WorldWideScience

Sample records for chiropractic manual therapy

  1. The journal 'chiropractic & osteopathy' changes its title to 'chiropractic & manual therapies'. a new name, a new era

    OpenAIRE

    Walker Bruce F; French Simon D; Cameron Melanie; Perle Stephen M; Lebouef-Yde Charlotte; Rubinstein Sidney M

    2011-01-01

    Abstract Chiropractic & Osteopathy changes its title to Chiropractic & Manual Therapies in January 2011. This change reflects the expanding base of submissions from clinical scientists interested in the discipline of manual therapy. It is also in accord with the findings of a review of the journal content and a joint venture between the original parent organisation the Chiropractic and Osteopathic College of Australasia and a new partner the European Academy of Chiropractic, which is a subsid...

  2. The journal 'chiropractic & osteopathy' changes its title to 'chiropractic & manual therapies'. a new name, a new era.

    Science.gov (United States)

    Walker, Bruce F; French, Simon D; Cameron, Melanie; Perle, Stephen M; Lebouef-Yde, Charlotte; Rubinstein, Sidney M

    2011-01-01

    Chiropractic & Osteopathy changes its title to Chiropractic & Manual Therapies in January 2011. This change reflects the expanding base of submissions from clinical scientists interested in the discipline of manual therapy. It is also in accord with the findings of a review of the journal content and a joint venture between the original parent organisation the Chiropractic and Osteopathic College of Australasia and a new partner the European Academy of Chiropractic, which is a subsidiary body of the European Chiropractors' Union. The title change should encourage submissions from all professionals interested in manual therapy including chiropractors, osteopaths, physiotherapists, medical doctors and scientists interested in this field. PMID:21247414

  3. The journal 'chiropractic & osteopathy' changes its title to 'chiropractic & manual therapies'. a new name, a new era

    Directory of Open Access Journals (Sweden)

    Walker Bruce F

    2011-01-01

    Full Text Available Abstract Chiropractic & Osteopathy changes its title to Chiropractic & Manual Therapies in January 2011. This change reflects the expanding base of submissions from clinical scientists interested in the discipline of manual therapy. It is also in accord with the findings of a review of the journal content and a joint venture between the original parent organisation the Chiropractic and Osteopathic College of Australasia and a new partner the European Academy of Chiropractic, which is a subsidiary body of the European Chiropractors' Union. The title change should encourage submissions from all professionals interested in manual therapy including chiropractors, osteopaths, physiotherapists, medical doctors and scientists interested in this field.

  4. Plantar fasciitis: corticosteroid injection versus chiropractic therapy

    Directory of Open Access Journals (Sweden)

    Siddharth Raveendran

    2014-04-01

    Full Text Available The diagnosis of plantar fasciitis is usually clinical and rarely needs to be investigated further. The patient complains of pain in the medial side of the heel, most noticeable with initial steps after a period of inactivity and usually lessens with increasing level of activity during the day, but will tend to worsen toward the end of the day. Symptoms may become worse following prolonged weight bearing, and often precipitated by increase in weight bearing activities. Paresthesia is uncommon. It is usually unilateral, but up to 30% of cases have a bilateral presentation. In our study patients who received chiropractic therapy were treated by rest, heat, ice pack, non-steroidal anti-inflammatory drugs (NSAIDS, heel pads, magnetic insole, night splints, walking cast, taping, ultrasound, plantar and Achilles stretching for a period of 6 weeks scheduled accordingly. Patients receiving corticosteroid injection were administered 80mg methyl prednisolone locally at the heel. Each patient received 3 doses of methyl prednisolone injections on 1st day, 2nd week, and 4th week. The results with corticosteroid injection were better when analyzed with numeric rating scale over a period of 6 weeks. [Int J Res Med Sci 2014; 2(2.000: 639-642

  5. The new chiropractic

    OpenAIRE

    Walker, Bruce F.

    2016-01-01

    Background Physical manipulation and manual therapies are thousands of years old. The most popular western world iteration of these therapies is delivered by chiropractors. It can be argued that the collective public health benefit from chiropractic for spinal pain has been very substantial, however as chiropractic has transitioned from craft to profession it has encountered many internally and externally driven machinations that have retarded its progress to a fully accepted allied health pr...

  6. Adding chiropractic to standard medical therapy for nonspecific low back pain

    DEFF Research Database (Denmark)

    Goertz, Christine M; Long, Cynthia R; Hondras, Maria;

    2013-01-01

    Study Design. Randomized controlled trial.Objective. To assess changes in pain levels and physical functioning in response to standard medical care (SMC) versus SMC plus chiropractic manipulative therapy (CMT) for the treatment of low back pain (LBP) among 18 to 35-year-old active-duty military...... controlled trials demonstrates that manipulative therapy may be as effective as other conservative treatments of LBP, but its appropriate role in the healthcare delivery system has not been established.Methods. Prospective, 2-arm randomized controlled trial pilot study comparing SMC plus CMT with only SMC...

  7. Manipulative therapy (Feldenkrais, massage, chiropractic manipulation) for neck pain.

    Science.gov (United States)

    Plastaras, Christopher; Schran, Seth; Kim, Natasha; Darr, Deborah; Chen, Mary Susan

    2013-07-01

    Neck pain is an extremely common symptom with many possible etiologies. A substantial number of patients are turning to complementary and alternative medicine (CAM). Low-quality evidence supports the beneficial effects of CAM. Feldenkrais, massage therapy, and spinal manipulation are discussed in detail. Complications are generally benign and self-limited, although occasional catastrophic consequences have been documented. Despite the favorable opinion many rheumatologists have of some CAM therapy, many patients are not disclosing CAM use to their medical providers. By expressing interest, asking questions, and taking a shared-decision-making approach, providers can encourage disclosure and provide valuable input. PMID:23666468

  8. Manual therapy as a conservative treatment for adolescent idiopathic scoliosis: a systematic review

    Directory of Open Access Journals (Sweden)

    Negrini Stefano

    2008-01-01

    Full Text Available Abstract Background The treatment of adolescent idiopathic scoliosis is contingent upon many variables. Simple observation is enough for less serious curvatures, but for very serious cases surgical intervention could be proposed. Between these there is a wide range of different treatments. Manual therapy is commonly used: the aim of this paper is to verify the data existing in the literature on the efficacy of this approach. Methods A systematic review of the scientific literature published internationally has been performed. We have included in the term manual therapy all the manipulative and generally passive techniques performed by an external operator. In a more specific meaning, osteopathic, chiropractic and massage techniques have been considered as manipulative therapeutic methods. We performed our systematic research in Medline, Embase, Cinhal, Cochrane Library, Pedro with the following terms: idiopathic scoliosis combined with chiropractic; manipulation; mobilization; manual therapy; massage; osteopathy; and therapeutic manipulation. The criteria for inclusion were as follows: Any kind of research; diagnosis of adolescent idiopathic scoliosis; patients treated exclusively by one of the procedures established as a standard for this review (chiropractic manipulation, osteopathic techniques, massage; and outcome in Cobb degrees. Results We founded 145 texts, but only three papers were relevant to our study. However, no one of the three satisfied all the required inclusion criteria because they were characterized by a combination of manual techniques and other therapeutic approaches. Conclusion The lack of any kind of serious scientific data does not allow us to draw any conclusion on the efficacy of manual therapy as an efficacious technique for the treatment of Adolescent idiopathic scoliosis.

  9. Compensation claims for chiropractic in Denmark and Norway 2004-2012

    DEFF Research Database (Denmark)

    Jevne, Jørgen; Hartvigsen, Jan; Christensen, Henrik Wulff

    2014-01-01

    .3%). A total financial payment of €2,305,757 (median payment €7,730) were distributed among the forty-one cases with complaints relating to a few cases of cervical artery dissection (n = 11, 5.7%) accounting for 88.7% of the total amount. CONCLUSION: Chiropractors in Denmark and Norway received......BACKGROUND: Adverse events are commonly observed in all parts of health care and have been reported extensively following manual therapy, including chiropractic. The majority of reported adverse events following chiropractic care are mild, transitory and self-limiting. However, little is known...... about patient filed compensation claims related to the chiropractic consultation process. The aim of this study was to describe claims reported to the Danish Patient Compensation Association and the Norwegian System of Compensation to Patients related to chiropractic from 2004 to 2012. METHODS: All...

  10. Chiropractic care and public health

    DEFF Research Database (Denmark)

    Johnson, Claire; Rubinstein, Sidney M; Côté, Pierre;

    2012-01-01

    The purpose of this collaborative summary is to document current chiropractic involvement in the public health movement, reflect on social ecological levels of influence as a profession, and summarize the relationship of chiropractic to the current public health topics of: safety, health issues t...... prevention and public health? What role do citizen-doctors of chiropractic have in organizing community action on health-related matters? How can our future chiropractic graduates become socially responsible agents of change?......The purpose of this collaborative summary is to document current chiropractic involvement in the public health movement, reflect on social ecological levels of influence as a profession, and summarize the relationship of chiropractic to the current public health topics of: safety, health issues...... through the lifespan, and effective participation in community health issues. The questions that are addressed include: Is spinal manipulative therapy for neck and low-back pain a public health problem? What is the role of chiropractic care in prevention or reduction of musculoskeletal injuries in...

  11. Chiropractic Handbook.

    Science.gov (United States)

    New York State Education Dept., Albany. Office of the Professions.

    This reference guide contains laws, regulations, and licensing requirements and procedures governing chiropractic practice in New York State. Following a general introduction to professional regulation in New York State, licensure requirements are spelled out in detail, including general requirements, education requirements, examination…

  12. What Is Chiropractic?

    Science.gov (United States)

    ... ACA News Digital Edition Archives: ACA News Articles Advertising Opportunities News Newsroom News Releases Letters to the Editor Facts About Chiropractic Chiropractic in the Media ACA Radio Chiropractic Cares Social Media Facebook Twitter YouTube Instagram LinkedIn Advocacy Regulatory Policy Issue ...

  13. History of Chiropractic Care

    Science.gov (United States)

    ... ACA News Digital Edition Archives: ACA News Articles Advertising Opportunities News Newsroom News Releases Letters to the Editor Facts About Chiropractic Chiropractic in the Media ACA Radio Chiropractic Cares Social Media Facebook Twitter YouTube Instagram LinkedIn Advocacy Regulatory Policy Issue ...

  14. American Chiropractic Association

    Science.gov (United States)

    ... ACA News Digital Edition Archives: ACA News Articles Advertising Opportunities News Newsroom News Releases Letters to the Editor Facts About Chiropractic Chiropractic in the Media ACA Radio Chiropractic Cares Social Media Facebook Twitter YouTube Instagram LinkedIn Advocacy Regulatory Policy Issue ...

  15. A descriptive study of a manual therapy intervention within a randomised controlled trial for hamstring and lower limb injury prevention

    Directory of Open Access Journals (Sweden)

    Hoskins Wayne

    2010-08-01

    Full Text Available Abstract Background There is little literature describing the use of manual therapy performed on athletes. It was our purpose to document the usage of a sports chiropractic manual therapy intervention within a RCT by identifying the type, amount, frequency, location and reason for treatment provided. This information is useful for the uptake of the intervention into clinical settings and to allow clinicians to better understand a role that sports chiropractors offer. Methods All treatment rendered to 29 semi-elite Australian Rules footballers in the sports chiropractic intervention group of an 8 month RCT investigating hamstring and lower-limb injury prevention was recorded. Treatment was pragmatically and individually determined and could consist of high-velocity, low-amplitude (HVLA manipulation, mobilization and/or supporting soft tissue therapies. Descriptive statistics recorded the treatment rendered for symptomatic or asymptomatic benefit, delivered to joint or soft tissue structures and categorized into body regions. For the joint therapy, it was recorded whether treatment consisted of HVLA manipulation, HVLA manipulation and mobilization, or mobilization only. Breakdown of the HVLA technique was performed. Results A total of 487 treatments were provided (mean 16.8 consultations/player with 64% of treatment for asymptomatic benefit (73% joint therapies, 57% soft tissue therapies. Treatment was delivered to approximately 4 soft tissue and 4 joint regions each consultation. The most common asymptomatic regions treated with joint therapies were thoracic (22%, knee (20%, hip (19%, sacroiliac joint (13% and lumbar (11%. For soft tissue therapies it was gluteal (22%, hip flexor (14%, knee (12% and lumbar (11%. The most common symptomatic regions treated with joint therapies were lumbar (25%, thoracic (15% and hip (14%. For soft tissue therapies it was gluteal (22%, lumbar (15% and posterior thigh (8%. Of the joint therapy, 56% was HVLA

  16. Predictors of outcome in neck pain patients undergoing chiropractic care: comparison of acute and chronic patients

    Directory of Open Access Journals (Sweden)

    Peterson Cynthia

    2012-08-01

    Full Text Available Abstract Background Neck pain is a common complaint in patients presenting for chiropractic treatment. The few studies on predictors for improvement in patients while undergoing treatment identify duration of symptoms, neck stiffness and number of previous episodes as the strong predictor variables. The purpose of this study is to continue the research for predictors of a positive outcome in neck pain patients undergoing chiropractic treatment. Methods Acute ( 3 months (n = 255 neck pain patients with no chiropractic or manual therapy in the prior 3 months were included. Patients completed the numerical pain rating scale (NRS and Bournemouth questionnaire (BQ at baseline prior to treatment. At 1 week, 1 month and 3 months after start of treatment the NRS and BQ were completed along with the Patient Global Impression of Change (PGIC scale. Demographic information was provided by the clinician. Improvement at each of the follow up points was categorized using the PGIC. Multivariate regression analyses were done to determine significant independent predictors of improvement. Results Baseline mean neck pain and total disability scores were significantly (p  Conclusions The most consistent predictor of clinically relevant improvement at both 1 and 3 months after the start of chiropractic treatment for both acute and chronic patients is if they report improvement early in the course of treatment. The co-existence of either radiculopathy or dizziness however do not imply poorer prognosis in these patients.

  17. Back problems. Chiropractic evaluation and management.

    Science.gov (United States)

    Haussler, K K

    1999-04-01

    A thorough knowledge of equine spinal anatomy, biomechanics, and potential pathology is required to understand the principles and theories behind chiropractic and to apply its techniques properly. Chiropractic provides additional diagnostic and therapeutic means that may help equine practitioners to identify and treat the primary cause of lameness or poor performance. Specialized training in the evaluation and treatment of vertebral joint dysfunction and neuromusculoskeletal disorders places chiropractic in the forefront of conservative treatment of spinal-related disorders. Nevertheless, limited research is currently available on equine chiropractic and other nontraditional modalities in veterinary medicine. In 1996, the American Veterinary Medicine Association's Committee on Alternative and Complementary Therapies suggested that the research community should be encouraged to prioritize avenues of research and to allocate research funds to projects that are designed to provide further scientific evaluation of these modalities. The future of equine chiropractic in veterinary medicine is dependent on future research into the clinical effects of chiropractic techniques and the basic pathophysiology of spinal-related disorders in horses. PMID:10218250

  18. Educational Standards for Chiropractic Colleges.

    Science.gov (United States)

    Council on Chiropractic Education, Des Moines, IA.

    The policy of accreditation for the chiropractic profession and educational standards for chiropractic colleges are presented. The following types are historical development of chiropractic accreditation; the structure and function of the Council on Chiropractic Education; and eligibility, procedures, and classifications for status as an…

  19. Chiropractic and children

    DEFF Research Database (Denmark)

    Leboeuf-Yde, Charlotte; Hestbæk, Lise

    2010-01-01

    , possible, or unsuitable.In this thematic series of Chiropractic & Osteopathy a number of reviews are presented, in which the research status of pediatric chiropractic is scrutinized and found wanting. Two important aspects were studied in these reviews: the effect of treatment and safety issues. Two types...

  20. The evidence base for chiropractic treatment of musculoskeletal conditions in children and adolescents: The emperor's new suit?

    Directory of Open Access Journals (Sweden)

    Stochkendahl Mette

    2010-06-01

    Full Text Available Abstract Five to ten percent of chiropractic patients are children and adolescents. Most of these consult because of spinal pain, or other musculoskeletal complaints. These musculoskeletal disorders in early life not only affect the quality of children's lives, but also seem to have an impact on adult musculoskeletal health. Thus, this is an important part of the chiropractors' scope of practice, and the objective of this review is to assess the evidence base for manual treatment of musculoskeletal disorders in children and adolescents. Randomized, quasi-randomized and non-randomized clinical studies were included if they investigated the effect of manual therapy on musculoskeletal disorders in children and/or adolescents. The MEDLINE and MANTIS databases were searched, and studies published in English, Danish, Swedish or Norwegian were included. Only three studies were identified that in some way attempted to look at the effectiveness of manual therapy for children or adolescents with spinal problems, and none of these was a randomized controlled clinical trial. As for the rest of the musculoskeletal system, only one study of temporomandibular disorder was identified. With this review, we have detected a paradox within the chiropractic profession: Although the major reason for pediatric patients to attend a chiropractor is spinal pain, no adequate studies have been performed in this area. It is time for the chiropractic profession to take responsibility and systematically investigate the efficiency of joint manipulation of problems relating to the developing musculoskeletal system.

  1. Chiropractic care for back pain

    Science.gov (United States)

    Chiropractic care is a way to diagnose and treat health problems that affect the nerves, muscles, bones, ... the body. A health care provider who provides chiropractic care is called a chiropractor. Hands-on adjustment ...

  2. Frequently Asked Questions about Chiropractic

    Science.gov (United States)

    ... ACA News Digital Edition Archives: ACA News Articles Advertising Opportunities News Newsroom News Releases Letters to the Editor Facts About Chiropractic Chiropractic in the Media ACA Radio Chiropractic Cares Social Media Facebook Twitter YouTube Instagram LinkedIn Advocacy Regulatory Policy Issue ...

  3. The perceptions, attitudes and knowledge of physiotherapy and chiropractic students regarding each others’ professional practice

    Directory of Open Access Journals (Sweden)

    N. Naidoo

    2009-02-01

    Full Text Available Introduction: The roles of physiotherapists and chiropractors demon-strate some overlap. Both are members of a multidisciplinary team and contributeto the holistic care of patients. Good understanding of each others’ professionalpractice may lead to good working relationships with effective referrals, inter -disciplinary and multidisciplinary management of patients. Purpose: To investigate the perceptions, attitudes and knowledge of undergraduatephysiotherapy and chiropractic students about each others’ professional roles inclinical practice. Methodology: Data was obtained using a questionnaire with closed and open-ended questions. First and final-yearphysiotherapy (n = 72 and chiropractic students (n = 49 participated. Results: First and final year physiotherapy students scored 58% and 62% respectively in the “test” on chiropractic;chiropractic students scored 52% and 68% respectively in the test on physiotherapy. Seventy percent of the chiropractic and 14% of the physiotherapy students had visited the practice of other profession. Sixty seven percent of the chiropractic and 38% of the physiotherapy students found it was effective. Forty seven percent chiropractic and 80% physiotherapy students considered physiotherapy and chiropractic to be in direct competition. Sixty six percentof the chiropractic students and 49% of the physiotherapy students expressed the intention of working together withthe other profession.  Discussion: The reason for the possible feelings of competitiveness could be because in South A frica there is vastoverlap of practice in both professions; Physiotherapists and chiropractors are seen to use modalities that are similar.This may be viewed as an indication of the importance in defining the roles, scope and characteristics of both physio-therapy and chiropractic.Conclusion: The knowledge of the physiotherapy and chiropractic students is equal, however, chiropractic studentshave more positive perceptions

  4. The role of chiropractic care in older adults

    Directory of Open Access Journals (Sweden)

    Dougherty Paul E

    2012-02-01

    Full Text Available Abstract There are a rising number of older adults; in the US alone nearly 20% of the population will be 65 or older by 2030. Chiropractic is one of the most frequently utilized types of complementary and alternative care by older adults, used by an estimated 5% of older adults in the U.S. annually. Chiropractic care involves many different types of interventions, including preventive strategies. This commentary by experts in the field of geriatrics, discusses the evidence for the use of spinal manipulative therapy, acupuncture, nutritional counseling and fall prevention strategies as delivered by doctors of chiropractic. Given the utilization of chiropractic services by the older adult, it is imperative that providers be familiar with the evidence for and the prudent use of different management strategies for older adults.

  5. Chiropractic. New York State.

    Science.gov (United States)

    New York State Education Dept., Albany. Office of the Professions.

    A reference guide to laws, rules, and regulations that govern the chiropractic practice in New York State is presented. After an overview of professional regulation in the state, licensing requirements/procedures for chiropractors are described. Provisions of Title VIII, Articles 130 and 132, of the Education Law are also covered, along with…

  6. Children and chiropractic care

    DEFF Research Database (Denmark)

    Hartvigsen, Jan; Hestbaek, Lise

    2009-01-01

    care profession has convincingly assumed the responsibility of spinal and musculoskeletal health for children. Considering the magnitude of the challenges ahead for both researchers and clinicians, this may be a good opportunity for doctors of chiropractic to take responsibility and engage...

  7. Corticosteroid Injections Versus Manual Physical Therapy for Treatment of the Shoulder Impingement Syndrome

    Science.gov (United States)

    ... Medicine Summaries for Patients Corticosteroid Injections Versus Manual Physical Therapy for Treatment of the Shoulder Impingement Syndrome The ... Outcome of Subacromial Corticosteroid Injection Compared With Manual Physical Therapy for the Management of the Unilateral Shoulder Impingement ...

  8. The Journal of Chiropractic Medicine and selected specialties in the chiropractic profession

    OpenAIRE

    Johnson, Claire

    2010-01-01

    This article presents a brief description of the specialty chiropractic groups that are affiliated with the Journal of Chiropractic Medicine: American Academy of Chiropractic Physicians (AACP), The American Chiropractic Board of Sports Physicians (ACBSP), The College on Forensic Sciences (CFS), and The International Academy of Chiropractic Neurology (IACN).

  9. The Journal of Chiropractic Medicine: an update on selected specialties in the chiropractic profession☆

    OpenAIRE

    Johnson, Claire

    2012-01-01

    This article presents a brief description of the specialty chiropractic groups that are affiliated with the Journal of Chiropractic Medicine: American Academy of Chiropractic Physicians (AACP), The American Chiropractic Board of Sports Physicians (ACBSP), The College on Forensic Sciences (CFS), and The International Academy of Chiropractic Neurology (IACN), and the Council on Diagnostic Imaging (CDI).

  10. Danish Chiropractic Practice

    DEFF Research Database (Denmark)

    Myburgh, Cornelius; Boyle, Eleanor; Christensen, Henrik Wulff

    2015-01-01

    . Patients value competence and professionalism in their clinical encounter with their chiropractor. Conclusion: Danish chiropractic practice is strongly influenced by modern consumer behaviour and team-oriented practice trends. Furthermore, the administrative hub plays an important role in operationalizing...... this multi-practitioner approach, thus shaping the patient’s experience. And whilst patients appear receptive of this type of clinical encounter, the anchoring role of a competent chiropractor (lead clinician) is key....

  11. Medical-chiropractic correspondence *

    OpenAIRE

    Cassidy, J David; Mierau, Dale R; Nykoliation, Jim W.; Arthur, Brian

    1985-01-01

    The authors are engaged in a multidisciplinary practice setting and have accumulated years of experience in medical-chiropractic co-operation. This paper outlines the importance of effective communication between disciplines in day-to-day clinical practice. It is important to know when and how to write letters of referral and chart notes. The proper development of these skills will foster greater interdisciplinary co-operation, better practice management skills, and an increased number of pat...

  12. Manual therapy treatment of lumbar radiculopathy: A single case report

    OpenAIRE

    J.A. Riley

    2011-01-01

    Patients  with  lumbar  radiculopathy  are  often  managed with  manual therapy.  The  aim  of  this  single  case  study  was  to  describe  the outcome of manual therapy treatment of a patient with lumbar radiculopathy.  A 47-year-old female presented with acute, severe left buttock and postero-lateral thigh pain.  Symptom provocation occurred during lumbar flexion, coughing, sneezing, driving and prolonged sitting. her left straight leg raise neurodynamic test was limited and reproduced he...

  13. Chiropractic. State of the Art.

    Science.gov (United States)

    Schafer, R. C., Ed.

    The review covers: (1) the discipline (description, scientific theories and principles, its practice, contributions to the health field, and history); (2) the profession (a doctor profile, patients, students, and the American Chiropractic Association); (3) chiropractic education (colleges, career opportunities, standard basic curriculum,…

  14. Chiropractic & Osteopathy. A new journal

    OpenAIRE

    Walker Bruce F; French Simon D; Cameron Melainie

    2005-01-01

    Abstract Both chiropractic and osteopathy are over a century old. They are now regarded as complementary health professions. There is an imperative for both professions to research the principles and claims that underpin them, and the new journal Chiropractic & Osteopathy provides a scientific forum for the publication of such research.

  15. Chiropractic & Osteopathy. A new journal

    Directory of Open Access Journals (Sweden)

    Walker Bruce F

    2005-04-01

    Full Text Available Abstract Both chiropractic and osteopathy are over a century old. They are now regarded as complementary health professions. There is an imperative for both professions to research the principles and claims that underpin them, and the new journal Chiropractic & Osteopathy provides a scientific forum for the publication of such research.

  16. Chiropractic radiology in Canada: an anthology of the Chiropractic College of Radiologists (Canada) Inc

    OpenAIRE

    Shrubb, Eric F.

    1990-01-01

    Although there are numerous chiropractic institutions, one which receives little acclaim, but contributes significantly to chiropractic life in Canada, is the Chiropractic College of Radiologists (Canada) Inc. The following presentation represents a brief historical perspective of this most prestigious organization.

  17. Manual therapy treatment of lumbar radiculopathy: A single case report

    Directory of Open Access Journals (Sweden)

    J.A. Riley

    2011-02-01

    Full Text Available Patients  with  lumbar  radiculopathy  are  often  managed with  manual therapy.  The  aim  of  this  single  case  study  was  to  describe  the outcome of manual therapy treatment of a patient with lumbar radiculopathy.  A 47-year-old female presented with acute, severe left buttock and postero-lateral thigh pain.  Symptom provocation occurred during lumbar flexion, coughing, sneezing, driving and prolonged sitting. her left straight leg raise neurodynamic test was limited and reproduced her pain, as did trigger points in the left lumbar and gluteal muscles. clinical neuro-conduction testing revealed weakness of the big and other toe extensors, as well as eversion and plantar flexion of the left ankle, and a diminished left ankle reflex. This indicated possible involvement of both the l5 and S1 nerve roots.   A  manual  therapy  treatment  approach including  lumbar rotation mobilisations (Maitland approach, massage, trigger point pressure release  and  Transversus  Abdominus muscle activation  was  used.   The  patient  was  symptom  free,  had  full pain-free  range  of  all  lumbar  movements,  a full  pain-free  left  straight leg  raise  neurodynamic  test  and  normal  neurological  conduction  six weeks  after  onset, following seven manual therapy treatments.  Although the results of this case report cannot be generalised, it describes the successful outcome of a patient with severe radicular pain and neurological deficits, whose signs and symptoms  had completely resolved following manual therapy treatment.

  18. Chiropractic Manipulation: Reasons for Concern?

    OpenAIRE

    Gouveia, LO; Castanho, P.; Ferreira, JJ; Guedes, MM; Falcão, F; Pinho e Melo, T

    2007-01-01

    Chiropractic's popularity is rising among the general population. Moreover, few studies have been conducted to properly evaluate its safety. We report three cases of serious neurological adverse events in patients treated with chiropractic manipulation. The first case is a 41 years old woman who developed a vertebro-basilar stroke 48 h after cervical manipulation. The second case represents a 68 years old woman who presented a neuropraxic injury of both radial nerves after three sessions of s...

  19. EFFECT OF MANUAL THERAPY VERSUS CONVENTIONAL THERAPY IN PATIENTS WITH PLANTAR FASCIITIS – A COMPARATIVE STUDY

    Directory of Open Access Journals (Sweden)

    Shashwat Prakash

    2014-02-01

    Full Text Available Objective: To compare the effectiveness of manual therapy with conventional therapy on pain and disability in patients with plantar fasciitis. Background: There is limited evidence available which support that manual therapy can be used as an intervention in the management of plantar fasciitis. Study Design: experimental study and different subject design Methods: Patients diagnosed with plantar fasciitis underwent a standard evaluation and completed a self-report questionnaire including the Foot Function Index (FFI, and the Numeric Pain Rating Scale (NPRS. 30 patients were randomly divided in two groups, to be treated with either Conventional therapy or Manual therapy approach. Outcomes of treatment were captured on the 1st day and 21st day of the treatment session. Results: The data was analysed using unpaired‘t’ tests. NPRS was mean 6.53 versus 6.80 for pre-treatment in group A and group B respectively; t28=0.50, p=0.62 and mean 2.27 versus 1.00 for post-treatment in group A and group B respectively; t28=2.62, p=0.01 FFI was mean 41.01 versus 42.67 for pre-treatment in group A and group B respectively; t28=0.77, p=0.49 and mean 6.20 versus 4.16 for post-treatment in group A and group B respectively; t28=2.68, p=0.01 Conclusion: The results of this study provide evidence that manual therapy is a superior approach in improving pain and disability in individuals with plantar fasciitis and can be incorporated in the regular treatment regime of the same.

  20. Manual Therapy: The Historical, Current, and Future Role in the Treatment of Pain

    Directory of Open Access Journals (Sweden)

    A. Russell Smith

    2007-01-01

    Full Text Available Manual therapy has been an approach in the management of patients with various disorders dating back to ancient times and continues to play a significant role in current health care. The future role of manual therapy in health care is an important area of research. This paper reviews the history of manual therapy, examines the current literature related to the use of manual techniques (including manipulation, massage, and nerve manipulation, and discusses future research topics. The literature related to manual therapy has historically been anecdotal and theoretical, and current research tends to have a generic approach with broad definitions of manual therapy and inconsistencies in the classification of specific disorders. Systematic reviews of various types of manual therapy have differed on their conclusions regarding the effectiveness of this treatment modality. The current demand in health care for evidence-based practice necessitates a movement towards more specificity in the research of the effectiveness of manual therapy, with emphasis on specific patient signs and symptoms and specific manual techniques that result in effective care.

  1. Clinical presentation and manual therapy for upper quadrant musculoskeletal conditions.

    Science.gov (United States)

    Isabel de-la-Llave-Rincón, Ana; Puentedura, Emilio J; Fernández-de-Las-Peñas, César

    2011-11-01

    In recent years, increased knowledge of the pathogenesis of upper quadrant pain syndromes has translated to better management strategies. Recent studies have demonstrated evidence of peripheral and central sensitization mechanisms in different local pain syndromes of the upper quadrant such as idiopathic neck pain, lateral epicondylalgia, whiplash-associated disorders, shoulder impingement, and carpal tunnel syndrome. Therefore, a treatment-based classification approach where subjects receive matched interventions has been developed and, it has been found that these patients experience better outcomes than those receiving non-matched interventions. There is evidence suggesting that the cervical and thoracic spine is involved in upper quadrant pain. Spinal manipulation has been found to be effective for patients with elbow pain, neck pain, or cervicobrachial pain. Additionally, it is known that spinal manipulative therapy exerts neurophysiological effects that can activate pain modulation mechanisms. This paper exposes some manual therapies for upper quadrant pain syndromes, based on a nociceptive pain rationale for modulating central nervous system including trigger point therapy, dry needling, mobilization or manipulation, and cognitive pain approaches. PMID:23115473

  2. Manualization of Occupational Therapy Interventions: Illustrations from the Pressure Ulcer Prevention Research Program

    OpenAIRE

    Blanche, Erna Imperatore; Fogelberg, Donald; Diaz, Jesus; Carlson, Mike; Clark, Florence

    2011-01-01

    The manualization of a complex occupational therapy intervention is a crucial step in ensuring treatment fidelity for both clinical application and research purposes. Towards this latter end, intervention manuals are essential for assuring trustworthiness and replicability of randomized controlled trials (RCT’s) that aim to provide evidence of the effectiveness of occupational therapy. In this paper, literature on the process of intervention manualization is reviewed. The prescribed steps are...

  3. Effectiveness of Manual Physical Therapy for Painful Shoulder Conditions: A Systematic Review

    OpenAIRE

    Camarinos, James; Marinko, Lee

    2009-01-01

    Multiple disease-specific systematic reviews on the effectiveness of physical therapy intervention for shoulder dysfunction have been inconclusive. To date, there have been two systematic reviews that examined manual therapy specifically but both considered effects within diagnoses. The purpose of this systematic review was to identify the effectiveness of manual therapy to the glenohumeral joint across all painful shoulder conditions. A search of MEDLINE, CINAHL, Web of Science, and Cochrane...

  4. Manual therapy improved signs and symptoms of temporomandibular disorders.

    Science.gov (United States)

    Morell, Gaston Coutsiers

    2016-03-01

    Data sourcesMedline, Cochrane, Web of Science, SciELO and Embase databases from 1993-2014.Study selectionRandomised Controlled Trials (RCTs) comparing a manual therapy physical therapy intervention to a reference group (placebo intervention, controlled comparison intervention, standard treatment or other treatment).Data extraction and synthesisTwo independent reviewers abstracted data and assessed quality and clinical relevance of each paper. In case of disagreement, a third reviewer was consulted. The PEDro (Physiotherapy Evidence-Based Database) scale was used to assess the methodological quality of the studies.ResultsEight studies were included. The number of patients in the studies ranged from 30-93. Seven out of the eight studies presented high methodological quality. Treatment effect size was calculated for pain, maximum mouth opening (MMO) and pressure pain threshold (PPT). There was moderate and low evidence that myofascial release and massage techniques are more effective than placebo or no intervention for MMO and pain outcomes respectively. There was also moderate evidence that no significant difference exists between myofascial release and toxin botulinum for improvement on the same outcomes. There was low to high quality evidence that upper cervical spine thrust manipulation or mobilisation techniques are more effective than control, while thoracic manipulations are not. Overall there was moderate-to-high evidence that MT techniques protocols are effective. Methodological heterogeneity of the trial protocols frequently contributed to a decrease in the quality of evidence.ConclusionsThere is widely varying evidence that MT improves pain, MMO and PPT in subjects with TMD signs and symptoms, depending on the technique. Further studies should consider using standardised evaluations and better study designs to strengthen clinical relevance. PMID:27012575

  5. Developing a Manualized Occupational Therapy Diabetes Management Intervention: Resilient, Empowered, Active Living With Diabetes

    OpenAIRE

    Pyatak, Elizabeth A.; Carandang, Kristine; Davis, Shain

    2015-01-01

    This article reports on the development of a manualized occupational therapy intervention for diabetes management. An initial theoretical framework and core content areas for a Stage 1 intervention manual were developed based on an in-depth needs assessment and review of existing literature. After evaluation by a panel of experts and completion of a feasibility study, the intervention was revised into a Stage 2 manual in preparation for a randomized study evaluating the intervention’s efficac...

  6. Effectiveness of manual therapies: the UK evidence report

    Directory of Open Access Journals (Sweden)

    Leininger Brent

    2010-02-01

    Full Text Available Abstract Background The purpose of this report is to provide a succinct but comprehensive summary of the scientific evidence regarding the effectiveness of manual treatment for the management of a variety of musculoskeletal and non-musculoskeletal conditions. Methods The conclusions are based on the results of systematic reviews of randomized clinical trials (RCTs, widely accepted and primarily UK and United States evidence-based clinical guidelines, plus the results of all RCTs not yet included in the first three categories. The strength/quality of the evidence regarding effectiveness was based on an adapted version of the grading system developed by the US Preventive Services Task Force and a study risk of bias assessment tool for the recent RCTs. Results By September 2009, 26 categories of conditions were located containing RCT evidence for the use of manual therapy: 13 musculoskeletal conditions, four types of chronic headache and nine non-musculoskeletal conditions. We identified 49 recent relevant systematic reviews and 16 evidence-based clinical guidelines plus an additional 46 RCTs not yet included in systematic reviews and guidelines. Additionally, brief references are made to other effective non-pharmacological, non-invasive physical treatments. Conclusions Spinal manipulation/mobilization is effective in adults for: acute, subacute, and chronic low back pain; migraine and cervicogenic headache; cervicogenic dizziness; manipulation/mobilization is effective for several extremity joint conditions; and thoracic manipulation/mobilization is effective for acute/subacute neck pain. The evidence is inconclusive for cervical manipulation/mobilization alone for neck pain of any duration, and for manipulation/mobilization for mid back pain, sciatica, tension-type headache, coccydynia, temporomandibular joint disorders, fibromyalgia, premenstrual syndrome, and pneumonia in older adults. Spinal manipulation is not effective for asthma and

  7. Mechanistic basis of manual therapy in myofascial injuries. Sonoelastographic evolution control

    OpenAIRE

    Martínez Rodríguez, Raúl; Galán del Río, Fernando

    2013-01-01

    0,522 SJR (2013) Q1, posición 19 de 100 (Complementary and alternative medicine); Q2, posición 58 de 165 (Physical Therapy, Sports Therapy and Rehabilitation), posición 41 de 116 (Rehabilitation), posición 4 de 13 (Complementary and Manual Therapy)

  8. Assessing the attitudes, knowledge and perspectives of medical students to chiropractic

    Science.gov (United States)

    Wong, Jessica J.; Di Loreto, Luciano; Kara, Alim; Yu, Kavan; Mattia, Alicia; Soave, David; Weyman, Karen; Kopansky-Giles, Deborah

    2013-01-01

    Objective: To assess second-year medical students’ views on chiropractic. Methods: A three-step triangulation approach was designed, comprising a 53-item survey, nine key informant interviews and one focus group of 8 subjects. ANOVA was used to assess attitude-response survey totals over grouping variables. Constant comparison method and NVivo was used for thematic analysis. Results: 112 medical students completed the survey (50% response rate). Subjects reporting no previous chiropractic experience/exposure or interest in learning about chiropractic were significantly more attitude-negative towards chiropractic. Thematically, medical students viewed chiropractic as an increasingly evidence-based complementary therapy for low back/chronic pain, but based views on indirect sources. Within formal curriculum, they wanted to learn about clinical conditions and benefits/risks related to treatment, as greater understanding was needed for future patient referrals. Conclusion: The results highlight the importance of exposure to chiropractic within the formal medical curriculum to help foster future collaboration between these two professions. PMID:23482682

  9. Developing a Manualized Occupational Therapy Diabetes Management Intervention: Resilient, Empowered, Active Living With Diabetes.

    Science.gov (United States)

    Pyatak, Elizabeth A; Carandang, Kristine; Davis, Shain

    2015-07-01

    This article reports on the development of a manualized occupational therapy intervention for diabetes management. An initial theoretical framework and core content areas for a Stage I intervention manual were developed based on an in-depth needs assessment and review of existing literature. After evaluation by a panel of experts and completion of a feasibility study, the intervention was revised into a Stage 2 manual in preparation for a randomized study evaluating the intervention's efficacy. In developing the initial manual, we delineated core theoretical principles to allow for flexible application and tailoring of the intervention's content areas. Expert panel feedback and feasibility study results led to changes to the intervention structure and content as we developed the Stage 2 manual. Through describing this process, we illustrate the dynamic evolution of intervention manuals, which undergo revisions due to both theoretical and practical considerations at each stage of the research-to-clinical practice pipeline. PMID:26594741

  10. Manual therapy in the management of a patient with a symptomatic Morton's Neuroma: A case report.

    Science.gov (United States)

    Sault, Josiah D; Morris, Matthew V; Jayaseelan, Dhinu J; Emerson-Kavchak, Alicia J

    2016-02-01

    Patients with Morton's neuroma are rarely referred to physical therapy. This case reports the resolution of pain, increase in local pressure pain thresholds, and improvement of scores on the Lower Extremity Functional Scale and Foot and Ankle Ability Measure following a course of joint based manual therapy for a patient who had failed standard conservative medical treatment. PMID:25920337

  11. Economic evaluation of manual therapy for musculoskeletal diseases: a protocol for a systematic review and narrative synthesis of evidence

    OpenAIRE

    Kim, Chang-Gon; Mun, Su-Jeong; Kim, Ka-Na; Shin, Byung-Cheul; Kim, Nam-kwen; Lee, Dong-Hyo; Lee, Jung-Han

    2016-01-01

    Introduction Manual therapy is the non-surgical conservative management of musculoskeletal disorders using the practitioner's hands on the patient's body for diagnosing and treating disease. The aim of this study is to systematically review trial-based economic evaluations of manual therapy relative to other interventions used for the management of musculoskeletal diseases. Methods and analysis Randomised clinical trials (RCTs) on the economic evaluation of manual therapy for musculoskeletal ...

