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Navy Yard City, MA, United States

Wood L.J.,MGH Institute of Health Professions | Weymann K.,Oregon Health And Science University
Current Opinion in Supportive and Palliative Care | Year: 2013

Purpose of review Cancer patients undergoing treatment with cytotoxic chemotherapeutic agents (CCAs) often experience a cluster of treatment-related symptoms, which include fatigue, loss of appetite, disturbed sleep, depressed mood, cognitive difficulties, and changes in body composition. This symptom cluster collectively referred to herein as cancer treatment-related symptoms (CTRSs) decrease quality of life, and physical and social functioning. The preclinical and clinical studies described in this review represent important progress in understanding potential underlying mechanisms of CTRS. Recent findings Recent studies support a role for CCA-induced interleukin-1b (IL-1β) signaling in the cause of CTRS. CCAs may share a common ability to activate intracellular stress response pathways to trigger the synthesis, processing, and release of IL-1b from immune cells. Fatigue, sleep disturbance, and cognitive difficulties in cancer patients exposed to CCAs correlate with plasma levels of IL-6, IL-1 receptor antagonist, and soluble tumor necrosis factor receptor-I/II, surrogate markers of IL-1β-mediated central nervous system (CNS) inflammation. Additional preclinical work suggests IL-1β-mediated CNS inflammation may cause CTRS by altering hypothalamic and hippocampal functioning. Summary Although additional research is necessary to further establish the link between CCA exposure, IL-1bmediated inflammatory processes and CTRS, these data provide hints for future studies and therapeutic approaches in ameliorating these symptoms in cancer patients. © 2013 Wolters Kluwer Health Lippincott Williams and Wilkins. Source

Lof G.L.,MGH Institute of Health Professions
International Journal of Speech-Language Pathology | Year: 2011

Evidence-based practice (EBP) is a well established concept in the field of speech-language pathology. However, evidence from research may not be the primary information that practitioners use to guide their treatment selection from the many potential options. There are various alternative therapy procedures that are strongly promoted, so clinicians must become skilled at identifying pseudoscience from science in order to determine if a treatment is legitimate or actually quackery. In order to advance the use of EBP, clinicians can gather practice-based evidence (PBE) by using the scientific method. By adhering to the principles of science, speech-language pathologists can incorporate science-based practice (SBP) into all aspects of their clinical work. © 2011 The Speech Pathology Association of Australia Limited. Source

Evenson M.E.,MGH Institute of Health Professions
Work | Year: 2013

OBJECTIVE: The purpose of this study was to explore students' perceptions of their confidence to use research evidence to complete a client case analysis assignment in preparation for participation in fieldwork and future practice. PARTICIPANTS: A convenience sample of 42 entry-level occupational therapy Masters students, included 41 females and one male, ages 24 to 35. METHODS: A quasi-experimental pretest-posttest design was used. Students participated in a problem-based learning approach supported by educational technology. Measures included a pre-and post-semester confidence survey, a post-semester satisfaction survey, and an assignment rubric. RESULTS: Based on paired t-tests and Wilcoxin Signed Ranks Tests, statistically significant differences in pre-and post-test scores were noted for all 18 items on the confidence survey (p< 0.001). Significant increases in students' confidence were noted for verbal and written communication of descriptive, assessment, and intervention evidence, along with increased confidence to effectively use assessment evidence. CONCLUSIONS: Results suggest that problem-based learning methods were significantly associated with students' perceptions of their confidence to use research evidence to analyze a client case. These results cannot necessarily be generalized due to the limitations of using non-standardized measures with a convenience sample, without a control group, within the context of a single course as part of one academic program curriculum. © 2013-IOS Press and the authors. All rights reserved. Source

Gross K.D.,MGH Institute of Health Professions
Clinics in Geriatric Medicine | Year: 2010

With too few conservative options in the current medical system, increasing numbers of osteoarthritis (OA) sufferers are using untested folk remedies and self-prescribed dietary supplements. There is enormous popular demand for noninvasive and nonpharmacologic therapies for OA, and there is a pressing need for clinicians to respond to this demand by updating their practice. This review introduces clinicians to the most important noninvasive devices used in the conservative management of knee OA. Because the shared goal of these devices is to favorably alter lower limb biomechanics, each section of the review considers evidence of biomechanical and clinical efficacy. © 2010 Elsevier Inc. Source

Townsend E.L.,MGH Institute of Health Professions
Pediatric Physical Therapy | Year: 2014

PURPOSE:: Although bracing in the late ambulatory stage of Duchenne muscular dystrophy (DMD) has been described, the effects of ankle-foot orthoses (AFOs) in earlier stages have not been evaluated. The aim of this pilot study was to describe the effects of dynamic response AFO (DR-AFO) use in boys with DMD who are ambulatory.METHODS:: Using a crossover design, 3 boys were randomly assigned to either a 2-week DR-AFO or a placebo intervention. Phases were separated by a 1-week washout period. Primary outcomes were time to walk 10 m and a 6-Minute Walk Test.RESULTS:: With DR-AFO use, declines in 10-m walk time (median decline = 0.8 s) and 6-Minute Walk Distance (median = 25.0 m) occurred. Parental report suggested that the use of DR-AFOs increased falls in 2 of 3 participants.CONCLUSION:: This pilot study does not support the use of DR-AFOs by boys with DMD who are ambulatory. © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins and the Section on Pediatrics of the American Physical Therapy Association. Source

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