La logoterapia como alternativa terapéutica para la potenciación del sentido de la vida en pacientes alcohólicos / Logotherapy as therapeutic alternative for the potentiation of the life sense in alcoholic patients

El alcoholismo es una enfermedad crónica que afecta el sentido de la vida y dificulta en la mayoría de los casos la adherencia terapéutica y la abstinencia. Entre las terapias utilizadas en los pacientes alcohólicos, la logoterapia se presenta como una variedad complementaria en el plan terapéutico prescrito, por sus ventajas y aceptación

Alcoholism is a chronic disease which affects the life sense and in most of the cases it affects the therapeutic adherence and abstinence. Among the therapies used in the alcoholic patients, logotherapy is presented as a complementary variety in the prescribed therapeutic plan, due to its advantages and acceptance

[Competence Based Catalogue of Learning Objectives for Rehabilitation, Physical Medicine, Naturopathic Treatment - Revised Version - Joint Recommendations of the German Society of Rehabilitation Science and the German Society of Physical Medicine and Rehabilitation]. / Kompetenzbasierter Lernzielkatalog "Rehabilitation, Physikalische Medizin, Naturheilverfahren" (RPMN) ­ revidierte Fassung.

Since the first publication of learning objectives for the interdisciplinary subject "Rehabilitation, Physical Medicine, Naturopathic Treatment" in undergraduate medical education in 2004 a revision is reasonable due to heterogenous teaching programmes in the faculties and the introduction of the National Competence Based Catalogue of Learning Objectives in Medicine as well as the "Masterplan Medical Education 2020". Therefore the German Society of Rehabilitation Science and the German Society of Physical Medicine and Rehabilitation started a structured consensus process using the DELPHI-method to reduce the learning objectives and arrange them more clearly. Objectives of particular significance are emphasised. All learning objectives are assigned to the cognitive and methodological level 1 or to the action level 2. The learning objectives refer to the less detailed National Competence Based Catalogue of Learning Objectives in Medicine. The revised learning objectives will contribute to further progress in competence based and more homogenous medical teaching in core objectives of Rehabilitation, Physical Medicine, and Naturopathic Treatment in the faculties.

[Current Developments of the Interdisciplinary Subject Rehabilitation, Physical Medicine, Naturopathic Treatment in the German Medical Faculties: Results of the DGRW Faculty Survey in 2015]. / Aktuelle Entwicklungen der rehabilitationsbezogenen Lehre in den humanmedizinischen Studiengängen in Deutschland: Ergebnisse der DGRW-Fakultätenbefragung 2015.

To ascertain the current development of the rehabilitation-related medical teaching in the interdisciplinary subject Rehabilitation, Physical Medicine, Naturopathic Treatment (Q12) regarding its execution, content, exams and evaluation of teaching at the Medical Faculties the German Society of Rehabilitation Science conducted another faculty survey in 2015. Representatives of all degree courses of human medicine in German Universities (n=41) received a pseudonymised standardised questionnaire in summer 2015. The response rate was 76% (n=31). Half of the faculties (48%) stated that they had a teaching and research unit for at least 1 of the 3 subjects of the interdisciplinary Q12. The Q12-teaching of faculties including these units partially differed from the other faculties. Model medical education programmes provide on average 2 semesters more for Q12-teaching in comparison to the traditional programmes. More than 3 quarters of the traditional programmes and all other courses include other medical professionals besides physicians as lecturers. Multiple choice questions still constitute the most common examination type (94%). Nearly all Medical Faculties evaluate the rehabilitation-related teaching but only half of all them have implemented a financial gratification based on the evaluation results. Even 10 years after the implementation of Q12, major variations were demonstrated regarding the execution, content and methods of medical education in rehabilitation. In the future the influence of the National Competence Based Catalogues of Learning Objectives for Undergraduate Medical Education on the Q12-development and the Q12-teaching in medical university education in Germany with foreign qualification will be of particular interest.

[The department of balneology and physical medicine of the S.M. Kirov's Military-medical academy 75 years anniversary].