  12. Does Chiropractic “Add Years to Life”?

    OpenAIRE

    Gleberzon, Brian J.

    2004-01-01

    The chiropractic cliché “Chiropractic Adds Life to Years and Years to Life” was examined for validity. It was assumed that chiropractors themselves would be the best informed about the health benefits of chiropractic care. Chiropractors would therefore be most likely to receive some level of chiropractic care, and do so on a long-term basis. If chiropractic care significantly improves general health then chiropractors themselves should demonstrate longer life spans than the general population...

  13. CHIROPRACTIC AND OSTEOPATHIC EDUCATION AT ROYAL MELBOURNE INSTITUTE TECHNOLOGY

    OpenAIRE

    French, Simon D.; Marshall, Simone J.; Webb, Michael; Tucker, Cynthia

    1999-01-01

    Objective: To assess the attitudes of undergraduate chiropractic and osteopathic students at Royal Melbourne Institute of Technology (RMIT) in 1992 on the education they are receiving and on the effectiveness of chiropractic and osteopathic care. Design: Cross-sectional descriptive survey. Participants: Undergraduate chiropractic and osteopathic students enrolled at RMIT School of Chiropractic and Osteopathy in 1992. Results: This study surveyed 272 students, 196 who were chiropractic student...

  14. Group Cognitive-Behavioral Therapy for Depression in Spanish: Culture-Sensitive Manualized Treatment in Practice

    OpenAIRE

    Aguilera, Adrian; Garza, Monica J.; Muñoz, Ricardo F.

    2010-01-01

    The authors applied cognitive-behavioral therapy (CBT) for depression using the Healthy Management of Reality treatment manual. This 16-week group treatment comprised four 4-week modules: thoughts (cognitive restructuring), activities (behavioral activation), people (interpersonal skills training), and health (addresses physical health and depression). They illustrated the use of the culture-sensitive treatment manuals by way of the member characteristics and clinical process of a Spanish-lan...

  15. Effectiveness and Economic Evaluation of Chiropractic Care for the Treatment of Low Back Pain: A Systematic Review of Pragmatic Studies

    Science.gov (United States)

    Blanchette, Marc-André; Stochkendahl, Mette Jensen; Borges Da Silva, Roxane; Boruff, Jill; Harrison, Pamela; Bussières, André

    2016-01-01

    Background Context Low back pain (LBP) is one of the leading causes of disability worldwide and among the most common reasons for seeking primary sector care. Chiropractors, physical therapists and general practitioners are among those providers that treat LBP patients, but there is only limited evidence regarding the effectiveness and economic evaluation of care offered by these provider groups. Purpose To estimate the clinical effectiveness and to systematically review the literature of full economic evaluation of chiropractic care compared to other commonly used care approaches among adult patients with non-specific LBP. Study Design Systematic reviews of interventions and economic evaluations. Methods A comprehensive search strategy was conducted to identify 1) pragmatic randomized controlled trials (RCTs) and/or 2) full economic evaluations of chiropractic care for low back pain compared to standard care delivered by other healthcare providers. Studies published between 1990 and 4th June 2015 were considered. Primary outcomes included pain, functional status and global improvement. Study selection, critical quality appraisal and data extraction were conducted by two independent reviewers. Data from RCTs with low risk of bias were included in a meta-analysis to determine effect estimates. Cost estimates of full economic evaluations were converted to 2015 USD and results summarized using Slavin’s qualitative best-evidence synthesis. Results Six RCTs and three full economic evaluations were scientifically admissible. Five RCTs with low risk of bias compared chiropractic care to exercise therapy (n = 1), physical therapy (n = 3) and medical care (n = 1). Overall, we found similar effects for chiropractic care and the other types of care and no reports of serious adverse events. Three low to high quality full economic evaluations studies (one cost-effectiveness, one cost-minimization and one cost-benefit) compared chiropractic to medical care. Given the divergent

  16. Chiropractic manipulation in Adolescent Idiopathic Scoliosis: a pilot study

    Directory of Open Access Journals (Sweden)

    Stoline Michael R

    2006-08-01

    Full Text Available Abstract Background Adolescent idiopathic scoliosis (AIS remains the most common deforming orthopedic condition in children. Increasingly, both adults and children are seeking complementary and alternative therapy, including chiropractic treatment, for a wide variety of health concerns. The scientific evidence supporting the use chiropractic intervention is inadequate. The purpose of this study was to conduct a pilot study and explore issues of safety, patient recruitment and compliance, treatment standardization, sham treatment refinement, inter-professional cooperation, quality assurance, and outcome measure selection. Methods Six patients participated in this 6-month study, 5 of whom were female. One female was braced. The mean age of these patients was 14 years, and the mean Cobb angle was 22.2 degrees. The study design was a randomized controlled clinical trial with two independent and blinded observers. Three patients were treated by standard medical care (observation or brace treatment, two were treated with standard medical care plus chiropractic manipulation, and one was treated with standard medical care plus sham manipulation. The primary outcome measure was Cobb, and the psychosocial measure was Scoliosis Quality of Life Index. Results Orthopedic surgeons and chiropractors were easily recruited and worked cooperatively throughout the trial. Patient recruitment and compliance was good. Chiropractic treatments were safely employed, and research protocols were successful. Conclusion Overall, our pilot study showed the viability for a larger randomized trial. This pilot confirms the strength of existing protocols with amendments for use in a full randomized controlled trial. Trial registration This trial has been assigned an international standard randomized controlled trial number by Current Controlled Trials, Ltd. http://www.controlled-trials.com/isrctn/. The number is ISRCTN41221647.

  17. Acupuncture, chiropractic and osteopathy use in Australia: a national population survey

    OpenAIRE

    Polus Barbara; Myers Ray; Lin Vivian; Zhang Anthony L; Xue Charlie CL; Story David F

    2008-01-01

    Abstract Background There have been no published national studies on the use in Australia of the manipulative therapies, acupuncture, chiropractic or osteopathy, or on matters including the purposes for which these therapies are used, treatment outcomes and the socio-demographic characteristics of users. Methods This study on the three manipulative therapies was a component of a broader investigation on the use of complementary and alternative therapies. For this we conducted a cross-sectiona...

  18. Chiropractic care for paediatric and adolescent Attention-Deficit/Hyperactivity Disorder: A systematic review

    Directory of Open Access Journals (Sweden)

    Bonello Rod

    2010-06-01

    Full Text Available Abstract Background Psychostimulants are first line of therapy for paediatric and adolescent AD/HD. The evidence suggests that up to 30% of those prescribed stimulant medications do not show clinically significant outcomes. In addition, many children and adolescents experience side-effects from these medications. As a result, parents are seeking alternate interventions for their children. Complementary and alternative medicine therapies for behavioural disorders such as AD/HD are increasing with as many as 68% of parents having sought help from alternative practitioners, including chiropractors. Objective The review seeks to answer the question of whether chiropractic care can reduce symptoms of inattention, impulsivity and hyperactivity for paediatric and adolescent AD/HD. Methods Electronic databases (Cochrane CENTRAL register of Controlled Trials, Cochrane Database of Systematic reviews, MEDLINE, PsycINFO, CINAHL, Scopus, ISI Web of Science, Index to Chiropractic Literature were searched from inception until July 2009 for English language studies for chiropractic care and AD/HD. Inclusion and exclusion criteria were applied to select studies. All randomised controlled trials were evaluated using the Jadad score and a checklist developed from the CONSORT (Consolidated Standards of Reporting Trials guidelines. Results The search yielded 58 citations of which 22 were intervention studies. Of these, only three studies were identified for paediatric and adolescent AD/HD cohorts. The methodological quality was poor and none of the studies qualified using inclusion criteria. Conclusions To date there is insufficient evidence to evaluate the efficacy of chiropractic care for paediatric and adolescent AD/HD. The claim that chiropractic care improves paediatric and adolescent AD/HD, is only supported by low levels of scientific evidence. In the interest of paediatric and adolescent health, if chiropractic care for AD/HD is to continue, more rigorous

  19. Chiropractic and CAM Utilization: A Descriptive Review

    Directory of Open Access Journals (Sweden)

    Meeker William C

    2007-01-01

    Full Text Available Abstract Objective To conduct a descriptive review of the scientific literature examining use rates of modalities and procedures used by CAM clinicians to manage chronic LBP and other conditions Data Sources A literature of PubMed and MANTIS was performed using the key terms Chiropractic; Low Back Pain; Utilization Rate; Use Rate; Complementary and Alternative Medicine; and Health Services in various combinations. Data Selection A total of 137 papers were selected, based upon including information about chiropractic utilization, CAM utilization and low back pain and other conditions. Data Synthesis Information was extracted from each paper addressing use of chiropractic and CAM, and is summarized in tabular form. Results Thematic analysis of the paper topics indicated that there were 5 functional areas covered by the literature: back pain papers, general chiropractic papers, insurance-related papers, general CAM-related papers; and worker's compensation papers. Conclusion Studies looking at chiropractic utilization demonstrate that the rates vary, but generally fall into a range from around 6% to 12% of the population, most of whom seek chiropractic care for low back pain and not for organic disease or visceral dysfunction. CAM is itself used by people suffering from a variety of conditions, though it is often used not as a primary intervention, but rather as an additional form of care. CAM and chiropractic often offer lower costs for comparable results compared to conventional medicine.

  20. Exercise therapy, manual therapy, or both, for osteoarthritis of the hip or knee: a factorial randomised controlled trial protocol

    Directory of Open Access Journals (Sweden)

    Baxter G David

    2009-02-01

    Full Text Available Abstract Background Non-pharmacological, non-surgical interventions are recommended as the first line of treatment for osteoarthritis (OA of the hip and knee. There is evidence that exercise therapy is effective for reducing pain and improving function in patients with knee OA, some evidence that exercise therapy is effective for hip OA, and early indications that manual therapy may be efficacious for hip and knee OA. There is little evidence as to which approach is more effective, if benefits endure, or if providing these therapies is cost-effective for the management of this disorder. The MOA Trial (Management of OsteoArthritis aims to test the effectiveness of two physiotherapy interventions for improving disability and pain in adults with hip or knee OA in New Zealand. Specifically, our primary objectives are to investigate whether: 1. Exercise therapy versus no exercise therapy improves disability at 12 months; 2. Manual physiotherapy versus no manual therapy improves disability at 12 months; 3. Providing physiotherapy programmes in addition to usual care is more cost-effective than usual care alone in the management of osteoarthritis at 24 months. Methods This is a 2 × 2 factorial randomised controlled trial. We plan to recruit 224 participants with hip or knee OA. Eligible participants will be randomly allocated to receive either: (a a supervised multi-modal exercise therapy programme; (b an individualised manual therapy programme; (c both exercise therapy and manual therapy; or, (d no trial physiotherapy. All participants will continue to receive usual medical care. The outcome assessors, orthopaedic surgeons, general medical practitioners, and statistician will be blind to group allocation until the statistical analysis is completed. The trial is funded by Health Research Council of New Zealand Project Grants (Project numbers 07/199, 07/200. Discussion The MOA Trial will be the first to investigate the effectiveness and cost

  1. Therapist Adherence and Competence with Manualized Cognitive-Behavioral Therapy for PTSD Delivered via Videoconferencing Technology

    Science.gov (United States)

    Frueh, B. Christopher; Monnier, Jeannine; Grubaugh, Anouk L.; Elhai, Jon D.; Yim, Eunsil; Knapp, Rebecca

    2007-01-01

    Using secondary analyses from a randomized trial comparing the effectiveness of manualized cognitive-behavioral therapy for posttraumatic stress disorder, we compared ratings of therapist competency and adherence between two service delivery modes: telepsychiatry (TP) and same room (SR). Patients were 38 male treatment-seeking veterans recruited…

  2. Case Study: Manual Therapy in Patient of 18 Years with Youthful Scoliosis Idiopathic Summary

    Directory of Open Access Journals (Sweden)

    Claudia Yaneth Franco Monsalve

    2007-12-01

    Full Text Available Scoliosis is a lateral deviation of the spine from the mean line, characterized by a lateral curvature and a vertebral rotation. It is generallyof idiopathic character and appears mainly in adolescent females. Multiple techniques of conservative treatment for the scoliosis exist such as the manual therapy that complements the treatment for this pathology. This technique uses manipulation of soft tissue and bone, obtainingtherefore a more effective recovery, improving the quality of life of the patient. The objective of this study of case was to compareand to describe the changes in the conditionsof an eighteen years old patient, with left thoracolumbar scoliosis by the application of manual therapy; integral valuation was carried out by manual therapy, orthopedic, computerizedposition analysis, analyses the place of job, treatments with physical instruments, mobilizationsof the thoracic and lumbar joints (segmentsT5-T6, T6-T7, T7-T8, T8-T9, muscular energy techniques, exercises of global postural re-education, cervical and lumbar stabilization, exercises of fortification for weak musculature and stretching exercises to elongate retracted musculature. At the beginning of the treatment, the angle of Cobb was 24º ,verified through ax-ray, and after the sessions of manual therapy it was 18º, demonstrating significantly improved angle (6º. The effectiveness of the treatment was verified: diminution of the pain, increase of the muscular force, postural realignment, the satisfactionof the patient and significant recovery confirmed by the radiographic studies.

  3. Manual therapy and therapeutic exercise in the treatment of osteoarthritis of the hip: a systematic review

    Directory of Open Access Journals (Sweden)

    A. Romeo

    2013-05-01

    Full Text Available This systematic review aimed at investigating the role of therapeutic exercise and/or manual therapy in the treatment of hip osteoarthritis (OA. Two independent reviewers (AR, CV searched PubMed, Cinahl, Cochrane Library, PEDro and Scopus databases and a third one (SP was consulted in case of disagreement. The research criteria were publication period (from May 2007 to April 2012 and publication language (English or Italian. Ten randomized controlled trials matched inclusion criteria, eight of which concerning therapeutic exercise and two manual therapy. Few good quality studies were found. At mid- and long-term follow-up land-based exercises showed insufficient evidence of effectiveness with respect to pain and quality of life, but positive results were found for physical function. Water exercises significantly reduced fall risk when combined with functional exercises. Programs containing progressive and gradual exposure of difficult activities, education and exercises promoted better outcomes, higher adherence to home program and increased amount of physical activity, especially walking. Manual therapy seemed to reduce pain and decrease disability at short-term. Less use of nonsteroidal anti-inflammatory drugs was statistically significant at long-term follow-up in patients treated with manual therapy. The relationship between clinical results and radiological grade of OA was not investigated. Encouraging results were found in recent literature for manual therapy and functional training. Further research is needed to elucidate this issue through high-quality trials, especially addressing the aspects that have not been thoroughly explored yet, for instance type, amount and scheduling of conservative treatment.

  4. Does an online psychological intervention improve self-efficacy and disability in people also receiving Multimodal Manual Therapy for chronic low back pain compared to Multimodal Manual Therapy alone? Design of a randomized controlled trial

    OpenAIRE

    Petrozzi, M. John; Leaver, Andrew; Jones, Mairwen K.; Ferreira, Paulo H; Rubinstein, Sidney M.; Mackey, Martin G.

    2015-01-01

    Background Various interventions are available for the treatment of chronic low back pain (LBP), including Manual Therapy and Cognitive Behavioural Therapy (CBT). The purpose of this study is to evaluate whether the addition of an internet-based CBT program leads to better outcomes in patients who are treated with multimodal manual therapy for chronic LBP. Methods/Design A randomized controlled trial comparing a combined intervention, consisting of internet-based CBT utilising MoodGYM plus mu...

  5. Case management of chiropractic patients with cervical brachialgia

    DEFF Research Database (Denmark)

    Guenoun, Olivier; Debarle, Michel; Garnesson, Coralie; Proisl, Sylvie; Ray, Delphine; Leboeuf-Yde, Charlotte

    2011-01-01

    Not much is known about the French chiropractic profession on, for example, level of consensus on clinical issues.......Not much is known about the French chiropractic profession on, for example, level of consensus on clinical issues....

  6. Attitudes Toward Chiropractic: A Survey of Canadian Obstetricians.

    Science.gov (United States)

    Weis, Carol Ann; Stuber, Kent; Barrett, Jon; Greco, Alexandra; Kipershlak, Alexander; Glenn, Tierney; Desjardins, Ryan; Nash, Jennifer; Busse, Jason

    2016-04-01

    We assessed the attitudes of Canadian obstetricians toward chiropractic with a 38-item cross-sectional survey. Ninety-one obstetricians completed the survey, for a response rate of 14% (91 of 659). Overall, 30% of respondents held positive views toward chiropractic, 37% were neutral, and 33% reported negative views. Most (77%) reported that chiropractic care was effective for some musculoskeletal complaints, but 74% disagreed that chiropractic had a role in treatment of non-musculoskeletal conditions. Forty percent of respondents referred at least some patients for chiropractic care each year, and 56% were interested in learning more about chiropractic care. Written comments from respondents revealed concerns regarding safety of spinal manipulation and variability among chiropractors. Canadian obstetricians' attitudes toward chiropractic are diverse and referrals to chiropractic care for their patients who suffer from pregnancy-related low back pain are limited. Improved interprofessional relations may help optimize care of pregnant patients suffering from low back pain. PMID:26350243

  7. Chiropractic practice in the Danish public health care sector

    DEFF Research Database (Denmark)

    Myburgh, Corrie

    2009-01-01

    This commentary offers preliminary considerations around a phenomenological investigation of chiropractic services in a Danish public sector setting. In this narrative description, the main venue for chiropractic public (secondary) sector practice in the Danish context is briefly described and...

  8. Efficacy of Manual Therapy versus Conventional Physical Therapy in Chronic Low Back Pain Due to Lumbar Spondylosis. A Pilot Study

    Directory of Open Access Journals (Sweden)

    Arti Sharma

    2015-06-01

    Full Text Available Objectives: The objective of this work was to compare the efficacy of Maitland mobilization and conventional physical therapy on pain response, range of motion (ROM and functional ability in patients with chronic low back pain due to lumbar spondylosis. Methods: A total sample of 30 subjects (40–70 years of age with complaints of slow insidious onset of low back pain (LBP, with or without radiation not less than three months duration and decrease ROM were randomly assigned to: group-I, Maitland mobilization and lumbar stabilization exercises; group-II conventional physical therapy (traction, strengthening, stretching exercises. and outcomes were assessed for dependent variables. Results: There is statically a significant difference between pre and post measurement readings with time (p = 0.00 and between groups (p < 0.05 with respect to pain and function, but, with respect to ROM readings, showed statistical significance with time (p = 0.00 and no significance between groups (p > 0.05, indicating manual therapy group-I is improving faster and better than conventional physical therapy group-II. Conclusion: Our results showed that manual therapy interventions are more effective in managing low back pain, and function and range of motion of the lumbar spine than conventional physical therapy treatment.

  9. Legislative approaches to the regulation of the chiropractic profession

    OpenAIRE

    Chapman-Smith, David A

    1996-01-01

    Traditional or complementary health care services have a growing and significant role in both developed and developing countries. In the United Kingdom there was new legislation to regulate the chiropractic and osteopathy professions in 1993 and 1994. This was supported by the British Medical Association. There is now legislation regulating chiropractic practice in many jurisdictions. In general chiropractic is regulated as a separate discipline, although chiropractic and osteopathy are joint...

  10. Terapia manual en epicondalgia lateral (revisión sistemática Manual therapy in lateral epicondylalgia (systematic review

    Directory of Open Access Journals (Sweden)

    R.A. Aguilera Eguía

    2009-03-01

    rehabilitation is based on clinical experience and on the treatment of the physical limitations found during the clinical examination. The main physical limitation in LE is lack of grip strength due to pain, leading to motor function impairment. Multiple treatments have been proposed in the literature (complementary therapies, physiotherapy, drug treatment, manual therapy, surgery but most are lacking an evidence base to support their use. The aim of the present study was to select the clinical interventions in manual therapy with the highest level of evidence for the treatment of LE. A search was made of Pubmed, Cochcrane, National Guideline Clearinghouse, NHS Guidelines Finder, and CMA infobase for meta-analyses, randomized clinical trials and clinical trials. To evaluate the internal validity of each of the selected studies, the Physiotherapy Evidence Database (PEDro scale was applied and the level of evidence was subsequently classified according to the scale of the Centre for Evidence-Based Medicine in Oxford. One randomized clinical trial and one randomized pilot study met the inclusion and exclusion criteria. There is level 1B evidence with level A recommendation for the use of the lateral glide and wrist manipulation techniques for the treatment of chronic unilateral epicondylalgia.

  11. Understanding and working with the psychodynamics of practitioner-patient relationships in the manual therapies.

    Science.gov (United States)

    Sher, Danny; Sher, Mannie

    2016-04-01

    In this paper, we argue that practitioner-patient relationships in the manual therapies would be strengthened by a deeper understanding of the psychodynamics and emotions of those relationships. We suggest that in many cases, a purely bio-mechanical approach may neglect underlying psychological and emotional reasons of the patient's presenting condition, and consequently, lead to a less than adequate outcome for the patient. We offer easily adopted suggestions that could enhance the practice of practitioners of manual therapies as well as other professions that rely on the application of physical methods of diagnosis and treatment. These suggestions could lead to improved prognosis and increased professional satisfaction for practitioners. This paper describes five key dynamics that characterize practitioner-patient relationships: (i) pain as a form of communication; (ii) the 'heart-sink' patient; (iii) dependency; (iv) the erotic transference; (v) endings and loss. PMID:27210846

  12. The forgotten cousins : dental and chiropractic radiography

    International Nuclear Information System (INIS)

    Radiation protection surveillance methods should be appropriate to the particular use of x-rays employed. Dentists use small fixed position radiation fields with low output machines, making frequent routine visits unnecessary. There are also large numbers of them. On the other hand chiropractors use large fields and potentially high doses as well as a wide variety of projections and filters, which makes routine visits necessary. These differences have not unsurprisingly led to the National Radiation Laboratory adopting quite different approaches to monitoring these domains. In dental radiography past surveys have shown that the x-ray units themselves to be very robust and stable. A simple postal test was developed for dentists. A small number of visits are also made to dental x-ray facilities per year. Because of the greater possible level of hazard involved routine visits are made to chiropractic establishments. Chiropractic radiation protection surveys have now been extended to include calculating patient doses. The wide variety of projections and the extensive use of beam shaping filters and diaphragms means that we had to develop a program (called Chirodos) to allow for these filters in calculating the chiropractic patient doses. Data collected during the radiation protection surveys includes technique factors, filter materials, positions, and shielding. A national database of chiropractic doses has led us to establish reference doses for chiropractic x-ray exams. (author)

  13. Manual therapy for tension-type headache related to quality of work life and work presenteeism

    DEFF Research Database (Denmark)

    Monzani, Lucas; Espí-López, Gemma Victoria; Zurriaga, Rosario; Andersen, Lars L.

    2016-01-01

    OBJECTIVE: The objective of this research is to evaluate the efficacy of manual therapy for tension-type headache (TTH) in restoring workers quality of work life, and how work presenteeism affects this relation. DESIGN: This study is a secondary analysis of a factorial, randomized clinical trial ...... presenteeism frequency. CONCLUSION: Articulatory manipulation technique is the more efficient treatment to improve quality of work life when the frequency of work presenteeism is high. Implications for future research and practice are discussed....

  14. The Mechanisms of Manual Therapy in the Treatment of Musculoskeletal Pain: A Comprehensive Model

    OpenAIRE

    Bialosky, Joel E; Bishop, Mark D.; Price, Don D.; Robinson, Michael E.; George, Steven Z.

    2008-01-01

    Prior studies suggest manual therapy (MT) as effective in the treatment of musculoskeletal pain; however, the mechanisms through which MT exerts its effects are not established. In this paper we present a comprehensive model to direct future studies in MT. This model provides visualization of potential individual mechanisms of MT that the current literature suggests as pertinent and provides a framework for the consideration of the potential interaction between these individual mechanisms. Sp...

  15. The clinical effect of hydraulic distension plus manual therapy on patients with frozen shoulder

    Science.gov (United States)

    Kwak, Kwang-Il; Kim, Eun-Kyung

    2016-01-01

    [Purpose] This study aimed to develop a clinical protocol for the treatment of frozen shoulder using applied hydraulic distension plus manual therapy. [Subjects and Methods] Patients were randomly assigned to 2 groups: 60 patients in group A were treated with hydraulic distension plus manual therapy, and 61 in group B were treated with hydraulic distension alone. Treatment effects were assessed using the Visual Analog Scale (VAS) (pain and satisfaction), and active range of motion of the shoulder (forward flexion, internal and external rotation) before treatments and at 2, 6, 12, 24 weeks, and 1 year after the last injections. [Results] Patients in group A achieved faster pain relief and better satisfaction than patients in group B during the 6 weeks after treatment. However, no significant difference in VAS was observed between the groups at final follow-up. AROM of the shoulder was improved at final follow-up in both groups. [Conclusion] Hydraulic distension plus manual therapy provided faster pain relief, a higher level of patient satisfaction, and an earlier improvement in AROM of the shoulder than hydraulic distension alone in patients with frozen shoulder.

  16. 针刺、整脊疗法配合阿米替林治疗纤维肌痛综合征的临床研究%Clinical research of acupuncture, chiropractic therapy combined with amitriptyline in the treatment of fibromyalgia syndrome

    Institute of Scientific and Technical Information of China (English)

    陈柚杕

    2015-01-01

    目的:观察针刺、整脊疗法配合阿米替林治疗纤维肌痛综合征(FS)的临床疗效。方法42例纤维肌痛综合征患者,按就诊时间顺序分为治疗组(针刺、整脊疗法配合阿米替林治疗)和对照组(单纯用阿米替林治疗),各21例。比较两组治疗前后麦吉尔疼痛量表(MPQ)和汉密顿抑郁量表(HAMD)计分变化情况,并对两组的临床疗效进行评定。结果治疗后治疗组临床治疗效果及MPQ、HAMD计分均明显优于对照组,差异有统计学意义(P<0.01)。结论针刺、整脊疗法配合阿米替林是治疗纤维肌痛综合征的有效治疗方法,值得临床应用。%Objective To observe clinical effect of acupuncture, chiropractic therapy combined with amitriptyline in the treatment of fibromyalgia syndrome (FS). Methods A total of 42 fibromyalgia syndrome patients were divided by admission time into treatment group (acupuncture, chiropractic therapy combined with amitriptyline for treatment) and control group (amitriptyline alone for treatment), and each group contained 21 cases. Changes of McGill pain questionnaire (MPQ) and Hamilton depression scale (HAMD) were compared between the two groups before and after treatment, and clinical effects of the two groups were evaluated. Results The treatment group had obviously better clinical effect, MPQ and HAMD scores than the control group after treatment, and their difference had statistical significance (P<0.01). Conclusion It is effective for treating fibromyalgia syndrome by acupuncture, chiropractic therapy combined with amitriptyline. This method is worthy of clinical application.

  17. Chiropractic as spine care: a model for the profession

    Directory of Open Access Journals (Sweden)

    Metz R Douglas

    2005-07-01

    Full Text Available Abstract Background More than 100 years after its inception the chiropractic profession has failed to define itself in a way that is understandable, credible and scientifically coherent. This failure has prevented the profession from establishing its cultural authority over any specific domain of health care. Objective To present a model for the chiropractic profession to establish cultural authority and increase market share of the public seeking chiropractic care. Discussion The continued failure by the chiropractic profession to remedy this state of affairs will pose a distinct threat to the future viability of the profession. Three specific characteristics of the profession are identified as impediments to the creation of a credible definition of chiropractic: Departures from accepted standards of professional ethics; reliance upon obsolete principles of chiropractic philosophy; and the promotion of chiropractors as primary care providers. A chiropractic professional identity should be based on spinal care as the defining clinical purpose of chiropractic, chiropractic as an integrated part of the healthcare mainstream, the rigorous implementation of accepted standards of professional ethics, chiropractors as portal-of-entry providers, the acceptance and promotion of evidence-based health care, and a conservative clinical approach. Conclusion This paper presents the spine care model as a means of developing chiropractic cultural authority and relevancy. The model is based on principles that would help integrate chiropractic care into the mainstream delivery system while still retaining self-identity for the profession.

  18. Patient doses in chiropractic radiography

    International Nuclear Information System (INIS)

    In New Zealand chiroptractic radiography is of the spinal column and pelvis. A wide variety of different techniques is used and in particular because of their need to assess the relationships of bone and spinal structures to each other, chiropractors tend to use large x-ray field sizes. This in turn gives rise to the use of beam-shaping filters and diaphragms, to improve image quality over areas of the body where the body thickness may vary markedly, and to reduce the patient dose. Reference doses and examples of good radiographic technique for chiropractic radiography have been derived using the survey data. The examples of good chiroptractic radiographic technuique have some similarities with those for medical radiography of corresponding body parts, with the addition of the use of beam shaping filters and diaphragms whter appropriate. The diagnostic requiremnets for each chiroptractic radiographic projection have not been specifies. It is hoped that the chiroptractic profession can provide this information. (author). 3 refs., 1 tab

  19. Comparative study between the effects of isolated manual therapy techniques and those associated with low level laser therapy on pain in patients with temporomandibular dysfunction

    Directory of Open Access Journals (Sweden)

    Juliana Cristina Frare

    2008-01-01

    Full Text Available Objective: This study sought to evaluate the pain condition in patients with temporomandibular dysfunction after applying manual therapy techniques and those associated with this low level laser therapy. Methods: The study involved 20 patients with temporomandibular dysfunction, divided randomly into two groups: G1 (n = 10, formed by 7 women and 3 men, average age 28.2 years (± 7, treated with manual therapy techniques and G2 (n = 10, formed by 8 women and 2 men, with average age 24.01 (± 6.04, treated with the combination of manual therapy techniques and low level laser therapy. The patients were treated three times a week for four consecutive weeks. The memorandum of manual therapy techniques based on Chaintow,Makofsky and Bienfaint was used. For low level laser therapy GaAs laser (904 nm, 6 J/cm2, 0.38 mW/cm2 was used, applied at 4pre-auricular points. To analyze the pain level, the visual analog pain scale was used. For data analysis the Student’s-t and Wilcoxon tests were used, both with significance level of 5% (p <0.05.Results: There was significant reduction (p <0.05 in the level of pain in both groups treated, but in G2 the significance was higher.Conclusion: Manual therapy techniques, either alone or associated with low level laser therapy showed satisfactory results for pain control in patients with temporomandibular dysfunction.

  20. Case report: manualized trauma-focused cognitive behavioral therapy with an unaccompanied refugee minor girl

    Directory of Open Access Journals (Sweden)

    Johanna Unterhitzenberger

    2016-01-01

    Full Text Available Background: There is uncertainty whether young traumatized refugees should be treated with culturally adapted psychotherapy or with an evidence-based western approach. As yet, empirical studies on culturally adapted treatments for unaccompanied young refugees in industrialized host countries are not available. Studies do, however, suggest that trauma-focused treatment is promising for this group. Objective: We describe the treatment of an unaccompanied refugee minor girl with posttraumatic stress disorder (PTSD who underwent manualized trauma-focused cognitive behavioral therapy (TF-CBT; Cohen, Mannarino, & Deblinger, 2006. Methods: A 17-year-old girl from East Africa, who came to Germany without a caregiver, was treated for PTSD resulting from several traumatic experiences and losses in her home country and while fleeing. She lived in a group home for adolescents. Baseline, post, and follow-up data are reported. Results: The girl participated in 12 sessions of manualized TF-CBT. Her caregiver from the youth services received another 12 sessions in line with the treatment manual. Symptoms decreased in a clinically significant manner; at the end of the treatment, the girl was deemed to have recovered from PTSD. Treatment success remained stable over 6 months. Conclusions: Manualized TF-CBT is feasible for young refugees without significant cultural adaptations. It can, however, be seen as culturally sensitive.

  1. Case report: manualized trauma-focused cognitive behavioral therapy with an unaccompanied refugee minor girl

    Science.gov (United States)

    Unterhitzenberger, Johanna; Rosner, Rita

    2016-01-01

    Background There is uncertainty whether young traumatized refugees should be treated with culturally adapted psychotherapy or with an evidence-based western approach. As yet, empirical studies on culturally adapted treatments for unaccompanied young refugees in industrialized host countries are not available. Studies do, however, suggest that trauma-focused treatment is promising for this group. Objective We describe the treatment of an unaccompanied refugee minor girl with posttraumatic stress disorder (PTSD) who underwent manualized trauma-focused cognitive behavioral therapy (TF-CBT; Cohen, Mannarino, & Deblinger, 2006). Methods A 17-year-old girl from East Africa, who came to Germany without a caregiver, was treated for PTSD resulting from several traumatic experiences and losses in her home country and while fleeing. She lived in a group home for adolescents. Baseline, post, and follow-up data are reported. Results The girl participated in 12 sessions of manualized TF-CBT. Her caregiver from the youth services received another 12 sessions in line with the treatment manual. Symptoms decreased in a clinically significant manner; at the end of the treatment, the girl was deemed to have recovered from PTSD. Treatment success remained stable over 6 months. Conclusions Manualized TF-CBT is feasible for young refugees without significant cultural adaptations. It can, however, be seen as culturally sensitive. PMID:26781638

  2. Association of worker characteristics and early reimbursement for physical therapy, chiropractic and opioid prescriptions with workers’ compensation claim duration, for cases of acute low back pain: an observational cohort study

    Science.gov (United States)

    Busse, Jason W; Ebrahim, Shanil; Heels-Ansdell, Diane; Wang, Li; Couban, Rachel; Walter, Stephen D

    2015-01-01

    Objective To assess the association between early reimbursement for physiotherapy, chiropractic and opioid prescriptions for acute low back pain (LBP) with disability claim duration. Design Observational cohort study. Setting and participants From a random sample of 6665 claims for acute, uncomplicated LBP approved by the Ontario Workplace Safety and Insurance Board (WSIB) in 2005, we analysed 1442 who remained on full benefits at 4 weeks after claim approval. Primary outcome measure Our primary outcome was WSIB claim duration. Results We had complete data for all but 3 variables, which had $920 vs ≤$480/week=0.34; 99% CI 0.17 to 0.68). Missing data for union membership (HR=1.27; 99% CI 1.01 to 1.59), and working for an employer with a return-to-work programme were associated with fewer days on claim (HR=1.78; 99% CI 1.45 to 2.18). Neither reimbursement for physiotherapy (HR=1.01; 99% CI 0.86 to 1.19) nor chiropractic care (HR for active claims at 60 days=1.15; 99% CI 0.94 to 1.41) within the first 4 weeks was associated with claim duration. Our meta-analysis of 3 studies (n=51 069 workers) confirmed a strong association between early opioid use and prolonged claim duration (HR=0.57, 95% CI 0.48 to 0.69; low certainty evidence). Conclusions Our analysis found that early WSIB reimbursement for physiotherapy or chiropractic care, in claimants fully off work for more than 4 weeks, was not associated with claim duration, and that early reimbursement for opioids predicted prolonged claim duration. Well-designed randomised controlled trials are needed to verify our findings and establish causality between these variables and claim duration. PMID:26310398

  3. Chiropractic Colleges Seek Legitimacy amid Financial Woes

    Science.gov (United States)

    Fuller, Andrea

    2012-01-01

    Many of the nation's chiropractic colleges, like other small colleges that rely heavily on tuition, are struggling to stay in business. At the same time that they are working to improve their stature in higher education and broadening their missions to increase their appeal, a number of the colleges are seeing enrollments plummet--and revenues are…

  4. Manual lymphatic drainage therapy in patients with breast cancer related lymphoedema

    Directory of Open Access Journals (Sweden)

    Martínez Helena

    2011-03-01

    Full Text Available Abstract Background Lymphoedema is a common and troublesome condition that develops following breast cancer treatment. The aim of this study is to analyze the effectiveness of Manual Lymphatic Drainage in the treatment of postmastectomy lymphoedema in order to reduce the volume of lymphoedema and evaluate the improvement of the concomitant symptomatology. Methods A randomized, controlled clinical trial in 58 women with post-mastectomy lymphoedema. The control group includes 29 patients with standard treatment (skin care, exercise and compression measures, bandages for one month and, subsequently, compression garnments. The experimental group includes 29 patients with standard treatment plus Manual Lymphatic Drainage. The therapy will be administered daily for four weeks and the patient's condition will be assessed one, three and six months after treatment. The primary outcome parameter is volume reduction of the affected arm after treatment, expressed as a percentage. Secondary outcome parameters include: duration of lymphoedema reduction and improvement of the concomitant symptomatology (degree of pain, sensation of swelling and functional limitation in the affected extremity, subjective feeling of being physically less atractive and less feminine, difficulty looking at oneself naked and dissatisfaction with the corporal image. Discussion The results of this study will provide information on the effectiveness of Manual Lymphatic Drainage and its impact on the quality of life and physical limitations of these patients. Trial registration ClinicalTrials (NCT: NCT01152099

  5. Comparative study between the effects of isolated manual therapy techniques and those associated with low level laser therapy on pain in patients with temporomandibular dysfunction

    OpenAIRE

    Juliana Cristina Frare; Tarcila Nascimento Correa de Andrade

    2008-01-01

    Objective: This study sought to evaluate the pain condition in patients with temporomandibular dysfunction after applying manual therapy techniques and those associated with this low level laser therapy. Methods: The study involved 20 patients with temporomandibular dysfunction, divided randomly into two groups: G1 (n = 10), formed by 7 women and 3 men, average age 28.2 years (± 7), treated with manual therapy techniques and G2 (n = 10), formed by 8 women and 2 men, with average age 24.01 (± ...

  6. Initial Sleep Time Predicts Success in Manual-Guided Cognitive Behavioral Therapy for Insomnia.

    Science.gov (United States)

    Bothelius, Kristoffer; Kyhle, Kicki; Broman, Jan-Erik; Gordh, Torsten; Fredrikson, Mats

    2016-01-01

    Cognitive behavioral therapy produces significant and long-lasting improvement for individuals with insomnia, but treatment resources are scarce. A "stepped care" approach has therefore been proposed, but knowledge is limited on how to best allocate patients to different treatment steps. In this study, 66 primary-care patients with insomnia attended a low-end treatment step: manual-guided cognitive behavioral therapy (CBT) for insomnia delivered by ordinary primary-care personnel. Based on clinically significant treatment effects, subjects were grouped into treatment responders or nonresponders. Baseline data were analyzed to identify predictors for treatment success. Long total sleep time at baseline assessment was the only statistically significant predictor for becoming a responder, and sleep time may thus be important to consider before enrolling patients in low-end treatments. PMID:26323054

  7. Identification of potential neuromotor mechanisms of manual therapy in patients with musculoskeletal disablement: rationale and description of a clinical trial

    Directory of Open Access Journals (Sweden)

    Kulig Kornelia

    2009-05-01

    Full Text Available Abstract Background Many health care practitioners use a variety of hands-on treatments to improve symptoms and disablement in patients with musculoskeletal pathology. Research to date indirectly suggests a potentially broad effect of manual therapy on the neuromotor processing of functional behavior within the supraspinal central nervous system (CNS in a manner that may be independent of modification at the level of local spinal circuits. However, the effect of treatment speed, as well as the specific mechanism and locus of CNS changes, remain unclear. Methods/Design We developed a placebo-controlled, randomized study to test the hypothesis that manual therapy procedures directed to the talocrural joint in individuals with post-acute ankle sprain induce a change in corticospinal excitability that is relevant to improve the performance of lower extremity functional behavior. Discussion This study is designed to identify potential neuromotor changes associated with manual therapy procedures directed to the appendicular skeleton, compare the relative effect of treatment speed on potential neuromotor effects of manual therapy procedures, and determine the behavioral relevance of potential neuromotor effects of manual therapy procedures. Trial Registration http://www.clinicaltrials.gov identifier NCT00847769.

