"Personal road map for recovery:" examining the therapeutic use of weblogs by stroke survivors with aphasia.

BACKGROUND: Strokes are a leading cause of disability in the United States. Approximately 25-40% of individuals who experience a stroke will have aphasia. Individuals with aphasia experience many life changes and some have found that writing activities, such as publishing text entries on a personal website, or weblog, to be therapeutic. PURPOSE: This study aimed to gain a greater understanding of the therapeutic use of blogs for stroke survivors with aphasia. DESIGN: Inductive qualitative content analysis. METHODS: Potential, publicly available weblogs written by people with aphasia were identified using a pre-determined search method and five met inclusion criteria. Data were collected from websites and collated into 453 pages of narratives. An inductive qualitative content analysis process was used to extract codes that were reduced to sub-categories and generic categories. RESULTS: A main category of therapeutic healing and three generic categories of (1) living with aphasia, (2) accepting a new identity, and (3) creating a community were identified. CONCLUSION: Weblog writing was therapeutic for stroke survivors with aphasia. Authors reported benefits across cognitive, psychological, emotional, and social domains. Health professionals should consider recommending weblog writing, journaling, or other methods of writing for stroke survivors with aphasia.Implications for rehabilitationCreating illness weblog posts can be therapeutically beneficial for stroke survivors with aphasia as a tool that addresses psychological, emotional, and social aspects in their recovery.Blogging appeared to offer a medium for stroke survivors with aphasia to practice writing, to express what living with aphasia is like, to explore changes in their post-stroke identities, and to create a community with others.Health professionals should consider recommending weblog writing, journaling, or other methods of writing for stroke survivors with aphasia.

Effect of laying on of hands as a complementary therapy for pain and functioning in older women with knee osteoarthritis: A randomized controlled clinical trial.

AIM: To assess the effects of laying on of hands (LooH) as a complementary therapy to kinesiotherapy, on pain, joint stiffness, and functional capacity of older women with knee osteoarthritis (KOA) compared to a control group. METHODS: In this randomized controlled clinical trial, participants were assigned into 3 groups: LooH with a spiritual component ("Spiritist passe" Group - SPG), LooH without a spiritual component (LooH Group - LHG), and a control group receiving no complementary intervention (Control Group - CG). Patients were assessed at baseline, 8 weeks, and 16 weeks. Primary outcomes were joint stiffness and functional capacity (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC]), and pain (WOMAC and visual analog scale). Secondary outcomes were anxiety, depression, mobility, and quality of life. Differences between groups were evaluated using an intention-to-treat approach. RESULTS: A total of 120 women (mean age = 69.2 ± 5.2 years) with KOA were randomized (40 participants per group). At 8 weeks, SPG differed significantly from the LHG for WOMAC Functional Status (between-group difference in the change = 0.97; 95% CI: 0.35 to 1.59, P = .001); Anxiety levels (between-group difference in the change = 1.38; 95% CI: 0.11 to 2.65, P = .027); and also from the CG for all outcomes with exception of WOMAC Stiffness. After 16 weeks, SPG differed significantly from the LHG only for WOMAC Functional Status (between-group difference in the change = 0.92; 95% CI: 0.32 to 1.52, P = .001]) and also from the CG for all outcomes with exception of WOMAC Stiffness and timed up-and-go. CONCLUSION: Our results suggest that LooH with a "spiritual component" may promote better long-term functional outcomes than both LooH without a "spiritual component" and a control group without LooH.

Effects of laying on of hands with and without a spiritual context on pain and functionality of older women with knee osteoarthritis: study protocol for a randomized controlled trial.

BACKGROUND: Laying on of hands (LooH) is a culturally-accepted therapy in several traditions. In Brazil, "Spiritism" (third-largest religious tradition in number of followers) uses LooH with the name of "Spiritist Passe" (SP). However, there are few studies assessing SP's role in medical outcomes. The present study aims to investigate the effects of LooH, with and without a spiritual context, on pain, joint stiffness, and functional capacity of older women (≥60 years old) with knee osteoarthritis (KOA). METHODS/DESIGN: In this triple-blind, prospective randomized controlled trial, older women with KOA are assigned to three groups: LooH with a spiritual context group, LooH group without a spiritual context, and a control group receiving no intervention. Patients are assessed by a blinded researcher at baseline, 8 weeks, and 16 weeks. Pain, joint stiffness, and functional capacity are assessed using Western Ontario and McMaster Universities Osteoarthritis Index. Other measures such as anxiety, depression, gait speed, and quality of life will also be assessed. To detect differences between groups, a post-intervention comparison between the three groups and a mean change (post-pre) comparison among the three groups will be done using analysis of variance. All statistical analyses will be performed using an intention-to-treat approach and a per-protocol analysis. DISCUSSION: A pragmatic design using SP, LooH without spiritual context, and no LooH may provide further scientific evidence on SP's feasibility and efficacy for KOA patients. TRIAL REGISTRATION: ClinicalTrials.gov Identifier NCT02917356.