The article highlights the history of the creation of the Department of balneology and physiotherapy at the S.M. Kirov Military-medical academy and the stages of its development. Employees of the Academy have a priority in the scientific substantiation of main principles of physical medicine and rehabilitation. They stood at the forefront of development of scientific schools and research institutions. The article presents the main achievements of the Department in academic, research and clinical work.

La comunicación de malas noticias en el daño cerebral aquirido: ¿mucha ciencia pero tal vez poca complacencia? / Breaking bad news in traumatic brain injury: much science but possibly not enough art?

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Developing behavioural training services to meet defined standards within an Australian statewide disability service system and the associated client outcomes.

BACKGROUND: LaVigna, Christian, and Willis (2005) reported on a project where Institute for Applied Behaviour Analysis (IABA) staff trained a professional team in New Zealand (NZ) to provide behavioural services that met defined criteria. The NZ team was then trained to train other practitioners to meet the same professional standards. However, no client outcomes were reported in that study. METHOD: This study replicates the NZ study within disability services in Tasmania, Australia. Further, this study examined the associated client outcomes and the impact of the training on severity ratings of subsequent referrals. RESULTS: Tasmanian trainers trained participants to provide behavioural services that met the same professional standards. Client behavioural outcome data showed significant improvement. Referral data showed decreases in severity ratings. CONCLUSIONS: The trainer of trainers process is effective in training staff to meet defined professional standards, including desired client outcomes, and to effectively make positive behaviour support accessible to a large number of people.

Swallowing neurorehabilitation: from the research laboratory to routine clinical application.

The recent application of neurostimulation techniques to enhance the understanding of swallowing neural plasticity has expanded the focus of rehabilitation research from manipulation of swallowing biomechanics to manipulation of underlying neural systems. Neuromodulatory strategies that promote the brain's ability to reorganize its neural connections have been shown to hold promising potential to aid the recovery of impaired swallowing function. These techniques include those applied to the brain through the intact skull, such as transcranial magnetic stimulation or transcranial direct current stimulation, or those applied to the sensorimotor system in the periphery, such as neuromuscular electrical stimulation. Recent research has demonstrated that each of these techniques, either by themselves or in combination with these and other treatments, can, under certain circumstances, modify the excitability of motor representations of muscles involved in swallowing. In some studies, experimentally induced plastic changes have been shown to have functional relevance for swallowing biomechanics. However, the transition of novel, neuromodulatory brain stimulation techniques from the research laboratory to routine clinical practice is accompanied by a number of ethical, organizational, and clinical implications that impact professions concerned with the treatment of swallowing rehabilitation. In this article, we provide a brief overview of the neuromodulatory strategies that may hold potential to aid the recovery of swallowing function, and raise a number of issues that we believe the clinical professions involved in the rehabilitation of swallowing disorders must confront as these novel brain stimulation techniques emerge into clinical practice.

[Postgraduate studies on reflexotherapy: prospects of improved methods of rehabilitation].

Formation adaptive effect of reflexology is one of the most important non-specific mechanisms of action to ensure implementation of its sacrificial, sanohenetichnoho and preventive effects. Today, basic education in acupuncture should focus on common international standards, including anatomical, physiological, biochemical and biophysical basis. Based on primary specialization of reflexology should be in continuous improvement of the methods of acupuncture in various fields of clinical medicine aggregate of not less than 350 hours, which is usually carried out intermittently for several years.

[Teaching rehabilitation in neurology for general practitioners of family medicine].

UNLABELLED: In the article the educational and pedagogical and organizational measures designed and implemented in practice staff of the Department of Neurology and reflexology to improve the training of doctors cycle "general practice family medicines". OBJECTIVE: To optimize teaching process for doctors neurology "General practice - family medicine". We recommend using the following methods for diagnosing the level of training of cadets: Control of practical skills--the ability to explore the neurological status and interpret it in different neurological diseases, questionnaires, computer tests, solving situational problems.

Hannover model for the implementation of physical and rehabilitation medicine teaching in undergraduate medical training.