  8. Validation of an educative manual for patients with head and neck cancer submitted to radiation therapy 1

    Science.gov (United States)

    da Cruz, Flávia Oliveira de Almeida Marques; Ferreira, Elaine Barros; Vasques, Christiane Inocêncio; da Mata, Luciana Regina Ferreira; dos Reis, Paula Elaine Diniz

    2016-01-01

    Abstract Objective: develop the content and face validation of an educative manual for patients with head and neck cancer submitted to radiation therapy. Method: descriptive methodological research. The Theory of Psychometrics was used for the validation process, developed by 15 experts in the theme area of the educative manual and by two language and publicity professionals. A minimum agreement level of 80% was considered to guarantee the validity of the material. Results: the items addressed in the assessment tool of the educative manual were divided in three blocks: objectives, structure and format, and relevance. Only one item, related to the sociocultural level of the target public, obtained an agreement rate educative manual proposed were attended to. This can contribute to the understanding of the therapeutic process the head and neck cancer patient is submitted to during the radiation therapy, besides supporting clinical practice through the nursing consultation. PMID:27305178

  9. Effectiveness of combined acupuncture and manual therapy relative to no treatment for canine musculoskeletal pain.

    Science.gov (United States)

    Lane, David M; Hill, Sarah A

    2016-04-01

    Despite the rise in popularity of both acupuncture and manual therapy in veterinary medicine, and the increasing number of Canadian veterinarians practising these techniques, there is little research demonstrating their effectiveness. In this repeated measures, therapeutic trial, 47 client-owned dogs with naturally occurring lameness were assessed for clinical response to treatment. Owners were blinded to the treatment schedule and completed questionnaires to assess their dogs' comfort and mobility. Comparison between pre- and post-treatment results demonstrated that combined acupuncture and manual therapy provides immediate short-term improvement in comfort and mobility, as demonstrated by owner observed changes in play behavior (P = 0.015), walking (P trotting (P = 0.002), jumping (P < 0.001), descending stairs (P = 0.003), rising from a lying position (P < 0.001), and reduced stiffness after rest (P < 0.001) or following exercise (P < 0.001). Mood and attitude also improved, but did not attain statistical significance. PMID:27041759

  10. Treating Small Bowel Obstruction with a Manual Physical Therapy: A Prospective Efficacy Study

    Science.gov (United States)

    Rice, Amanda D.; Patterson, Kimberley; Reed, Evette D.; Wurn, Belinda F.; Klingenberg, Bernhard; King, C. Richard; Wurn, Lawrence J.

    2016-01-01

    Small bowel obstructions (SBOs) caused by adhesions are a common, often life-threatening postsurgical complication with few treatment options available for patients. This study examines the efficacy of a manual physical therapy treatment regimen on the pain and quality of life of subjects with a history of bowel obstructions due to adhesions in a prospective, controlled survey based study. Changes in six domains of quality of life were measured via ratings reported before and after treatment using the validated Small Bowel Obstruction Questionnaire (SBO-Q). Improvements in the domains for pain (p = 0.0087), overall quality of life (p = 0.0016), and pain severity (p = 0.0006) were significant when average scores before treatment were compared with scores after treatment. The gastrointestinal symptoms (p = 0.0258) domain was marginally significant. There was no statistically significant improvement identified in the diet or medication domains in the SBO-Q for this population. Significant improvements in range of motion in the trunk (p ≤ 0.001), often limited by adhesions, were also observed for all measures. This study demonstrates in a small number of subjects that this manual physical therapy protocol is an effective treatment option for patients with adhesive small bowel obstructions as measured by subject reported symptoms and quality of life. PMID:26989690

  11. Work-related thumb disorders in South African physiotherapists treating musculoskeletal conditions using manual therapy techniques

    Directory of Open Access Journals (Sweden)

    Heather Jenkins

    2015-04-01

    Full Text Available Research question: What is the prevalence of and factors associated with work-related thumb problems (WRTP in South African physiotherapists treating musculoskeletal conditions using manual therapy techniques?Design: A cross-sectional, descriptive study design was used and data were collected using two Internet-based questionnaires.Participants: The sample size calculated for the study was 284 using 95% confidence levels and a 5% margin of error. There were 395 participants that were included in the study. Outcome measures: The variables measured included demographic, employment, educational and occupational factors.Results: The lifetime prevalence of WRTP in the physiotherapists was 65.3%. The manual techniques that were significantly associated with WRTP in the respondents who reported thumb problems were all grades of transverse glides applied to the spine as well as grade II–IV unilateral and central posterior-anterior pressures to the spine. The factors that remained significantly associated with WRTP in all 395 respondents after regression analysis were the cervical treatment of up to six patients a day and hyperextension > 30° of the non-dominant interphalangeal (IP joint of the thumb.Conclusion: This study confirms that a high percentage of physiotherapists using manual therapy techniques to treat musculoskeletal conditions are experiencing WRTP.Recommendations: The development of a valid and reliable WRTP screening tool is needed to aid in the identification of physiotherapists at risk and thus in the primary prevention of WRTP. A longitudinal study which follows newly qualified physiotherapists is recommended to investigate a possible cause-effect relationship and preventative strategies for WRTP in physiotherapists.

  12. Integrating Massage, Chiropractic, and Acupuncture in University Clinics: A Guided Student Observation

    Science.gov (United States)

    Estrin Dashe, Alejandra A.

    2012-01-01

    Background Several studies have reported on the health benefits of applying an integrated complementary health care model. Purpose This paper presents the results of pilot research focusing on the observations massage therapy students made about complementary health care education and integration during massage, chiropractic, and acupuncture treatments at two university clinics. Setting: Observations took place at Northwestern Health Sciences University’s associated clinics that offered massage, chiropractic, and acupuncture. Research Design: Students directly observed how clinicians and interns educated their patients and integrated other forms of complementary health care into their practice. Participants: chiropractors, massage therapists, and acupuncturists, and their patients. All participants were English-speaking and 18–65 years old. Main Outcome Measures: Observations recorded by students in journals about education and integration during massage therapy, chiropractic, and acupuncture treatments were coded and counted. Results Qualitative observations showed that clinicians and interns educated patients to some degree, but the clinicians were less apt to integrate other modalities than the interns. Conclusions Observations support that professional integrity may limit clinicians in their ability to integrate multiple modalities of health care while treating patients. Since it is well established that integration of multiple health care modalities is beneficial to patient health, it is recommended that clinics assist their clinical staff in applying an integrative approach to their practice. PMID:22811755

  13. Iowa Chiropractic Students Outlook for Practitioners and Need for State-Funded Assistance.

    Science.gov (United States)

    Greiner, Keith

    This state-mandated study examined the needs of Iowa chiropractic students and the Iowa demand for chiropractic health care in order to determine the feasibility of establishing a chiropractic forgivable loan program. The project used financial aid data and repayment rate data to evaluate the need for financial aid for chiropractic students;…

  14. Examinations on Applications of Manual Calculation Programs on Lung Cancer Radiation Therapy Using Analytical Anisotropic Algorithm

    International Nuclear Information System (INIS)

    There was a problem with using MU verification programs for the reasons that there were errors of MU when using MU verification programs based on Pencil Beam Convolution (PBC) Algorithm with radiation treatment plans around lung using Analytical Anisotropic Algorithm (AAA). On this study, we studied the methods that can verify the calculated treatment plans using AAA. Using Eclipse treatment planning system (Version 8.9, Varian, USA), for each 57 fields of 7 cases of Lung Stereotactic Body Radiation Therapy (SBRT), we have calculated using PBC and AAA with dose calculation algorithm. By developing MU of established plans, we compared and analyzed with MU of manual calculation programs. We have analyzed relationship between errors and 4 variables such as field size, lung path distance of radiation, Tumor path distance of radiation, effective depth that can affect on errors created from PBC algorithm and AAA using commonly used programs. Errors of PBC algorithm have showned 0.2±1.0% and errors of AAA have showned 3.5±2.8%. Moreover, as a result of analyzing 4 variables that can affect on errors, relationship in errors between lung path distance and MU, connection coefficient 0.648 (P=0.000) has been increased and we could calculate MU correction factor that is A.E=L.P 0.00903+0.02048 and as a result of replying for manual calculation program, errors of 3.5±2.8% before the application has been decreased within 0.4±2.0%. On this study, we have learned that errors from manual calculation program have been increased as lung path distance of radiation increases and we could verified MU of AAA with a simple method that is called MU correction factor.

  15. Reflex control of the spine and posture: a review of the literature from a chiropractic perspective

    Directory of Open Access Journals (Sweden)

    Schlappi Mark

    2005-08-01

    Full Text Available Abstract Objective This review details the anatomy and interactions of the postural and somatosensory reflexes. We attempt to identify the important role the nervous system plays in maintaining reflex control of the spine and posture. We also review, illustrate, and discuss how the human vertebral column develops, functions, and adapts to Earth's gravity in an upright position. We identify functional characteristics of the postural reflexes by reporting previous observations of subjects during periods of microgravity or weightlessness. Background Historically, chiropractic has centered around the concept that the nervous system controls and regulates all other bodily systems; and that disruption to normal nervous system function can contribute to a wide variety of common ailments. Surprisingly, the chiropractic literature has paid relatively little attention to the importance of neurological regulation of static upright human posture. With so much information available on how posture may affect health and function, we felt it important to review the neuroanatomical structures and pathways responsible for maintaining the spine and posture. Maintenance of static upright posture is regulated by the nervous system through the various postural reflexes. Hence, from a chiropractic standpoint, it is clinically beneficial to understand how the individual postural reflexes work, as it may explain some of the clinical presentations seen in chiropractic practice. Method We performed a manual search for available relevant textbooks, and a computer search of the MEDLINE, MANTIS, and Index to Chiropractic Literature databases from 1970 to present, using the following key words and phrases: "posture," "ocular," "vestibular," "cervical facet joint," "afferent," "vestibulocollic," "cervicocollic," "postural reflexes," "spaceflight," "microgravity," "weightlessness," "gravity," "posture," and "postural." Studies were selected if they specifically tested any or

  16. Core Competencies of the Certified Pediatric Doctor of Chiropractic

    DEFF Research Database (Denmark)

    Hewitt, Elise; Hestbaek, Lise; Pohlman, Katherine A

    2016-01-01

    An outline of the minimum core competencies expected from a certified pediatric doctor of chiropractic was developed using a Delphi consensus process. The initial set of seed statements and substatements was modeled on competency documents used by organizations that oversee chiropractic and medical...

  17. National Board Scores versus Student GPA's in Chiropractic Education.

    Science.gov (United States)

    Kalthoff, Theodore J.

    1985-01-01

    The relationship between student GPAs and scores on the National Board of Chiropractic Examiners tests was investigated in an effort to determine if the chiropractic curriculum was properly preparing students to be licensed. The study found that there was a significant correlation between GPAs and board scores. (Author/MLW)

  18. Chiropractic Use by Urban and Rural Residents with Insurance Coverage

    Science.gov (United States)

    Lind, Bonnie K.; Diehr, Paula K.; Grembowski, David E.; Lafferty, William E.

    2009-01-01

    Purpose: To describe the use of chiropractic care by urban and rural residents in Washington state with musculoskeletal diagnoses, all of whom have insurance coverage for this care. The analyses investigate whether restricting the analyses to insured individuals attenuates previously reported differences in the prevalence of chiropractic use…

  19. Therapy response evaluation of malignant lymphoma in a multicenter study. Comparison of manual and semiautomatic measurements in CT

    Energy Technology Data Exchange (ETDEWEB)

    Wessling, J.; Schuelke, C. [Muenster Univ. (Germany). Dept. of Clinical Radiology; Koch, R. [Muenster Univ. (Germany). Dept. of Medical Informatics and Biomathematics; and others

    2014-08-15

    Purpose: Comparison of manual one-/bi-dimensional measurements versus semi-automatically derived one-/bi-dimensional and volumetric measurements for therapy response evaluation of malignant lymphoma during CT follow-up examinations in a multicenter setting. Materials and Methods: MSCT data sets of patients with malignant lymphoma were evaluated before (baseline) and after two cycles of chemotherapy (follow-up) at radiological centers of five university hospitals. The long axis diameter (LAD), the short axis diameter (SAD) and the bi-dimensional WHO of 307 target lymph nodes were measured manually and semi-automatically using dedicated software. Lymph node volumetry was performed semi-automatically only. The therapeutic response was evaluated according to lymphoma-adapted RECIST. Results: Based on a single lymph node, semi-automatically derived multidimensional parameters allowed for significantly more accurate therapy response classification than the manual or the semi-automatic unidimensional parameters. Incorrect classifications were reduced by up to 9.6%. Compared to the manual approach, the influence of the study center on correct therapy classification is significantly less relevant when using semi-automatic measurements. Conclusion: Semi-automatic volumetry and bi-dimensional WHO significantly reduce the number of incorrectly classified lymphoma patients by approximately 9.6% in the multicenter setting in comparison to linear parameters. Semi-automatic quantitative software tools may help to significantly reduce wrong classifications that are associated with the manual assessment approach. (orig.)

  20. Therapy response evaluation of malignant lymphoma in a multicenter study. Comparison of manual and semiautomatic measurements in CT

    International Nuclear Information System (INIS)

    Purpose: Comparison of manual one-/bi-dimensional measurements versus semi-automatically derived one-/bi-dimensional and volumetric measurements for therapy response evaluation of malignant lymphoma during CT follow-up examinations in a multicenter setting. Materials and Methods: MSCT data sets of patients with malignant lymphoma were evaluated before (baseline) and after two cycles of chemotherapy (follow-up) at radiological centers of five university hospitals. The long axis diameter (LAD), the short axis diameter (SAD) and the bi-dimensional WHO of 307 target lymph nodes were measured manually and semi-automatically using dedicated software. Lymph node volumetry was performed semi-automatically only. The therapeutic response was evaluated according to lymphoma-adapted RECIST. Results: Based on a single lymph node, semi-automatically derived multidimensional parameters allowed for significantly more accurate therapy response classification than the manual or the semi-automatic unidimensional parameters. Incorrect classifications were reduced by up to 9.6%. Compared to the manual approach, the influence of the study center on correct therapy classification is significantly less relevant when using semi-automatic measurements. Conclusion: Semi-automatic volumetry and bi-dimensional WHO significantly reduce the number of incorrectly classified lymphoma patients by approximately 9.6% in the multicenter setting in comparison to linear parameters. Semi-automatic quantitative software tools may help to significantly reduce wrong classifications that are associated with the manual assessment approach. (orig.)

  1. The sterno-clavicular joint: anatomy, biomechanic, clinical features and aspects of manual therapy

    Directory of Open Access Journals (Sweden)

    M. Cutolo

    2011-09-01

    Full Text Available The sterno-clavicular joint covers one remarkable importance in the complex of the shoulder girdle. This review investigates the anatomy, biomechanics, main affections and involvement of this joint in the pathological processes of the shoulder girdle in its complex. Moreover, it focuses on the opportunities offered from the conservative treatment, using in particular the manual therapy. Active and passive, as well as against isometric resistance movements, are discussed. In particular, the passive mobilization is demonstrated effective in the restoration of joint mobility. The sterno- clavicular joint is not structured in order to complete great work loads and has the tendency to become hypermotile or unstable, if subordinate to overload works, becoming painful. In this case, the techniques of passive mobilization and of modulation of the pain turn out effective.

  2. Use of the measure your medical outcome profile (MYMOP2 and W-BQ12 (Well-Being outcomes measures to evaluate chiropractic treatment: an observational study

    Directory of Open Access Journals (Sweden)

    Polus Barbara I

    2011-03-01

    Full Text Available Abstract Background The objective was to assess the use of the Measure Yourself Medical Outcome Profile (MYMOP2 and W-BQ12 well-being questionnaire for measuring clinical change associated with a course of chiropractic treatment. Methods Chiropractic care of the patients involved spinal manipulative therapy (SMT, mechanically assisted techniques, soft tissue therapy, and physiological therapeutic devices. Outcome measures used were MYMOP2 and the Well-Being Questionnaire 12 (W-BQ12. Results Statistical and clinical significant changes were demonstrated with W-BQ12 and MYMOP2. Conclusions The study demonstrated that MYMOP2 was responsive to change and may be a useful instrument for assessing clinical changes among chiropractic patients who present with a variety of symptoms and clinical conditions.

  3. Manual Therapy and Exercise for a Patient With Neck-Tongue Syndrome: A Case Report.

    Science.gov (United States)

    Niethamer, Lisa; Myers, Robin

    2016-03-01

    Study Design Case report. Background Neck-tongue syndrome (NTS) is defined as neck and/or head pain accompanied by ipsilateral dysesthesia of the tongue with sudden rotation of the head. Proposed causes include compression or irritation of the C2 nerve root as it courses behind the atlantoaxial joint or hypertrophy of the inferior oblique muscle. The primary purpose of this case report was to describe the conservative physical therapy treatment of a patient with uncomplicated NTS. Case Description The patient was a 13-year-old girl who reported insidious onset of sharp pain in the neck, numbness/tingling of the ipsilateral tongue/face, and tinnitus with cervical rotation. Symptoms occurred several times a week for approximately 10 seconds. Examination revealed impaired function, increased forward head posture, decreased cervical range of motion, and positive neurodynamic assessment. The patient's treatment included manual therapy and exercise for postural stabilization. Outcomes Following 8 visits, pain of the neck and tongue numbness had resolved. Score on the Patient-Specific Functional Scale (PSFS), cervical range of motion, and posture had also improved. At the 22-month follow-up, infrequent, momentary symptoms in the neck and dysesthesia of the tongue were reported. The PSFS remained the same. Objective measures were normal. Discussion This case report describes the physical therapy management of an individual with NTS. The management strategy followed a protocol similar to that used for cervicogenic headaches, due to the involvement of the upper cervical spine with both NTS and cervicogenic headache and the lack of evidence for the treatment of NTS. Level of Evidence Therapy, level 4. J Orthop Sports Phys Ther 2016;46(3):217-224. Epub 11 Feb 2016. doi:10.2519/jospt.2016.6195. PMID:26868897

  4. The Council on Chiropractic Education's New Wellness Standard: A call to action for the chiropractic profession

    Directory of Open Access Journals (Sweden)

    Rupert Ronald

    2006-10-01

    Full Text Available Abstract Background The chiropractic profession has long considered itself to be a preventive science. Recently the Council on Chiropractic Education (CCE has defined a set of standards that must be implemented at all US chiropractic colleges as of January of 2007. These are specific to wellness measures and health promoting efforts that should be performed by chiropractors. This will mandate traditional health promotion and prevention methods be taught to students at accredited colleges and to practicing chiropractors. Objective To present the idea of performing traditional health promotion and wellness-concepts in chiropractic practice as a call to action for clinicians and generate discussion on the topic. Discussion This manuscript discusses relevant topics of health promotion and prevention for chiropractors and other practicing clinicians that should be made priorities with patients in order to enhance both patient health and community and population health. Conclusion All practicing chiropractors, as well as other clinicians should take these new standards from the CCE as a call to action to begin helping patients address the removable causes of morbidity, disability and premature mortality where they exist, in addition to treating their painful spinal conditions.

  5. Manual de Adiestramiento sobre Terapia de Rehidratacion Oral y Control de las Enfermedades Diarreicas (Oral Rehydration Therapy and the Control of Diarrheal Diseases). Training for Development. Peace Corps Information Collection & Exchange Training Manual No. T-53.

    Science.gov (United States)

    Clark, Mari; And Others

    This Spanish-language manual was developed to train Peace Corps volunteers and other community health workers in Spanish-speaking countries in oral rehydration therapy (ORT) and the control of diarrheal diseases. Using a competency-based format, the manual contains three training modules (organized in seven sessions) that focus on interrelated…

  6. Manual khalifa therapy in patients with completely ruptured anterior cruciate ligament in the knee: First preliminary results from thermal imaging

    Directory of Open Access Journals (Sweden)

    Gerhard Litscher

    2013-01-01

    Full Text Available Background: This preliminary publication describes acute temperature effects after manual Khalifa therapy. Aims : The goal of this study was to describe temperature distribution and the effects on surface temperature of the knees and feet in patients with completely ruptured anterior cruciate ligament before and immediately after the manual therapy. Materials and Methods: Ten male patients were investigated with thermal imaging. An infrared camera operating at a wavelength range of 7.5-13 μm was used. Temperature was analyzed at three locations on both knees and in addition on both feet. Results: The study revealed that baseline temperature of the injured knee differed from that of the untreated control knee. After the therapy on the injured knee, the surface temperature was significantly increased on both knees (injured and control. There were no significant changes in the temperature of the feet. Conclusions: Further studies using continuous thermal image recording may help to explain the details concerning the temperature distribution.

  7. Chiropractic and children: Is more research enough?

    Directory of Open Access Journals (Sweden)

    Leboeuf-Yde Charlotte

    2010-06-01

    Full Text Available Abstract Many health science research and review articles end with the words: "More research is needed". However, when it comes to research, it is not as much a question of quantity as of quality. There are a number of important prerequisites before research should be initiated. The three pillars, relevance, quality and ethics should be respected but for a project to be meaningful, it must also be based on plausible rationale. In evidence-based (informed practice, one takes into account not only research-based evidence but also clinical expertise and the patients' perspectives. In this paper, we briefly discuss how this should be handled in clinical practice is briefly discussed, using the concept of "traffic lights" (red, yellow, green. We explain how the combination of evidence and plausibility can be used to reach a decision as to whether a treatment or diagnostic procedure is suitable, possible, or unsuitable. In this thematic series of Chiropractic & Osteopathy a number of reviews are presented, in which the research status of pediatric chiropractic is scrutinized and found wanting. Two important aspects were studied in these reviews: the effect of treatment and safety issues. Two types of problems were identified: the lack of research in general and the lack of research using the appropriate study designs and methodology in particular. Therefore, we discuss the meager research noted in the areas of chiropractic care in children and the clinical consequences this should have. The prerequisites for "more research" are scrutinized and an example given of suitable research programs. Finally, the important issue of implementation of research findings is covered, emphasizing the responsibility of all stakeholders involved at both the undergraduate and the postgraduate level, within professional associations, and on an individual level.

  8. Robotic Measurement and Control for Chiropractic Research

    Directory of Open Access Journals (Sweden)

    P. Goldsmith

    2006-01-01

    Full Text Available The precision and programmability of robotic manipulators makes them suitable for biomechanics research, particularly when an experimental procedure must be accurately repeated multiple times. This paper describes a robotic system used to investigate biomechanical mechanisms of stroke in humans. A parallel robot manipulator is used to reproduce chiropractic manipulations on animal subjects using a 3-D vision system. An algorithm for calibrating the system is proposed and tested on the robot. An iterative learning control scheme is then introduced to improve positional accuracy. Experimental results demonstrate that the calibration procedure and learning scheme are both effective.

  9. [History of conservative spinal therapy].

    Science.gov (United States)

    Kladny, B

    2015-12-01

    Hippocrates was the first to intensively describe and document the principles for the treatment of injuries and diseases of the spine. His principles for abrupt treatment of the "hunchback" were followed by physicians even up to the end of the nineteenth century. The non-operative treatment of scoliosis was improved in the beginning of the sixteenth century by the introduction of mechanical devices that started the development of corsets which are still in use in modern scoliosis treatment. Stretching beds were only in temporary use. With the beginning of the nineteenth century gymnastics and physiotherapy became more and more important. Manual therapy was exercised by physicians until the late Middle Ages. After a long period of time in which bonesetters and other laymen performed manual therapy it was professionalized at the end of the nineteenth century again by the introduction of osteopathy and chiropractic. In Germany the development and introduction of manual treatment started relatively late in the twentieth century, predominantly as manual medicine. PMID:26542053

  10. Process versus outcome: challenges of the chiropractic wellness paradigm

    OpenAIRE

    Russell, Eric G.

    2010-01-01

    Objective The purpose of this article is to discuss the term wellness in the context of the philosophy of chiropractic. Discussion PubMed and Index to Chiropractic Literature show an upward trend in use of the term wellness. Wellness may be used differently depending upon the profession and may be considered a process by some and an outcome by others. Conclusion There appears to be no consensus on the definition of wellness or how it is being used. Wellness is not exclusive to chiropractic, a...

  11. Naprapathic Manual Therapy or Conventional Orthopedic Care for Outpatients on Orthopedic Waiting Lists? A pragmatic randomized controlled trial.

    OpenAIRE

    Lilje, Stina; Friberg, Håkan; Wykman, Anders; Skillgate, Eva

    2010-01-01

    Objectives: Traditionally, orthopedic outpatient waiting lists are long, and many referrals are for conditions that do not respond to interventions available at an orthopedic outpatient department. The overall objective of this trial was to investigate whether it is possible to reduce orthopedic waiting lists through integrative medicine. Specific aims were to compare the effects of naprapathic manual therapy to conventional orthopedic care for outpatients with nonurgent musculoskeletal disor...

  12. Investigation of the effects of mirror therapy on the upper extremity functions of stroke patients using the manual function test

    OpenAIRE

    Kim, Hwanhee; Shim, Jemyung

    2015-01-01

    [Purpose] The purpose of this study was to investigate the effects of mirror therapy on the upper extremity functions of stroke patients. [Subjects] The subjects of this study were 14 hemiplegia patients (8 males, 6 females; 9 infarction, 5 hemorrhage; 8 right hemiplegia, 6 left hemiplegia) who voluntarily consented to participate in the study. [Methods] The Korean version of the manual function test (MFT) was used in this study. The test was performed in the following order: arm movement (4 ...

  13. Identification of potential neuromotor mechanisms of manual therapy in patients with musculoskeletal disablement: rationale and description of a clinical trial

    OpenAIRE

    Kulig Kornelia; Davenport Todd E; Fisher Beth E; Wu Allan D

    2009-01-01

    Abstract Background Many health care practitioners use a variety of hands-on treatments to improve symptoms and disablement in patients with musculoskeletal pathology. Research to date indirectly suggests a potentially broad effect of manual therapy on the neuromotor processing of functional behavior within the supraspinal central nervous system (CNS) in a manner that may be independent of modification at the level of local spinal circuits. However, the effect of treatment speed, as well as t...

  14. Does targeting manual therapy and/or exercise improve patient outcomes in nonspecific low back pain? A systematic review

    OpenAIRE

    Mjøsund Hanne L; Kent Peter; Petersen Ditte HD

    2010-01-01

    Abstract Background A central element in the current debate about best practice management of non-specific low back pain (NSLBP) is the efficacy of targeted versus generic (non-targeted) treatment. Many clinicians and researchers believe that tailoring treatment to NSLBP subgroups positively impacts on patient outcomes. Despite this, there are no systematic reviews comparing the efficacy of targeted versus non-targeted manual therapy and/or exercise. This systematic review was undertaken in o...

  15. Effects of complex manual therapy on PTSD, pain, function, and balance of male torture survivors with chronic low back pain.

    Science.gov (United States)

    Kim, Hyun Jin; Yu, Seong Hun

    2015-09-01

    [Purpose] This study aimed to identify the impact of physiotherapy using complex manual therapy as a part of an integrated treatment for sequelae in the musculoskeletal system of torture survivors. [Subjects] This study reviewed 30 male torture survivors presenting with chronic low back pain. They were randomly selected and divided into two groups: an experimental group and a control group. [Methods] For the experimental group, complex manual therapy was performed twice a week for 8 weeks to improve the physical sequelae of patients. Improvement was measured using the PDS-K for Post-traumatic Stress Disorder (PTSD), the Visual Analog Scale (VAS) for pain examination, the Korean Oswestry Disability Index (KODI) for back function assessment, and the Balance System SD as a dynamic balance test. The total period of the intervention for both groups was 8 weeks. [Results] For the experimental group, PDS-K, VAS, KODI, and the dynamic balance test all showed significant improvements after the intervention, which they did not for the control group. In the comparison of the groups, PDS-K, VAS, KODI, and the dynamic balance test all showed significant differences. [Conclusion] Complex manual therapy for torture survivors with chronic low back pain contributes to functional recovery by reducing back pain. The treatment can be considered to have positive effects on sequelae in the musculoskeletal system of torture survivors as they age. PMID:26504288

  16. Efficacy of complete decongestive therapy and manual lymphatic drainage on treatment-related lymphedema in breast cancer

    International Nuclear Information System (INIS)

    Objective: To evaluate the results of combined decongestive therapy and manual lymphatic drainage in patients with breast cancer-related lymphedema. Methods and Materials: The data from 250 patients were reviewed. The pre- and posttreatment volumetric measurements were compared, and the correlation with age, body mass index, and type of surgery, chemotherapy, and radiotherapy was determined. The Spearman correlation coefficients and Wilcoxon two-sample test were used for statistical analysis. Results: Of the 250 patients, 138 were included in the final analysis. The mean age at presentation was 54.3 years. Patients were stratified on the basis of the treatment modality used for breast cancer management. Lymphedema was managed with combined decongestive therapy in 55%, manual lymphatic drainage alone in 32%, and the home program in 13%. The mean pretreatment volume of the affected and normal arms was 2929 and 2531 mL. At the end of 1 year, the posttreatment volume of the affected arm was 2741 mL. The absolute volume of the affected arm was reduced by a mean of 188 mL (p < 0.0001). The type of surgery (p = 0.0142), age (p = 0.0354), and body mass index (p < 0.0001) were related to the severity of lymphedema. Conclusion: Combined decongestive therapy and manual lymphatic drainage with exercises were associated with a significant reduction in the lymphedema volume

  17. Terapia manual no tratamento da espondilólise e espondilolistese: revisão de literatura Manual therapy for treating spondylolysis and spondylolisthesis: a literature review

    Directory of Open Access Journals (Sweden)

    Fabrício José Jassi

    2010-12-01

    /listhesis, especially manual therapy, in order to guide practitioners for effective intervention. Results show that both manual therapy and conventional physiotherapy were effective in relieving low-back pain and beneficial for patient's functional outcome. Manual therapy involved spine manipulation, sacroiliac joint manipulation, muscle-energy techniques and stretching affected muscles. Stabilizing lombopelvic exercises, postural muscles strengthening, and hamstring and psoas stretching were also considered important in treating spondylolysis/listhesis. Each case's clinical and radiological features must be individually considered in order to determinate therapeutic strategy. Among non-surgical options, none has proved better than others and all may be included in symptomatic treatment of patients with spondylolysis/listhesis.

  18. Oral Rehydration Therapy and the Control of Diarrheal Diseases. Training for Development. Peace Corps Information Collection & Exchange Training Manual No. T-34.

    Science.gov (United States)

    Clark, Mari; And Others

    This manual was developed to train Peace Corps volunteers and other community health workers in oral rehydration therapy (ORT) and the control of diarrheal diseases. Using a competency-based format, the manual contains six training modules (organized in 22 sessions) that focus on interrelated health education and technical content areas. Each…

  19. The chiropractic profession in Norway 2011

    DEFF Research Database (Denmark)

    Kvammen, O. C.; Leboeuf-Yde, C.

    2014-01-01

    BACKGROUND: The chiropractic profession in Norway has increased five-fold in the last two decades. As there is no academic graduate program in Norway, all chiropractors have been trained outside of Norway, in either Europe, America or Australia. This might have given Norwegian chiropractors...... Norway. METHOD: Two surveys were distributed to all 530 registered chiropractors in Norway in 2011. One survey was for all chiropractors (Survey 1) and the other for clinic owners (Survey 2). Results have been reported as tables and as approximate percentages in the text for ease of reading. RESULT......: Response rates were 61% (Survey 1, N = 320) and 71% (Survey 2, N = 217). More than two-thirds of the chiropractors in Norway had been in practice for under a decade. Only one in four chiropractors worked in solo practice and the majority shared premises with at least one colleague, typically at least one...

  20. Plastination: a modern approach to chiropractic teaching

    Science.gov (United States)

    Grondin, Gilles

    1998-01-01

    Plastination is a unique method for the preservation of biological material for teaching and research. The plastinated specimens are dry, odorless, non-toxic and durable. They can be manipulated by teachers and students without protective equipment like gloves. Invented in 1978 by Doctor Gunther von Hagens from the University of Heidelberg, this technique, that involves the replacement of water by a curable polymer, has spread rapidly all around the world and is actually used in over 250 universities and colleges. To our knowledge, the Université du Québec à Trois-Rivières, is the first institution to use plastinated specimens for teaching anatomy, neuroanatomy, pathology and radiology to students in chiropractic. This paper describes the various steps of the method (fixation, dehydration, impregnation and curing) and presents some examples of the utilization of plastinated specimens. ImagesFigure 1Figure 2Figure 3Figure 4Figure 5Figure 6

  1. Use of the term subluxation in publications during the formative years of the chiropractic profession

    OpenAIRE

    Johnson, Claire

    2011-01-01

    The term subluxation has come to have different meanings for different health care professions in the United States for over the past century. This controversy has resulted in some contention both internal and external to the chiropractic profession. Some current factions within the chiropractic profession hold the term subluxation to be synonymous with the identity of chiropractic itself; however, this term was not solely used by chiropractic during its formative years. The purpose of this a...

  2. Use of localized human growth hormone and testosterone injections in addition to manual therapy and exercise for lower back pain: a case series with 12-month follow-up

    Directory of Open Access Journals (Sweden)

    Dubick MN

    2015-06-01

    Full Text Available Marc N Dubick,1 Thomas H Ravin,2 Yvonne Michel,3 David C Morrisette4 1Interventional Pain Management, Division of Anesthesiology, Bon Secours St Francis Hospital, Charleston, SC, USA; 2Musculoskeletal Medicine, Val d'Isere Health Clinic, Denver, CO, USA; 3Statistical Consultant, Private Practice, Daniel Island, SC, USA; 4Division of Physical Therapy, Medical University of South Carolina, SC, USA Objective: The objective of this case series was to investigate the feasibility and safety of a novel method for the management of chronic lower back pain. Injections of recombinant human growth hormone and testosterone to the painful and dysfunctional areas in individuals with chronic lower back pain were used. In addition, the participants received manual therapies and exercise addressing physical impairments such as motor control, strength, endurance, pain, and loss of movement. Pain ratings and self-rated functional outcomes were assessed.Study design: This is a case series involving consecutive patients with chronic lower back pain who received the intervention of injections of recombinant human growth hormone and testosterone, and attended chiropractic and/or physical therapy. Outcomes were measured at 12 months from the time of injection.Setting: A community based hospital affiliated office, and a private practice block suite.Participants: A total of 60 consecutive patients attending a pain management practice for chronic lower back pain were recruited for the experimental treatment. Most participants were private pay.Interventions: Participants who provided informed consent and were determined not to have radicular pain received diagnostic blocks. Those who responded favorably to the diagnostic blocks received injections of recombinant human growth hormone and testosterone in the areas treated with the blocks. Participants also received manipulation- and impairment-based exercises.Outcome measures: Outcomes were assessed at 12 months through pain

  3. The Effects of Chiropractic Treatment on Students With Learning and Behavioral Impairments Due to Neurological Dysfunction.

    Science.gov (United States)

    Walton, E. V.; Brzozowski, Walter T.

    The effects of chiropractic treatment on children with learning and behavioral problems was investigated with 24 elementary and secondary level students, 12 receiving regular chiropractic treatment and 12 receiving medication. Results indicated that chiropractic treatment was more effective for the wide range symptoms common in the neurological…

  4. Chiropractic and self-care for back-related leg pain: design of a randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Schulz Craig A

    2011-03-01

    Full Text Available Abstract Background Back-related leg pain (BRLP is a common variation of low back pain (LBP, with lifetime prevalence estimates as high as 40%. Often disabling, BRLP accounts for greater work loss, recurrences, and higher costs than uncomplicated LBP and more often leads to surgery with a lifetime incidence of 10% for those with severe BRLP, compared to 1-2% for those with LBP. In the US, half of those with back-related conditions seek CAM treatments, the most common of which is chiropractic care. While there is preliminary evidence suggesting chiropractic spinal manipulative therapy is beneficial for patients with BRLP, there is insufficient evidence currently available to assess the effectiveness of this care. Methods/Design This study is a two-site, prospective, parallel group, observer-blinded randomized clinical trial (RCT. A total of 192 study patients will be recruited from the Twin Cities, MN (n = 122 and Quad Cities area in Iowa and Illinois (n = 70 to the research clinics at WHCCS and PCCR, respectively. It compares two interventions: chiropractic spinal manipulative therapy (SMT plus home exercise program (HEP to HEP alone (minimal intervention comparison for patients with subacute or chronic back-related leg pain. Discussion Back-related leg pain (BRLP is a costly and often disabling variation of the ubiquitous back pain conditions. As health care costs continue to climb, the search for effective treatments with few side-effects is critical. While SMT is the most commonly sought CAM treatment for LBP sufferers, there is only a small, albeit promising, body of research to support its use for patients with BRLP. This study seeks to fill a critical gap in the LBP literature by performing the first full scale RCT assessing chiropractic SMT for patients with sub-acute or chronic BRLP using important patient-oriented and objective biomechanical outcome measures. Trial Registration ClinicalTrials.gov NCT00494065

  5. Efficacy of manual therapy treatments for people with cervicogenic dizziness and pain: protocol of a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Reid Susan A

    2012-10-01

    Full Text Available Abstract Background Cervicogenic dizziness is a disabling condition characterised by postural unsteadiness that is aggravated by cervical spine movements and associated with a painful and/or stiff neck. Two manual therapy treatments (Mulligan’s Sustained Natural Apophyseal Glides (SNAGs and Maitland’s passive joint mobilisations are used by physiotherapists to treat this condition but there is little evidence from randomised controlled trials to support their use. The aim of this study is to conduct a randomised controlled trial to compare these two forms of manual therapy (Mulligan glides and Maitland mobilisations to each other and to a placebo in reducing symptoms of cervicogenic dizziness in the longer term and to conduct an economic evaluation of the interventions. Methods Participants with symptoms of dizziness described as imbalance, together with a painful and/or stiff neck will be recruited via media releases, advertisements and mail-outs to medical practitioners in the Hunter region of NSW, Australia. Potential participants will be screened by a physiotherapist and a neurologist to rule out other causes of their dizziness. Once diagnosed with cervciogenic dizziness, 90 participants will be randomly allocated to one of three groups: Maitland mobilisations plus range-of-motion exercises, Mulligan SNAGs plus self-SNAG exercises or placebo. Participants will receive two to six treatments over six weeks. The trial will have unblinded treatment but blinded outcome assessments. Assessments will occur at baseline, post-treatment, six weeks, 12 weeks, six months and 12 months post treatment. The primary outcome will be intensity of dizziness. Other outcome measures will be frequency of dizziness, disability, intensity of cervical pain, cervical range of motion, balance, head repositioning, adverse effects and treatment satisfaction. Economic outcomes will also be collected. Discussion This paper describes the methods for a randomised

  6. Does targeting manual therapy and/or exercise improve patient outcomes in nonspecific low back pain? A systematic review

    DEFF Research Database (Denmark)

    Kent, Peter; Mjøsund, Hanne L; Petersen, Ditte H D

    2010-01-01

    A central element in the current debate about best practice management of non-specific low back pain (NSLBP) is the efficacy of targeted versus generic (non-targeted) treatment. Many clinicians and researchers believe that tailoring treatment to NSLBP subgroups positively impacts on patient...... outcomes. Despite this, there are no systematic reviews comparing the efficacy of targeted versus non-targeted manual therapy and/or exercise. This systematic review was undertaken in order to determine the efficacy of such targeted treatment in adults with NSLBP....

