Search

Individuals with a developmental disability can now be provided a variety of empirically supported treatments that have been shown to be useful in promoting educational attainments, social and vocational skills, and self-care, and in reducing behavioral problems. Unfortunately, a large number of pseudoscientific or bogus therapies continue to be offered to this population and their families. We review the characteristics of pseudoscientific and bogus treatments and provide several examples of unsupported or harmful interventions offered by contemporary social workers and other human service professionals, to the detriment of people with disabilities. We encourage social workers to identify pseudoscientific interventions and avoid providing these, in favor of using empirically supported treatments. [ABSTRACT FROM AUTHOR]

Aim: To investigate the current concepts related to the definition of human viability in a historical perspective. Methods: A review of the international literature was performed by using PubMed, Google, Embase to find definitions of Human Viability. The papers collected were divided chronologically. Results: Over the years, many authors have debated the concept of the limit of human viability, starting from Ballantyne in the early 1900. The definition differs from author to author. Conclusion: The definition of human viability is still under discussion. It depends primarily, but not only, on gestational age. A number of genetic, cultural, social and technological variables are also influential. This definition could have an impact on legislation and the widespread misunderstanding of this concept in the lay public could also be enhanced by a frank discussion among clinicians and other professionals. [ABSTRACT FROM AUTHOR]

Medical housestaff are rarely members of interdisciplinary teams. In this study, housestaff participated in interdisciplinary team rounds during a month-long rotation on an Acute Care for Elders (ACE) unit and were then surveyed to determine their attitudes about the team and the unit. Twenty-nine residents responded, for a response rate of 85.3%. Over 90% found interdisciplinary rounds helpful for improving efficiency of patient management, the understanding of the patient's hospital course, the roles of other health professionals, and the sensitivity to the needs of geriatric patients. Very few found rounds to be burdensome or a waste of time. ACE units may serve as viable experiential models for training in interdisciplinary teamwork as well as geriatric medicine. [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine the effect of an older adult simulation suit on empathy in physical therapy students. The study used a mixed-methods design. An older adult simulator suit was designed for use in this study. The primary outcome measure was empathy as measured by a 20-item Empathy Questionnaire (EQ). Secondary outcomes included rate of perceived exertion, functional mobility, and physical difficulty. Participants were physical therapy students ( n  = 24) enrolled in an accredited program in the United States. Participants performed a Modified Physical Performance Test (MPPT) with and without the simulator suit, followed by an interview about their experience. For the primary outcome of empathy, there was a significant difference on the EQ ( n  = 2.51, n  = .02), indicating increased empathy following exposure to the suit. For secondary outcomes, there were significant differences on perceived exertion ( n  = 5.61, n  < .001) and MPPT scores ( n  = 9.18, n  < .001). Two themes were developed: 1.) Experience Creates Awareness and Inspires Empathy, and 2.) Empathy Impacts Treatment Perspective. Results support that an older adult simulator suit can affect empathy in student physical therapists. The benefits of having experienced the older adult simulator may help student physical therapists in making treatment decisions when working with older adults.

Background: While considerable attention has been focused in recent years on evidence-based practice, less attention has been placed on clinical social workers' choice to use ineffective or harmful interventions, referred to in the present paper as Novel Unsupported Therapies (NUSTs)., Method: The present study surveyed 400 Licensed Clinical Social Workers (LCSWs) across the United States in order to determine the extent of their usage of NUSTs, as well as their usage of conventional therapies that lacked support and empirically supported therapies (ESTs). Reasons for selecting interventions were also assessed., Results: While the vast majority (97.5%) reported using some form of EST, 75% of our sample also reported using at least one NUST. Logistic regression analysis revealed that NUST usage was related to female gender and trauma specialization. A split plot ANOVA revealed that respondents rated positive clinical experience higher than published research as a reason for selecting an intervention. LCSWs with a CBT theoretical orientation rated research evidence more highly than those of other theoretical orientations. However, even within the group of LCSWs with a CBT orientation, clinical experience was rated more highly than research evidence., Conclusions: Implications for practice are discussed.

Background: In 2008, Leichsenring and Rabung performed a meta-analysis of 8 studies of longer-term psychodynamic psychotherapy (LTPP). The work was published in the Journal of the American Medical Association (vol. 300, pp 1551-1565), and they concluded that LTPP was more effective than shorter-term therapies., Method: Given that such claims have the potential to influence treatment decisions and policies, we re-examined the meta-analysis and the 8 studies., Results: We found a miscalculation of the effect sizes used to make key comparisons. Claims for the effectiveness of LTPP depended on a set of small, underpowered studies that were highly heterogeneous in terms of patients treated, interventions, comparison-control groups, and outcomes. LTPP was compared to 12 types of comparison-controls, including control groups that did not involve any psychotherapy, short-term psychodynamic psychotherapy, and unvalidated treatments. Additionally, the studies failed to protect against threats to bias, and had poor internal validity., Conclusion: Overall, we found no evidence to support claims of superiority of LTPP over shorter-term methods of psychotherapy., (Copyright 2010 S. Karger AG, Basel.)