As any patient may require rehabilitation and physical therapies, all physicians need to acquire at least a basic knowledge of Physical and Rehabilitation Medicine (PRM). In 2005 PRM teaching was implemented in all phases of the curriculum for medical students in Germany. The curriculum includes, among others, the following topics: principles of rehabilitation; the model of the International Classification of Functioning, Disability and Health (ICF); principles and effects of physiotherapy and occupational therapy; indications and contraindications for PRM interventions. Teaching of PRM topics is implemented from the first week in all phases of the curriculum, as: (i) lectures in the module "Introduction to Medicine (Propaedeuticum)"; (ii) a cross-sectional course entitled "Rehabilitation, Physical Medicine and Naturopathic Treatment (RPMN)"; (iii) single lectures on PRM in other fields; (iv) elective mandatory courses on the social model of rehabilitation, balneology, and others; and (v) the option to choose PRM as a subject for practical training. All modules are evaluated regularly by the students. Global ratings of the module "Propaedeuticum" were good, and of the cross-sectional course "RPMN" very good. The advanced part of the practical training was rated highly by the students. In conclusion, the implementation of teaching of PRM and other rehabilitation topics in undergraduate medical education is a successful concept that fulfils the criteria for education in medical school set out by the American Association of Academic Physiatrists.

[Changes of teaching in the interdisciplinary subject "rehabilitation, physical medicine, naturopathic treatment" in the German medical faculties 2004 to 2006/07]. / Entwicklung der Lehre im Querschnittsbereich "Rehabilitation, Physikalische Medizin, Naturheilverfahren" an den medizinischen Fakultäten 2004-2006/07.

BACKGROUND: Rehabilitation, Physical Medicine, Naturopathic Treatment (Querschnittsbereich Q-12) was introduced as a compulsory interdisciplinary subject in the revised Federal Medical Licensing Regulations (Approbationsordnung für Arzte) in October 2003. This offered the opportunity to increase the students' interest in rehabilitation-related issues and to integrate current evidence of rehabilitation research. The implementation of the Q-12 in the German medical faculties was investigated by yearly questionnaires during a three-year-period. METHODS: In 2004, 2005, and 2006/07 anonymous postal questionnaires concerning the teaching in Q-12 were sent to the 36 medical faculties in Germany. Non-responders were reminded at least once by a repeat postal questionnaire. RESULTS: The response rates were 67% in 2004, 72% in 2005, 50% in 2006/07, respectively. Of the 36 faculties 34 responded at least once. Ten faculties responded to all questionnaires. In a considerable number of faculties, Q-12 is being coordinated by university institutions which are not denominated as one of the subjects designated in the Q-12 title. Major differences regarding the implementation of Q-12 were found between the faculties. Further development of Q-12 faces several limitations of resources. Almost all faculties provide curricula for teaching Q 12, some of which are still incomplete. During all three examinations lecturer-centered teaching methods (lectures, seminars, other presentations) were used most frequently. POL-cases and other structured patient oriented teaching were also reported less frequently. E-learning was very rarely offered to the students. Musculoskeletal and neurological disorders were the most frequent specific indications for practice-related integration of Q-12 issues. Compulsory election subjects (Wahlpflichtfächer) related to Q-12 issues before and during the final year of the medical students, are not being offered by all faculties. The vast majority of the faculties advocate an exchange of materials for teaching and examinations. CONCLUSIONS: During the three examinations, major differences concerning the implementation of Q-12 were found between the faculties. Therefore, it is recommended that all faculties verify whether they adequately cover the joint educational objectives recommended for Q-12 by two German scientific societies. Furthermore, the more frequent application of up-to-date practice-oriented teaching and examination methods, an intensified implementation of Q-12-related issues in teaching specific indications, the completion of curricula, enhanced offer of compulsory election subjects related to Q-12 issues, continued scientific investigations and symposia/workshops concerning the promotion of Q-12-related teaching as well as the generation and exchange of teaching and examination materials are recommended.

Religion and disability: clinical, research and training considerations for rehabilitation professionals.