  7. Does targeting manual therapy and/or exercise improve patient outcomes in nonspecific low back pain? A systematic review

    Directory of Open Access Journals (Sweden)

    Mjøsund Hanne L

    2010-04-01

    Full Text Available Abstract Background A central element in the current debate about best practice management of non-specific low back pain (NSLBP is the efficacy of targeted versus generic (non-targeted treatment. Many clinicians and researchers believe that tailoring treatment to NSLBP subgroups positively impacts on patient outcomes. Despite this, there are no systematic reviews comparing the efficacy of targeted versus non-targeted manual therapy and/or exercise. This systematic review was undertaken in order to determine the efficacy of such targeted treatment in adults with NSLBP. Method MEDLINE, EMBASE, Current Contents, AMED and the Cochrane Central Register of Controlled Trials were electronically searched, reference lists were examined and citation tracking performed. Inclusion criteria were randomized controlled trials of targeted manual therapy and/or exercise for NSLPB that used trial designs capable of providing robust information on targeted treatment (treatment effect modification for the outcomes of activity limitation and pain. Included trials needed to be hypothesis-testing studies published in English, Danish or Norwegian. Method quality was assessed using the criteria recommended by the Cochrane Back Review Group. Results Four high-quality randomized controlled trials of targeted manual therapy and/or exercise for NSLBP met the inclusion criteria. One study showed statistically significant effects for short-term outcomes using McKenzie directional preference-based exercise. Research into subgroups requires much larger sample sizes than traditional two-group trials and other included studies showed effects that might be clinically important in size but were not statistically significant with their samples sizes. Conclusions The clinical implications of these results are that they provide very cautious evidence supporting the notion that treatment targeted to subgroups of patients with NSLBP may improve patient outcomes. The results of the

  8. Attitudes towards chiropractic: an analysis of written comments from a survey of north american orthopaedic surgeons

    Directory of Open Access Journals (Sweden)

    Busse Jason W

    2011-10-01

    Full Text Available Abstract Background There is increasing interest by chiropractors in North America regarding integration into mainstream healthcare; however, there is limited information about attitudes towards the profession among conventional healthcare providers, including orthopaedic surgeons. Methods We administered a 43-item cross-sectional survey to 1000 Canadian and American orthopaedic surgeons that inquired about demographic variables and their attitudes towards chiropractic. Our survey included an option for respondants to include written comments, and our present analysis is restricted to these comments. Two reviewers, independantly and in duplicate, coded all written comments using thematic analysis. Results 487 surgeons completed the survey (response rate 49%, and 174 provided written comments. Our analysis revealed 8 themes and 24 sub-themes represented in surgeons' comments. Reported themes were: variability amongst chiropractors (n = 55; concerns with chiropractic treatment (n = 54; areas where chiropractic is perceived as effective (n = 43; unethical behavior (n = 43; patient interaction (n = 36; the scientific basis of chiropractic (n = 26; personal experiences with chiropractic (n = 21; and chiropractic training (n = 18. Common sub-themes endorsed by surgeon's were diversity within the chiropractic profession as a barrier to increased interprofessional collaboration, endorsement for chiropractic treatment of musculoskeletal complaints, criticism for treatment of non-musculoskeletal complaints, and concern over whether chiropractic care was evidence-based. Conclusions Our analysis identified a number of issues that will have to be considered by the chiropractic profession as part of its efforts to further integrate chiropractic into mainstream healthcare.

  9. Clinical evaluation tools: a survey of doctors of chiropractic and students at one chiropractic college

    Science.gov (United States)

    Mansholt, Barbara A.; Vining, Robert D.

    2016-01-01

    Introduction: The reliability and validity of many evaluation tools leading to clinical decision-making for spinal manipulation are varied. We surveyed senior students and DC employees at one chiropractic college regarding 1) which analysis tools should be used and 2) factors that influence their choices. Methods: The survey queried which tools should be used on a routine patient encounter. Clinical evaluation tools included palpation, skin temperature analysis, leg length analysis, and radiographs. Results: Surveys were collected from 58 doctors of chiropractic (DCs) and 74 students. Respondents from both groups reported to most commonly use static palpation, followed by motion palpation and leg length analysis. DC respondents ranked evidence and personal experience high for rationale; student respondents frequently chose patient preference. Conclusion: DC and student respondents reported use of clinical evaluation tools consistently. However, some variations in rationale were noted. It is important for educators to provide a balanced presentation of the strengths and limitations of clinical analysis procedures to support the development of well-justified evidence-based clinical decision-making skills. PMID:27069264

  10. Articulatory Changes in Muscle Tension Dysphonia: Evidence of Vowel Space Expansion Following Manual Circumlaryngeal Therapy

    Science.gov (United States)

    Roy, Nelson; Nissen, Shawn L.; Dromey, Christopher; Sapir, Shimon

    2009-01-01

    In a preliminary study, we documented significant changes in formant transitions associated with successful manual circumlaryngeal treatment (MCT) of muscle tension dysphonia (MTD), suggesting improvement in speech articulation. The present study explores further the effects of MTD on vowel articulation by means of additional vowel acoustic…

  11. Use of Instructor-Produced YouTube® Videos to Supplement Manual Skills Training in Occupational Therapy Education.

    Science.gov (United States)

    McAlister, Robert B

    2014-01-01

    An ongoing challenge to occupational therapy educators is how to provide resources and strategies that best assist students in learning, retaining, and replicating protocols in clinical manual assessment. This pilot survey study explored how 43 first-year master's of occupational therapy students enrolled in a kinesiology course perceived the value of implementing instructor-produced YouTube® videos of in-class assessment demonstrations. The videos, taken on a smartphone, were uploaded to a private YouTube URL created by the instructor and then linked to a pre-established Moodle learning platform. By the end of the 6-wk course, students had registered 2,573 views averaging 60 views per student. Postcourse mixed survey results revealed students perceived that the videos improved the quality of the course, increased their level of engagement and learning, and boosted confidence in their manual skills. Survey results also found that students correlated the instructor's willingness to develop online videos with a commitment to student learning. PMID:25397941

  12. Manual lymphatic drainage therapy in patients with breast cancer related lymphoedema

    OpenAIRE

    Martínez Helena; Rodríguez Francisco; Avendaño Cristina; Hernández Miguel A; Martín Marta

    2011-01-01

    Abstract Background Lymphoedema is a common and troublesome condition that develops following breast cancer treatment. The aim of this study is to analyze the effectiveness of Manual Lymphatic Drainage in the treatment of postmastectomy lymphoedema in order to reduce the volume of lymphoedema and evaluate the improvement of the concomitant symptomatology. Methods A randomized, controlled clinical trial in 58 women with post-mastectomy lymphoedema. The control group includes 29 patients with s...

  13. Back and neck pain : Epidemiological studies on some risk factors and treatments, including naprapathic manual therapy

    OpenAIRE

    Skillgate, Eva

    2007-01-01

    Introduction: Back and neck pain are common and constitute the main cause for persistent pain in the population. The knowledge about the etiology and about the effect of different treatments that are offered for back and neck pain is not fully understood, with a few exceptions. Objectives: The overall aim was to give epidemiological aspects of some potential risk factors for back and neck pain, as well as on manual treatment of such pain. Objectives in Studies I and II were...

  14. [Fatal outcome during physiotherapy (Vojta's method) in a 3-month old infant. Case report and comments on manual therapy in children].

    Science.gov (United States)

    Jacobi, G; Riepert, T; Kieslich, M; Bohl, J

    2001-01-01

    Detailed clinical and neuropathological report on a fatal incident during the first manual therapy according to Vojta conducted in a 3 months old baby: during forced active rotation and head retraction the baby suffered from a bleeding into the adventitia of both her vertebral arteries at the level of C1 prompting ischemia of the caudal brainstem with subarachnoid haemorrhage around. It has to be suggested that similar cases already have occurred but have not been reported yet. There might be a time lag between the performance of physiotherapy and the beginning of neurologic symptoms. The risks of manual therapy in children will be discussed. PMID:11305197

  15. Prevalence of hip osteoarthritis in chiropractic practice in denmark

    DEFF Research Database (Denmark)

    Poulsen, Erik; Christensen, Henrik W; Overgaard, Søren; Hartvigsen, Jan

    2012-01-01

    The purposes of this study were to measure the prevalence of clinical and radiographic hip osteoarthritis (OA) and first-time diagnosis of hip OA in consecutive patients presenting to chiropractic practices in Denmark and to report the components of the initial treatment rendered by the...

  16. Chiropractic management of patients post-disc arthroplasty: eight case reports

    Directory of Open Access Journals (Sweden)

    Descarreaux Martin

    2010-04-01

    Full Text Available Abstract Background When conservative therapies for low back pain (LBP are not effective, elective surgery may be proposed to these patients. Over the last 20 years, a new technology, disc replacement, has become increasingly popular because it is believed to maintain or restore the integrity of spinal movement and minimize the side-effects compared to fusion. Although disc replacement may relieve a patient from pain and related disability, soreness and stiffness of the lumbopelvic region seem to be common aftermaths of the surgery. This prospective case series was undertaken to identify and describe potential adverse events of lumbar spinal manipulation, a common therapy for low back pain, in a group of patients with symptoms after disc prostheses. Cases presentation Eight patients who underwent lumbar spine total disc replacement were referred by an orthopaedic surgeon for chiropractic treatments. These patients had 1 or 2 total lumbar disc replacements and were considered stable according to the surgical protocol but presented persistent, post-surgical, non-specific LBP or pelvic pain. They were treated with lumbar spine side posture manipulations only and received 8 to 10 chiropractic treatments based on the clinical evolution and the chiropractor's judgment. Outcome measures included benign, self-limiting, and serious adverse events after low back spinal manipulative therapy. The Oswestry Disability Index, a pain scale and the fear avoidance belief questionnaire were administered to respectively assess disability, pain and fear avoidance belief about work and physical activity. This prospective case series comprised 8 patients who all had at least 1 total disc replacement at the L4/L5 or L5/S1 level and described persistent post-surgical LBP interfering with their daily activities. Commonly-reported side-effects of a benign nature included increased pain and/or stiffness of short duration in nearly half of the chiropractic treatment period

  17. Chiropractic Health Care: A National Study of Cost of Education, Service Utilization, Number of Practicing Doctors of Chiropractic, and Other Key Policy Issues. Volumes I-II.

    Science.gov (United States)

    von Kuster, Thomas, Jr.

    Results from the first federally sponsored study of the chiropractic health care profession are presented, and a broad range of facts and issues of concern to policy-makers, the profession, and the public are described. The two-year project included three national surveys of: service providers (doctors of chiropractic in practice more than two…

  18. Patient education with or without manual therapy compared to a control group in patients with osteoarthritis of the hip. A proof-of-principle three-arm parallel group randomized clinical trial

    DEFF Research Database (Denmark)

    Poulsen, E; Hartvigsen, J; Christensen, H W;

    2013-01-01

    To investigate the effectiveness of a patient education (PE) program with or without the added effect of manual therapy (MT) compared to a minimal control intervention (MCI).......To investigate the effectiveness of a patient education (PE) program with or without the added effect of manual therapy (MT) compared to a minimal control intervention (MCI)....

  19. Australian chiropractic sports medicine: half way there or living on a prayer?

    Directory of Open Access Journals (Sweden)

    Dragasevic George

    2007-09-01

    Full Text Available Abstract Sports chiropractic within Australia has a chequered historical background of unorthodox individualistic displays of egocentric treatment approaches that emphasise specific technique preference and individual prowess rather than standardised evidence based management. This situation has changed in recent years with the acceptance of many within sports chiropractic to operate under an evidence informed banner and to embrace a research culture. Despite recent developments within the sports chiropractic movement, the profession is still plagued by a minority of practitioners continuing to espouse certain marginal and outlandish technique systems that beleaguer the mainstream core of sports chiropractic as a cohesive and homogeneous group. Modern chiropractic management is frequently multimodal in nature and incorporates components of passive and active care. Such management typically incorporates spinal and peripheral manipulation, mobilisation, soft tissue techniques, rehabilitation and therapeutic exercises. Externally, sports chiropractic has faced hurdles too, with a lack of recognition and acceptance by organized and orthodox sports medical groups. Whilst some arguments against the inclusion of chiropractic may be legitimate due to its historical baggage, much of the argument appears to be anti-competitive, insecure and driven by a closed-shop mentality.sequently, chiropractic as a profession still remains a pariah to the organised sports medicine world. Add to this an uncertain continuing education system, a lack of protection for the title 'sports chiropractor', a lack of a recognized specialist status and a lack of support from traditional chiropractic, the challenges for the growth and acceptance of the sports chiropractor are considerable. This article outlines the historical and current challenges, both internal and external, faced by sports chiropractic within Australia and proposes positive changes that will assist in

  20. 牵引并手法治疗混合型颈椎病70例%Traction combined with manual therapy on 70 cases of cervical spondylopathy

    Institute of Scientific and Technical Information of China (English)

    李兴海; 李丹

    2002-01-01

    @@ Background:Traction of cervical vertebrae is an effective method in treatment of cervical spondylopathy. Manual therapy can correct dysfunction,has the effects of function exercises and has an active significance to the rehabilitation of mixed cervical spondylopathy.Combination of these two methods could enhance therapeutic effects and do good to functional recovery.

  1. [A Cognitive Behavioural Group Therapy Manual for Elderly People with Type 2 Diabetes and Minor Depression].

    Science.gov (United States)

    Petrak, Frank; Hautzinger, Martin; Müller, Matthias J; Herpertz, Stephan

    2016-08-01

    Diabetes in the elderly is often associated with depressive symptoms. This comorbidity leads to a higher risk for diabetes related complications, disability and mortality and can be observed not only in major depression but also in subthreshold or minor depression. Specific psychological interventions for this high-risk patient group were not available yet. Therefore, we developed a diabetes specific cognitive behavioral group intervention for elderly outpatients with subthreshold or minor depression and type 2 diabetes within a randomized controlled trial. The treatment goals focus on improvement in health related quality of life, depression symptoms, glycemic control and cost effectiveness. In this article we give an overview of the manualized treatment program. PMID:27485930

  2. The effectiveness and cost-evaluation of manual therapy and physical therapy in patients with sub-acute and chronic non specific neck pain. Rationale and design of a Randomized Controlled Trial (RCT

    Directory of Open Access Journals (Sweden)

    van Assen Luite

    2010-01-01

    Full Text Available Abstract Background Manual Therapy applied to patients with non specific neck pain has been investigated several times. In the Netherlands, manual therapy as applied according to the Utrecht School of Manual Therapy (MTU has not been the subject of a randomized controlled trial. MTU differs in diagnoses and treatment from other forms of manual therapy. Methods/Design This is a single blind randomized controlled trial in patients with sub-acute and chronic non specific neck pain. Patients with neck complaints existing for two weeks (minimum till one year (maximum will participate in the trial. 180 participants will be recruited in thirteen primary health care centres in the Netherlands. The experimental group will be treated with MTU during a six week period. The control group will be treated with physical therapy (standard care, mainly active exercise therapy, also for a period of six weeks. Primary outcomes are Global Perceived Effect (GPE and functional status (Neck Disability Index (NDI-DV. Secondary outcomes are neck pain (Numeric Rating Scale (NRS, Eurocol, costs and quality of life (SF36. Discussion This paper presents details on the rationale of MTU, design, methods and operational aspects of the trial. Trial registration ClinicalTrials.gov Identifier: NCT00713843

  3. Manual medicine related injuries experienced by physicians: a missing aspect in therapies using manipulation of joints.

    Science.gov (United States)

    Steinhaeuser, Jost; Goetz, Katja; Oser, Andreas; Joos, Stefanie

    2015-01-01

    Background. In 2010 Manual Medicine (MM) was the second most common additional qualification among physicians in Germany, which is recommended to be used in several guidelines. Aim of this analysis was to raise the amount of information on MM related injuries (MMri) experienced by physicians at any point of their career while applying MM. Methods. Data on MMri of a questionnaire that was used to gain first insights into MM in Germany from a health services research perspective was analysed. Results. A total of 301 physicians (20% female) participated in this study. The participants' mean age was 46. 11% of the participants experienced some kind of MMri during their career as a MM provider. In the three worst cases these MMri were fractures and therefore classified as moderate. Mild MMri were joint dysfunction syndromes (N = 30), distortions of fingers (N = 7), and shoulder pain (N = 3). Subgroup analyses showed no significant differences in the rate of MMri when comparing gender, provider organizations for postgraduate MM courses, and medical disciplines. Conclusion. Our analysis shows risks for providers of MM. As this analysis suffers from the risk of recall bias, future studies should be performed to get more insights into this aspect of MM. PMID:25815036

  4. Assessment of robotic patient simulators for training in manual physical therapy examination techniques.

    Science.gov (United States)

    Ishikawa, Shun; Okamoto, Shogo; Isogai, Kaoru; Akiyama, Yasuhiro; Yanagihara, Naomi; Yamada, Yoji

    2015-01-01

    Robots that simulate patients suffering from joint resistance caused by biomechanical and neural impairments are used to aid the training of physical therapists in manual examination techniques. However, there are few methods for assessing such robots. This article proposes two types of assessment measures based on typical judgments of clinicians. One of the measures involves the evaluation of how well the simulator presents different severities of a specified disease. Experienced clinicians were requested to rate the simulated symptoms in terms of severity, and the consistency of their ratings was used as a performance measure. The other measure involves the evaluation of how well the simulator presents different types of symptoms. In this case, the clinicians were requested to classify the simulated resistances in terms of symptom type, and the average ratios of their answers were used as performance measures. For both types of assessment measures, a higher index implied higher agreement among the experienced clinicians that subjectively assessed the symptoms based on typical symptom features. We applied these two assessment methods to a patient knee robot and achieved positive appraisals. The assessment measures have potential for use in comparing several patient simulators for training physical therapists, rather than as absolute indices for developing a standard. PMID:25923719

  5. The first research agenda for the chiropractic profession in Europe

    DEFF Research Database (Denmark)

    Rubinstein, Sidney M; Bolton, Jenni; Webb, Alexandra L;

    2014-01-01

    in an independent institution. In total, 58% of the participants were from the UK and Denmark, collectively representing 44% of the chiropractors working in Europe. In total, 70 research priorities were identified, of which 19 reached consensus as priorities for future research. The following three items were...... to best channel the available resources and facilitate advancement of the profession. METHODS: In total, 60 academics and clinicians working in a chiropractic setting, and who had attended any of the annual European Chiropractors' Union/European Academy of Chiropractic (ECU/EAC) Researchers' Day meetings...... since their inception in 2008, were invited to participate. Data collection consisted of the following phases: phase 1 identification of themes; phase 2 consensus, which employed a Delphi process and allowed us to distill the list of research priorities; and phase 3 presentation of the results during...

  6. The use of diagnostic coding in chiropractic practice

    DEFF Research Database (Denmark)

    Testern, Cecilie D; Hestbæk, Lise; French, Simon D

    2015-01-01

    BACKGROUND: Diagnostic coding has several potential benefits, including improving the feasibility of data collection for research and clinical audits and providing a common language to improve interdisciplinary collaboration. The primary aim of this study was to determine the views and perspectives...... extension (ICPC-2 PLUS) provided the 14 chiropractors with some experience in diagnostic coding, followed by an interview on the topic. The interviews were analysed thematically. The participating chiropractors and an independent coder applied ICPC-2 PLUS terms to the diagnoses of 10 patients. Then the...... practice, 2) ICPC-2 PLUS terminology issues for chiropractic practice and 3) Implementation of a coding system into chiropractic practice. The participating chiropractors did not uniformly support or condemn the idea of using diagnostic coding. However there was a strong agreement that the terminology in...

  7. The present use of guinea pigs for chiropractic research *

    OpenAIRE

    McGregor, Marion; Wiles, Michael R.; Grice, Adrian S.

    1980-01-01

    The necessity for an animal model in chiropractic research is considered and a short review of previous experimentation of manipulation on animals is presented. The guinea pig is proposed as a suitable animal model, and research into its suitability is presented. Analysis includes the animal’s physical characteristics, the choice of anesthetic and parametric and roentgenographic evaluation. A device for supporting the anesthetized animal during standard and motion roentgenographic examination...

  8. THE JOURNAL OF THE CHIROPRACTIC & OSTEOPATHIC COLLEGE OF AUSTRALASIA

    OpenAIRE

    Walker, Bruce F.

    1998-01-01

    The first edition of the Journal of the Chiropractic and Osteopathic College of Australasia was known as COMSIG Review and was published in November, 1992 to coincide with a large conference that COCA had organised in Melbourne. In the first few years the majority of articles were magazine style reviews, similar to these found in the Australian Family Physician. The first Editor was Bruce Walker and subsequent Editors have included John Drinkwater, Stephanie Campbell and John Reggars. The cur...

  9. Potential unique causes of burnout for chiropractic professionals

    OpenAIRE

    Williams, Shawn

    2011-01-01

    Objective The objective of this narrative review is to discuss the potential for burnout in chiropractic practitioners. This discussion is grounded in the job demands-resource model, the conservation of resources model, the unique profession-specific stressors experienced by chiropractors, and information from similar health care professions. Methods A search using both the indexed (PubMed and PsychLit) and nonindexed psychosocial literature was used. Other resources included the Cochrane Lib...

  10. Improvements in The Journal of Chiropractic Education for 2013

    OpenAIRE

    Green, Bart N.

    2013-01-01

    This editorial introduces new developments with the Journal of Chiropractic Education that will help the journal fulfill its mission more effectively. Recent improvements include a website upgrade, early online posting of accepted and edited papers, “in press” citations in PubMed, a new electronic web-based manuscript submission and peer-review system, cross linking of references, a new appearance for the journal cover, and improved page format. Improvements in publication processes with the ...

  11. Improvement in hearing after chiropractic care: a case series

    Directory of Open Access Journals (Sweden)

    Di Duro Joseph O

    2006-01-01

    Full Text Available Abstract Background The first chiropractic adjustment given in 1895 was reported to have cured deafness. This study examined the effects of a single, initial chiropractic visit on the central nervous system by documenting clinical changes of audiometry in patients after chiropractic care. Case presentation Fifteen patients are presented (9 male, 6 female with a mean age of 54.3 (range 34–71. A Welch Allyn AudioScope 3 was used to screen frequencies of 1000, 2000, 4000 and 500 Hz respectively at three standard decibel levels 20 decibels (dB, 25 dB and 40 dB, respectively, before and immediately after the first chiropractic intervention. Several criteria were used to determine hearing impairment. Ventry & Weinstein criteria of missing one or more tones in either ear at 40 dB and Speech-frequency criteria of missing one or more tones in either ear at 25 dB. All patients were classified as hearing impaired though greater on the right. At 40 dB using the Ventry & Weinstein criteria, 6 had hearing restored, 7 improved and 2 had no change. At 25 dB using the Speech-frequency criteria, none were restored, 11 improved, 4 had no change and 3 missed a tone. Conclusion A percentage of patients presenting to the chiropractor have a mild to moderate hearing loss, most notably in the right ear. The clinical progress documented in this report suggests that manipulation delivered to the neuromusculoskeletal system may create central plastic changes in the auditory system.

  12. Manual of recommendations for the diagnosis, therapy and follow-up of patients with Breast Cancer of the Tumor Center Munich - a regional hands-on publication

    OpenAIRE

    Janni, Wolfgang

    2008-01-01

    The revised 11th edition of the Manual of Recommendations for the Diagnosis, Therapy, and Follow-Up of Patients with Breast Cancer of the publications series of the Tumor Center Munich (Tumorzentrum München, TZM) is an excellent example of a regional hands-on publication which, while based on national and international guidelines, does not replace these. By virtue of countless additions and revisions in the course of 10 editions, the ‘blue tumor manual for breast cancer’ has matured into a ha...

  13. 78 FR 48904 - United States v. Chiropractic Associates, Ltd. of South Dakota; Public Comment and Response on...

    Science.gov (United States)

    2013-08-12

    ... Antitrust Division United States v. Chiropractic Associates, Ltd. of South Dakota; Public Comment and... United States v. Chiropractic Associates, Ltd. of South Dakota., Civil Action No. 13-CV- 4030-LLP, which... DIVISION UNITED STATES OF AMERICA, Plaintiff, v. CHIROPRACTIC ASSOCIATES, LTD. OF SOUTH DAKOTA,...

  14. Chiropractic at the crossroads or are we just going around in circles?

    Directory of Open Access Journals (Sweden)

    Reggars John W

    2011-05-01

    Full Text Available Abstract Background Chiropractic in Australia has seen many changes over the past 30 years. Some of these changes have advanced the professional status of chiropractic, improved undergraduate training and paved the way for a research culture. Unfortunately, other changes or lack of changes, have hindered the growth, public utilisation and professional standing of chiropractic in Australia. This article explores what influences have impacted on the credibility, advancement and public utilisation of chiropractic in Australia. Discussion The 1970's and 1980's saw a dramatic change within the chiropractic profession in Australia. With the advent of government regulation, came government funded teaching institutions, quality research and increased public acceptance and utilisation of chiropractic services. However, since that time the profession appears to have taken a backward step, which in the author's opinion, is directly linked to a shift by sections of the profession to the fundamentalist approach to chiropractic and the vertebral subluxation complex. The abandonment, by some groups, of a scientific and evidenced based approach to practice for one founded on ideological dogma is beginning to take its toll. Summary The future of chiropractic in Australia is at a crossroads. For the profession to move forward it must base its future on science and not ideological dogma. The push by some for it to become a unique and all encompassing alternative system of healthcare is both misguided and irrational.

  15. Evidence-Based Chiropractic Education: Are We Equipping Graduates for Clinical Practice with Improved Patient Outcomes?

    OpenAIRE

    Shreeve, Michael W.

    2012-01-01

    Evidence-based practice has emerged as a driving factor in current curriculum development in chiropractic education. This commentary discusses educational strategies incorporating evidence-based practices in the doctor of chiropractic curriculum and explores whether all five steps of the evidence-based process and patient outcomes from evidence-based practice are being assessed.

  16. A description of children and adolescents in Danish chiropractic practice: results from a nationwide survey

    DEFF Research Database (Denmark)

    Hestbaek, Lise; Jørgensen, Anette; Hartvigsen, Jan

    2009-01-01

    OBJECTIVE: The purpose of this study was to describe Danish chiropractic patients younger than 18 years. METHODS: Questionnaires were mailed to all chiropractic clinics in Denmark during a randomly assigned month between September 2007 and September 2008. All patients younger than 18 years or the...... treatment effectiveness indicate the need for further research in these age groups....

  17. Core Competencies of the Certified Pediatric Doctor of Chiropractic: Results of a Delphi Consensus Process.

    Science.gov (United States)

    Hewitt, Elise; Hestbaek, Lise; Pohlman, Katherine A

    2016-04-01

    An outline of the minimum core competencies expected from a certified pediatric doctor of chiropractic was developed using a Delphi consensus process. The initial set of seed statements and substatements was modeled on competency documents used by organizations that oversee chiropractic and medical education. These statements were distributed to the Delphi panel, reaching consensus when 80% of the panelists approved each segment. The panel consisted of 23 specialists in chiropractic pediatrics (14 females) from across the broad spectrum of the chiropractic profession. Sixty-one percent of panelists had postgraduate pediatric certifications or degrees, 39% had additional graduate degrees, and 74% were faculty at a chiropractic institution and/or in a postgraduate pediatrics program. The panel were initially given 10 statements with related substatements formulated by the study's steering committee. On all 3 rounds of the Delphi process the panelists reached consensus; however, multiple rounds occurred to incorporate the valuable qualitative feedback received. PMID:26739669

  18. Racial Disparities in Use of Chiropractic Services by Medicare Beneficiaries Aged 65 to 99 in Los Angeles County, California.

    Science.gov (United States)

    Whedon, James M; Kimura, Melissa N; Phillips, Reed B

    2016-04-01

    Racial and ethnic disparities in utilization of chiropractic services have been described at the state level, but little is known about such local disparities. We analyzed Medicare data for the year 2008 to evaluate by ZIP code for utilization of chiropractic services among older adults in Los Angeles County, California. We evaluated for availability and use of chiropractic services by racial/ethnic category, quantified geographic variations by coefficient of variation, and mapped utilization by selected racial/ethnic categories. Among 7502 beneficiaries who used chiropractic services, 72% were white, 12% Asian, 1% black, 1% Hispanic, and 14% other/unknown. Variation in the number of beneficiaries per ZIP code who used chiropractic services was highest among Hispanics, blacks, and Asians. We found evidence of racial disparities in use of chiropractic services at the local level in Los Angeles County. Older blacks and Hispanics in Los Angeles County may be underserved with regard to chiropractic care. PMID:26350244

  19. Kinesio Taping Does Not Provide Additional Benefits in Patients With Chronic Low Back Pain Who Receive Exercise and Manual Therapy: A Randomized Controlled Trial.

    Science.gov (United States)

    Added, Marco Aurélio Nemitalla; Costa, Leonardo Oliveira Pena; de Freitas, Diego Galace; Fukuda, Thiago Yukio; Monteiro, Renan Lima; Salomão, Evelyn Cassia; de Medeiros, Flávia Cordeiro; Costa, Lucíola da Cunha Menezes

    2016-07-01

    Study Design Randomized controlled trial. Background Many clinical practice guidelines endorse both manual therapy and exercise as effective treatment options for patients with low back pain. To optimize the effects of the treatments recommended by the guidelines, a new intervention known as Kinesio Taping is being widely used in these patients. Objectives To determine the effectiveness of Kinesio Taping in patients with chronic nonspecific low back pain when added to a physical therapy program consisting of exercise and manual therapy. Methods One hundred forty-eight patients with chronic nonspecific low back pain were randomly allocated to receive 10 (twice weekly) sessions of physical therapy, consisting of exercise and manual therapy, or the same treatment with the addition of Kinesio Taping applied to the lower back. The primary outcomes were pain intensity and disability (5 weeks after randomization) and the secondary outcomes were pain intensity, disability (3 months and 6 months after randomization), global perceived effect, and satisfaction with care (5 weeks after treatment). Data were collected by a blinded assessor. Results No between-group differences were observed in the primary outcomes of pain intensity (mean difference, -0.01 points; 95% confidence interval [CI]: -0.88, 0.85) or disability (mean difference, 1.14 points; 95% CI: -0.85, 3.13) at 5 weeks' follow-up. In addition, no between-group differences were observed for any of the other outcomes evaluated, except for disability 6 months after randomization (mean difference, 2.01 points; 95% CI: 0.03, 4.00) in favor of the control group. Conclusion Patients who received a physical therapy program consisting of exercise and manual therapy did not get additional benefit from the use of Kinesio Taping. Level of Evidence Therapy, level 1b. Prospectively registered May 28, 2013 at www.ClinicalTrials.gov (NCT01866332). J Orthop Sports Phys Ther 2016;46(7):506-513. Epub 6 Jun 2016. doi:10.2519/jospt.2016

  20. A longitudinal study of chiropractic use among older adults in the United States

    Directory of Open Access Journals (Sweden)

    Jones Michael P

    2010-12-01

    Full Text Available Abstract Background Longitudinal patterns of chiropractic use in the United States, particularly among Medicare beneficiaries, are not well documented. Using a nationally representative sample of older Medicare beneficiaries we describe the use of chiropractic over fifteen years, and classify chiropractic users by annual visit volume. We assess the characteristics that are associated with chiropractic use versus nonuse, as well as between different levels of use. Methods We analyzed data from two linked sources: the baseline (1993-1994 interview responses of 5,510 self-respondents in the Survey on Assets and Health Dynamics Among the Oldest Old (AHEAD, and their Medicare claims from 1993 to 2007. Binomial logistic regression was used to identify factors associated with chiropractic use versus nonuse, and conditional upon use, to identify factors associated with high volume relative to lower volume use. Results There were 806 users of chiropractic in the AHEAD sample yielding a full period prevalence for 1993-2007 of 14.6%. Average annual prevalence between 1993 and 2007 was 4.8% with a range from 4.1% to 5.4%. Approximately 42% of the users consumed chiropractic services only in a single calendar year while 38% used chiropractic in three or more calendar years. Chiropractic users were more likely to be women, white, overweight, have pain, have multiple comorbid conditions, better self-rated health, access to transportation, higher physician utilization levels, live in the Midwest, and live in an area with fewer physicians per capita. Among chiropractic users, 16% had at least one year in which they exceeded Medicare's "soft cap" of 12 visits per calendar year. These over-the-cap users were more likely to have arthritis and mobility limitations, but were less likely to have a high school education. Additionally, these over-the-cap individuals accounted for 58% of total chiropractic claim volume. High volume users saw chiropractors the most among

  1. Improvements in manual dexterity relate to improvements in cognitive planning after assisted cycling therapy (ACT) in adolescents with down syndrome.

    Science.gov (United States)

    Holzapfel, Simon D; Ringenbach, Shannon D R; Mulvey, Genna M; Sandoval-Menendez, Amber M; Cook, Megan R; Ganger, Rachel O; Bennett, Kristen

    2015-01-01

    We have previously reported beneficial effects of acute (i.e., single session) Assisted Cycling Therapy (ACT) on manual dexterity and cognitive planning ability in adolescents with Down syndrome (DS). In the present study, we report the chronic effects of eight weeks of ACT, voluntary cycling (VC), and no cycling (NC), on the same measures in adolescents with DS. Participants completed 8 weeks of ACT, VC, or NC. Those in the ACT and VC groups completed 30min sessions three times per week on a stationary bicycle. During ACT, the mechanical motor of the bicycle augmented the cadence to a rate which was on average 79% faster than the voluntary cadence. During VC, the participants pedaled at a self-selected rate. Unimanual dexterity scores as measured with the Purdue Pegboard test (PPT) improved significantly more for the ACT and VC groups compared to the NC group. ACT lead to greater improvements than VC and NC in the assembly sub-test, which is a task that requires more advanced temporal and spatial processing. The ACT group improved significantly more than the VC group and non-significantly more than the NC group in cognitive planning ability as measured by the Tower of London test (ToL). There were also significant correlations between the assembly subtest of the PPT and all measures of the ToL. These correlations were stronger during post-testing than pre-testing. Pre-post changes in the combined PPT score and ToL number of correct moves correlated positively in the ACT group. These results support the efficacy of the salutary effects of ACT on global fine motor function and executive function in DS. Additionally, the performance on complex bimanual dexterity tasks appears to be related to the capacity of cognitive planning ability. This research has important implications for persons with movement deficits that affect activities of daily living. PMID:26280691

  2. An educational campaign to increase chiropractic intern advising roles on patient smoking cessation

    Directory of Open Access Journals (Sweden)

    Strasser Sheryl M

    2006-10-01

    Full Text Available Abstract Background Tobacco use, particularly smoking, is the most preventable cause of death in the United States. More than 400,000 premature deaths are associated with its use and the health care costs are in the billions. All health care provider groups should be concerned with patients who continue to smoke and use tobacco. The US Preventive Services Taskforce and Health People 2010 guidelines encourage providers to counsel smokers on cessation. Current studies, though limited regarding chiropractic advising practices indicate a low engagement rate when it comes to providing cessation information. Objective To test a campaign regarding initial impact aimed at increasing chiropractic interns advising on cessation and delivery of information to smokers on cessation. Discussion Chiropractic interns do engage patients on smoking status and can be encouraged to provide more cessation messages and information to patients. The initial impact assessment of this campaign increased the provision of information to patients by about 25%. The prevalence of smoking among chiropractic patients, particularly at teaching clinics may be lower than the national averages. Conclusion Chiropractic interns can and should be encouraged to advise smokers about cessation. A systematic method of intake information on smoking status is needed and a standardized education protocol for chiropractic colleges is needed. Chiropractic colleges should assess the adequacy of their advising roles and implement changes to increase cessation messages to their patients as soon as possible.

  3. Chiropractic management of a patient with benign paroxysmal positional vertigo

    DEFF Research Database (Denmark)

    Nørregaard, Anette R; Lauridsen, Henrik H; Hartvigsen, Jan

    2009-01-01

    OBJECTIVE: This article describes and discusses the case of a patient with benign paroxysmal positional vertigo (BPPV) characterized by severe vertigo with dizziness, nausea, and nystagmus, treated without the use of spinal manipulation by a doctor of chiropractic. CLINICAL FEATURES: A 46-year......-old woman presented for care with complaints of acute vertigo and dizziness. INTERVENTION AND OUTCOME: The patient was examined and diagnosed with left posterior canalolithiasis by means of the Dix-Hallpike maneuver. She was treated successfully with the Epley maneuver once and subsequently discharged...

  4. Exercise and Manual therapy Arthritis Research Trial (EMPART) for osteoarthritis of the hip: A Multicentre Randomised Controlled trial.

    LENUS (Irish Health Repository)

    French, Helen P

    2012-10-16

    OBJECTIVE: To determine the effectiveness of exercise therapy (ET) compared to ET with adjunctive manual therapy (ET+MT) for people with hip osteoarthritis (OA). A secondary aim was to identify if immediate commencement of ET or ET+MT was more beneficial than a 9 week waiting period for either intervention. DESIGN: Assessor-blind randomised controlled trial with 9 and 18 week follow-ups. SETTING: Four academic teaching hospitals, Dublin, Ireland. PARTICIPANTS: 131 patients with hip OA recruited from general practitioners, rheumatologists, orthopaedic surgeons, and other hospital consultants were randomised to one of three groups: ET (n=45), ET+MT (n=43) and wait-list control (n=43). INTERVENTIONS: Participants in both ET and ET+ MT groups received up to 8 treatments over 8 weeks. Control group participants were re-randomised into either ET or ET+MT group after 9 week follow-up. Their data were pooled with original treatment group data: ET (n=66) and ET+MT (n=65). MAIN OUTCOME MEASURES: The primary outcome was the WOMAC physical function (PF) subscale. Secondary outcomes included physical performance, pain, hip range of motion (HROM), anxiety\\/depression, quality of life, medication usage, patient-perceived change and patient satisfaction. RESULTS: There was no significant difference in WOMAC PF between ET (n=66) and ET+MT (n=65) groups at 9 weeks (mean diff 0.09 (95% CI -4.41, 5.25)) or at 18 weeks (mean diff 0.42 (95% CI -3.98, 6.83)), or other outcomes, except \\'patient satisfaction with outcome\\' which was higher in the ET+MT group (p=0.02). Improvements in WOMAC, HROM and patient-perceived change occurred in both treatment groups compared with the control group. CONCLUSION: Self-reported function, HROM and patient-perceived improvement occurred after an 8 week programme of ET for patients with hip OA MT as an adjunct provided no further benefit, except for higher patient satisfaction.

  5. Comparison of the lumbosacral spine radiographic examination performed in hospitals and nonhospital and chiropractic facilities

    International Nuclear Information System (INIS)

    This paper estimates the average entrance skin exposure (ESE) and associated technical parameters for the lumbosacral diagnostic radiographic examination as conducted in hospitals, nonhospitals, and chiropractic facilities. A random sample of facilities was selected for survey utilizing the Nationwide Evaluation of X-Ray Trends (NEXT) protocol, which employs a clinically validated patient-equivalent phantom for exposure measurements. Radiation exposure, technique factors, equipment data, and film processing parameters were collected from 250 hospitals, 135 nonhospital radiography facilities, and 152 chiropractic facilities. Average observed ESEs were 420 mR for hospitals, 420 mR for nonhospital facilities and 430 mR for chiropractic facilities

  6. Short-term effects of high-intensity laser therapy, manual therapy, and Kinesio taping in patients with subacromial impingement syndrome.