A review of the evidence on energy psychology (EP) was published in this journal (see record 2008-07317-008). Although Feinstein's stated intention of reviewing the evidence is one we support, we noted that important EP studies were omitted from the review that did not confirm the claims being made by EP proponents. We also identify other problems with the review, such as the lack of specific inclusion and exclusion criteria, misportrayal of criticism of EP, incorrectly characterizing one of the studies as a randomized clinical trial, and lack of disclosure regarding an EP-related business. We note that in the American Psychological Association, decisions on classification of therapies as empirically supported are most rightfully the function of Division 12-appointed committees of psychologists. It is not enough for any one individual or group of proponents of a particular approach to make such a determination. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

With the continuing progress of obstetrical and neonatal care, the limit of human viability has continued to shift towards younger gestational ages. The survival rate as well as the survival without disability increases with each additional week of gestation but, for infants born from 22 to 25 w GA, it is still really low, and the threshold of human viability appears to be limited to the physiological development of the lungs, which take place around the 23rd-24th w GA. At present, the care of such infants, born at the threshold of human viability, presents a variety of complex medical, social, and economical decisions assuming the characteristics of ethical decisions in that the limits between benefits and disadvantages is not so clearcut. What is the true infant's best interest is far to be understood and concern about the ethical basis of providing such intensive care is arising in the scientific community. In this paper the authors provide a review of the ethical basis of decisions related to the care of such infants: to treat, not to treat, intensive or compassionate care, withhold or withdraw treatment.

Callahan's response evades the key issues raised by merely restating and elaborating upon what has already been said, providing citations that are out of context and irrelevant to the issues at hand, and misrepresenting what was actually said by his critics and me and the authors of articles he cites. He spends paragraphs refuting "straw men." He provides additional anecdotes, which offer no convincing evidence for his claims. His critics have expressed concern that Callahan and Thought Field Therapy (TFT) proponents will cite his response article, as published in the Journal of Clinical Psychology, to promote TFT, as TFT proponents have repeatedly done for the non-peer-reviewed earlier issue devoted to TFT. Callahan has been given an unprecedented opportunity to present his work in a reputable journal without prior peer review and has failed to meet the burden of proof for his claims, thus undermining his own claim, that his work has been rejected solely as a result of bias against innovation., (2004 Wiley Periodicals, Inc.)

This article is a retraction of the conclusions drawn in a previous article, published as part of a special October 2001 issue of the Journal of Clinical Psychology on Thought Field Therapy (TFT). I decided to write this retraction after reconsidering a number of issues raised in the critiques of the articles. Additionally, subsequent misinterpretations of the literature on heart rate variability (HRV) by Roger Callahan, which led to further questioning of his premises and claims regarding TFT and HRV as represented in the articles, are discussed. I conclude that the burden of proof is on TFT proponents to demonstrate its efficacy and that well-designed controlled studies using standardized assessment measures and long-term follow-up must be performed to allow the scientific community to take claims made for TFT seriously., (2004 Wiley Periodicals, Inc.)

The need for empirical, objective, clear, and practical outcome measures for therapy has long been recognized by clinicians and researchers. Pragmatic tools for objective determination of the efficacy of therapy have been scarce in clinical practice settings. Heart rate variability (HRV) is increasing in popularity for use in clinical settings as a measure of treatment success. Since HRV is stable and placebo-free, it has the potential to meet this need. Thirty-nine cases are presented from the clinical practices of the authors and three other clinicians where HRV was used as an outcome measure for Thought Field Therapy (TFT). The cases included TFT treatments which addressed a wide variety of problems including phobias, anxiety, trauma, depression, fatigue, attention deficit hyperactivity disorder, learning difficulties, compulsions, obsessions, eating disorders, anger, and physical pain. A lowering of subjective units of distress was in most cases related to an improvement in HRV., (Copyright 2001 John Wiley & Sons, Inc.)

The increasingly prolonged survival of extremely premature infants who required long-term venous access means that this is often a major problem in modern neonatal unit. The insertion of central venous catheters has become an established practice and the development of silastic catheters inserted by newer percutaneous techniques through a peripheral vein is, now, the choice technique in awake non sedated critically-ill infants. Such technique has an high percentage of failure. We have undertaken a retrospective study to determine whether the brachial plexus block performed via the axillary approach could improve the success rate for the insertion of central venous catheter from a peripheral vein of the upper limb in infants minimizing physical and emotional stress to the neonates. Data from 157 low and very low birthweight infants, submitted or not submitted to the axillary block, were examined. The failure rate for the insertion of the central venous catheter was 27% without using the brachial plexus block vs. 9% in the patients that underwent the block. Use of the brachial plexus block via the axillary route, although retrospectively evaluated, improves the success rate and the pain control for the insertion of small diameter central venous silicon catheter from a peripheral vein of the upper limb in low and very low birthweight infants.

Ten patients with myotonic dystrophy have been studied by M-mode and 2-dimensional echocardiography. Six patients had echocardiographic abnormalities: mitral valve prolapse, hypertrophy of the papillary muscles (2 cases); impaired regional left ventricular relaxation, probably due to "cardiac myotonia" (4 patients); and dilatative cardiomyopathy in the sole patient with overt heart disease. There seems to be no relation between involvement of skeletal and cardiac muscle. It is likely, although not proved, that myocardial involvement in myotonic dystrophy occur initially as "myotonia", followed by a "dystrophic" phase with severe dilatative cardiomyopathy, not unlike the skeletal muscle.