Handbook on Sensitive Practice for Health Care Practitioners: Lessons from Adult Survivors of Childhood Sexual Abuse

This handbook is the culmination of a multiphase, multidisciplinary research project that used grounded theory and participatory action research to illuminate ways that healthcare providers can work sensitively (in a trauma-informed way) with adult survivors of childhood sexual abuse. The research identified nine Principles of Sensitive Practice: respect, rapport, taking time, sharing information and control, respecting boundaries, fostering mutual learning, understanding non-linear healing and demonstrating an understanding of trauma to patients. Specific guidelines were developed for a wide variety of issues pertinent to clinical practice such as, removal of clothing, touch, responding to disclosures of abuse, managing triggers among others. The methodology included interviews with women and men adult survivors of childhood sexual abuse from across Canada about how healthcare practitioners can be sensitive to their needs as survivors. It also included learnings from group meetings where survivors and healthcare practitioners discussed together ways healthcare practice could better respond to the needs of survivors. Written feedback received from physicians, nurses, dentists and dental hygienists, physical and occupational therapists, massage therapists, chiropractors, kinesiologists, professional regulators, mental health professionals and survivors from across Canada ensured that suggestions for clinical practice reflected both survivor needs and the realities of clinical practice. We concluded that because healthcare providers are not always aware that they are working with individuals who have experienced childhood trauma, clinicians should apply these principles and guidelines universally in order to work in a trauma-informed manner with all patients

Exercise Therapy for Fibromyalgia

Fibromyalgia syndrome, a chronic condition typically characterized by widespread pain, nonrestorative sleep, fatigue, cognitive dysfunction, and other somatic symptoms, negatively impacts physical and emotional function and reduces quality of life. Exercise is commonly recommended in the management of people with fibromyalgia, and interest in examining exercise benefits for those with the syndrome has grown substantially over the past 25 years. Research supports aerobic and strength training to improve physical fitness and function, reduce fibromyalgia symptoms, and improve quality of life. However, other forms of exercise (e.g., tai chi, yoga, Nordic walking, vibration techniques) and lifestyle physical activity also have been investigated to determine their effects. This paper highlights findings from recent randomized controlled trials and reviews of exercise for people with fibromyalgia, and includes information regarding factors that influence response and adherence to exercise to assist clinicians with exercise and physical activity prescription decision-making to optimize health and well-being

Handbook on Sensitive Practice for Health Care Practitioners: Lessons from Adult Survivors of Childhood Sexual Abuse

This handbook is the culmination of a multiphase, multidisciplinary research project that used grounded theory and participatory action research to illuminate ways that healthcare providers can work sensitively (in a trauma-informed way) with adult survivors of childhood sexual abuse. The research identified nine Principles of Sensitive Practice: respect, rapport, taking time, sharing information and control, respecting boundaries, fostering mutual learning, understanding non-linear healing and demonstrating an understanding of trauma to patients. Specific guidelines were developed for a wide variety of issues pertinent to clinical practice such as, removal of clothing, touch, responding to disclosures of abuse, managing triggers among others. The methodology included interviews with women and men adult survivors of childhood sexual abuse from across Canada about how healthcare practitioners can be sensitive to their needs as survivors. It also included learnings from group meetings where survivors and healthcare practitioners discussed together ways healthcare practice could better respond to the needs of survivors. Written feedback received from physicians, nurses, dentists and dental hygienists, physical and occupational therapists, massage therapists, chiropractors, kinesiologists, professional regulators, mental health professionals and survivors from across Canada ensured that suggestions for clinical practice reflected both survivor needs and the realities of clinical practice. We concluded that because healthcare providers are not always aware that they are working with individuals who have experienced childhood trauma, clinicians should apply these principles and guidelines universally in order to work in a trauma-informed manner with all patients

Cellular accumulation of heat shock protein (Hsp) 72i in fetuses of trained rats

Forty-five Sprague-Dawley rats (60–80 days old) were randomly placed into one of three groups: sedentary pregnant control (PC); prepregnancy trained animals that exercised throughout pregnancy (PR); and nonpregnant trained animals (NPR). Each exercising animal ran at approximately 60–70% aerobic capacity (V̇O2max) for 1 hour/day up to and including day 18 of gestation (term = 21 days). On day 20 of gestation, fetuses were excised from each pregnant animal and scrutinized for gross abnormalities. In 3 randomly chosen fetuses from each litter, brain, heart, kidney, hind limb, and placental tissues were removed to assess the accumulation of the inducible isoform of the 70-kilodalton heat shock protein (Hsp 72i). No significant differences were detected between fetal hearts, hind limbs, or placental tissues of PC or PR groups. No Hsp 72i signal could be detected in fetal kidney or brain tissues from either pregnant group. Results indicate that maternal core temperature did not reach the threshold that would induce either gross fetal abnormalities or a fetal heat shock protein response. However, fetal and placental growth was reduced by the exercise protocol