and clinical questions. Is a gender identity diagnosis helpful? What is the right time to treat, and should the adolescent's age matter in decision making? In this article, we discuss these questions in light of a case in which an adolescent wishes to pursue hormone therapy. Our analysis focuses on the importance of balanced decision making when counseling and treating adolescents with nonconforming gender identities...
August 1, 2017: AMA Journal of Ethics
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