    Science.gov (United States)

    Pekyavas, Nihan Ozunlu; Baltaci, Gul

    2016-08-01

    Subacromial impingement syndrome (SAIS) is a major contributing factor of shoulder pain; and treatment approaches (Kinesio® taping [KT], Exercise [EX], manual therapy [MT], and high-intensity laser therapy [HILT]) have been developed to treat the pain. The key objective of this study was to compare the effects of KT, MT, and HILT on the pain, the range of motion (ROM), and the functioning in patients with SAIS. Seventy patients with SAIS were randomly divided into four groups based on the treatment(s) each group received [EX (n = 15), KT + EX (n = 20), MT + KT + EX (n = 16), and MT + KT + HILT + EX (n = 19)]. All the patients were assessed before and at the end of the treatment (15th day). The main outcome assessments included the evaluation of severity of pain by visual analogue scale (VAS) and shoulder flexion, abduction, and external rotation ROM measurements by a universal goniometry. Shoulder pain and disability index (SPADI) was used to measure pain and disability associated with shoulder pathology. Statistically significant differences were found in the treatment results of all parameters in MT + KT + EX and HILT + MT + KT + EX groups (p < 0.05). When the means of ROM and SPADI results of three groups were compared, statistically significant differences were found between all the groups (p < 0.05). These differences were significant especially between the groups MT + KT + EX and KT + EX (p < 0.05) and HILT + MT + KT + EX and KT + EX (p < 0.05). HILT and MT were found to be more effective in minimizing pain and disability and increasing ROM in patients with SAIS. Further studies with follow-up periods are required to determine the advantages of these treatments conclusively. PMID:27220527

  7. Do chiropractic college faculty understand informed consent: a pilot study

    Directory of Open Access Journals (Sweden)

    Hondras Maria A

    2006-12-01

    Full Text Available Abstract Background The purpose of this study was to survey full-time faculty at a single chiropractic college concerning their knowledge of Institutional Review Board (IRB policies in their institution as they pertain to educational research. Methods All full-time faculty were invited to participate in an anonymous survey. Four scenarios involving educational research were described and respondents were asked to select from three possible courses of action for each. In addition, respondents were queried about their knowledge of IRB policies, how they learned of these policies and about their years of service and departmental assignments. Results The response rate was 55%. In no scenario did the level of correct answers by all respondents score higher than 41% and in most, the scores were closer to just under 1 in 3. Sixty-five percent of respondents indicated they were unsure whether Palmer had any policies in place at all, while 4% felt that no such policies were in place. Just over one-quarter (27% were correct in noting that students can decline consent, while more than half (54% did not know whether there were any procedures governing student consent. Conclusion Palmer faculty have only modest understanding about institutional policies regarding the IRB and human subject research, especially pertaining to educational research. The institution needs to develop methods to provide knowledge and training to faculty. The results from this pilot study will be instrumental in developing better protocols for a study designed to survey the entire chiropractic academic community.

  8. The effect of oscillating-energy manual therapy on lateral epicondylitis: a randomized, placebo-control, double-blinded study.

    Science.gov (United States)

    Nourbakhsh, Mohammad Reza; Fearon, Frank J

    2008-01-01

    Symptoms of lateral epicondylitis (LE) are attributed to degenerative changes and inflammatory reactions in the common extensor tendon induced by microscopic tears in the tissue after repetitive or overload functions of the wrist and hand extensor muscles. Conventional treatments, provided on the premise of inflammatory basis of LE, have shown 39-80% failure rate. An alternative approach suggests that symptoms of LE could be due to active tender points developed in the origin of hand and wrist extensor muscles after overuse or repetitive movements. Oscillating-energy Manual Therapy (OEMT), also known as V-spread, is a craniosacral manual technique that has been clinically used for treating tender points over the suture lines in the skull. Considering symptoms of LE may result from active tender points, the purpose of this study was to investigate the effect of OEMT on pain, grip strength, and functional abilities of subjects with chronic LE. Twenty-three subjects with chronic LE (>3mo) between ages of 24 and 72 years participated in this study. Before their participation, all subjects were screened to rule out cervical and other pathologies that could possibly contribute to their lateral elbow pain. Subjects who met the inclusion criteria were randomized into treatment and placebo treatment groups by a second (treating) therapist. Subjects were blinded to their group assignment. Subjects in the treatment group received OEMT for six sessions. During each treatment session, first a tender point was located through palpation. After proper hand placement, the therapist focused the direction of the oscillating energy on the localized tender point. Subjects in the placebo group underwent the same procedure, but the direction of the oscillating energy was directed to an area above or below the tender points, not covering the affected area. Jamar Dynamometer, Patient Specific Functional Scale (PSFS), and Numeric Rating Scale (NRS) were used to measure grip strength

  9. Integration of Chiropractic Services in Military and Veteran Health Care Facilities: A Systematic Review of the Literature.

    Science.gov (United States)

    Green, Bart N; Johnson, Claire D; Daniels, Clinton J; Napuli, Jason G; Gliedt, Jordan A; Paris, David J

    2016-04-01

    This literature review examined studies that described practice, utilization, and policy of chiropractic services within military and veteran health care environments. A systematic search of Medline, CINAHL, and Index to Chiropractic Literature was performed from inception through April 2015. Thirty articles met inclusion criteria. Studies reporting utilization and policy show that chiropractic services are successfully implemented in various military and veteran health care settings and that integration varies by facility. Doctors of chiropractic that are integrated within military and veteran health care facilities manage common neurological, musculoskeletal, and other conditions; severe injuries obtained in combat; complex cases; and cases that include psychosocial factors. Chiropractors collaboratively manage patients with other providers and focus on reducing morbidity for veterans and rehabilitating military service members to full duty status. Patient satisfaction with chiropractic services is high. Preliminary findings show that chiropractic management of common conditions shows significant improvement. PMID:26677851

  10. The implementation of problem-based learning in collaborative groups in a chiropractic program in Malaysia

    OpenAIRE

    Ni Ni Win; Nadarajah, Vishna Devi V; Daw Khin Win

    2015-01-01

    Purpose: Problem-based learning (PBL) is usually conducted in small-group learning sessions with approximately eight students per facilitator. In this study, we implemented a modified version of PBL involving collaborative groups in an undergraduate chiropractic program and assessed its pedagogical effectiveness. Methods: This study was conducted at the International Medical University, Kuala Lumpur, Malaysia, and involved the 2012 chiropractic student cohort. Six PBL cases were provided to c...

  11. Self-reported recognition of undiagnosed life threatening conditions in chiropractic practice: a random survey

    Directory of Open Access Journals (Sweden)

    Daniel Dwain M

    2012-07-01

    Full Text Available Abstract Background The purpose of this study was to identify the type and frequency of previously undiagnosed life threatening conditions (LTC, based on self-reports of chiropractic physicians, which were first recognized by the chiropractic physician. Additionally this information may have a preliminary role in determining whether chiropractic education provides the knowledge necessary to recognize these events. Methods The study design was a postal, cross-sectional, epidemiological self-administered survey. Two thousand Doctors of Chiropractic in the US were randomly selected from a list of 57878. The survey asked respondents to state the number of cases from the list where they were the first physician to recognize the condition over the course of their practice careers. Space was provided for unlisted conditions. Results The response rate was 29.9%. Respondents represented 11442 years in practice and included 3861 patients with a reported undiagnosed LTC. The most commonly presenting conditions were in rank order: carcinoma, abdominal aneurysm, deep vein thrombosis, stroke, myocardial infarction, subdural hematoma and a large group of other diagnoses. The occurrence of a previously undiagnosed LTC can be expected to present to the chiropractic physician every 2.5 years based on the responding doctors reports. Conclusion Based on this survey chiropractic physicians report encountering undiagnosed LTC’s in the normal course of practice. The findings of this study are of importance to the chiropractic profession and chiropractic education. Increased awareness and emphasis on recognition of LTC is a critical part of the education process and practice life.

  12. Development of disease-specific quality indicators for danish chiropractic patients with low back pain

    DEFF Research Database (Denmark)

    Sorensen, Line P; Krog, Birgitte R; Kongsted, Alice; Bronfort, Gert; Hartvigsen, Jan

    2011-01-01

    The purpose of this study is to develop disease-specific quality indicators for Danish chiropractic patients with low back pain (LBP) as an initial effort to include chiropractors in the Danish Health Care Quality Programme.......The purpose of this study is to develop disease-specific quality indicators for Danish chiropractic patients with low back pain (LBP) as an initial effort to include chiropractors in the Danish Health Care Quality Programme....

  13. Assessing the change in attitudes, knowledge, and perspectives of medical students towards chiropractic after an educational intervention.

    Science.gov (United States)

    Wong, Jessica J; Di Loreto, Luciano; Kara, Alim; Yu, Kavan; Mattia, Alicia; Soave, David; Weyman, Karen; Kopansky-Giles, Deborah

    2014-10-01

    Objective : We assessed the change in attitudes, knowledge, and perspectives of medical students towards chiropractic after a 1-hour educational intervention. Methods : A mixed-methods approach was used with a 52-item cross-sectional paper survey and 1 focus group of third-year medical students. The views of these medical students towards chiropractic were assessed previously in their second-year of medical school. ANOVA and the Wilcoxon rank-sum test were used to assess between-group differences between the medical students' views before and after the educational intervention. The constant comparative method for analyzing qualitative data was used to identify emergent themes from the focus group transcript. Results : Of 112 third-year medical students, 58 completed the survey (51.7% response rate). The focus group consisted of 6 medical students. Self-reported understanding of chiropractic and number of attitude-positive responses were significantly higher in the group after the educational session. The average number of correct responses assessing knowledge on chiropractic also was significantly higher. Focus group themes were that medical students wanted exposure to chiropractic in clinical settings, had negative attitudes towards chiropractic formed from hidden curriculum, had concerns regarding evidence and safety of chiropractic, and thought that timing of the session on chiropractic was too late in the curriculum. Conclusions : The attitudes and knowledge of medical students towards chiropractic improved immediately after a 1-hour educational intervention. Formally educating medical students on chiropractic may help minimize hidden curriculum issues regarding chiropractic, as identified by the medical students, and facilitate collaboration between medical and chiropractic providers. PMID:25237768

  14. Assessing the change in attitudes, knowledge, and perspectives of medical students towards chiropractic after an educational intervention*

    Science.gov (United States)

    Wong, Jessica J.; Di Loreto, Luciano; Kara, Alim; Yu, Kavan; Mattia, Alicia; Soave, David; Weyman, Karen; Kopansky-Giles, Deborah

    2014-01-01

    Objective We assessed the change in attitudes, knowledge, and perspectives of medical students towards chiropractic after a 1-hour educational intervention. Methods A mixed-methods approach was used with a 52-item cross-sectional paper survey and 1 focus group of third-year medical students. The views of these medical students towards chiropractic were assessed previously in their second-year of medical school. ANOVA and the Wilcoxon rank-sum test were used to assess between-group differences between the medical students' views before and after the educational intervention. The constant comparative method for analyzing qualitative data was used to identify emergent themes from the focus group transcript. Results Of 112 third-year medical students, 58 completed the survey (51.7% response rate). The focus group consisted of 6 medical students. Self-reported understanding of chiropractic and number of attitude-positive responses were significantly higher in the group after the educational session. The average number of correct responses assessing knowledge on chiropractic also was significantly higher. Focus group themes were that medical students wanted exposure to chiropractic in clinical settings, had negative attitudes towards chiropractic formed from hidden curriculum, had concerns regarding evidence and safety of chiropractic, and thought that timing of the session on chiropractic was too late in the curriculum. Conclusions The attitudes and knowledge of medical students towards chiropractic improved immediately after a 1-hour educational intervention. Formally educating medical students on chiropractic may help minimize hidden curriculum issues regarding chiropractic, as identified by the medical students, and facilitate collaboration between medical and chiropractic providers. PMID:25237768

  15. Effectiveness and economic evaluation of chiropractic care for the treatment of low back pain: a systematic review protocol

    OpenAIRE

    Blanchette, Marc-André; Bussières, André; Stochkendahl, Mette Jensen; Boruff, Jill; Harrison, Pamela

    2015-01-01

    Background Chiropractic care is a common treatment for low back pain (LBP). Previous studies have failed to clarify the relative cost-effectiveness of chiropractic care in comparison with other commonly used approaches because previous attempts to synthetize the economic literature has only included partial economic evaluations. The objective of this project is to estimate the clinical effectiveness and cost-effectiveness of chiropractic care compared to other commonly used care approaches am...

  16. Chiropractic: Is it Efficient in Treatment of Diseases? Review of Systematic Reviews

    Directory of Open Access Journals (Sweden)

    Alireza Salehi

    2015-10-01

    Full Text Available Abstract Chiropractic is a complementary medicine that has been growing increasingly in different countries over recent decades. It addresses the prevention, diagnosis and treatment of the neuromusculoskeletal system disorders and their effects on the whole body health. This study aims to evaluate the effectiveness of chiropractic in the treatment of different diseases. To gather data, scientific electronic databases, such as Cochrane, Medline, Google Scholar, and Scirus were searched and all systematic reviews in the field of chiropractic were obtained. Reviews were included if they were specifically concerned with the effectiveness of chiropractic treatment, included evidence from at least one clinical trial, included randomized studies and focused on a specific disease. The research data including the article’s first author’s name, type of disease, intervention type, number and types of research used, meta-analysis, number of participants, and overall results of the study, were extracted, studied and analyzed. Totally, 23 chiropractic systematic reviews were found, and 11 articles met the defined criteria. The results showed the influence of chiropractic on improvement of neck pain, shoulder and neck trigger points, and sport injuries. In the cases of asthma, infant colic, autism spectrum disorder, gastrointestinal problems, fibromyalgia, back pain and carpal tunnel syndrome, there was no conclusive scientific evidence. There is heterogeneity in some of the studies and also limited number of clinical trials in the assessed systematic reviews. Thus, conducting comprehensive studies based on more reliable study designs are highly recommended.

  17. Chiropractic: Is it Efficient in Treatment of Diseases? Review of Systematic Reviews.

    Science.gov (United States)

    Salehi, Alireza; Hashemi, Neda; Imanieh, Mohammad Hadi; Saber, Mahboobeh

    2015-10-01

    Chiropractic is a complementary medicine that has been growing increasingly in different countries over recent decades. It addresses the prevention, diagnosis and treatment of the neuromusculoskeletal system disorders and their effects on the whole body health. This study aims to evaluate the effectiveness of chiropractic in the treatment of different diseases. To gather data, scientific electronic databases, such as Cochrane, Medline, Google Scholar, and Scirus were searched and all systematic reviews in the field of chiropractic were obtained. Reviews were included if they were specifically concerned with the effectiveness of chiropractic treatment, included evidence from at least one clinical trial, included randomized studies and focused on a specific disease. The research data including the article's first author's name, type of disease, intervention type, number and types of research used, meta-analysis, number of participants, and overall results of the study, were extracted, studied and analyzed. Totally, 23 chiropractic systematic reviews were found, and 11 articles met the defined criteria. The results showed the influence of chiropractic on improvement of neck pain, shoulder and neck trigger points, and sport injuries. In the cases of asthma, infant colic, autism spectrum disorder, gastrointestinal problems, fibromyalgia, back pain and carpal tunnel syndrome, there was no conclusive scientific evidence. There is heterogeneity in some of the studies and also limited number of clinical trials in the assessed systematic reviews. Thus, conducting comprehensive studies based on more reliable study designs are highly recommended. PMID:26448951

  18. Annotated bibliography of the biomedical literature pertaining to chiropractic, pediatrics and manipulation in relation to the treatment of health conditions

    Science.gov (United States)

    Gotlib, Allan C; Beingessner, Melanie

    1995-01-01

    Biomedical literature retrieval, both indexed and non-indexed, with respect to the application of manipulative therapy with therapeutic intent and pediatric health conditions (ages 0 to 17 years) yielded 66 discrete documents which met specified inclusion and exclusion criteria. There was one experimental study (RCT’s), 3 observational (cohort, case control) studies and 62 descriptive studies (case series, case reports, surveys, literature reviews). An independent rating panel determined consistency with a modified quality of evidence scale adopted from procedure ratings system 1 of Clinical Guidelines for Chiropractic Practice in Canada. Results indicate minimal Class 1 and Class 2 and some Class 3 evidence for a variety of pediatric conditions utilizing the application of manipulation with therapeutic intent.

  19. Intervenção fisioterapêutica nas sequelas de drenagem linfática manual iatrogênica: relato de caso Physical therapy in sequelae of iatrogenic manual lymphatic drainage: a case report

    Directory of Open Access Journals (Sweden)

    Rogério Eduardo Tacani

    2011-06-01

    Full Text Available Atualmente, a drenagem linfática manual (DLM é um dos recursos de grande destaque no tratamento de edemas, linfedemas e condições inestéticas, porém, na prática clínica têm-se observado sua aplicação de forma iatrogênica. Os objetivos deste relato de caso foram apontar as sequelas da aplicação iatrogênica da DLM, em uma jovem caucasiana, e verificar os efeitos da intervenção fisioterapêutica no tratamento dessas. Voluntária de 27 anos, apresentava-se com uma equimose importante na região lateral da coxa esquerda (28 x 9,5 cm, telangiectasias, microvaricosidades e petéquias em ambas as coxas e pernas, dor de forte intensidade e edema, após ter se submetido a um procedimento manual iatrogênico com finalidade estética há dois dias. As condutas fisioterapêuticas adotadas foram: Ultrassom 3 MHz, pulsado (2 ms on, 8 ms off, 0,4 W/cm² SATP na região da equimose e DLM (Método Leduc durante 20 minutos, na coxa esquerda. Foram realizadas nove sessões até a alta no 16º dia pós-lesão, observando-se apenas a redução gradativa da dor e da equimose. Verificou-se a efetividade da intervenção fisioterapêutica em apenas algumas das sequelas provocadas pela iatrogenia, sem desconsiderar que a remissão espontânea dos sinais e sintomas também pode ter contribuído para tal. Destaca-se a importância de conscientizar os fisioterapeutas que atuam com este procedimento para que o aplique de forma adequada, evitando tais iatrogenias.Recently, the manual lymphatic drainage (MLD is an important resource in the treatment of edemas, lymphedemas, and other unaesthetic conditions. However, problems caused by the incorrect application of this therapy have been observed in the clinical practice. The aims of this case report were to describe sequelae resulting from the negligent application of MLD on a young patient, and to determine the effects of physical therapy on the treatment of sequelae. A 27-year-old Caucasian woman presented

  20. Constructing a philosophy of chiropractic: evolving worldviews and postmodern core☆

    Science.gov (United States)

    Senzon, Simon A.

    2011-01-01

    Objective The purpose of this article is to explore the postmodern, postrational, and postconventional core of DD Palmer's self-sense and philosophy. Discussion DD Palmer's self and philosophy can be viewed as a reaction to the self of modernity and its challenges of a fracture between mind and body, spirit, and nature. It is argued that Palmer's solution to these vexing problems facing the modern self was to use postrational and postconventional logic to overcome the dualisms. His philosophy resonates with similar postrational approaches, most notably, the German idealist Schelling. Conclusion It is argued that Palmer was one of the first postrational individuals in America and that chiropractic was an attempt at the first postrational health profession. PMID:22693480

  1. The prevalence of the term subluxation in North American English-Language Doctor of chiropractic programs

    Directory of Open Access Journals (Sweden)

    Mirtz Timothy A

    2011-06-01

    Full Text Available Abstract Background The subluxation construct has been a divisive term in the chiropractic profession. There is a paucity of evidence to document the subluxation. Some authors have questioned the propriety of continuing to use the term. Aim The purpose of this study is to examine current North American English language chiropractic college academic catalogs and determine the prevalence of the term subluxation in the respective chiropractic program curricula. Methods Sixteen current English-language North American chiropractic college academic catalogs were studied. The term subluxation was searched for in each of the catalogs. Categories were developed for the usage of the term. These included "total times mentioned", "subluxation mentioned in a course description", "subluxation mentioned in a course title", "subluxation mentioned in a technique course description", and "subluxation mentioned in a philosophy course description." The prevalence of the "subluxation mentioned in a course description" was compared to the total programmatic curriculum. Results Palmer College in Florida devoted 22.72% of its curriculum to courses mentioning the subluxation followed by Life University (Marietta, GA and Sherman College with 16.44% and 12.80% respectively. As per specific coursework or subjects, an average of 5.22 courses or subjects have descriptions mentioning the term subluxation. Three schools made no mention of the term subluxation in their academic catalogs; they were National University of Health Sciences, Canadian Memorial Chiropractic College, and Southern California University of Health Sciences. Conclusion Despite the controversies and paucity of evidence the term subluxation is still found often within the chiropractic curricula of most North American chiropractic programs. Future research should determine if changes in accreditation standards and research on evidence based practice will affect this prevalence.

  2. A randomized clinical trial of chiropractic treatment and self-management in patients with acute musculoskeletal chest pain

    DEFF Research Database (Denmark)

    Stochkendahl, Mette J; Christensen, Henrik W; Vach, Werner;

    2012-01-01

    We have previously reported short-term follow-up from a pragmatic randomized clinical trial comparing 2 treatments for acute musculoskeletal chest pain: (1) chiropractic treatment and (2) self-management. Results indicated a positive effect in favor of the chiropractic treatment after 4 and 12...

  3. The effect of chiropractic techniques on the Cobb angle in idiopathic scoliosis arising in adolescence

    Science.gov (United States)

    Byun, Sunghak; Han, Dongwook

    2016-01-01

    [Purpose] The purpose of this study was to examine whether chiropractic techniques would reduce the curvature of idiopathic scoliosis, which commonly occurs in elementary school children. [Subjects] The subjects of this study were 5 healthy elementary students who listened to an explanation of the study methods and purpose of the study and agreed to participate in the experiment. [Methods] The Cobb angle was measured by taking an X-ray (FCT-1, Dongmun, Goyangsi, Republic of Korea) taken from the rear, using X-ray film. The method of intervention this study used was application of chiropractic techniques. Spinal correction was carried out for 30 minutes per session, which included soft tissue massage, 3 times a week for 8 weeks. [Results] It was established that the Cobb angle was noticeably decreased after 4 weeks of the intervention. Post Hoc analysis revealed that the Cobb angle noticeably decreased after 4 weeks compared with the Cobb angle before the chiropractic techniques were applied. However, no significant difference in Cobb angle was evident after the fourth week. [Conclusion] This study demonstrated that chiropractic techniques can effectively reduce the Cobb angle within as little as 4 weeks. So, we can confirm that the chiropractic techniques were effective for reducing the curvature of idiopathic scoliosis.

  4. 手工作业对作业治疗教学效果的影响①%Effect of Manual Operation on Teaching of Occupational Therapy

    Institute of Scientific and Technical Information of China (English)

    朱毅; 李凝; 闫彦宁; 黄眀威; 马全胜

    2013-01-01

      目的评价手工作业对作业疗法学教学效果的影响。方法将83名学生随机分为常规教学组41人和手工作业教学组42人,分别采用常规教学法和手工作业教学法。4学时教学后采用加拿大职业行为模式(CMOP)评估量表对教学效果进行评价。结果常规教学组和手工作业教学组分别收回37份、41份问卷,两组各有2份及3份不完整被剔除。在课堂氛围和谐生动、课程内容激发兴趣、教师能充分讲解课程内涵、掌握一定的职业思想、培养解决实际问题的能力、培养良好医患沟通技巧、课堂讨论能够激发活跃思维7个方面,手工作业教学组明显优于常规教学组(P<0.01)。结论手工作业是一种新型、有效、便捷、低成本的教学模式,能提高作业治疗教学水平。%Objective To investigate the effect of manual operation on occupational therapy teaching. Methods 83 students were ran-domly divided into 2 groups:41 students of general teaching group and the other 42 of manual operation teaching group, who received the ordinary classroom teaching and manual operation teaching respectively. After 4 h of study, they were measured with Canadian Model of Oc-cupational Performance (CMOP). Results There were 37 and 41 questionnaires recalled from the general teaching group and the manual op-eration teaching group, and 2 and 3 questionnaires excluded as incomplete respectively. The scores of the classroom atmosphere, interesting stimulation, explanation of curriculum connotation, obtaining professional ideology, ability cultivated to solve practical problems, good rela-tionship between doctors and patients developing, and thinking of discussion stimulating were more in the manual operation teaching group than in the general teaching group (P<0.01). Conclusion Manual operation is a new, effective, convenient, and low-cost mode of teaching for occupational therapy.

  5. The use of a manual-driven group cognitive behavior therapy in a Brazilian sample of obese individuals with binge-eating disorder Utilização de terapia cognitivo-comportamental em grupo baseada em manual em uma amostra brasileira de indivíduos obesos com transtorno da compulsão alimentar periódica

    OpenAIRE

    Mônica Duchesne; José Carlos Appolinario; Bernard Pimentel Rangé; Julia Fandiño; Tatiana Moya; Silvia R. Freitas

    2007-01-01

    OBJECTIVE: To assess the effectiveness of a manual-based cognitive behavior therapy adapted to a group format in a sample of Brazilian obese subjects with binge-eating disorder. METHOD: In an open trial, 21 obese subjects with binge-eating disorder received a group cognitive-behavioral therapy program. Changes in binge-eating frequency, weight, body shape concerns, and depressive symptoms were compared between baseline and the end of the study. RESULTS: The mean frequency of binge-eating epis...

  6. Cost-effectiveness of chiropractic care versus self-management in patients with musculoskeletal chest pain

    DEFF Research Database (Denmark)

    Stochkendahl, Mette Jensen; Sørensen, Jan; Vach, Werner;

    2016-01-01

    AIMS: To assess whether primary sector healthcare in the form of chiropractic care is cost-effective compared with self-management in patients with musculoskeletal chest pain, that is, a subgroup of patients with non-specific chest pain. METHODS AND RESULTS: 115 adults aged 18-75 years with acute...... information session aimed at encouraging self-management as complementary to usual care (n=56). Data on resource use were obtained from Danish national registries and valued from a societal perspective. Patient cost and health-related quality-adjusted life years (QALYs; based on EuroQol five...... QALYs between the groups were negligible. CONCLUSIONS: Chiropractic care was more cost-effective than self-management. Therefore, chiropractic care can be seen as a good example of a targeted primary care approach for a subgroup of patients with non-specific chest pain. TRIAL REGISTRATION NUMBER: NCT...

  7. Generalizability of a composite student selection procedure at a university-based chiropractic program

    DEFF Research Database (Denmark)

    O'Neill, Lotte D; Korsholm, Lars; Wallstedt, Birgitta;

    2009-01-01

    PURPOSE: Non-cognitive admission criteria are typically used in chiropractic student selection to supplement grades. The reliability of non-cognitive student admission criteria in chiropractic education has not previously been examined. In addition, very few studies have examined the overall test...... generalizability of composites of non-cognitive admission variables in admission to health science programs. The aim of this study was to estimate the generalizability of a composite selection to a chiropractic program, consisting of: application form information, a written motivational essay, a common knowledge...... generalizability was found for the common knowledge test (G=1.00) and the admission interview (G=0.88). Good generalizability was found for application form information (G=0.75) and moderate generalizability (G=0.50) for the written motivation essay. The generalizability of the final composite admission procedure...

  8. Cost-effectiveness of chiropractic care versus self-management in patients with musculoskeletal chest pain

    Science.gov (United States)

    Sørensen, Jan; Vach, Werner; Christensen, Henrik Wulff; Høilund-Carlsen, Poul Flemming; Hartvigsen, Jan

    2016-01-01

    Aims To assess whether primary sector healthcare in the form of chiropractic care is cost-effective compared with self-management in patients with musculoskeletal chest pain, that is, a subgroup of patients with non-specific chest pain. Methods and results 115 adults aged 18–75 years with acute, non-specific chest pain of musculoskeletal origin were recruited from a cardiology department in Denmark. After ruling out acute coronary syndrome and receiving usual care, patients with musculoskeletal chest pain were randomised to 4 weeks of community-based chiropractic care (n=59) or to a single information session aimed at encouraging self-management as complementary to usual care (n=56). Data on resource use were obtained from Danish national registries and valued from a societal perspective. Patient cost and health-related quality-adjusted life years (QALYs; based on EuroQol five-dimension questionnaire (EQ-5D) and Short Form 36-item Health Survey (SF-36)) were compared in cost-effectiveness analyses over 12 months from baseline. Mean costs were €2183 lower for the group with chiropractic care, but not statistically significant (95% CI −4410.5 to 43.0). The incremental cost-effectiveness ratio suggested that chiropractic care was cost-effective with a probability of 97%, given a threshold value of €30 000 per QALY gained. In both groups, there was an increase in the health-related quality of life, and the mean increases were similar over the 12-month evaluation period. The mean differences in QALYs between the groups were negligible. Conclusions Chiropractic care was more cost-effective than self-management. Therefore, chiropractic care can be seen as a good example of a targeted primary care approach for a subgroup of patients with non-specific chest pain. Trial registration number NCT00462241. PMID:27175285

  9. Outcomes of usual chiropractic, harm & efficacy, the ouch study: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Walker Bruce F

    2011-10-01

    Full Text Available Abstract Background Previous studies have demonstrated that adverse events occur during chiropractic treatment. However, because of these studies design we do not know the frequency and extent of these events when compared to sham treatment. The principal aims of this study are to establish the frequency and severity of adverse effects from short term usual chiropractic treatment of the spine when compared to a sham treatment group. The secondary aim of this study is to establish the efficacy of usual short term chiropractic care for spinal pain when compared to a sham intervention. Methods One hundred and eighty participants will be randomly allocated to either usual chiropractic care or a sham intervention group. To be considered for inclusion the participants must have experienced non-specific spinal pain for at least one week. The study will be conducted at the clinics of registered chiropractors in Western Australia. Participants in each group will receive two treatments at intervals no less than one week. For the usual chiropractic care group, the selection of therapeutic techniques will be left to the chiropractors' discretion. For the sham intervention group, de-tuned ultrasound and de-tuned activator treatment will be applied by the chiropractors to the regions where spinal pain is experienced. Adverse events will be assessed two days after each appointment using a questionnaire developed for this study. The efficacy of short term chiropractic care for spinal pain will be examined at two week follow-up by assessing pain, physical function, minimum acceptable outcome, and satisfaction with care, with the use of the following outcome measures: Numerical Rating Scale, Functional Rating Index, Neck Disability Index, Minimum Acceptable Outcome Questionnaire, Oswestry Disability Index, and a global measure of treatment satisfaction. The statistician, outcome assessor, and participants will be blinded to treatment allocation. Trial

  10. Internal carotid artery dissection following chiropractic treatment in a pregnant woman with Systemic Lupus Erythematosus

    Directory of Open Access Journals (Sweden)

    Morton Adam

    2012-12-01

    Full Text Available Abstract A case of internal carotid artery dissection in a pregnant woman with Systemic Lupus Erythematosus (SLE immediately following chiropractic treatment is presented. The literature regarding complications of neck manipulation during pregnancy, spontaneous dissection of craniocervical arteries in pregnancy and the postpartum period, and dissection of craniocervical arteries in SLE are reviewed. To the best of the author’s knowledge, this is the first case of carotid artery dissection following chiropractic treatment in a pregnant woman published in the literature.

  11. A pilot study of a chiropractic intervention for management of chronic myofascial temporomandibular disorder

    DEFF Research Database (Denmark)

    DeVocht, James W; Goertz, Christine M; Hondras, Maria;

    2013-01-01

    BACKGROUND: Temporomandibular pain has multiple etiologies and a range of therapeutic options. In this pilot study, the authors assessed the feasibility of conducting a larger trial to evaluate chiropractic treatment of temporomandibular disorders (TMDs). METHODS: The authors assigned 80 particip......BACKGROUND: Temporomandibular pain has multiple etiologies and a range of therapeutic options. In this pilot study, the authors assessed the feasibility of conducting a larger trial to evaluate chiropractic treatment of temporomandibular disorders (TMDs). METHODS: The authors assigned 80...... that will provide clinicians with information that should be helpful when discussing treatment options for patients with TMD....

  12. Development and psychometric evaluation of scales to measure professional confidence in manual medicine: a Rasch measurement approach

    OpenAIRE

    Hecimovich, Mark D.; Styles, Irene; Volet, Simone E

    2014-01-01

    Background Health professionals in athletic training, chiropractic, osteopathy, and physiotherapy fields, require high-level knowledge and skills in their assessment and management of patients. This is important when communicating with patients and applying a range of manual procedures. Prior to embarking on professional practice, it is imperative to acquire optimal situation-specific levels of self-confidence for a beginner practitioner in these areas. In order to foster this professional se...

  13. Etiologies of illness among patients meeting integrated management of adolescent and adult illness district clinician manual criteria for severe infections in northern Tanzania: implications for empiric antimicrobial therapy.

    Science.gov (United States)

    Rubach, Matthew P; Maro, Venance P; Bartlett, John A; Crump, John A

    2015-02-01

    We describe the laboratory-confirmed etiologies of illness among participants in a hospital-based febrile illness cohort study in northern Tanzania who retrospectively met Integrated Management of Adolescent and Adult Illness District Clinician Manual (IMAI) criteria for septic shock, severe respiratory distress without shock, and severe pneumonia, and compare these etiologies against commonly used antimicrobials, including IMAI recommendations for emergency antibacterials (ceftriaxone or ampicillin plus gentamicin) and IMAI first-line recommendations for severe pneumonia (ceftriaxone and a macrolide). Among 423 participants hospitalized with febrile illness, there were 25 septic shock, 37 severe respiratory distress without shock, and 109 severe pneumonia cases. Ceftriaxone had the highest potential utility of all antimicrobials assessed, with responsive etiologies in 12 (48%) septic shock, 5 (14%) severe respiratory distress without shock, and 19 (17%) severe pneumonia illnesses. For each syndrome 17-27% of participants had etiologic diagnoses that would be non-responsive to ceftriaxone, but responsive to other available antimicrobial regimens including amphotericin for cryptococcosis and histoplasmosis; anti-tuberculosis therapy for bacteremic disseminated tuberculosis; or tetracycline therapy for rickettsioses and Q fever. We conclude that although empiric ceftriaxone is appropriate in our setting, etiologies not explicitly addressed in IMAI guidance for these syndromes, such as cryptococcosis, histoplasmosis, and tetracycline-responsive bacterial infections, were common. PMID:25385866

  14. Exploring integrative medicine for back and neck pain : On the integration of manual and complementary therapies in Swedish primary care

    OpenAIRE

    Sundberg, Tobias

    2010-01-01

    Background and aims: The integration of complementary therapies (CTs) with an emerging evidence base into conventional care services is common, despite limited evidence as to the clinical effectiveness of comprehensive models delivering such care, i.e. integrative medicine (IM). Low back and neck pain (LBP/NP) are two of the most common reasons for people to use CTs. The objectives of this thesis were to develop, implement and explore the relevance of IM as a potential healt...

  15. VARK Learning Preferences and Mobile Anatomy Software Application Use in Pre-Clinical Chiropractic Students

    Science.gov (United States)

    Meyer, Amanda J.; Stomski, Norman J.; Innes, Stanley I.; Armson, Anthony J.

    2016-01-01

    Ubiquitous smartphone ownership and reduced face-to-face teaching time may lead to students making greater use of mobile technologies in their learning. This is the first study to report on the prevalence of mobile gross anatomy software applications (apps) usage in pre-clinical chiropractic students and to ascertain if a relationship exists…

  16. The development of contemporary chiropractic education in Denmark: an exploratory study

    DEFF Research Database (Denmark)

    Myburgh, Corrie; Mouton, Johan

    2008-01-01

    quo issues around education at the University of Southern Denmark, and 1 explored perceived health care integration benefits attributable to the chosen model of education. CONCLUSION: The Danish chiropractic profession's incentive to raise its legitimacy lay in the access it stood to gain, through a...

  17. Self-Regulation of a Chiropractic Association through Participatory Action Research

    Science.gov (United States)

    Sheppard, Lorraine A.; Jorgensen, Anna Maria S.; Crowe, Michael J.

    2012-01-01

    Participatory action research (PAR) can be used in the health professions to redefine their roles. This study investigated a small health professional group, the members of The Chiropractic Association Singapore (TCAS), by using a PAR method; researchers and participants gained insights into the self-regulation of a health profession. A…

  18. Texas Chiropractic College Practice Management Education: The Patient's Point of View.

    Science.gov (United States)

    Waigandt, Alex; And Others

    A survey was conducted to determine the patient's perception of treatment received from clinicians at the Texas Chiropractic College Clinic in Pasadena, Texas. A questionnaire designed to assess various aspects of the school's clinical and dispensary services was administered to 79 patients who had completed their treatment prescriptions. The…

  19. Correlations Between Chiropractic National Board (Part I) Scores and Basic Science Course Grades and Related Data.

    Science.gov (United States)

    Wolfenberger, Virginia

    1999-01-01

    A study at one institution found significant correlations between students' scores on the National Board of Chiropractic Examiners test and academic achievement data. Results indicate that it is not always course subject matter that influences the relationship between course grade and board scores, but may instead be the ability to assimilate…

  20. An Investigation into the Faculty Development Practices in Chiropractic Education Programs

    Science.gov (United States)

    Scaringe, John G.

    2010-01-01

    A descriptive case study design using a cross-sectional quantitative survey method was used to investigate the impact of faculty development programs on teaching effectiveness perceived by faculty teaching at chiropractic colleges in the United States. The availability of faculty development programs related to teaching and student learning was…

  1. Individual and population doses in Manitoba from chiropractic x-ray procedures

    International Nuclear Information System (INIS)

    Manitoba (population of 1.0 million) has 37 chiropractors who perform x-rays on behalf of 100 practising chiropractors. In 1987 these specialists performed approximately 33 300 spinal x-ray studies. Cervical spine examinations contribute the lowest patient dose (average HE of 26 μSv); thoracic and lumbar spine examinations show considerably higher patient dose (HE in the range 24-410 μSv) Average patient HE was determined to be 220 μSv. Lumbar spine examinations account for 45% of all chiropractic x-ray examinations (84% of the collective dose). Cervical spine examinations also account for 45% of chiropractic x-ray examinations, but contribute only 5% of the collective dose with thoracic spine examinations contributing the 11% balance of the collective dose. Patients undergoing chiropractic procedures involving exposure to x-rays account for about 3.6% of all diagnostic x-ray procedures. The per caput dose contribution from chiropractic practice was calculated to be 7.3 μSv (1.2% of total population dose from diagnostic procedures employing ionising radiation). (author)

  2. Code of safe practice for the use of x-rays in diagnosis (chiropractic)

    International Nuclear Information System (INIS)

    The purpose of this code is to provide criteria for working procedures, x-ra diagnosis according to currently accepted standards of safety. The code is intended to apply to chiropractic diagnostic uses of x-rays. Reference is also made to radiation protection aspects of installation and servicing of diagnostic x-ray machines. refs., 1 fig., 1 ill

  3. Individual and population doses in Manitoba from chiropractic x-ray procedures

    Energy Technology Data Exchange (ETDEWEB)

    Huda, W.; Sourkes, A.M. (Manitoba Cancer Treatment and Research Foundation, Winnipeg, MB (Canada))

    1989-12-01

    Manitoba (population of 1.0 million) has 37 chiropractors who perform x-rays on behalf of 100 practising chiropractors. In 1987 these specialists performed approximately 33 300 spinal x-ray studies. Cervical spine examinations contribute the lowest patient dose (average H{sub E} of 26 {mu}Sv); thoracic and lumbar spine examinations show considerably higher patient dose (H{sub E} in the range 24-410 {mu}Sv) Average patient H{sub E} was determined to be 220 {mu}Sv. Lumbar spine examinations account for 45% of all chiropractic x-ray examinations (84% of the collective dose). Cervical spine examinations also account for 45% of chiropractic x-ray examinations, but contribute only 5% of the collective dose with thoracic spine examinations contributing the 11% balance of the collective dose. Patients undergoing chiropractic procedures involving exposure to x-rays account for about 3.6% of all diagnostic x-ray procedures. The per caput dose contribution from chiropractic practice was calculated to be 7.3 {mu}Sv (1.2% of total population dose from diagnostic procedures employing ionising radiation). (author).