Effects of laying on of hands with and without a spiritual context on pain and functionality of older women with knee osteoarthritis: study protocol for a randomized controlled trial / 中西医结合学报

<p><b>BACKGROUND</b>Laying on of hands (LooH) is a culturally-accepted therapy in several traditions. In Brazil, "Spiritism" (third-largest religious tradition in number of followers) uses LooH with the name of "Spiritist Passe" (SP). However, there are few studies assessing SP's role in medical outcomes. The present study aims to investigate the effects of LooH, with and without a spiritual context, on pain, joint stiffness, and functional capacity of older women (≥60 years old) with knee osteoarthritis (KOA).</p><p><b>METHODS/DESIGN</b>In this triple-blind, prospective randomized controlled trial, older women with KOA are assigned to three groups: LooH with a spiritual context group, LooH group without a spiritual context, and a control group receiving no intervention. Patients are assessed by a blinded researcher at baseline, 8 weeks, and 16 weeks. Pain, joint stiffness, and functional capacity are assessed using Western Ontario and McMaster Universities Osteoarthritis Index. Other measures such as anxiety, depression, gait speed, and quality of life will also be assessed. To detect differences between groups, a post-intervention comparison between the three groups and a mean change (post-pre) comparison among the three groups will be done using analysis of variance. All statistical analyses will be performed using an intention-to-treat approach and a per-protocol analysis.</p><p><b>DISCUSSION</b>A pragmatic design using SP, LooH without spiritual context, and no LooH may provide further scientific evidence on SP's feasibility and efficacy for KOA patients.</p><p><b>TRIAL REGISTRATION</b>ClinicalTrials.gov Identifier NCT02917356.</p>

Holistic Consideration of Patients with Schizophrenia to Improve Medication Adherence and Outcomes.

Although several algorithms have been applied to treat patients with schizophrenia, their clinical use remains still limited, because most emphasize the prescription of antipsychotics. A new algorithm with a more holistic approach to treating patients with schizophrenia, to be used before applying traditional prescribing guidelines, was thus proposed by an expert team of Taiwanese psychiatrists. In this algorithm, several important treatment tasks/modalities are proposed, including long-acting injection antipsychotics, shared decision-making, a case management system, compulsory treatment by law, community rehabilitation programs, the patients' feeling about their health care professionals (patients' behaviors) and their attitude/knowledge of their conditions/ illness. This study proposes that evaluating the medication adherence of patients can be determined by two key domains, namely patients' behaviors and attitudes. Based on different levels of their behaviors (X-axis) and attitude/knowledge (Y-axis), it is possible to categorize patients with schizophrenia into six subgroups, for which various different interventions, including the use of antipsychotics, could be applied and integrated. Further research is needed to assess the applicability of this treatment algorithm in clinical settings.

Holistic Consideration of Patients with Schizophrenia to Improve Medication Adherence and Outcomes

Although several algorithms have been applied to treat patients with schizophrenia, their clinical use remains still limited, because most emphasize the prescription of antipsychotics. A new algorithm with a more holistic approach to treating patients with schizophrenia, to be used before applying traditional prescribing guidelines, was thus proposed by an expert team of Taiwanese psychiatrists. In this algorithm, several important treatment tasks/modalities are proposed, including long-acting injection anti-psychotics, shared decision-making, a case management system, compulsory treatment by law, community rehabilitation programs, the patients' feeling about their health care professionals (patients' behaviors) and their attitude/knowledge of their conditions/illness. This study proposes that evaluating the medication adherence of patients can be determined by two key domains, namely patients' behaviors and attitudes. Based on different levels of their behaviors (X-axis) and attitude/knowledge (Y-axis), it is possible to categorize patients with schizophrenia into six subgroups, for which various different interventions, including the use of antipsychotics, could be applied and integrated. Further research is needed to assess the applicability of this treatment algorithm in clinical settings.

To Investigate Zhang CiGong’s Academic Achievement / 浙江中医药大学学报

Objective To investigate Zhang CiGong who was traditional Chinese medicine doctor and educator ’s academic achievement. [Methods]To summarize and analysize Zhang CiGong’s learning experiences,academic thoughts and examples of clinical experiences. [Results]Zhang CiGong had no prejudice on academic schools, integrated various academic schools’s advantages and then turned into his’s own feature. Zhang CiGong researched and clarified the essence of traditional Chinese medicine theory, and made it flourish. He found the real cause of the disease when treatment,used the holistic approach and syndrome differentiation treatment. He gathered his own experience into the ancients experience and emphasis on practice when he gave Chinese Herbal. [Conclusions]Zhang CiGong’s learning was great and we should learn from him.