PURPOSE: This article (i) reviews existing research on the relationships that exist among spirituality, religion, and health for persons with disabilities; and (ii) compares different theoretical coping models (i.e., spiritual vs. psychoneuroimmunological). BACKGROUND: Over the past decade interest has increased in relationships among spirituality, religion, and health in both the mainstream media (e.g., Newsweek) and scientific literature (e.g., Koenig). In general, research has concluded that religion and spirituality are linked to positive physical and mental health outcomes. Most religion and health research has focused on populations with life-threatening diseases (e.g., cancer, cardiovascular disorders, AIDS) with minimal attention to persons with chronic, life-long disabling conditions such as brain injury, spinal cord injury, and stroke. However, religion is used by many individuals with disabilities to help them adjust to their impairments and to give new meaning to their lives. CONCLUSIONS: Religion and spirituality are important coping strategies for persons with disabilities. Practical suggestions for rehabilitation professionals are provided regarding: (a) strategies to enhance religious coping; (b) methods to train rehabilitation professionals about religious issues; and (c) issues to consider regarding future research on rehabilitation and religion.

[Problem oriented learning (POL) in rehabilitation on the example of a patient with ankylosing spondylitis]. / Problemorientiertes Lernen (POL) in der Rehabilitation am Beispiel eines Patienten mit Spondylitis ankylosans.

Through innovative teaching and learning methods relevant topics in rehabilitation can be conveyed effectively. Therefore, in this paper a papercase for problem-oriented learning (POL) is presented concerning rehabilitation in rheumatology, exemplified by a patient with ankylosing spondylitis. This papercase can be applied in the integrated course Rehabilitation, Physical Medicine and Naturopathic Treatment, the curricular part of teaching rehabilitation during the medical training according to the 9 (th) revision of the Federal Medical Licensing Regulations (Approbationsordnung). In addition the teaching material presented can be used in other courses, such as elective courses for non-medical professionals of the interdisciplinary rehabilitation team. First experiences gathered with the papercase in the Health and Nursing Sciences study programme of the Faculty of Medicine of Martin-Luther-University Halle-Wittenberg are reported.

The development of expertise in pediatric rehabilitation therapists: changes in approach, self-knowledge, and use of enabling and customizing strategies.

PURPOSE: To examine the clinical decision making of novice, intermediate, and expert pediatric rehabilitation therapists from various disciplines. METHODS: Two qualitative studies were conducted. Thirteen therapists took part in a study using the critical incident interview technique and 11 therapists took part in a study using the 'think aloud' technique. Therapists were classified as novice, intermediate, or expert in developmental level based on a cluster analysis of data collected using a multifaceted battery of assessment tools. Data were analyzed using a grounded theory approach. RESULTS: Expert and intermediate therapists differed from novices with respect to content, self-, and procedural knowledge. CONCLUSION: With increasing expertise, therapists use a supportive, educational, holistic, functional, and strengths-based approach; have heightened humility yet increased self-confidence; and understand how to facilitate and support client change and adaptation by using principles of engagement, coherence, and manageability. Expert therapists use enabling and customizing strategies to ensure a successful therapeutic session, optimize the child's functioning in the mid-term, and ensure child and family adaptation and accommodation over the longer-term.

[Current teaching, learning and examination methods in medical education and potential applications in rehabilitative issues]. / Aktuelle Lehr-, Lern- und Prüfungsmethoden in der medizinischen Ausbildung und ihre Anwendungsmöglichkeiten für die Rehabilitation.

With introduction of the new Federal Medical Licensing Regulations (Approbationsordnung) in Germany, integrated teaching in "Rehabilitation, Physical Medicine, Naturopathic Treatment" (Querschnittsbereich Q12) has become obligatory for the first time. Furthermore, the new Regulations require the medical faculties in Germany to realize an innovative didactic orientation in teaching. This paper provides an overview of recent applications of teaching techniques and examination methods in medical education with special consideration of the new integrated course Q12 and further teaching methods related to rehabilitative issues. Problem-oriented learning (POL), problem-based learning (PBL), bedside teaching, eLearning, and the examination methods Objective Structured Clinical Examination (OSCE) and Triple Jump are in the focus. This overview is intended as the basis for subsequent publications of the Commission for Undergraduate and Postgraduate Training of the German Society of Rehabilitation Science (DGRW), which will present examples of innovative teaching material.