  4. Pregnant Students in the Gross Anatomy Laboratory: Policies and Practices at Chiropractic Colleges

    Science.gov (United States)

    Duray, Stephen M.; Mekow, Craig L.

    2011-01-01

    Chiropractic and medical colleges have experienced a significant increase in the number of female applicants in recent years, a percentage of whom are pregnant or become pregnant following admission. It is therefore important to ask the question: How do institutions that educate future health care providers address the issue of pregnancy and the…

  5. Chiropractic or exercise for seniors with back pain or neck pain

    DEFF Research Database (Denmark)

    Maiers, Michele; Hartvigsen, Jan; Shulz, Craig;

    2007-01-01

    BACKGROUND: Low back pain (LBP) and neck pain (NP) are common conditions in old age, leading to impaired functional ability and decreased independence. Manual and exercise therapies are common and effective therapies for the general LBP and NP populations. However, these treatments have not been...... adequately researched in older LBP and NP sufferers.The primary aim of these studies is to assess the relative clinical effectiveness of 1) manual treatment plus home exercise, 2) supervised rehabilitative exercise plus home exercise, and 3) home exercise alone, in terms of patient-rated pain, for senior LBP......-effectiveness and cost-utility will also be assessed. Finally, using qualitative methods, older LBP and NP patient's perceptions of treatment will be explored and described. METHODS/DESIGN: This paper describes the design of two multi-methods clinical studies focusing on elderly patients with non-acute LBP and NP...

  6. Chiropractic Name techniques in Canada: a continued look at demographic trends and their impact on issues of jurisprudence

    OpenAIRE

    Gleberzon, Brain J

    2002-01-01

    In a previous article, the author reported on the recommendations gathered from student projects between 1996 and 1999 investigating their preferences for including certain chiropractic Name technique systems into the curriculum at the Canadian Memorial Chiropractic College (CMCC). These results were found to be congruent with the professional treatment technique used by Canadian chiropractors. This article reports on the data obtained during the 2000 and 2001 academic years, comparing these ...

  7. Psychosocial factors and their predictive value in chiropractic patients with low back pain: a prospective inception cohort study

    OpenAIRE

    Breen Alan C; Langworthy Jennifer M

    2007-01-01

    Abstract Background Being able to estimate the likelihood of poor recovery from episodes of back pain is important for care. Studies of psychosocial factors in inception cohorts in general practice and occupational populations have begun to make inroads to these problems. However, no studies have yet investigated this in chiropractic patients. Methods A prospective inception cohort study of patients presenting to a UK chiropractic practice for new episodes of non-specific low back pain (LBP) ...

  8. Effectiveness of a manualized imagery rehearsal therapy for patients suffering from nightmare disorders with and without a comorbidity of depression or PTSD.

    Science.gov (United States)

    Thünker, Johanna; Pietrowsky, Reinhard

    2012-09-01

    Nightmares are a common and serious problem in psychotherapeutic practice, although they are seldom considered as independent mental disorders. There are some promising approaches to the treatment of nightmares, notably Imagery Rehearsal Therapy, a cognitive-restructuring treatment. The core of this approach is the modification of the nightmare script and repeated imagination of the new script. However, most evaluation surveys have been conducted only with trauma patients, and thus far there is no standardized manual in the German language. 69 participants were examined using self-rating questionnaires. Participants belonged to three groups: 22 primarily nightmare sufferers, 21 patients with major depression and nightmares, 26 with PTSD and nightmares. 12 of the PTSD patients were randomly assigned to a control condition. Primary outcome measures were nightmare frequency and anxiety during nightmares. Overall, nightmare frequency and the anxiety they caused decreased following the treatment. Nightmare frequency and anxiety during the nightmares were highest in the PTSD group initially. Nightmare frequency decreased in all groups. Anxiety scores decreased least in PTSD patients, in depressive patients and primarily nightmare sufferers anxiety scores decreased during intervention. In primarily nightmare sufferers anxiety remained low up to the catamnesis period as well. Thus, those who suffered primarily from nightmares showed the strongest benefit from the nightmare treatment. PMID:22738908

  9. Comparison of Dry Needling versus Orthopedic Manual Therapy in Patients with Myofascial Chronic Neck Pain: A Single-Blind, Randomized Pilot Study

    Directory of Open Access Journals (Sweden)

    Irene Campa-Moran

    2015-01-01

    Full Text Available Objective. The aim of this study was to compare the efficacy of three interventions for the treatment of myofascial chronic neck pain. Methods. Thirty-six patients were randomly assigned to one of three intervention groups: orthopedic manual therapy (OMT, dry needling and stretching (DN-S, and soft tissue techniques (STT. All groups received two treatment sessions with a 48 h time interval. Outcome measures included neck pain intensity measured using a visual analogue scale, cervical range of motion (ROM, pressure pain threshold for measuring mechanical hyperalgesia, and two self-reported questionnaires (neck disability index and pain catastrophizing scale. Results. The ANOVA revealed significant differences for the group × time interaction for neck disability, neck pain intensity, and pain catastrophizing. The DN-S and OMT groups reduced neck disability. Only the OMT group showed decreases in mechanical hyperalgesia and pain catastrophizing. The cervical ROM increased in OMT (i.e., flexion, side-bending, and rotation and DN-S (i.e., side-bending and rotation groups. Conclusions. The three interventions are all effective in reducing pain intensity. Reduction in mechanical hyperalgesia and pain catastrophizing was only observed in the OMT group. Cervical ROM improved in the DN-S and OMT groups and also neck disability being only clinically relevant for OMT group.

  10. Comparison of Dry Needling versus Orthopedic Manual Therapy in Patients with Myofascial Chronic Neck Pain: A Single-Blind, Randomized Pilot Study.

    Science.gov (United States)

    Campa-Moran, Irene; Rey-Gudin, Etelvina; Fernández-Carnero, Josué; Paris-Alemany, Alba; Gil-Martinez, Alfonso; Lerma Lara, Sergio; Prieto-Baquero, Almudena; Alonso-Perez, José Luis; La Touche, Roy

    2015-01-01

    Objective. The aim of this study was to compare the efficacy of three interventions for the treatment of myofascial chronic neck pain. Methods. Thirty-six patients were randomly assigned to one of three intervention groups: orthopedic manual therapy (OMT), dry needling and stretching (DN-S), and soft tissue techniques (STT). All groups received two treatment sessions with a 48 h time interval. Outcome measures included neck pain intensity measured using a visual analogue scale, cervical range of motion (ROM), pressure pain threshold for measuring mechanical hyperalgesia, and two self-reported questionnaires (neck disability index and pain catastrophizing scale). Results. The ANOVA revealed significant differences for the group × time interaction for neck disability, neck pain intensity, and pain catastrophizing. The DN-S and OMT groups reduced neck disability. Only the OMT group showed decreases in mechanical hyperalgesia and pain catastrophizing. The cervical ROM increased in OMT (i.e., flexion, side-bending, and rotation) and DN-S (i.e., side-bending and rotation) groups. Conclusions. The three interventions are all effective in reducing pain intensity. Reduction in mechanical hyperalgesia and pain catastrophizing was only observed in the OMT group. Cervical ROM improved in the DN-S and OMT groups and also neck disability being only clinically relevant for OMT group. PMID:26640708

  11. User's manual of a supporting system for treatment planning in boron neutron capture therapy. JAERI computational dosimetry system

    CERN Document Server

    Kumada, H

    2002-01-01

    A boron neutron capture therapy (BNCT) with epithermal neutron beam is expected to treat effectively for malignant tumor that is located deeply in the brain. It is indispensable to estimate preliminarily the irradiation dose in the brain of a patient in order to perform the epithermal neutron beam BNCT. Thus, the JAERI Computational Dosimetry System (JCDS), which can calculate the dose distributions in the brain, has been developed. JCDS is a software that creates a 3-dimensional head model of a patient by using CT and MRI images and that generates a input data file automatically for calculation neutron flux and gamma-ray dose distribution in the brain by the Monte Carlo code: MCNP, and that displays the dose distribution on the head model for dosimetry by using the MCNP calculation results. JCDS has any advantages as follows; By treating CT data and MRI data which are medical images, a detail three-dimensional model of patient's head is able to be made easily. The three-dimensional head image is editable to ...

  12. Effects of an exercise and manual therapy program on physical impairments, function and quality-of-life in people with osteoporotic vertebral fracture: a randomised, single-blind controlled pilot trial

    OpenAIRE

    Sherburn Margaret; Kelly Anne; Briggs Andrew; Greig Alison; Matthews Bernadette; Bennell Kim L; Larsen Judy; Wark John

    2010-01-01

    Abstract Background This randomised, single-blind controlled pilot trial aimed to determine the effectiveness of a physiotherapy program, including exercise and manual therapy, in reducing impairments and improving physical function and health-related quality of life in people with a history of painful osteoporotic vertebral fracture. Methods 20 participants were randomly allocated to an intervention (n = 11) or control (n = 9) group. The intervention group attended individual sessions with a...

  13. Biosafety Manual

    Energy Technology Data Exchange (ETDEWEB)

    King, Bruce W.

    2010-05-18

    Work with or potential exposure to biological materials in the course of performing research or other work activities at Lawrence Berkeley National Laboratory (LBNL) must be conducted in a safe, ethical, environmentally sound, and compliant manner. Work must be conducted in accordance with established biosafety standards, the principles and functions of Integrated Safety Management (ISM), this Biosafety Manual, Chapter 26 (Biosafety) of the Health and Safety Manual (PUB-3000), and applicable standards and LBNL policies. The purpose of the Biosafety Program is to protect workers, the public, agriculture, and the environment from exposure to biological agents or materials that may cause disease or other detrimental effects in humans, animals, or plants. This manual provides workers; line management; Environment, Health, and Safety (EH&S) Division staff; Institutional Biosafety Committee (IBC) members; and others with a comprehensive overview of biosafety principles, requirements from biosafety standards, and measures needed to control biological risks in work activities and facilities at LBNL.

  14. Evidence-based medicine and its implications for the profession of chiropractic.

    Science.gov (United States)

    Villanueva-Russell, Yvonne

    2005-02-01

    Evidence-based medicine (EBM) has grown in popularity and prominence in the world of orthodox medicine since the 1980s. The focus of this article is on the process of developing practice guidelines (one type of EBM) and its effects upon chiropractic, a profession with a "philosophy, science and art" that is constructed upon divergent epistemological and methodological tenets (namely, the idea of "vitalism"). The EBM movement is conceptualized as part of a larger political economy surrounding the health care environment that creates a new set of imperatives for orthodox medicine, and also branches of alternative medicine that are in the process of professionalization. The quantitative, positivist and empiricist assumptions of EBM dictate which approaches to treatment and which clinical procedures are legitimate and perhaps reimbursable under systems of managed care. The ramifications of practice guidelines and its effects upon the intraprofessional segments of the chiropractic profession are also discussed. PMID:15550303

  15. Cortex-sparing infarction in triple cervical artery dissection following chiropractic neck manipulation

    Science.gov (United States)

    Melikyan, Gayane; Kamran, Saadat; Akhtar, Naveed; Deleu, Dirk; Miyares, Francisco Ruiz

    2015-01-01

    Background: Multivessel cervical dissection with cortical sparing is exceptional in clinical practice. Case presentation: A 55-year-old man presented with acute-onset neck pain with associated sudden onset right-sided hemiparesis and dysphasia after chiropractic manipulation for chronic neck pain. Results and Discussion: Magnetic resonance imaging revealed bilateral internal carotid artery dissection and left extracranial vertebral artery dissection with bilateral anterior cerebral artery territory infarctions and large cortical-sparing left middle cerebral artery infarction. This suggests the presence of functionally patent and interconnecting leptomeningeal anastomoses between cerebral arteries, which may provide sufficient blood flow to salvage penumbral regions when a supplying artery is occluded. Conclusion: Chiropractic cervical manipulation can result in catastrophic vascular lesions preventable if these practices are limited to highly specialized personnel under very specific situations. PMID:26835412

  16. Improvement of lower extremity electrodiagnostic findings following a trial of spinal manipulation and motion-based therapy

    Directory of Open Access Journals (Sweden)

    Morningstar Mark W

    2006-09-01

    Full Text Available Abstract Background Lumbar disc herniation is a problem frequently encountered in manual medicine. While manual therapy has shown reasonable success in symptomatic management of these cases, little information is known how manual therapy may affect the structure and function of the lumbar disc itself. In cases where lumbar disc herniation is accompanied by radicular symptoms, electrodiagnostic testing has been used to provide objective clinical information on nerve function. This report examines the treatment rendered for a patient with lower extremity neurological deficit, as diagnosed on electrodiagnostic testing. Patient was treated using spinal manipulation and exercises performed on a Pettibon Wobble Chair™, using electrodiagnostic testing as the primary outcome assessment. Case Presentation An elderly male patient presented to a private spine clinic with right-sided foot drop. He had been prescribed an ankle-foot orthosis for this condition. All sensory, motor, and reflex findings in the right leg and foot were absent. This was validated on prior electromyography and nerve conduction velocity testing, performed by a board certified neurologist. Patient was treated using spinal manipulation twice-weekly and wobble chair exercises three times daily for 90 days total. Following this treatment, the patient was referred for follow-up electrodiagnostic studies. Significant improvements were made in these studies as well as self-rated daily function. Conclusion Motion-based therapies, as part of a comprehensive rehabilitation program, may contribute to the restoration of daily function and the reversal of neurological insult as detected by electrodiagnostic testing. Electrodiagnostic testing may be a useful clinical tool to evaluate the progress of chiropractic patients with lumbar disc herniation and radicular pain syndromes.

  17. Manual therapy for the management of pain and limited range of motion in subjects with signs and symptoms of temporomandibular disorder: a systematic review of randomised controlled trials.

    Science.gov (United States)

    Calixtre, L B; Moreira, R F C; Franchini, G H; Alburquerque-Sendín, F; Oliveira, A B

    2015-11-01

    There is a lack of knowledge about the effectiveness of manual therapy (MT) on subjects with temporomandibular disorders (TMD). The aim of this systematic review is to synthetise evidence regarding the isolated effect of MT in improving maximum mouth opening (MMO) and pain in subjects with signs and symptoms of TMD. MEDLINE(®) , Cochrane, Web of Science, SciELO and EMBASE(™) electronic databases were consulted, searching for randomised controlled trials applying MT for TMD compared to other intervention, no intervention or placebo. Two authors independently extracted data, PEDro scale was used to assess risk of bias, and GRADE (Grading of Recommendations Assessment, Development and Evaluation) was applied to synthetise overall quality of the body of evidence. Treatment effect size was calculated for pain, MMO and pressure pain threshold (PPT). Eight trials were included, seven of high methodological quality. Myofascial release and massage techniques applied on the masticatory muscles are more effective than control (low to moderate evidence) but as effective as toxin botulinum injections (moderate evidence). Upper cervical spine thrust manipulation or mobilisation techniques are more effective than control (low to high evidence), while thoracic manipulations are not. There is moderate-to-high evidence that MT techniques protocols are effective. The methodological heterogeneity across trials protocols frequently contributed to decrease quality of evidence. In conclusion, there is widely varying evidence that MT improves pain, MMO and PPT in subjects with TMD signs and symptoms, depending on the technique. Further studies should consider using standardised evaluations and better study designs to strengthen clinical relevance. PMID:26059857

  18. Cost-effectiveness of chiropractic care versus self-management in patients with musculoskeletal chest pain

    OpenAIRE

    Stochkendahl, Mette Jensen; Sørensen, Jan; Vach, Werner; Christensen, Henrik Wulff; Høilund-Carlsen, Poul Flemming; Hartvigsen, Jan

    2016-01-01

    Aims To assess whether primary sector healthcare in the form of chiropractic care is cost-effective compared with self-management in patients with musculoskeletal chest pain, that is, a subgroup of patients with non-specific chest pain. Methods and results 115 adults aged 18–75 years with acute, non-specific chest pain of musculoskeletal origin were recruited from a cardiology department in Denmark. After ruling out acute coronary syndrome and receiving usual care, patients with musculoskelet...

  19. Internal carotid artery dissection following chiropractic treatment in a pregnant woman with Systemic Lupus Erythematosus

    OpenAIRE

    Morton Adam

    2012-01-01

    Abstract A case of internal carotid artery dissection in a pregnant woman with Systemic Lupus Erythematosus (SLE) immediately following chiropractic treatment is presented. The literature regarding complications of neck manipulation during pregnancy, spontaneous dissection of craniocervical arteries in pregnancy and the postpartum period, and dissection of craniocervical arteries in SLE are reviewed. To the best of the author’s knowledge, this is the first case of carotid artery dissection fo...

  20. The perceptions, attitudes and knowledge of physiotherapy and chiropractic students regarding each others’ professional practice

    OpenAIRE

    Naidoo, N; Bühler, L.

    2009-01-01

    Introduction: The roles of physiotherapists and chiropractors demon-strate some overlap. Both are members of a multidisciplinary team and contributeto the holistic care of patients. Good understanding of each others’ professionalpractice may lead to good working relationships with effective referrals, inter -disciplinary and multidisciplinary management of patients. Purpose: To investigate the perceptions, attitudes and knowledge of undergraduatephysiotherapy and chiropractic students about e...

  1. Cortex-sparing infarction in triple cervical artery dissection following chiropractic neck manipulation

    OpenAIRE

    Melikyan, Gayane; Kamran, Saadat; Akhtar, Naveed; Deleu, Dirk; Miyares, Francisco Ruiz

    2016-01-01

    Background: Multivessel cervical dissection with cortical sparing is exceptional in clinical practice. Case presentation: A 55-year-old man presented with acute-onset neck pain with associated sudden onset right-sided hemiparesis and dysphasia after chiropractic manipulation for chronic neck pain. Results and Discussion: Magnetic resonance imaging revealed bilateral internal carotid artery dissection and left extracranial vertebral artery dissection with bilateral anterior cerebral artery ter...

  2. Brief screening questions for depression in chiropractic patients with low back pain

    DEFF Research Database (Denmark)

    Kongsted, Alice; Aambakk, Benedicte; Bossen, Sanne;

    2014-01-01

    Depression is an important prognostic factor in low back pain (LBP) that appears to be infrequent in chiropractic populations. Identification of depression in few patients would consequently implicate screening of many. It is therefore desirable to have brief screening tools for depression. The...... objective of this study was to investigate if one or two items from the Major Depression Inventory (MDI) could be a reasonable substitute for the complete scale....

  3. Computer Manual.

    Science.gov (United States)

    Illinois State Office of Education, Springfield.

    This manual designed to provide the teacher with methods of understanding the computer and its potential in the classroom includes four units with exercises and an answer sheet. Unit 1 covers computer fundamentals, the mini computer, programming languages, an introduction to BASIC, and control instructions. Variable names and constants described…

  4. A comparison of manual therapy and active rehabilitation in the treatment of non specific low back pain with particular reference to a patient's Linton & Hallden psychological screening score: a pilot study

    Directory of Open Access Journals (Sweden)

    Stephenson Richard

    2007-11-01

    Full Text Available Abstract Background Clinical guidelines for the management of back pain frequently recommend 'manual therapy' as a first line intervention, with psychosocial screening and 'active rehabilitation' for those not improving at 6 weeks post onset. The potential for psychosocial factors to predict treatment response and therefore outcome has not been adequately explored. The purpose of this pilot study was to determine the feasibility of a study to compare manual therapy and active rehabilitation outcomes for subjects with sub-acute/chronic back pain, investigate whether any difference in outcome was related to psychosocial factors, and to inform the design of a main study. Methods A convenience sample of 39 patients with non-specific low back pain referred to the physiotherapy department of an acute NHS Trust hospital was recruited over a nine month period. Patients completed the Linton and Hallden psychological screening questionnaire (LH and were allocated to a low LH (105 or below or high LH (106 or above scoring group. The low or high LH score was used to sequentially allocate patients to one of two treatment groups – Manual Therapy comprising physiotherapy based on manual means as chosen by the treating therapist or Active Rehabilitation comprising a progressive exercise and education programme – with the first low LH scoring patient being allocated to active rehabilitation and the next to manual therapy and so on. Treatment was administered for eight sessions over a four-week period and outcome measures were taken at baseline and at four weeks. Measures used were the Roland Morris Questionnaire (RMQ, two components of the Short Form McGill (total pain rating index [PRI] and pain intensity via visual analogue scale [VAS], and the LH. Results The manual therapy group demonstrated a greater treatment effect compared with active rehabilitation for RMQ (mean difference 3.6, 95% CI 1.1 – 6.2, p = 0.006 and PRI (7.1, 95% CI 2.0 – 12.2, p = 0

  5. International web survey of chiropractic students about evidence-based practice: a pilot study

    Directory of Open Access Journals (Sweden)

    Banzai Ryunosuke

    2011-03-01

    Full Text Available Abstract Background Positive attitude toward evidence-based practice (EBP principles in healthcare education may be one of the first steps for motivating a healthcare professional student to later apply EBP principles in clinical decision-making. The objectives for this project were to pilot an international web-based survey of chiropractic students and to describe student attitudes, behaviors, and knowledge about EBP principles. Methods We used SurveyMonkey™ to develop our survey based on an existing questionnaire used to measure basic knowledge, skills and beliefs about EBP among allied healthcare professionals and CAM practitioners. We invited 26 chiropractic educational institutions teaching in English and accredited by official organizations to participate. Academic officials and registrars at participating institutions forwarded an invitation email and two reminders to students between July and September 2010. The invitation contained a link to the 38-item web-based questionnaire. Descriptive statistics were performed for analysis. Results Fourteen institutions from Australia, Canada, US, Denmark and New Zealand participated. Among an estimated 7,142 student recipients of invitation letters, 674 participated in the survey for an estimated response rate of 9.4%. Most respondents reported having access to medical/healthcare literature through the internet, but only 11% read literature every week and 21% did not read literature at all. Respondents generally agreed that the use of research evidence in chiropractic was important. Although 76% of respondents found it easy to understand research evidence and 81% had some level of confidence assessing the general worth of research articles, 71% felt they needed more training in EBP to be able to apply evidence in chiropractic care. Respondents without previous training in research methods had lower confidence in assessing published papers. While more than 60% marked the correct answer for two

  6. Creating European guidelines for Chiropractic Incident Reporting and Learning Systems (CIRLS: relevance and structure

    Directory of Open Access Journals (Sweden)

    Wangler Martin

    2011-04-01

    Full Text Available Abstract Background In 2009, the heads of the Executive Council of the European Chiropractors' Union (ECU and the European Academy of Chiropractic (EAC involved in the European Committee for Standardization (CEN process for the chiropractic profession, set out to establish European guidelines for the reporting of adverse reactions to chiropractic treatment. There were a number of reasons for this: first, to improve the overall quality of patient care by aiming to reduce the application of potentially harmful interventions and to facilitate the treatment of patients within the context of achieving maximum benefit with a minimum risk of harm; second, to inform the training objectives for the Graduate Education and Continuing Professional Development programmes of all 19 ECU member nations, regarding knowledge and skills to be acquired for maximising patient safety; and third, to develop a guideline on patient safety incident reporting as it is likely to be part of future CEN standards for ECU member nations. Objective To introduce patient safety incident reporting within the context of chiropractic practice in Europe and to help individual countries and their national professional associations to develop or improve reporting and learning systems. Discussion Providing health care of any kind, including the provision of chiropractic treatment, can be a complex and, at times, a risky activity. Safety in healthcare cannot be guaranteed, it can only be improved. One of the most important aspects of any learning and reporting system lies in the appropriate use of the data and information it gathers. Reporting should not just be seen as a vehicle for obtaining information on patient safety issues, but also be utilised as a tool to facilitate learning, advance quality improvement and to ultimately minimise the rate of the occurrence of errors linked to patient care. Conclusions Before a reporting and learning system can be established it has to be clear

  7. Metrication manual

    International Nuclear Information System (INIS)

    In April 1978 a meeting of senior metrication officers convened by the Commonwealth Science Council of the Commonwealth Secretariat, was held in London. The participants were drawn from Australia, Bangladesh, Britain, Canada, Ghana, Guyana, India, Jamaica, Papua New Guinea, Solomon Islands and Trinidad and Tobago. Among other things, the meeting resolved to develop a set of guidelines to assist countries to change to SI and to compile such guidelines in the form of a working manual

  8. Curriculum reform in a public health course at a chiropractic college: are we making progress toward improving clinical relevance?

    Science.gov (United States)

    Borody, Cameron; Till, Hettie

    2007-01-01

    Improving education in health promotion and prevention has been identified as a priority for all accredited professional health care training programs, an issue recently addressed by a collaboration of stakeholders in chiropractic education who developed a model course outline for public health education. Using a course evaluation questionnaire, the authors surveyed students in the public health course at the Canadian Memorial Chiropractic College (CMCC) before and after the implementation of new course content based on the model course outline. Following the new course, there were significant improvements in perceived relevance to chiropractic practice and motivation to learn the material as a foundation for clinical practice. Changes made to the content and delivery of the course based on the model course outline were well received in the short term. PMID:18483637

  9. 手法治疗脑卒中口腔期吞咽障碍临床观察%Clinical Observation on Manual Therapy for the Treatment of Oral Phase Dysphagia of Stroke

    Institute of Scientific and Technical Information of China (English)

    程玉花; 郭艳芹; 栾冰; 程亭秀

    2013-01-01

    Objective:To investigate the clinical efficacy of manual therapy for the treatment of oral phase dysphagia of stroke. Methods: 12 patients with oral phase dysphagia of stroke were given manual therapy on the basis of the conventional dysphagia training. Results: Among 12 patients,5 patients with swallowing disorders were significantly improved; the swallowing organ movement of three cases changed from passive movement to voluntary movement; the muscle strength of swallowing organs in four cases was significantly improved and the effective rate was 100% . Conclusion: The application of manual therapy in the oral phase dysphagia training is a reliable and effective treatment method, which is simple for operation.%目的:探讨手法治疗脑卒中口腔期吞咽障碍的临床疗效.方法:对12例脑卒中口腔期吞咽障碍患者在常规吞咽障碍训练基础上采用手法治疗.结果:12例患者中5例吞咽障碍明显改善;3例吞咽器官运动从被动运动变为自主运动;4例吞咽器官肌肉力量明显改善,有效率为100%.结论:在对口腔期吞咽障碍患者训练中应用手法治疗是一种疗效可靠、操作简单易行,疗效显著的方法.

  10. 手法治疗肩关节脱位并发症的早期预防及护理%Early prevention and nursing of complications of shoulder joint dislocation patients treated by manual therapy

    Institute of Scientific and Technical Information of China (English)

    程俊阳; 张凤清; 方军

    2016-01-01

    总结了手法治疗肩关节脱位并发症的早期预防和护理方法,为进一步探讨有效的肩关节脱位并发症防治手法提供借鉴。%It summarized the early prevention and nursing of complications of shoulder j oint dislocation patients treated by manual therapy,so as to further provide references for the effective preventions and treatment of complications of patients with shoulder j oint dislocation.

  11. Collaborative Care for Older Adults with low back pain by family medicine physicians and doctors of chiropractic (COCOA)

    DEFF Research Database (Denmark)

    Goertz, Christine M; Salsbury, Stacie A; Vining, Robert D;

    2013-01-01

    one month, from a community-based sample in the Quad-Cities, Iowa/Illinois, USA. Eligible participants are allocated in a 1:1:1 ratio to receive 12 weeks of medical care, concurrent medical and chiropractic care, or collaborative medical and chiropractic care. Primary outcomes are self-rated back pain...... also are evaluated. Process outcomes are assessed through qualitative interviews with study participants and research clinicians, chart audits of progress notes and content analysis of clinical trial notes. DISCUSSION: This pragmatic, pilot randomized controlled trial uses a mixed method approach to...

  12. Pdap Manual

    DEFF Research Database (Denmark)

    Pedersen, Mads Mølgaard; Larsen, Torben J.

    Pdap, Python Data Analysis Program, is a program for post processing, analysis, visualization and presentation of data e.g. simulation results and measurements. It is intended but not limited to the domain of wind turbines. It combines an intuitive graphical user interface with python scripting...... that allows automation and implementation of custom functions. This manual gives a short introduction to the graphical user interface, describes the mathematical background for some of the functions, describes the scripting API and finally a few examples on how automate analysis via scripting is...

  13. Effects of Expanded Coverage for Chiropractic Services on Medicare Costs in a CMS Demonstration

    Science.gov (United States)

    Stason, William B.; Ritter, Grant A; Prottas, Jeffrey; Tompkins, Christopher; Shepard, Donald S.

    2016-01-01

    Background Moderately convincing evidence supports the benefits of chiropractic manipulations for low back pain. Its effectiveness in other applications is less well documented, and its cost-effectiveness is not known. These questions led the Centers for Medicaid and Medicare Services (CMS) to conduct a two-year demonstration of expanded Medicare coverage for chiropractic services in the treatment of beneficiaries with neuromusculoskeletal (NMS) conditions affecting the back, limbs, neck, or head. Methods The demonstration was conducted in 2005–2007 in selected counties of Illinois, Iowa, and Virginia and the entire states of Maine and New Mexico. Medicare claims were compiled for the preceding year and two demonstration years for the demonstration areas and matched comparison areas. The impact of the demonstration was analyzed through multivariate regression analysis with a difference-in-difference framework. Results Expanded coverage increased Medicare expenditures by $50 million or 28.5% in users of chiropractic services and by $114 million or 10.4% in all patients treated for NMS conditions in demonstration areas during the two-year period. Results varied widely among demonstration areas ranging from increased costs per user of $485 in Northern Illinois and Chicago counties to decreases in costs per user of $59 in New Mexico and $178 in Scott County, Iowa. Conclusion The demonstration did not assess possible decreases in costs to other insurers, out-of-pocket payments by patients, the need for and costs of pain medications, or longer term clinical benefits such as avoidance of orthopedic surgical procedures beyond the two-year period of the demonstration. It is possible that other payers or beneficiaries saved money during the demonstration while costs to Medicare were increased. PMID:26928221

  14. Effects of Expanded Coverage for Chiropractic Services on Medicare Costs in a CMS Demonstration.

    Directory of Open Access Journals (Sweden)

    William B Stason

    Full Text Available Moderately convincing evidence supports the benefits of chiropractic manipulations for low back pain. Its effectiveness in other applications is less well documented, and its cost-effectiveness is not known. These questions led the Centers for Medicaid and Medicare Services (CMS to conduct a two-year demonstration of expanded Medicare coverage for chiropractic services in the treatment of beneficiaries with neuromusculoskeletal (NMS conditions affecting the back, limbs, neck, or head.The demonstration was conducted in 2005-2007 in selected counties of Illinois, Iowa, and Virginia and the entire states of Maine and New Mexico. Medicare claims were compiled for the preceding year and two demonstration years for the demonstration areas and matched comparison areas. The impact of the demonstration was analyzed through multivariate regression analysis with a difference-in-difference framework.Expanded coverage increased Medicare expenditures by $50 million or 28.5% in users of chiropractic services and by $114 million or 10.4% in all patients treated for NMS conditions in demonstration areas during the two-year period. Results varied widely among demonstration areas ranging from increased costs per user of $485 in Northern Illinois and Chicago counties to decreases in costs per user of $59 in New Mexico and $178 in Scott County, Iowa.The demonstration did not assess possible decreases in costs to other insurers, out-of-pocket payments by patients, the need for and costs of pain medications, or longer term clinical benefits such as avoidance of orthopedic surgical procedures beyond the two-year period of the demonstration. It is possible that other payers or beneficiaries saved money during the demonstration while costs to Medicare were increased.

  15. Lost and Found, Letters and Methods: Assessing Attitudes toward Chiropractic and Medical Care

    Directory of Open Access Journals (Sweden)

    William H. Yeaton

    2010-01-01

    Full Text Available Attitudes toward traditional and chiropractic medicine were compared using Milgram's lost letter technique. A total of 192 letters were placed on the windshields of vehicles in parking lots at six restaurants and department stores in each of four quadrants of a medium-sized, Southeastern city. These letters were addressed to "Admissions" at either a fictitious Institute of Medicine or Institute of Chiropractic Care. Return addresses included either a male or a female name. Thus, those who found a lost letter were faced with the option of returning or not returning a letter from either a male or a female, addressed to an Institute of traditional or non-traditional medicine. After examining previous studies which had used the lost letter technique, numerous methodological improvements were implemented. For example, letters were randomly assigned to potential drop spots for each of 24 study locations (six study locations in each of four city quadrants, and a Latin square design was used to control for possible order effects in the four study conditions that were implemented. Nearly 65% of the letters (124 of 192 were returned. We found: 1 letters addressed to a fictitious Institute of Chiropractic Care were just as likely to be returned as those addressed to a fictitious Institute of Medicine; 2 letters with female return addresses were as likely to be returned as those with male return addresses; 3 there was no interaction between study conditions; 4 based on what was essentially a replication study, a comparison of the pattern of returns using the first and second cycle of lost letters (n = 96 for each cycle revealed an equivalent pattern of no-difference findings.

  16. A demographic and epidemiological study of a Mexican chiropractic college public clinic

    Directory of Open Access Journals (Sweden)

    Ndetan Harrison T

    2009-03-01

    Full Text Available Abstract Background Descriptive studies of chiropractic patients are not new, several have been performed in the U.S., Australia, Canada, and Europe. None have been performed in a Latin American country. The purpose of this study is to describe the patients who visited a Mexican chiropractic college public clinic with respect to demographics and clinical characteristics. Methods This study was reviewed and approved by the IRB of Parker College of Chiropractic and the Universidad Estatal del Valle de Ecatepec (UNEVE. Five hundred patient files from the UNEVE public clinic from May 2005 to May 2007 were selected from an approximate total number of 3,700. Information was collected for demographics, chief complaints, associated complaints, and previous care sought. Results The sample comprised 306 (61.2% female. Most files (44.2% were in the age range of 40–59 years (mean of 43.4 years. The most frequent complaints were lumbar pain (29.2% and extremity pain (28.0%, most commonly the knee. Most (62.0% described their complaints as greater than one year. Trauma (46.6% was indicated as the initial cause. Mean VAS score was 6.26/10 with 20% rated at 8/10. Conclusion Demographic results compared closer to studies conducted with private clinicians (females within the ages of 40–59. The primary complaint and duration was similar to previous studies (low back pain and chronic, except in this population the cause was usually initiated by trauma. The most striking features were the higher number of extremity complaints and the marked increased level of VAS score (20% rated as 8/10.

  17. Experiences of nursing professionals in alternative and complementing therapies applied to people in pain situations

    OpenAIRE

    Vanegas de Ahogado, Blanca Cecilia; CALDERÓN PERILLA, ARNOL YAMID; LARA SUÁREZ, PAOLA MILENA; FORERO ARCHBOLD, ANDRÉS; MARÍN ARIZA, DIEGO ANDRÉS; CELIS RINCÓN, ADRIANA

    2010-01-01

    To know the experiences of nursing professionals on the use of alternative and complementing therapies applied during health care to people in pain situations, a qualitative study was carried out, as a graduation project for a group of nursing students –undergraduates– from the Universidad del Bosque, between 2005 and 2007, in which four nursing professionals took part. They had several years of experience in the use of floral therapy, acupuncture, homeopathy, chiropractic massage therapy and...

  18. Inappropriate use of the title 'chiropractor' and term 'chiropractic manipulation' in the peer-reviewed biomedical literature

    Directory of Open Access Journals (Sweden)

    Wenban Adrian B

    2006-08-01

    Full Text Available Abstract Background The misuse of the title 'chiropractor' and term 'chiropractic manipulation', in relation to injury associated with cervical spine manipulation, have previously been reported in the peer-reviewed literature. The objectives of this study were to - 1 Prospectively monitor the peer-reviewed literature for papers reporting an association between chiropractic, or chiropractic manipulation, and injury; 2 Contact lead authors of papers that report such an association in order to determine the basis upon which the title 'chiropractor' and/or term 'chiropractic manipulation' was used; 3 Document the outcome of submission of letters to the editors of journals wherein the title 'chiropractor', and/or term 'chiropractic manipulation', had been misused and resulted in the over-reporting of chiropractic induced injury. Methods One electronic database (PubMed was monitored prospectively, via monthly PubMed searches, during a 12 month period (June 2003 to May 2004. Once relevant papers were located, they were reviewed. If the qualifications and/or profession of the care provider/s were not apparent, an attempt was made to confirm them via direct e-mail communication with the principal researcher of each respective paper. A letter was then sent to the editor of each involved journal. Results A total of twenty four different cases, spread across six separate publications, were located via the monthly PubMed searches. All twenty four cases took place in one of two European countries. The six publications consisted of four case reports, each containing one patient, one case series, involving twenty relevant cases, and a secondary report that pertained to one of the four case reports. In each of the six publications the authors suggest the care provider was a chiropractor and that each patient received chiropractic manipulation of the cervical spine prior to developing symptoms suggestive of traumatic injury. In two of the four case reports

  19. Case management of chiropractic patients with cervical brachialgia: A survey of French chiropractors

    Directory of Open Access Journals (Sweden)

    Guenoun Olivier

    2011-09-01

    Full Text Available Abstract Background Not much is known about the French chiropractic profession on, for example, level of consensus on clinical issues. Objectives The first objective was to investigate if French chiropractors' management choices appeared reasonable for various neck problem scenarios. The second objective was to investigate if there was agreement between chiropractors on the patient management. The third objective was to see to which degree and at what stages chiropractors would consider to interact with other health-care practitioners, such as physiotherapists, general practitioners and specialists. Method A questionnaire was sent to a randomly selected sample of all French chiropractors known to the national chiropractic college. It consisted of an invitation to participate in the study, a brief case description, and drawings of five stages of how a case of neck pain gradually evolves into a brachialgia to end up with a compromised spinal cord. Each stage offered five management choices. Participants were asked at what stages patients would be treated solely by the chiropractor and when patients would be referred out for second opinion or other care without chiropractic treatment, plus an open ended option, resulting in a "five-by-six" table. The percentages of respondents choosing the different management strategies were identified for the different scenarios and the 95% confidence intervals were calculated. There was a pre hoc agreement on when chiropractic care would or would not be suitable. Consensus was arbitrarily defined as "moderate" when 50- 69% of respondents agreed on the same management choice and as "excellent" when 70% or more provided the same answer. It was expected that inter professional contacts would be rare. Results The response rate was 53% out of 254 potential participants. The first two uncomplicated cases would generally have been treated by the chiropractors. As the patient worsened, the responses tended towards

  20. Complementary and alternative treatment for neck pain: chiropractic, acupuncture, TENS, massage, yoga, Tai Chi, and Feldenkrais.

    Science.gov (United States)

    Plastaras, Christopher T; Schran, Seth; Kim, Natasha; Sorosky, Susan; Darr, Deborah; Chen, Mary Susan; Lansky, Rebecca

    2011-08-01

    Of the multitude of treatment options for the management of neck pain, no obvious single treatment modality has been shown to be most efficacious. As such, the clinician should consider alternative treatment modalities if a modality is engaging, available, financially feasible, potentially efficacious, and is low risk for the patient. As evidence-based medicine for neck pain develops, the clinician is faced with the challenge of which treatments to encourage patients to pursue. Treatment modalities explored in this article, including chiropractic, acupuncture, TENS, massage, yoga, Tai Chi, and Feldenkrais, represent reasonable complementary and alternative medicine methods for patients with neck pain. PMID:21824591

  1. Chiropractic patients in Denmark 2002: an expanded description and comparison with 1999 survey

    DEFF Research Database (Denmark)

    Sorensen, Line Press; Stochkendahl, Mette Jensen; Hartvigsen, Jan; Nilsson, Niels Grunnet

    2006-01-01

    randomly assigned week in 2002 using a survey questionnaire. All 52 weeks of the year 2002 were represented with an even dispersion of weeks (182 clinics participated). Outcome measures included age, sex, education, occupation, location and duration of chief complaint, pain intensity, limitation of...... activities of daily living, mode of referral, duration of sick leave, previous treatments, comorbidity, SF-12, smoking habits, and use of x-ray. RESULTS: Eighty-five percent of all chiropractic clinics in Denmark participated in the study, and 1595 patients (81%) filled out a self-administered questionnaire...

  2. Intervenção fisioterapêutica nas sequelas de drenagem linfática manual iatrogênica: relato de caso Physical therapy in sequelae of iatrogenic manual lymphatic drainage: a case report

    OpenAIRE

    Rogério Eduardo Tacani; Pascale Mutti Tacani; Richard Eloin Liebano

    2011-01-01

    Atualmente, a drenagem linfática manual (DLM) é um dos recursos de grande destaque no tratamento de edemas, linfedemas e condições inestéticas, porém, na prática clínica têm-se observado sua aplicação de forma iatrogênica. Os objetivos deste relato de caso foram apontar as sequelas da aplicação iatrogênica da DLM, em uma jovem caucasiana, e verificar os efeitos da intervenção fisioterapêutica no tratamento dessas. Voluntária de 27 anos, apresentava-se com uma equimose importante na região lat...

  3. 手法治疗下腰痛临床随机对照试验的Meta分析%Effect of manual therapy on patients with low back pain:a meta-analysis

    Institute of Scientific and Technical Information of China (English)

    梁飞凡; 陈威烨; 陈博; 王辉昊; 徐勤光; 詹红生

    2016-01-01

    Objective To systematically review the clinical efficacy of manual therapy on the patients with Low Back Pain( LBP) . Methods Randomized controlled trials ( RCTs) focusing on manual therapy versus other treatments in treating LBP were electronically searched in PubMed, CBM ,EMbase, Cochrane Library, CNKI, VIP and WanFang Data ( search timespan: 2004-2014 ) . Two reviewers independently screened literature according to the inclusion and exclusion criteria, and then they performed data extraction and quality assessment. The results of Meta-Analysis were generated by RevMan 5. 2 software. Results Nine RCTs involved 939 patients were included. The results of Meta-Analysis indicated that:compared with the control group, Manual therapy significantly improved VAS score [ MD=-1. 05, 95%CI (-1. 25,-0. 86),P<0. 00001], ODI score [MD=-7. 40,95%CI (-12. 04,-2. 76),P=0. 002], and JOA score[SMD=1. 82,95%CI (0. 50,3. 13),P=0. 007]. There was significant difference between the manual therapy and control groups. Conclusion Manual therapy could improve LBP patients’ pain intensity, lumbar function and activity. Due to limited quantity and quality of the included studies, larger scale, multicenter, higher quality clinical RCTs are needed to enhance the aforementioned conclusion.%目的:系统评价手法治疗下腰痛( low back pain,LBP)的临床疗效。方法计算机检索PubMed、CBM、EMbase、The Cochrane Library、中国知网、维普和万方数据库,查找手法与其他疗法比较治疗LBP患者疗效的随机对照试验( RCT)。检索时间均从2004年至2014年5月。由两位评价员依据纳入排除标准分别独立筛选文献、提取资料和评价纳入研究的方法学质量后,通过RevMan 5.2软件进行Meta分析。结果最终纳入9个RCT,共计939例患者。 Meta分析结果显示:与对照组相比,手法可以明显降低下腰痛患者疼痛视觉模拟评分[MD=-1.05,95%CI(-1.25,-0.86),P<0.00001],改善腰

  4. Intradiscal Pressure Changes during Manual Cervical Distraction: A Cadaveric Study

    Directory of Open Access Journals (Sweden)

    M. R. Gudavalli

    2013-01-01

    Full Text Available The objective of this study was to measure intradiscal pressure (IDP changes in the lower cervical spine during a manual cervical distraction (MCD procedure. Incisions were made anteriorly, and pressure transducers were inserted into each nucleus at lower cervical discs. Four skilled doctors of chiropractic (DCs performed MCD procedure on nine specimens in prone position with contacts at C5 or at C6 vertebrae with the headpiece in different positions. IDP changes, traction forces, and manually applied posterior-to-anterior forces were analyzed using descriptive statistics. IDP decreases were observed during MCD procedure at all lower cervical levels C4-C5, C5-C6, and C6-C7. The mean IDP decreases were as high as 168.7 KPa. Mean traction forces were as high as 119.2 N. Posterior-to-anterior forces applied during manual traction were as high as 82.6 N. Intraclinician reliability for IDP decrease was high for all four DCs. While two DCs had high intraclinician reliability for applied traction force, the other two DCs demonstrated only moderate reliability. IDP decreases were greatest during moving flexion and traction. They were progressevely less pronouced with neutral traction, fixed flexion and traction, and generalized traction.

  5. Simultaneous bilateral internal carotid and vertebral artery dissection following chiropractic manipulation: case report and review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Nadgir, R.N.; Ahmed, T. [University of Pennsylvania School of Medicine, Hospital of the University of Pennsylvania, 3400 Spruce Street, PA 19104, Philadelphia (United States); Loevner, L.A.; Moonis, G.; Slawek, K.; Imbesi, S. [Neuroradiology Section, Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, PA 19104, Philadelphia (United States); Chalela, J. [Department of Neurology, Hospital of the University of Pennsylvania, 3400 Spruce Street, PA 19104, Philadelphia (United States)

    2003-05-01

    Single-vessel cervical arterial dissections typically occur in young adults and are a common cause of cerebral ischemia and stroke. Although the pathogenesis of multivessel dissection is unclear, it is thought to be a consequence of underlying collagen vascular disease. We present a 34-year-old previously healthy man who developed bilateral internal carotid and vertebral artery dissection following chiropractic manipulation. (orig.)

  6. Patient characteristics in low back pain subgroups based on an existing classification system. A descriptive cohort study in chiropractic practice

    DEFF Research Database (Denmark)

    Eirikstoft, Heidi; Kongsted, Alice

    2014-01-01

    Sub-grouping of low back pain (LBP) is believed to improve prediction of prognosis and treatment effects. The objectives of this study were: (1) to examine whether chiropractic patients could be sub-grouped according to an existing pathoanatomically-based classification system, (2) to describe...

  7. Simultaneous bilateral internal carotid and vertebral artery dissection following chiropractic manipulation: case report and review of the literature

    International Nuclear Information System (INIS)

    Single-vessel cervical arterial dissections typically occur in young adults and are a common cause of cerebral ischemia and stroke. Although the pathogenesis of multivessel dissection is unclear, it is thought to be a consequence of underlying collagen vascular disease. We present a 34-year-old previously healthy man who developed bilateral internal carotid and vertebral artery dissection following chiropractic manipulation. (orig.)

  8. The evidence base for chiropractic treatment of musculoskeletal conditions in children and adolescents: The emperor's new suit?

    DEFF Research Database (Denmark)

    Hestbæk, Lise; Stochkendahl, Mette Jensen

    2010-01-01

    ABSTRACT: Five to ten percent of chiropractic patients are children and adolescents. Most of these consult because of spinal pain, or other musculoskeletal complaints. These musculoskeletal disorders in early life not only affect the quality of children's lives, but also seem to have an impact on...

  9. Retrospective case series of clinical outcomes associated with chiropractic management for veterans with low back pain

    Directory of Open Access Journals (Sweden)

    Andrew S. Dunn, DC, MS, MEd

    2011-10-01

    Full Text Available Musculoskeletal complaints, most notably low back pain (LBP, are prevalent among veterans. Despite a focus on LBP management by chiropractors within the Veterans Health Administration, limited published accounts detail clinical outcomes with chiropractic management of LBP among veterans. This was a retrospective case series of 171 veterans with a chief complaint of LBP who were managed with chiropractic care. Descriptive statistics and paired t-tests were used, with the Numeric Rating Scale (NRS and the Back Bournemouth Questionnaire (BBQ serving as the outcome measures. A minimum clinically important difference (MCID was set as 30% improvement from baseline for both measures. The mean number of treatments was 8.7. For the NRS, the mean raw score improvement was 2.2 points, representing 37.4% change from baseline; 103 (60.2% patients met or exceeded the MCID. For the BBQ, the mean raw score improvement was 13.6 points, representing 34.6% change from baseline; 92 patients (53.8% met or exceeded the MCID. For this sample of veterans with LBP, the mean percentages of clinical improvement were statistically significant and clinically meaningful for both the NRS and BBQ.

  10. Clinical decision-making to facilitate appropriate patient management in chiropractic practice: 'the 3-questions model'

    Directory of Open Access Journals (Sweden)

    Amorin-Woods Lyndon G

    2012-03-01

    Full Text Available Abstract Background A definitive diagnosis in chiropractic clinical practice is frequently elusive, yet decisions around management are still necessary. Often, a clinical impression is made after the exclusion of serious illness or injury, and care provided within the context of diagnostic uncertainty. Rather than focussing on labelling the condition, the clinician may choose to develop a defendable management plan since the response to treatment often clarifies the diagnosis. Discussion This paper explores the concept and elements of defensive problem-solving practice, with a view to developing a model of agile, pragmatic decision-making amenable to real-world application. A theoretical framework that reflects the elements of this approach will be offered in order to validate the potential of a so called '3-Questions Model'; Summary Clinical decision-making is considered to be a key characteristic of any modern healthcare practitioner. It is, thus, prudent for chiropractors to re-visit the concept of defensible practice with a view to facilitate capable clinical decision-making and competent patient examination skills. In turn, the perception of competence and trustworthiness of chiropractors within the wider healthcare community helps integration of chiropractic services into broader healthcare settings.

  11. Application of lead-acrylic compensating filters in chiropractic full spine radiography: a technical report

    Energy Technology Data Exchange (ETDEWEB)

    Buehler, M.T.; Hrejsa, A.F.

    1985-09-01

    X-raying the entire spinal column in the standing position in a single exposure (mainly the AP projection) is an often-used chiropractic radiography procedure which has also found some application in medical scoliosis screening program. Aside from any controversy of clinical objectives or medical necessity, the primary agreed-upon requisite for such procedure is twofold; achieving the best possible film image quality with the least amount of radiation exposure to the patient. A popular method of accomplishing this objective is by the use of collimator-attached devices designed to selectively filter the primary x-ray beam in accordance with regional variations of body thickness and/or density. This study was conducted to evaluate the use of a new lead-acrylic filter system under specialized chiropractic conditions. In comparison to other available systems, it was concluded that this new system; a) is generally equivalent in its radiation dose reduction capabilities; b) is capable of producing full spine radiographs with good to above average image quality; and c) is appreciably easier to use.

  12. Application of lead-acrylic compensating filters in chiropractic full spine radiography: a technical report

    International Nuclear Information System (INIS)

    X-raying the entire spinal column in the standing position in a single exposure (mainly the AP projection) is an often-used chiropractic radiography procedure which has also found some application in medical scoliosis screening program. Aside from any controversy of clinical objectives or medical necessity, the primary agreed-upon requisite for such procedure is twofold; achieving the best possible film image quality with the least amount of radiation exposure to the patient. A popular method of accomplishing this objective is by the use of collimator-attached devices designed to selectively filter the primary x-ray beam in accordance with regional variations of body thickness and/or density. This study was conducted to evaluate the use of a new lead-acrylic filter system under specialized chiropractic conditions. In comparison to other available systems, it was concluded that this new system; a) is generally equivalent in its radiation dose reduction capabilities; b) is capable of producing full spine radiographs with good to above average image quality; and c) is appreciably easier to use

  13. Chiropractic wellness on the web: the content and quality of information related to wellness and primary prevention on the Internet

    Directory of Open Access Journals (Sweden)

    Evans Marion

    2011-02-01

    Full Text Available Abstract Background The Internet has become a common source of information for patients wishing to learn about health information. Previous studies found information related to back pain poor and often contradictory to current guidelines. Wellness has become a common topic in the field of chiropractic and accrediting agencies have standards on delivery of wellness-based content in college curricula as well as directives for clinical applications. The purpose of this study was to evaluate the quality of the information on the Internet using the terms "chiropractic wellness," or "wellness chiropractic". Methods Five commonly used search engines were selected and the first 10 sites found using the strategy above were evaluated by two raters. Demographic assessments of the sites were made along with whether they were Health on the Net Foundation (HON certified, contained standard wellness content, mentioned any Healthy People Focus Areas, and other chiropractic topics. Kappa statistics compared inter-rater agreement. Results Potential patients appeared to be the audience 87% of the time and a private doctor of chiropractic appeared to be the typical site owner. The sites usually promoted the provider. No sites displayed HON certification logo nor did any appear to meet the HON certification criteria. Twenty-six sites (55% promoted regular physical activity in some manner and 18 (38% had information on health risks of tobacco. Four (9% had mental health or stress-reduction content but none had information supportive of vaccination. Some had information contradictory to common public health measures. Conclusions Patients searching the Internet for chiropractic wellness information will often find useless information that will not help them maintain health or become well. Most simply market the chiropractic practice or allow for a patients to provide personal information in exchange for more 'wellness' information. More research should be done on how

  14. Asphalt Raking. Instructor Manual. Trainee Manual.

    Science.gov (United States)

    Laborers-AGC Education and Training Fund, Pomfret Center, CT.

    This packet consists of the instructor and trainee manuals for an asphalt raking course. The instructor manual contains a course schedule for 4 days of instruction, content outline, and instructor outline. The trainee manual is divided into five sections: safety, asphalt basics, placing methods, repair and patching, and clean-up and maintenance.…

  15. Chiropractic Treatment vs Self-Management in Patients With Acute Chest Pain: A Randomized Controlled Trial of Patients Without Acute Coronary Syndrome

    DEFF Research Database (Denmark)

    Stochkendahl, Mette J; Christensen, Henrik W; Vach, Werner; Høilund-Carlsen, Poul F; Haghfelt, Torben; Hartvigsen, Jan

    2012-01-01

    ) self-management as an example of minimal intervention. METHODS: In a nonblinded, randomized, controlled trial set at an emergency cardiology department and 4 outpatient chiropractic clinics, 115 consecutive patients with acute chest pain and no clear medical diagnosis at initial presentation were...... included. After a baseline evaluation, patients with musculoskeletal chest pain were randomized to 4 weeks of chiropractic treatment or self-management, with posttreatment questionnaire follow-up 4 and 12 weeks later. Primary outcome measures were numeric change in pain intensity (11-point box numerical...... chiropractic treatment at 4 weeks regarding the primary outcome of self-perceived change in chest pain and at 12 weeks with respect to the primary outcome of numeric change in pain intensity. CONCLUSIONS: To the best of our knowledge, this is the first randomized trial assessing chiropractic treatment vs...

  16. 臭氧联合整脊手法治疗腰椎退行性骨关节病的临床分析%Clinical analysis of ozone combined with chiropractic manipulation in treating degenerative osteoarthritis of lumbar spine

    Institute of Scientific and Technical Information of China (English)

    宋永达; 黄俊卿; 王宏坤

    2013-01-01

    Objective:To investigate the clinical efficacy of ozone combined with chiropractic manipulation in treating degenerative osteoarthritis of lumbar spine. Methods:120 cases of lumbar degenerative joint disease were randomly divided into the treated group and the control group, 60 cases in each group. The treated group was treated with injection of ozone combined with chiropractic manipulation, control group treated by chiropractic therapy. Before and after treatment by visual analogue score (VAS), refers to the distance (FFD) and modified Japanese department of orthopedics association low back pain score (JOA) assessment. Results: After 4 weeks of treatment, compared with before treatment, after treatment, 2 groups of visual analogue score (VAS), FFD index decreased significantly (P<0.05), JOA scale score was significantly increased (P<0.05); compared with the control group, the treated group visual analogue score (VAS), FFD index decreased significantly (P<0.05), JOA questionnaire score was significantly increased (P<0.05); after treatment, the clinical total efficiency was higher than that of the control group (P<0.05). Conclusion: The injection of ozone combined with chiropractic manipulation in the treatment of lumbar degenerative joint disease has remarkable clinical curative effect. The chiropractic manipulation is simple. It is worthy of clinical application.%  目的:探讨臭氧联合整脊手法治疗腰椎退行性骨关节病的临床疗效。方法:将120例腰椎退行性骨关节病患者随机分为治疗组和对照组各60例,治疗组采用臭氧注射联合整脊手法,对照组采用单纯整脊手法治疗。治疗前后采用疼痛视觉类比评分法(VAS)、指地距离(FFD)及改良日本骨科学会下腰痛评分(JOA)进行评定。结果:治疗4周后与治疗前相比较,治疗后两组疼痛视觉类比评分法(VAS)、FFD指标显著降低(P<0.05),JOA问卷记分显著升高(P<0.05);与对

  17. SU-E-T-357: Semi-Automated Knowledge-Based Radiation Therapy (KBRT) Planning for Head-And-Neck Cancer (HNC): Can KBRT Plans Achieve Better Results Than Manual Planning?

    Energy Technology Data Exchange (ETDEWEB)

    Lutzky, C; Grzetic, S; Lo, J; Das, S [Duke University Medical Center, Durham, NC (United States)

    2014-06-01

    Purpose: Knowledge Based Radiation Therapy Treatment (KBRT) planning can be used to semi-automatically generate IMRT plans for new patients using constraints derived from previously manually-planned, geometrically similar patients. We investigate whether KBRT plans can achieve greater dose sparing than manual plans using optimized, organspecific constraint weighting factors. Methods: KBRT planning of HNC radiotherapy cases geometrically matched each new (query) case to one of the 105 clinically approved plans in our database. The dose distribution of the planned match was morphed to fit the querys geometry. Dose-volume constraints extracted from the morphed dose distribution were used to run the IMRT optimization with no user input. In the first version, all constraints were multiplied by a weighting factor of 0.7. The weighting factors were then systematically optimized (in order of OARs with increasing separation from the target) to maximize sparing to each OAR without compromising other OARs. The optimized, second version plans were compared against the first version plans and the clinically approved plans for 45 unilateral/bilateral target cases using the dose metrics: mean, median and maximum (brainstem and cord) doses. Results: Compared to the first version, the second version significantly reduced mean/median contralateral parotid doses (>2Gy) for bilateral cases. Other changes between the two versions were not clinically meaningful. Compared to the original clinical plans, both bilateral and unilateral plans in the second version had lower average dose metrics for 5 of the 6 OARs. Compared to the original plans, the second version achieved dose sparing that was at least as good for all OARs and better for the ipsilateral parotid (bilateral) and oral cavity (bilateral/unilateral). Differences in planning target volume coverage metrics were not clinically significant. Conclusion: HNC-KBRT planning generated IMRT plans with at least equivalent dose sparing to

  18. The Nordic back pain subpopulation program: predicting outcome among chiropractic patients in Finland

    Directory of Open Access Journals (Sweden)

    Pekkarinen Harri

    2008-11-01

    Full Text Available Abstract Background In a previous Swedish study it was shown that it is possible to predict which chiropractic patients with persistent LBP will not report definite improvement early in the course of treatment, namely those with LBP for altogether at least 30 days in the past year, who had leg pain, and who did not report definite general improvement by the second treatment. The objectives of this study were to investigate if the predictive value of this set of variables could be reproduced among chiropractic patients in Finland, and if the model could be improved by adding some new potential predictor variables. Methods The study was a multi-centre prospective outcome study with internal control groups, carried out in private chiropractic practices in Finland. Chiropractors collected data at the 1st, 2nd and 4th visits using standardized questionnaires on new patients with LBP and/or radiating leg pain. Status at base-line was identified in relation to pain and disability, at the 2nd visit in relation to disability, and "definitely better" at the 4th visit in relation to a global assessment. The Swedish questionnaire was used including three new questions on general health, pain in other parts of the spine, and body mass index. Results The Swedish model was reproduced in this study sample. An alternative model including leg pain (yes/no, improvement at 2nd visit (yes/no and BMI (underweight/normal/overweight or obese was also identified with similar predictive values. Common throughout the testing of various models was that improvement at the 2nd visit had an odds ratio of approximately 5. Additional analyses revealed a dose-response in that 84% of those patients who fulfilled none of these (bad criteria were classified as "definitely better" at the 4th visit, vs. 75%, 60% and 34% of those who fulfilled 1, 2 or all 3 of the criteria, respectively. Conclusion When treating patients with LBP, at the first visits, the treatment strategy should be

  19. The use of a manual-driven group cognitive behavior therapy in a Brazilian sample of obese individuals with binge-eating disorder Utilização de terapia cognitivo-comportamental em grupo baseada em manual em uma amostra brasileira de indivíduos obesos com transtorno da compulsão alimentar periódica

    Directory of Open Access Journals (Sweden)

    Mônica Duchesne

    2007-03-01

    Full Text Available OBJECTIVE: To assess the effectiveness of a manual-based cognitive behavior therapy adapted to a group format in a sample of Brazilian obese subjects with binge-eating disorder. METHOD: In an open trial, 21 obese subjects with binge-eating disorder received a group cognitive-behavioral therapy program. Changes in binge-eating frequency, weight, body shape concerns, and depressive symptoms were compared between baseline and the end of the study. RESULTS: The mean frequency of binge-eating episodes significantly decreased from baseline to post-treatment (p OBJETIVO: Avaliar a efetividade da terapia cognitivo-comportamental baseada em um manual adaptado para o formato de grupo em uma amostra brasileira de obesos com transtorno da compulsão alimentar periódica. MÉTODO: Em um estudo aberto, 21 pacientes obesos com transtorno da compulsão alimentar periódica participaram de um programa da terapia cognitivo-comportamental em grupo. A freqüência da compulsão alimentar, o peso corporal, o grau de satisfação com a forma corporal e os sintomas depressivos foram avaliados no início do tratamento e no final do estudo. RESULTADOS: Houve uma redução estatisticamente significativa da freqüência média de episódios de compulsão alimentar entre a linha de base e o final do tratamento (p < 0,001, com uma taxa de remissão de episódios no final do estudo de 76,1%. Foi observada, também, uma redução significativa dos sintomas depressivos e da insatisfação com a forma corporal (p < 0,001. Adicionalmente, a perda de peso foi clínica e estatisticamente significativa. CONCLUSÃO: A utilização de terapia cognitivo-comportamental baseada em um manual adaptado para o transtorno da compulsão alimentar periódica resultou em melhora significativa da compulsão alimentar, do peso corporal, da preocupação com a forma corporal e dos sintomas depressivos associados ao transtorno da compulsão alimentar periódica nessa amostra.

  20. Effects of an exercise and manual therapy program on physical impairments, function and quality-of-life in people with osteoporotic vertebral fracture: a randomised, single-blind controlled pilot trial

    Directory of Open Access Journals (Sweden)

    Sherburn Margaret

    2010-02-01

    Full Text Available Abstract Background This randomised, single-blind controlled pilot trial aimed to determine the effectiveness of a physiotherapy program, including exercise and manual therapy, in reducing impairments and improving physical function and health-related quality of life in people with a history of painful osteoporotic vertebral fracture. Methods 20 participants were randomly allocated to an intervention (n = 11 or control (n = 9 group. The intervention group attended individual sessions with an experienced clinician once a week for 10 weeks and performed daily home exercises with adherence monitored by a self-report diary. The control group received no treatment. Blinded assessment was conducted at baseline and 11 weeks. Questionnaires assessed self-reported changes in back pain, physical function, and health-related quality of life. Objective measures of thoracic kyphosis, back and shoulder muscle endurance (Timed Loaded Standing Test, and function (Timed Up and Go test were also taken. Results Compared with the control group, the intervention group showed significant reductions in pain during movement (mean difference (95% CI -1.8 (-3.5 to -0.1 and at rest (-2.0 (-3.8 to -0.2 and significantly greater improvements in Qualeffo physical function (-4.8 (-9.2 to -0.5 and the Timed Loaded Standing test (46.7 (16.1 to 77.3 secs. For the perceived change in back pain over the 10 weeks, 9/11 (82% participants in the intervention group rated their pain as 'much better' compared with only 1/9 (11% participants in the control group. Conclusion Despite the modest sample size, these results support the benefits of exercise and manual therapy in the clinical management of patients with osteoporotic vertebral fractures, but need to be confirmed in a larger sample. Trail registration NCT00638768

  1. Barriers to Implementing a Reporting and Learning Patient Safety System: Pediatric Chiropractic Perspective.

    Science.gov (United States)

    Pohlman, Katherine A; Carroll, Linda; Hartling, Lisa; Tsuyuki, Ross T; Vohra, Sunita

    2016-04-01

    A reporting and learning system is a method of monitoring the occurrence of incidents that affect patient safety. This cross-sectional survey asked pediatric chiropractors about factors that may limit their participation in such a system. The list of potential barriers for participation was developed using a systematic approach. All members of the 2 pediatric councils associated with US national chiropractic organizations were invited to complete the survey (N = 400). The cross-sectional survey was created using an online survey tool (REDCap) and sent directly to member emails addressed by the respective executive committees. Of the 400 potential respondents, 81 responded (20.3%). The most common limitations to participating were identified as time pressure (96%) and patient concerns (81%). Reporting and learning systems have been utilized to increase safety awareness in many high-risk industries. To be successful, future patient safety studies with pediatric chiropractors need to ensure these barriers are understood and addressed. PMID:26438719

  2. Health care encounters in Danish chiropractic practice from a consumer perspectives - a mixed methods investigation

    DEFF Research Database (Denmark)

    Myburgh, Corrie; Boyle, Eleanor; Larsen, Johanne Brinch;

    2016-01-01

    patients and 36 follow-up patients and finally video recorded 11 new and 24 follow-up consultations. Categorization and analysis led to the emergence six consumer touch point themes: 'the internet', 'the physical environment', 'practice models', 'administrative staff', 'the consultation sequence and timing......BACKGROUND: Perceived value is the key ingredient to carving and maintaining a competitive business niche. The opportunities to interact with consumers to understand and enhance perceived value are termed 'touch points'. Due to the out-of-pocket expense incurred by patients, Danish chiropractors...... are subject to consumer trends and behaviors. The purpose of this investigation was to explore and describe consumer touch points relevant to perceived value through healthcare journeys in chiropractic practices. METHOD: We designed a convergent parallel, mixed methods study. Our purposive sampling framework...

  3. Health care encounters in Danish chiropractic practice from a consumer perspectives - a mixed methods investigation

    DEFF Research Database (Denmark)

    Myburgh, Cornelius

    2016-01-01

    , 12 new patients and 36 follow-up patients and finally video recorded 11 new and 24 follow-up consultations. Categorization and analysis led to the emergence six consumer touch point themes: ‘the internet’, ‘the physical environment’, ‘practice models’, ‘administrative staff’, ‘the consultation......Background Perceived value is the key ingredient to carving and maintaining a competitive business niche. The opportunities to interact with consumers to understand and enhance perceived value are termed ‘touch points’. Due to the out-of-pocket expense incurred by patients, Danish chiropractors...... are subject to consumer trends and behaviors. Purpose The purpose of this investigation was to To explore and describe consumer touch points relevant to perceived value through healthcare journeys in chiropractic practices. Method We designed a convergent parallel, mixed methods study. Our purposive sampling...

  4. The establishment of the Chiropractic & Osteopathic College of Australasia in Queensland (1996–2002

    Directory of Open Access Journals (Sweden)

    Walker Bruce F

    2005-04-01

    Full Text Available Abstract Introduction For chiropractors and osteopaths after graduation, the learning process continues by way of experience and continuing education (CE. The provision of CE and other vocational services in Queensland between 1996 and 2002 is the subject of this paper. Methods The Chiropractic & Osteopathic College of Australasia (COCA implemented a plan, which involved continuing education, with speakers from a broad variety of health provider areas; and the introduction of the concepts of evidence-based practice. The plan also involved building membership. Results Membership of COCA in Queensland grew from 3 in June 1996 to 167 in 2002. There were a total of 25 COCA symposia in the same period. Evidence-based health care was introduced and attendees were generally satisfied with the conferences. Discussion The development of a vocational body (COCA for chiropractors and osteopaths in Queensland was achieved. Registrants in the field have supported an organisation that concentrates on the vocational aspects of their practice.

  5. A eficácia da terapia manual em indivíduos cefaleicos portadores e não-portadores de degeneração cervical: análise de seis casos The effectiveness of manual therapy in indiv iduals with headaches, with and without cervical degeneration: analysis of six cases

    Directory of Open Access Journals (Sweden)

    JGS Morelli

    2007-08-01

    Full Text Available CONTEXTUALIZAÇÃO: As cefaléias do tipo tensional (CTT geralmente são tratadas com fármacos que possuem ações profiláticas. No que se refere ao tratamento fisioterapêutico, vários tipos de procedimentos são relatados e vão desde a eletroterapia e acupuntura até técnicas de tração cervical, de mobilizações vertebrais, alongamentos e relaxamentos. OBJETIVO: Examinar a evolução de seis pacientes com diagnóstico de cefaléia do tipo tensional, submetidos a um protocolo de tratamento fisioterapêutico de terapia manual. MATERIAL E MÉTODO: Foram acompanhados seis indivíduos, três com alterações vertebrais associadas (indivíduos portadores - IP e três sem alterações vertebrais (indivíduos não-portadores - INP, sendo cinco mulheres e um homem, submetidos a um tratamento constituído por dez sessões de tração cervical manual, alongamentos, mobilização vertebral e massagem. FORAM MEDIDOS: a intensidade da dor por meio da escala visual analógica (EVA e o limiar de dor por pressão (LDP no músculo trapézio superior, por meio do algômetro de pressão analógico (PDT - Pain, Diagnostic & Treatment. Os dados, para análise, foram dispostos em um sistema de linha de base múltipla associado a um seguimento. RESULTADOS: Embora o tratamento tenha apresentado resultados eficazes em todos os casos, em relação à intensidade da dor, verificou-se maior dificuldade na remissão completa dos sintomas por parte dos indivíduos não-portadores de alterações vertebrais e, em relação ao LDP, verificou-se que os indivíduos portadores apresentaram melhora acentuada.BACKGROUND: Tension-type headaches (TTH are generally treated with prophylactic medication. With regard to Physical Therapy treatment, many types of procedures have been reported, ranging from electrotherapy and acupuncture to techniques such as cervical traction, vertebral mobilization, stretching and relaxation. OBJECTIVE: To examine the evolution of six patients

  6. Theoretical and practical outline of the Copenhagen PACT narrative-based exercise counselling manual to promote physical activity in post-therapy cancer survivors

    DEFF Research Database (Denmark)

    Midtgaard, Julie

    2013-01-01

    Sedentary behaviour and reduced exercise capacity are potential persisting effects of anti-cancer therapy that may predispose to serious health conditions. It is well-established that physical exercise may prevent some of these problems. However, the extent to which cancer survivors are able to...... adopt long-term physical activity habits depends largely on their motivation....

  7. Manual reduction and herbal fumigation washing therapy pronation type outreach effect of ankle fractures%手法复位加中药熏洗治疗旋前外展型踝关节骨折效果探讨

    Institute of Scientific and Technical Information of China (English)

    周剑

    2016-01-01

    目的:分析研究手法复位加中药熏洗治疗旋前外展型踝关节骨折的临床应用价值。方法:选取2008年8月至2012年8月在该院接收的旋前外展型踝关节骨折患者一共有56例,对56例患者采取手法复位加中药熏洗治疗,对其临床治疗效果给予分析。结果:56例患者,其中优43例(76.79%);良10例(17.86%);差3例(5.36%),优良率为94.64%,临床手术以后跟踪随访6个月~3年,病人全部治愈。结论:旋前外展型踝关节骨折采取手法复位加中药熏洗治疗,可以使相关症状得到明显改善,使临床治疗效果进一步提高,具有临床推广价值。%Objective:Manual reduction and herbal fumigation washing therapy pronation type outreach effect of ankle fracturesZhou Jian,Jianyang City, East New District,the new Chinese medicine hospital,Jianyang Sichuan 641400 to analyze the manual reduction and herbal fumigation washing therapy pronation outreach the clinical value of ankle fractures.Methods:August 2008 -August 2012 in our hospital before receiving the spin of outreach type,a total of 56 pa-tients with ankle fractures in 56 patients were treated with manual reduction and herbal fumigation washing,gives analysis to observe the clinical treatment effect.Results:in this paper,a total of 56 patients,including a total of 43 cases,accounting for 76.79% of the total;A total of 10 cases,accounting for 17.86%of the total;Sent a total of 3 cases,accounting for 5.36% of the total,fine rate was 94.64%,the clinical surgery after 6 months to 3 years follow -up,all patients cured.Conclusions:spiral type front outreach ankle fractures treated with manual reduction and herbal fumigation washing,make relevant symptoms can be signif-icantly improved,to further improve the clinical treatment effects,clinical popularization value.

  8. Chiropractic manipulation in pediatric health conditions – an updated systematic review

    Directory of Open Access Journals (Sweden)

    Gotlib Allan

    2008-09-01

    Full Text Available Abstract Objective Our purpose was to review the biomedical literature from January 2004 to June 2007 inclusive to determine the extent of new evidence related to the therapeutic application of manipulation for pediatric health conditions. This updates a previous systematic review published in 2005. No critical appraisal of the evidence is undertaken. Data Sources We searched both the indexed and non-indexed biomedical manual therapy literature. This included PubMed, MANTIS, CINAHL, ICL, as well as reference tracking. Other resources included the Cochrane Library, CCOHTA, PEDro, WHO ICTRP, AMED, EMBASE and AHRQ databases, as well as research conferences and symposium proceedings. Results The search identified 1275 citations of which 57 discrete citations met the eligibility criteria determined by three reviewers who then determined by consensus, each citation's appropriate level on the strength of evidence scale. The new evidence from the relevant time period was 1 systematic review, 1 RCT, 2 observational studies, 36 descriptive case studies and 17 conference abstracts. When this additional evidence is combined with the previous systematic review undertaken up to 2003, there are now in total, 2 systematic reviews, 10 RCT's, 3 observational studies, 177 descriptive studies, and 31 conference abstracts defining this body of knowledge. Summary There has been no substantive shift in this body of knowledge during the past 3 1/2 years. The health claims made by chiropractors with respect to the application of manipulation as a health care intervention for pediatric health conditions continue to be supported by only low levels of scientific evidence. Chiropractors continue to treat a wide variety of pediatric health conditions. The evidence rests primarily with clinical experience, descriptive case studies and very few observational and experimental studies. The health interests of pediatric patients would be advanced if more rigorous scientific

  9. Nutrient Control Design Manual

    Science.gov (United States)

    The purpose of this EPA design manual is to provide updated, state‐of‐the‐technology design guidance on nitrogen and phosphorus control at municipal Wastewater Treatment Plants (WWTPs). Similar to previous EPA manuals, this manual contains extensive information on the principles ...

  10. Seaweeds - a field manual

    Digital Repository Service at National Institute of Oceanography (India)

    Dhargalkar, V.K.; Kavlekar, D.P.

    stream_size 47956 stream_content_type text/plain stream_name Seaweeds-Manual.pdf.txt stream_source_info Seaweeds-Manual.pdf.txt Content-Encoding ISO-8859-1 Content-Type text/plain; charset=ISO-8859-1 1 Seaweeds ? A... field Manual 2 Seaweeds - a field manual ? National Institute of Oceanography, Dona Paula, Goa. 403 004 Disclaimer : The authors are responsible for the contents of this manual First Edition : March 2004 V.K. Dhargalkar Devanand Kavlekar National...

  11. Egyptian Mythological Manuals

    DEFF Research Database (Denmark)

    Jørgensen, Jens Kristoffer Blach

    by the native priesthood, much of which has only been published in recent years. As part of this corpus of texts, the ancient Egyptian mythological manuals offer a unique perspective on how the Egyptian priesthood structured and interpreted Egyptian myths. The thesis looks at the different interpretative...... techniques used in the Tebtunis Mythological Manual (Second century CE) and the Mythological Manual of the Delta (Sixth century BCE) and the place of these manuals within the larger corpus of priestly scholarly literature from ancient Egypt. To organize the wealth of local myths the manuals use model...

  12. Experiences of nursing professionals in alternative and complementing therapies applied to people in pain situations Experiencias de profesionales de enfermería en terapias alternativas y complementarias aplicadas a personas en situaciones de dolor

    OpenAIRE

    MARÍN ARIZA DIEGO ANDRÉS; FORERO ARCHBOLD ANDRÉS; LARA SUÁREZ PAOLA MILENA; CALDERÓN PERILLA ARNOL YAMID; VANEGAS DE AHOGADO BLANCA CECILIA; CELIS RINCÓN ADRIANA

    2008-01-01

    To know the experiences of nursing professionals on the use of alternative and complementing therapies applied during health care to people in pain situations, a qualitative study was carried out, as a graduation project for a group of nursing students –undergraduates– from the Universidad del Bosque, between 2005 and 2007, in which four nursing professionals took part. They had several years of experience in the use of floral therapy, acupuncture, homeopathy, chiropractic massage therapy and...

  13. Efficacy observation on treating old ankle sprain by manual therapy combined with acupoint injection%手法配合穴位注射治疗陈旧性踝关节扭伤疗效观察

    Institute of Scientific and Technical Information of China (English)

    张茂亮

    2013-01-01

    Ankle sprain is one of common clinicaltraumatology diseases, with a high incidence in joint damage in the human body. Old ankle sprain is mainly in acute ankle sprain. After treatment, the patient has been unhealed or has no timely break after cured and lead to recurrent. The author uses manual therapy combined with acupoint injection (Canggui Tanxue needling and liquid injection) method for the treatment of old ankle sprain, obtains satisfactory results, reported below.%踝关节扭伤是临床上常见的伤科疾病之一,在人体的关节损伤中发病率较高。陈旧性的踝关节扭伤多指踝关节在急性扭伤后,经治疗而一直未愈的或愈后未得到及时休息且又反复发作的。笔者采用手法治疗配合穴位注射(行苍龟探穴刺法并注射药液)的方法,针对陈旧性踝关节扭伤治疗取得较满意疗效,报道如下。

  14. Stress in chiropractic education: a student survey of a five-year course.

    Science.gov (United States)

    Hester, Hilary; Cunliffe, Christina; Hunnisett, Adrian

    2013-01-01

    Objective : Stress encompasses academic issues, such as time management, increased work load, and new subject matter, but cannot be separated from stressors, such as social adjustment and financial pressure. Our study investigated whether perceived level of academic or practical attainment and the method of study were associated with the amount of perceived stress during students" studies. Methods : A semi-structured self-administered questionnaire was piloted and distributed to 134 students at a chiropractic college at the end of a lecture. Results : The survey had a response rate of 81%. Students in their fourth year consistently reported the highest perceived levels of stress, with 81% feeling that their ability to study was affected by their financial situation and 56% felt overwhelmed at their ability to cope with their college workload. All year groups were stressed during their course of studies, but the stressor varies depending on the year of study. Conclusions : Year 4 consistently demonstrated the highest levels of stress. All students, regardless of year group, experienced varying degrees of stress while studying and the central stressor changed depending on the time position within the course. PMID:23957319

  15. Survey based investigation into general practitioner referral patterns for spinal manipulative therapy

    OpenAIRE

    Kier, Annabel; George, Matthew; McCarthy, Peter W

    2013-01-01

    Background In the UK Physiotherapy, Chiropractic and Osteopathy are all statutory regulated professions. Though guidelines have supported the use of Spinal Manipulative Therapy (SMT) for low back pain (LBP), General Practitioners (GP) referral patterns to the 3 registered professions that perform SMT are generally unknown. Method A short questionnaire was designed and piloted. Demographic information, patient referral to SMT and the GPs own personal utilisation of SMT were obtained. 385 GP’s ...