[Implementation of the new Federal Medical Licensing Regulations for doctors in the interdisciplinary subject "Rehabilitation, physical medicine, naturopathic treatment" by the German medical faculties]. / Umsetzung der neuen Approbationsordnung für Arzte im Querschnittsbereich "Rehabilitation, Physikalische Medizin und Naturheilverfahren" an den medizinischen Fakultäten in Deutschland.

The introduction of the new interdisciplinary subject "Rehabilitation, Physical Medicine, Naturopathic Treatment" based on the 9th revision of the Federal Medical Licensing Regulations (Approbationsordnung fur Arzte) implies new opportunities and challenges for teaching. In order to investigate the transfer of the new subject to teaching practise, a written questionnaire was sent to all German medical faculties. With regard to the implementation of new teaching structures and procedures in the subject, a range of different indicators was examined. 50 % of the medical faculties have been planning for comprehensive teaching sessions as compared to distribution over the whole semester. Lectures predominate with an average of more than half of the teaching time available for the subject. For examination purposes written tests are used in 83 %, compared to only 17 % Objective Structured Clinical Examinations. Considering the diversity among the medical faculties, there is room for improvement in many universities concerning more patient- and practice-oriented medical training as intended by the Federal Medical Licensing Regulations. However, in spite of increased demands, supplementary funds for additional equipment or manpower are rarely provided for. In the future, enhanced allocation of resources based on performance-related evaluation within the medical faculties and teaching competition between universities may provide significant stimuli for advances in medical training also in the new interdisciplinary subject. Further improvement of general teaching conditions is necessary in order to utilize all the opportunities offered by the new Federal Medical Regulations.

Opiate addiction and the entanglements of imperialism and patriarchy in Manchukuo, 1932-45.

In the Japanese colonial state of Manchukuo, opiate addiction was condemned by officials and critics alike. But the state-sponsored creation of a monopoly, opium laws, and rehabilitation programs failed to reduce rates of addiction. Further, official media condemnation of opiate addiction melded with local Chinese-language literature to stigmatise addiction, casing a negative light over the state's failure to realise its own anti-opiate agenda. Chinese writers were thus transfixed in a complex colonial environment in which they applauded measures to reduce harm to the local population while levelling critiques of Japanese colonial rule. This paper demonstrates how the Chinese-language literature of Manchukuo did not simply parrot official politics. It also delegitimised Japanese rule through opiate narratives that are gendered, consistently negative, and more critical of the state than might be expected in a colonial literature.

[Educational objectives in the new interdisciplinary subject "Rehabilitation, Physical Medicine, Naturopathic Techniques" under the 9th Revision of the Licensing Regulations for Doctors--consensus recommendations of the German Society for Rehabilitative Sciences and the German Society for Physical Medicine and Rehabilitation]. / Lernziele im Querschnittsbereich Rehabilitation, Physikalische Medizin und Naturheilverfahren nach der 9. Revision der Approbationsordnung für Arzte--Gemeinsame Empfehlung der Deutschen Gesellschaft für Rehabilitationswissenschaften und der Deutschen Gesellschaft für Physikalische Medizin und Rehabilitation.

In October 2003 the 9 (th) revision of the Federal Medical Training Regulations (Approbationsordnung) came into effect. The new compulsory interdisciplinary subject "Rehabilitation, Physical Medicine, Naturopathic Treatment" offers the opportunity to teach all students in comprehensive concepts of Rehabilitation such as the International Classification of Functioning, Disability and Health (ICF) of the WHO and the new book 9 of the German Social Code (SGB 9), as well as Physical Medicine and Naturopathic Treatment. Since the content of this new subject has not been defined up to date a joint task force of the German Society of Rehabilitation Science and the German Society of Physical Medicine and Rehabilitation was founded in order to recommend teaching standards. As part of these teaching standards educational objectives are introduced in this article. They should guide the persons in charge of teaching the subject in the medical faculties. In some areas the students should acquire profound abilities and skills in addition to knowledge. The medical faculties may focus on different educational targets according to their individual teaching profile.