  16. Manual on radiation haematology

    International Nuclear Information System (INIS)

    Studies of the biological effects of ionizing radiation have led to the introduction of various measures to protect both the public and personnel engaged in occupations where they could be exposed to such radiations. Many recent studies deal with the basic mechanism of radiation injuries and with their treatment, and some of these investigations have been sponsored by the World Health Organization and the International Atomic Energy Agency. Fundamental studies of the blood-forming tissue have provided the information necessary for formulating recommendations of the International Commission on Radiological Protection. Heinecke in 1903 was the first to note damage to the haemato-poietic tissue after whole-body irradiation. Since that time we have learned much of the functions of the various components of the blood. Many studies have been undertaken to understand the proliferative capacities of the various 'stem' cells involved in the haematopoietic processes and the extent to which these processes can be interfered with by ionizing radiations. We now understand which are the reliable criteria by which radiation damage can be assessed from its effects on the haematopoietic system. In addition, much work has been done to determine how radiation injury to the hematopoietic system may be offset by therapy. In developing countries radiation is being increasingly applied in medical work and many other fields, and there is an immediate need to disseminate information relevant to radiation hazards. This Manual on Radiation Haematology is an attempt at a synthesis of much that is relevant to these matters. As the Contents List shows, many experts have contributed to the book. Their styles have been changed as little as possible. A certain amount of duplication of information could not be avoided; where an editorial decision to remove a passage would have resulted in losing the exact concept that the author wished to express, this passage has been retained. Information from

  17. The capital budgeting manual

    OpenAIRE

    Segelod, Esbjörn

    1995-01-01

    There has been very many postal surveys of capital budgeting practice, but almost no studies of the written routines that fix the practice of those groups that use a capital budgeting manual. This article fills this vacuum by describing and analysing the capital budgeting manuals used by major Swedish groups, most of whom are multinationals. Changes in the manuals during the last 30 years are studied using hvo earlier Swedish studies of manuals from the 60’s and 70’s. Comparisons are made wit...

  18. EMSL Operations Manual

    Energy Technology Data Exchange (ETDEWEB)

    Foster, Nancy S.

    2009-06-18

    This manual is a general resource tool to assist EMSL users and Laboratory staff within EMSL locate official policy, practice and subject matter experts. It is not intended to replace or amend any formal Battelle policy or practice. Users of this manual should rely only on Battelle’s Standard Based Management System (SBMS) for official policy. No contractual commitment or right of any kind is created by this manual. Battelle management reserves the right to alter, change, or delete any information contained within this manual without prior notice.

  19. PCs The Missing Manual

    CERN Document Server

    Karp, David

    2005-01-01

    Your vacuum comes with one. Even your blender comes with one. But your PC--something that costs a whole lot more and is likely to be used daily and for tasks of far greater importance and complexity--doesn't come with a printed manual. Thankfully, that's not a problem any longer: PCs: The Missing Manual explains everything you need to know about PCs, both inside and out, and how to keep them running smoothly and working the way you want them to work. A complete PC manual for both beginners and power users, PCs: The Missing Manual has something for everyone. PC novices will appreciate the una

  20. EMSL Operations Manual

    Energy Technology Data Exchange (ETDEWEB)

    Foster, Nancy S.

    2009-03-25

    This manual is a general resource tool to assist EMSL users and Laboratory staff within EMSL locate official policy, practice and subject matter experts. It is not intended to replace or amend any formal Battelle policy or practice. Users of this manual should rely only on Battelle’s Standard Based Management System (SBMS) for official policy. No contractual commitment or right of any kind is created by this manual. Battelle management reserves the right to alter, change, or delete any information contained within this manual without prior notice.

  1. Radiological Control Manual

    Energy Technology Data Exchange (ETDEWEB)

    1993-04-01

    This manual has been prepared by Lawrence Berkeley Laboratory to provide guidance for site-specific additions, supplements, and clarifications to the DOE Radiological Control Manual. The guidance provided in this manual is based on the requirements given in Title 10 Code of Federal Regulations Part 835, Radiation Protection for Occupational Workers, DOE Order 5480.11, Radiation Protection for Occupational Workers, and the DOE Radiological Control Manual. The topics covered are (1) excellence in radiological control, (2) radiological standards, (3) conduct of radiological work, (4) radioactive materials, (5) radiological health support operations, (6) training and qualification, and (7) radiological records.

  2. Radiological Control Manual

    International Nuclear Information System (INIS)

    This manual has been prepared by Lawrence Berkeley Laboratory to provide guidance for site-specific additions, supplements, and clarifications to the DOE Radiological Control Manual. The guidance provided in this manual is based on the requirements given in Title 10 Code of Federal Regulations Part 835, Radiation Protection for Occupational Workers, DOE Order 5480.11, Radiation Protection for Occupational Workers, and the DOE Radiological Control Manual. The topics covered are (1) excellence in radiological control, (2) radiological standards, (3) conduct of radiological work, (4) radioactive materials, (5) radiological health support operations, (6) training and qualification, and (7) radiological records

  3. Indoor Air Quality Manual.

    Science.gov (United States)

    Baldwin Union Free School District, NY.

    This manual identifies ways to improve a school's indoor air quality (IAQ) and discusses practical actions that can be carried out by school staff in managing air quality. The manual includes discussions of the many sources contributing to school indoor air pollution and the preventive planning for each including renovation and repair work,…

  4. Technical Manual. The ACT®

    Science.gov (United States)

    ACT, Inc., 2014

    2014-01-01

    This manual contains technical information about the ACT® college readiness assessment. The principal purpose of this manual is to document the technical characteristics of the ACT in light of its intended purposes. ACT regularly conducts research as part of the ongoing formative evaluation of its programs. The research is intended to ensure that…

  5. Thesis Preparation Manual

    OpenAIRE

    1999-01-01

    "This Thesis Preparation Manual has been written to provide you with format and procedure guidance for preparing and processing your thesis at the Naval Postgraduate School. It covers both unclassified and classified theses. All theses and thesis technical reports must be prepared in accordance with these guidelines. Please note that this manual is not written in the thesis format." form the Foreword

  6. Boating Safety Training Manual.

    Science.gov (United States)

    Coast Guard, Washington, DC.

    The training manual serves as the text for the Coast Guard's boating safety 32-hour course and for the D-8 Qualification Code Recertification Course. The manual is designed for self-study or for use with an instructor-led course. Each chapter concludes with a quiz to be used as a review of chaper content. Opening chapters review the use of the…

  7. NYS Foster Parent Manual

    Science.gov (United States)

    McBride, Rebecca

    2007-01-01

    This manual was developed for use in foster parents' day-to-day life with the children in their care. It gives them practical information on topics like medical care, payments, and the role of the court, and also provides guidance on areas like welcoming a child, discipline, and parent visits. The manual emphasizes the role of foster parents in…

  8. Dental Charting. Student's Manual.

    Science.gov (United States)

    Weaver, Trudy Karlene; Apfel, Maura

    This manual is part of a series dealing with skills and information needed by students in dental assisting. The individualized student materials are suitable for classroom, laboratory, or cooperative training programs. This student manual contains four units covering the following topics: dental anatomical terminology; tooth numbering systems;…

  9. Eco-Innovation Manual

    DEFF Research Database (Denmark)

    O'Hare, Jamie Alexander; McAloone, Tim C.; Pigosso, Daniela Cristina Antelmi;

    Aim of this manual is to introduce a methodology for the implementation of eco‐innovation within small and medium sized companies in developing and emerging economies. The intended audience of this manual is organizations that provide professional services to guide and support manufacturing...

  10. VARK learning preferences and mobile anatomy software application use in pre-clinical chiropractic students.

    Science.gov (United States)

    Meyer, Amanda J; Stomski, Norman J; Innes, Stanley I; Armson, Anthony J

    2016-05-01

    Ubiquitous smartphone ownership and reduced face-to-face teaching time may lead to students making greater use of mobile technologies in their learning. This is the first study to report on the prevalence of mobile gross anatomy software applications (apps) usage in pre-clinical chiropractic students and to ascertain if a relationship exists between preferred learning styles as determined by the validated VARK(©) questionnaire and use of mobile anatomy apps. The majority of the students who completed the VARK questionnaire were multimodal learners with kinesthetic and visual preferences. Sixty-seven percent (73/109) of students owned one or more mobile anatomy apps which were used by 57 students. Most of these students owned one to five apps and spent less than 30 minutes per week using them. Six of the top eight mobile anatomy apps owned and recommended by the students were developed by 3D4Medical. Visual learning preferences were not associated with time spent using mobile anatomy apps (OR = 0.40, 95% CI 0.12-1.40). Similarly, kinesthetic learning preferences (OR = 1.88, 95% CI 0.18-20.2), quadmodal preferences (OR = 0.71, 95% CI 0.06-9.25), or gender (OR = 1.51, 95% CI 0.48-4.81) did not affect the time students' spent using mobile anatomy apps. Learning preferences do not appear to influence students' time spent using mobile anatomy apps. Anat Sci Educ 9: 247-254. © 2015 American Association of Anatomists. PMID:26109371

  11. Fuel Element Technical Manual

    Energy Technology Data Exchange (ETDEWEB)

    Burley, H.H. [ed.

    1956-08-01

    It is the purpose of the Fuel Element Technical Manual to Provide a single document describing the fabrication processes used in the manufacture of the fuel element as well as the technical bases for these processes. The manual will be instrumental in the indoctrination of personnel new to the field and will provide a single data reference for all personnel involved in the design or manufacture of the fuel element. The material contained in this manual was assembled by members of the Engineering Department and the Manufacturing Department at the Hanford Atomic Products Operation between the dates October, 1955 and June, 1956. Arrangement of the manual. The manual is divided into six parts: Part I--introduction; Part II--technical bases; Part III--process; Part IV--plant and equipment; Part V--process control and improvement; and VI--safety.

  12. MARS CODE MANUAL VOLUME III - Programmer's Manual

    International Nuclear Information System (INIS)

    Korea Advanced Energy Research Institute (KAERI) conceived and started the development of MARS code with the main objective of producing a state-of-the-art realistic thermal hydraulic systems analysis code with multi-dimensional analysis capability. MARS achieves this objective by very tightly integrating the one dimensional RELAP5/MOD3 with the multi-dimensional COBRA-TF codes. The method of integration of the two codes is based on the dynamic link library techniques, and the system pressure equation matrices of both codes are implicitly integrated and solved simultaneously. In addition, the Equation-Of-State (EOS) for the light water was unified by replacing the EOS of COBRA-TF by that of the RELAP5. This programmer's manual provides a complete list of overall information of code structure and input/output function of MARS. In addition, brief descriptions for each subroutine and major variables used in MARS are also included in this report, so that this report would be very useful for the code maintenance. The overall structure of the manual is modeled on the structure of the RELAP5 and as such the layout of the manual is very similar to that of the RELAP. This similitude to RELAP5 input is intentional as this input scheme will allow minimum modification between the inputs of RELAP5 and MARS3.1. MARS3.1 development team would like to express its appreciation to the RELAP5 Development Team and the USNRC for making this manual possible

  13. Completing Invoices. Student's Manual and Instructor's Manual.

    Science.gov (United States)

    Hamer, Jean

    Supporting performance objective 46 of the V-TECS (Vocational-Technical Education Consortium of States) Secretarial Catalog, both a set of student materials and an instructor's manual on completing invoices are included in this packet. (The packet is the fifth in a set of nine on performing computational clerical activities--CE 016 951-959.) The…

  14. Prevalence of pain-free weeks in chiropractic subjects with low back pain - a longitudinal study using data gathered with text messages

    DEFF Research Database (Denmark)

    Lemeunier, Nadege; Kongsted, Alice; Axen, Iben

    2011-01-01

    -31 %). Smaller percentages were reported for [greater than or equal to] 7 zero weeks in a row. There were no significant differences between the two study groups. CONCLUSION: It was uncommon that chiropractic subjects treated for non-specific LBP experienced an entire week without any LBP at all over 18 weeks...

  15. Mixed-Methods Research in a Complex Multisite VA Health Services Study: Variations in the Implementation and Characteristics of Chiropractic Services in VA

    Directory of Open Access Journals (Sweden)

    Raheleh Khorsan

    2013-01-01

    Full Text Available Maximizing the quality and benefits of newly established chiropractic services represents an important policy and practice goal for the US Department of Veterans Affairs’ healthcare system. Understanding the implementation process and characteristics of new chiropractic clinics and the determinants and consequences of these processes and characteristics is a critical first step in guiding quality improvement. This paper reports insights and lessons learned regarding the successful application of mixed methods research approaches—insights derived from a study of chiropractic clinic implementation and characteristics, Variations in the Implementation and Characteristics of Chiropractic Services in VA (VICCS. Challenges and solutions are presented in areas ranging from selection and recruitment of sites and participants to the collection and analysis of varied data sources. The VICCS study illustrates the importance of several factors in successful mixed-methods approaches, including (1 the importance of a formal, fully developed logic model to identify and link data sources, variables, and outcomes of interest to the study’s analysis plan and its data collection instruments and codebook and (2 ensuring that data collection methods, including mixed-methods, match study aims. Overall, successful application of a mixed-methods approach requires careful planning, frequent trade-offs, and complex coding and analysis.

  16. Salinas : theory manual.

    Energy Technology Data Exchange (ETDEWEB)

    Walsh, Timothy Francis; Reese, Garth M.; Bhardwaj, Manoj Kumar

    2004-08-01

    This manual describes the theory behind many of the constructs in Salinas. For a more detailed description of how to use Salinas , we refer the reader to Salinas, User's Notes. Many of the constructs in Salinas are pulled directly from published material. Where possible, these materials are referenced herein. However, certain functions in Salinas are specific to our implementation. We try to be far more complete in those areas. The theory manual was developed from several sources including general notes, a programer-notes manual, the user's notes and of course the material in the open literature.

  17. Fire Protection Program Manual

    Energy Technology Data Exchange (ETDEWEB)

    Sharry, J A

    2012-05-18

    This manual documents the Lawrence Livermore National Laboratory (LLNL) Fire Protection Program. Department of Energy (DOE) Orders 420.1B, Facility Safety, requires LLNL to have a comprehensive and effective fire protection program that protects LLNL personnel and property, the public and the environment. The manual provides LLNL and its facilities with general information and guidance for meeting DOE 420.1B requirements. The recommended readers for this manual are: fire protection officers, fire protection engineers, fire fighters, facility managers, directorage assurance managers, facility coordinators, and ES and H team members.

  18. Geochemical engineering reference manual

    Energy Technology Data Exchange (ETDEWEB)

    Owen, L.B.; Michels, D.E.

    1984-01-01

    The following topics are included in this manual: physical and chemical properties of geothermal brine and steam, scale and solids control, processing spent brine for reinjection, control of noncondensable gas emissions, and goethermal mineral recovery. (MHR)

  19. NCDC Archive Documentation Manuals

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The National Climatic Data Center Tape Deck Documentation library is a collection of over 400 manuals describing NCDC's digital holdings (both historic and...

  20. SEVERO code - user's manual

    International Nuclear Information System (INIS)

    This user's manual contains all the necessary information concerning the use of SEVERO code. This computer code is related to the statistics of extremes = extreme winds, extreme precipitation and flooding hazard risk analysis. (A.C.A.S.)

  1. Surface Weather Observing Manuals

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Manuals and instructions for taking weather observations. Includes the annual Weather Bureau 'Instructions for Preparing Meteorological Forms...' and early airways...

  2. Psychosocial factors and their predictive value in chiropractic patients with low back pain: a prospective inception cohort study

    Directory of Open Access Journals (Sweden)

    Breen Alan C

    2007-03-01

    Full Text Available Abstract Background Being able to estimate the likelihood of poor recovery from episodes of back pain is important for care. Studies of psychosocial factors in inception cohorts in general practice and occupational populations have begun to make inroads to these problems. However, no studies have yet investigated this in chiropractic patients. Methods A prospective inception cohort study of patients presenting to a UK chiropractic practice for new episodes of non-specific low back pain (LBP was conducted. Baseline questionnaires asked about age, gender, occupation, work status, duration of current episode, chronicity, aggravating features and bothersomeness using Deyo's 'Core Set'. Psychological factors (fear-avoidance beliefs, inevitability, anxiety/distress and coping, and co-morbidity were also assessed at baseline. Satisfaction with care, number of attendances and pain impact were determined at 6 weeks. Predictors of poor outcome were sought by the calculation of relative risk ratios. Results Most patients presented within 4 weeks of onset. Of 158 eligible and willing patients, 130 completed both baseline and 6-week follow-up questionnaires. Greatest improvements at 6 weeks were in interference with normal work (ES 1.12 and LBP bothersomeness (ES 1.37. Although most patients began with moderate-high back pain bothersomeness scores, few had high psychometric ones. Co-morbidity was a risk for high-moderate interference with normal work at 6 weeks (RR 2.37; 95% C.I. 1.15–4.74. An episode duration of >4 weeks was associated with moderate to high bothersomeness at 6 weeks (RR 2.07; 95% C.I. 1.19 – 3.38 and negative outlook (inevitability with moderate to high interference with normal work (RR 2.56; 95% C.I. 1.08 – 5.08. Conclusion Patients attending a private UK chiropractic clinic for new episodes of non-specific LBP exhibited few psychosocial predictors of poor outcome, unlike other patient populations that have been studied. Despite

  3. SHARP User Manual

    Energy Technology Data Exchange (ETDEWEB)

    Yu, Y. Q. [Argonne National Lab. (ANL), Argonne, IL (United States); Shemon, E. R. [Argonne National Lab. (ANL), Argonne, IL (United States); Thomas, J. W. [Argonne National Lab. (ANL), Argonne, IL (United States); Mahadevan, Vijay S. [Argonne National Lab. (ANL), Argonne, IL (United States); Rahaman, Ronald O. [Argonne National Lab. (ANL), Argonne, IL (United States); Solberg, Jerome [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2016-03-31

    SHARP is an advanced modeling and simulation toolkit for the analysis of nuclear reactors. It is comprised of several components including physical modeling tools, tools to integrate the physics codes for multi-physics analyses, and a set of tools to couple the codes within the MOAB framework. Physics modules currently include the neutronics code PROTEUS, the thermal-hydraulics code Nek5000, and the structural mechanics code Diablo. This manual focuses on performing multi-physics calculations with the SHARP ToolKit. Manuals for the three individual physics modules are available with the SHARP distribution to help the user to either carry out the primary multi-physics calculation with basic knowledge or perform further advanced development with in-depth knowledge of these codes. This manual provides step-by-step instructions on employing SHARP, including how to download and install the code, how to build the drivers for a test case, how to perform a calculation and how to visualize the results. Since SHARP has some specific library and environment dependencies, it is highly recommended that the user read this manual prior to installing SHARP. Verification tests cases are included to check proper installation of each module. It is suggested that the new user should first follow the step-by-step instructions provided for a test problem in this manual to understand the basic procedure of using SHARP before using SHARP for his/her own analysis. Both reference output and scripts are provided along with the test cases in order to verify correct installation and execution of the SHARP package. At the end of this manual, detailed instructions are provided on how to create a new test case so that user can perform novel multi-physics calculations with SHARP. Frequently asked questions are listed at the end of this manual to help the user to troubleshoot issues.

  4. A descriptive report of management strategies used by chiropractors, as reviewed by a single independent chiropractic consultant in the Australian workers compensation system

    Directory of Open Access Journals (Sweden)

    de Luca Katie

    2009-11-01

    Full Text Available Abstract Background In New South Wales, Australia, an injured worker enters the workers compensation system with the case often managed by a pre-determined insurer. The goal of the treating practitioner is to facilitate the claimant to return to suitable duties and progress to their pre-injury status, job and quality of life. Currently, there is very little documentation on the management of injured workers by chiropractors in the Australian healthcare setting. This study aims to examine treatment protocols and recommendations given to chiropractic practitioners by one independent chiropractic reviewer in the state of New South Wales, and to discuss management strategies recommended for the injured worker. Methods A total of 146 consecutive Independent Chiropractic Consultant reports were collated into a database. Pain information and management recommendations made by the Independent Chiropractic Consultant were tabulated and analysed for trends. The data formulated from the reports is purely descriptive in nature. Results The Independent Chiropractic Consultant determined the current treatment plan to be "reasonable" (80.1% or "unreasonable" (23.6%. The consultant recommended to "phase out" treatment in 74.6% of cases, with an average of six remaining treatments. In eight cases treatment was unreasonable with no further treatment; in five cases treatment was reasonable with no further treatment. In 78.6% of cases, injured workers were to be discharged from treatment and 21.4% were to be reassessed for the need of a further treatment plan. Additional recommendations for treatment included an active care program (95.2%, general fitness program (77.4%, flexibility/range of movement exercises (54.1%, referral to a chronic pain specialist (50.7% and work hardening program (22.6%. Conclusion It is essential chiropractic practitioners perform 'reasonably necessary treatment' to reduce dependency on passive treatment, increase compliance to active

  5. The Role of Chiropractic Care in the Treatment of Dizziness or Balance Disorders: Analysis of National Health Interview Survey Data.

    Science.gov (United States)

    Ndetan, Harrison; Hawk, Cheryl; Sekhon, Vishaldeep Ka; Chiusano, Miguel

    2016-04-01

    The purpose of this study was to explore the role of chiropractic in the treatment of dizziness or balance disorders through an analysis of data from the 2008 National Health Interview Survey. Odds ratios and 95% confidence intervals (CIs) were used to assess the likelihood that respondents with dizziness or balance problems perceived that they were helped by specified practitioners. Eleven percent of respondents reported having had a balance or dizziness problem; more than 35% were aged 65 years and older. The odds ratio for perceiving being helped by a chiropractor was 4.36 (95% CI, 1.17-16.31) for respondents aged 65 years or older; 9.5 (95% CI, 7.92-11.40) for respondents reporting head or neck trauma; and 13.78 (95% CI, 5.59-33.99) for those reporting neurological or muscular conditions as the cause of their balance or dizziness. PMID:26362851

  6. The Nordic maintenance care program – case management of chiropractic patients with low back pain: A survey of Swedish chiropractors

    Directory of Open Access Journals (Sweden)

    Jørgensen Kristian

    2008-06-01

    Full Text Available Abstract Background Chiropractic treatment for low back pain (LBP can often be divided into two phases: Initial treatment of the problem to attempt to remove pain and bring it back into its pre-clinical or maximum improvement status, and "maintenance care", during which it is attempted to maintain this status. Although the use of chiropractic maintenance care has been described and discussed in the literature, there is no information as to its precise indications. The objective of this study is to investigate if there is agreement among Swedish chiropractors on the overall patient management for various types of LBP-scenarios, with a special emphasis on maintenance care. Method The design was a mailed questionnaire survey. Members of the Swedish Chiropractors' Association, who were participants in previous practice-based research, were sent a closed-end questionnaire consisting of nine case scenarios and six clinical management alternatives and the possibility to create one's own alternative, resulting in a "nine-by-seven" table. The research team defined its own pre hoc choice of "clinically logical" answers based on the team's clinical experience. The frequency of findings was compared to the suggestions of the research team. Results Replies were received from 59 (60% of the 99 persons who were invited to take part in the study. A pattern of self-reported clinical management strategies emerged, largely corresponding to the "clinically logical" answers suggested by the research team. In general, patients of concern would be referred out for a second opinion, cases with early recovery and without a history of previous low back pain would be quickly closed, and cases with quick recovery and a history of recurring events would be considered for maintenance care. However, also other management patterns were noted, in particular in the direction of maintenance care. Conclusion To a reasonable extent, Swedish chiropractors participating in this

  7. Physical injury assessment of male versus female chiropractic students when learning and performing various adjustive techniques: a preliminary investigative study

    Directory of Open Access Journals (Sweden)

    Huber Laura L

    2006-08-01

    Full Text Available Abstract Background Reports of musculoskeletal injuries that some chiropractic students experienced while in the role of adjustor became increasingly evident and developed into the basis of this study. The main objective of this study was to survey a select student population and identify, by gender, the specific types of musculoskeletal injuries they experienced when learning adjustive techniques in the classroom, and performing them in the clinical setting. Methods A survey was developed to record musculoskeletal injuries that students reported to have sustained while practicing chiropractic adjustment set-ups and while delivering adjustments. The survey was modeled from similar instruments used in the university's clinic as well as those used in professional practice. Stratified sampling was used to obtain participants for the study. Data reported the anatomical areas of injury, adjustive technique utilized, the type of injury received, and the recovery time from sustained injuries. The survey also inquired as to the type and area of any past physical injuries as well as the mechanism(s of injury. Results Data obtained from the study identified injuries of the shoulder, wrist, elbow, neck, low back, and mid-back. The low back was the most common injury site reported by females, and the neck was the most common site reported by males. The reported wrist injuries in both genders were 1% male complaints and 17% female complaints. A total of 13% of female respondents reported shoulder injuries, whereas less than 1% of male respondents indicated similar complaints. Conclusion The data collected from the project indicated that obtaining further information on the subject would be worthwhile, and could provide an integral step toward developing methods of behavior modification in an attempt to reduce and/or prevent the incidence of musculoskeletal injuries.

  8. Nuclear material operations manual

    Energy Technology Data Exchange (ETDEWEB)

    Tyler, R.P.

    1981-02-01

    This manual provides a concise and comprehensive documentation of the operating procedures currently practiced at Sandia National Laboratories with regard to the management, control, and accountability of nuclear materials. The manual is divided into chapters which are devoted to the separate functions performed in nuclear material operations-management, control, accountability, and safeguards, and the final two chapters comprise a document which is also issued separately to provide a summary of the information and operating procedures relevant to custodians and users of radioactive and nuclear materials. The manual also contains samples of the forms utilized in carrying out nuclear material activities. To enhance the clarity of presentation, operating procedures are presented in the form of playscripts in which the responsible organizations and necessary actions are clearly delineated in a chronological fashion from the initiation of a transaction to its completion.

  9. Nuclear material operations manuals

    International Nuclear Information System (INIS)

    This manual is intended to provide a concise and comprehensive documentation of the operating procedures currently practiced at Sandia Laboratories with regard to the management, control, and accountability of radioactive and nuclear materials. The manual is divided into chapters which are devoted to the separate functions performed in nuclear material operations-management, control, accountability, and safeguards, and the final two chapters comprise a document which is also issued separately to provide a summary of the information and operating procedures relevant to custodians and users of radioactive and nuclear materials. The manual also contains samples of the forms utilized in carrying out nuclear material activities. To enhance the clarity of presentation, operating procedures are presented in the form of playscripts in which the responsible organizations and necessary actions are clearly delineated in a chronological fashion from the initiation of a transaction to its completion

  10. Oil spill contingency manual

    International Nuclear Information System (INIS)

    This manual is intended to provide initial spill responders with a series of specific checklists that will likely be required during the initial strategies and on-going control operations of a spill response, and checklists that will assist them with their spill control activities. The seven types of checklists covered in the Manual are: (1) a contact checklist for use in the initial stages of a spill response, (2) a spill assessment checklist, (3) containment and recovery checklist, (4) in-situ burning guidelines, (5) job descriptions for senior members of the spill response team, (6) public relations checklist, and (7) documentation checklist. Each checklist is subdivided into a series of concisely stated ACTIONS, each of these being followed by a series of clear and concise PROCEDURES. Where appropriate, PRIORITIES are also identified. This Action/Procedure/Priorities sequence is followed throughout the Manual

  11. Nuclear material operations manual

    International Nuclear Information System (INIS)

    This manual provides a concise and comprehensive documentation of the operating procedures currently practiced at Sandia National Laboratories with regard to the management, control, and accountability of nuclear materials. The manual is divided into chapters which are devoted to the separate functions performed in nuclear material operations-management, control, accountability, and safeguards, and the final two chapters comprise a document which is also issued separately to provide a summary of the information and operating procedures relevant to custodians and users of radioactive and nuclear materials. The manual also contains samples of the forms utilized in carrying out nuclear material activities. To enhance the clarity of presentation, operating procedures are presented in the form of playscripts in which the responsible organizations and necessary actions are clearly delineated in a chronological fashion from the initiation of a transaction to its completion

  12. Salinas : theory manual.

    Energy Technology Data Exchange (ETDEWEB)

    Walsh, Timothy Francis; Reese, Garth M.; Bhardwaj, Manoj Kumar

    2011-11-01

    Salinas provides a massively parallel implementation of structural dynamics finite element analysis, required for high fidelity, validated models used in modal, vibration, static and shock analysis of structural systems. This manual describes the theory behind many of the constructs in Salinas. For a more detailed description of how to use Salinas, we refer the reader to Salinas, User's Notes. Many of the constructs in Salinas are pulled directly from published material. Where possible, these materials are referenced herein. However, certain functions in Salinas are specific to our implementation. We try to be far more complete in those areas. The theory manual was developed from several sources including general notes, a programmer notes manual, the user's notes and of course the material in the open literature.

  13. Netbooks The Missing Manual

    CERN Document Server

    Biersdorfer, J

    2009-01-01

    Netbooks are the hot new thing in PCs -- small, inexpensive laptops designed for web browsing, email, and working with web-based programs. But chances are you don't know how to choose a netbook, let alone use one. Not to worry: with this Missing Manual, you'll learn which netbook is right for you and how to set it up and use it for everything from spreadsheets for work to hobbies like gaming and photo sharing. Netbooks: The Missing Manual provides easy-to-follow instructions and lots of advice to help you: Learn the basics for using a Windows- or Linux-based netbookConnect speakers, printe

  14. RELAP-7 Theory Manual

    Energy Technology Data Exchange (ETDEWEB)

    Berry, Ray Alden [Idaho National Lab. (INL), Idaho Falls, ID (United States); Zou, Ling [Idaho National Lab. (INL), Idaho Falls, ID (United States); Zhao, Haihua [Idaho National Lab. (INL), Idaho Falls, ID (United States); Zhang, Hongbin [Idaho National Lab. (INL), Idaho Falls, ID (United States); Peterson, John William [Idaho National Lab. (INL), Idaho Falls, ID (United States); Martineau, Richard Charles [Idaho National Lab. (INL), Idaho Falls, ID (United States); Kadioglu, Samet Yucel [Idaho National Lab. (INL), Idaho Falls, ID (United States); Andrs, David [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2016-03-01

    This document summarizes the physical models and mathematical formulations used in the RELAP-7 code. In summary, the MOOSE based RELAP-7 code development is an ongoing effort. The MOOSE framework enables rapid development of the RELAP-7 code. The developmental efforts and results demonstrate that the RELAP-7 project is on a path to success. This theory manual documents the main features implemented into the RELAP-7 code. Because the code is an ongoing development effort, this RELAP-7 Theory Manual will evolve with periodic updates to keep it current with the state of the development, implementation, and model additions/revisions.

  15. Security electronics circuits manual

    CERN Document Server

    MARSTON, R M

    1998-01-01

    Security Electronics Circuits Manual is an invaluable guide for engineers and technicians in the security industry. It will also prove to be a useful guide for students and experimenters, as well as providing experienced amateurs and DIY enthusiasts with numerous ideas to protect their homes, businesses and properties.As with all Ray Marston's Circuits Manuals, the style is easy-to-read and non-mathematical, with the emphasis firmly on practical applications, circuits and design ideas. The ICs and other devices used in the practical circuits are modestly priced and readily available ty

  16. TRUBA User Manual

    International Nuclear Information System (INIS)

    The TRUBA (pipeline in Russian) code is a computational tool for studying the propagation of Gaussian-shaped microwave beams in a prescribed equilibrium plasma. This manual covers the basic material handed to use the implementation of TRUBA (version 3,4) interfaced with the numerical library of the TJ-II stellarator. The manual provides a concise theoretical background of the problem, specifications for setting up the input files and interpreting the output of the code, and some information useful in modifying TRUBA. (Author) 13 refs

  17. Radar and ARPA manual

    CERN Document Server

    Bole, A G

    2013-01-01

    Radar and ARPA Manual focuses on the theoretical and practical aspects of electronic navigation. The manual first discusses basic radar principles, including principles of range and bearing measurements and picture orientation and presentation. The text then looks at the operational principles of radar systems. Function of units; aerial, receiver, and display principles; transmitter principles; and sitting of units on board ships are discussed. The book also describes target detection, Automatic Radar Plotting Aids (ARPA), and operational controls of radar systems, and then discusses radar plo

  18. Assessing patient-centered care in patients with chronic health conditions attending chiropractic practice: protocol for a mixed-methods study

    OpenAIRE

    Stuber, Kent Jason; Langweiler, Mark; Mior, Silvano; McCarthy, Peter William

    2016-01-01

    Background The management of chronic health conditions increasingly requires an organized, coordinated, and patient-centered approach to care. The Chronic Care Model (CCM) has been adopted in primary care to improve care delivery for those with chronic health conditions. Chiropractors manage chronic health conditions; however, little is known if such care is patient-centered. The primary aim of this study is to determine to what extent chiropractic patients with chronic health conditions perc...

  19. Collaborative Care for Older Adults with low back pain by family medicine physicians and doctors of chiropractic (COCOA): study protocol for a randomized controlled trial

    OpenAIRE

    Goertz Christine M; Salsbury Stacie A; Vining Robert D; Long Cynthia R; Andresen Andrew A; Jones Mark E; Lyons Kevin J; Hondras Maria A; Killinger Lisa Z; Wolinsky Fredric D; Wallace Robert B

    2013-01-01

    Abstract Background Low back pain is a prevalent and debilitating condition that affects the health and quality of life of older adults. Older people often consult primary care physicians about back pain, with many also receiving concurrent care from complementary and alternative medicine providers, most commonly doctors of chiropractic. However, a collaborative model of treatment coordination between these two provider groups has yet to be tested. The primary aim of the Collaborative Care fo...

  20. Cancer Alternative Therapies

    Science.gov (United States)

    You have many choices to make about your cancer treatment. One choice you might be thinking about ... are acupuncture, chiropractic, and herbal medicines. People with cancer may use CAM to Help cope with the ...

  1. Peer Leadership Manual.

    Science.gov (United States)

    Lovell, Nikki; Hachmeister, Paula

    This is a manual for peer counselors and parents in an alcohol and drug abuse prevention program for teenagers. The document opens with the training objectives for the peer helpers: to know yourself, to be a resource, and to promote and establish a drug-free peer group and drug-free activities in school. Discussion on these topics is provided: (1)…

  2. Christmas Tree Category Manual.

    Science.gov (United States)

    Bowman, James S.; Turmel, Jon P.

    This manual provides information needed to meet the standards for pesticide applicator certification. Pests and diseases of christmas tree plantations are identified and discussed. Section one deals with weeds and woody plants and the application, formulation and effects of herbicides in controlling them. Section two discusses specific diseases…

  3. Student Attendance Accounting Manual.

    Science.gov (United States)

    Freitas, Joseph M.

    In response to state legislation authorizing procedures for changes in academic calendars and measurement of student workload in California community colleges, this manual from the Chancellor's Office provides guidelines for student attendance accounting. Chapter 1 explains general items such as the academic calendar, admissions policies, student…

  4. ORACLE Manual for Programmers

    Energy Technology Data Exchange (ETDEWEB)

    Atta, Susie E.

    1958-01-22

    The "ORACLE", Oak Ridge Automatic Computer and Logical Engine, was installed at Oak Ridge National Laboratory :in 1953 and.has been in operation since that time. This manual describes the machine's design, the number systems it uses, and its basic operations.

  5. Waste Management Technical Manual

    Energy Technology Data Exchange (ETDEWEB)

    Buckingham, J.S. [ed.

    1967-08-31

    This Manual has been prepared to provide a documented compendium of the technical bases and general physical features of Isochem Incorporated`s Waste Management Program. The manual is intended to be used as a means of training and as a reference handbook for use by personnel responsible for executing the Waste Management Program. The material in this manual was assembled by members of Isochem`s Chemical Processing Division, Battelle Northwest Laboratory, and Hanford Engineering Services between September 1965 and March 1967. The manual is divided into the following parts: Introduction, contains a summary of the overall Waste Management Program. It is written to provide the reader with a synoptic view and as an aid in understanding the subsequent parts; Feed Material, contains detailed discussion of the type and sources of feed material used in the Waste Management Program, including a chapter on nuclear reactions and the formation of fission products; Waste Fractionization Plant Processing, contains detailed discussions of the processes used in the Waste Fractionization Plant with supporting data and documentation of the technology employed; Waste Fractionization Plant Product and Waste Effluent Handling, contains detailed discussions of the methods of handling the product and waste material generated by the Waste Fractionization Plant; Plant and Equipment, describes the layout of the Waste Management facilities, arrangement of equipment, and individual equipment pieces; Process Control, describes the instruments and analytical methods used for process control; and Safety describes process hazards and the methods used to safeguard against them.

  6. Nuclear electronics laboratory manual

    International Nuclear Information System (INIS)

    The Nuclear Electronics Laboratory Manual is a joint product of several electronics experts who have been associated with IAEA activity in this field for many years. The manual does not include experiments of a basic nature, such as characteristics of different active electronics components. It starts by introducing small electronics blocks, employing one or more active components. The most demanding exercises instruct a student in the design and construction of complete circuits, as used in commercial nuclear instruments. It is expected that a student who completes all the experiments in the manual should be in a position to design nuclear electronics units and also to understand the functions of advanced commercial instruments which need to be repaired or maintained. The future tasks of nuclear electronics engineers will be increasingly oriented towards designing and building the interfaces between a nuclear experiment and a computer. The manual pays tribute to this development by introducing a number of experiments which illustrate the principles and the technology of interfacing

  7. Drywall Finishing Manual.

    Science.gov (United States)

    Lengert, Gerald

    This manual, a self-study guide for apprentices in the drywall finishing trade in British Columbia, attempts to establish standards for the trade. It tells how to produce a properly taped and filled drywall surface and describes what that surface should look like. The standards emphasize quality work that can be realistically achieved on the job.…

  8. Matematica 3. Manual.

    Science.gov (United States)

    D'Alu, Maria Jose Miranda de Sousa

    This teachers manual accompanies a mathematics textbook, written in Portuguese, for third graders. It closely follows the objectives and methodology of the major curricula used throughout the schools in the United States. The 11 chapters deal with: numeration (0-999,999); addition with and without regrouping; subtraction with and without…

  9. WM Program manual

    CERN Document Server

    Tahat, Amani; Tahat, Mohammad

    2012-01-01

    This user manual has been written to describe the open source code WM to be distributed associated with a research article in the information technology journal 44124-ITJ-ANSI.entitled: "Maintenance and Reengineering of software: Creating a Visual C++ Graphical User Interface to Perform Specific Tasks Related to Soil Structure Interaction in Poroelastic Soil".

  10. Consumer Decisions. Student Manual.

    Science.gov (United States)

    Florida State Dept. of Education, Tallahassee. Div. of Vocational Education.

    This student manual covers five areas relating to consumer decisions. Titles of the five sections are Consumer Law, Consumer Decision Making, Buying a Car, Convenience Foods, and Books for Preschool Children. Each section may contain some or all of these materials: list of objectives, informative sections, questions on the information and answers,…

  11. AELIB user's manual

    International Nuclear Information System (INIS)

    This report is an updatable manual for users of AELIB, the AECL Library of FORTRAN-callable routines for the CRNL CDC 6600/CYBER 170 system. It provides general advice on the use of this library and detailed information on the selection and usage of particular library routines

  12. Therapeutic Recreation Practicum Manual.

    Science.gov (United States)

    Schneegas, Kay

    This manual provides information on the practicum program offered by Moraine Valley Community College (MVCC) for students in its therapeutic recreation program. Sections I and II outline the rationale and goals for providing practical, on-the-job work experiences for therapeutic recreation students. Section III specifies MVCC's responsibilities…

  13. RRFC hardware operation manual

    International Nuclear Information System (INIS)

    The Research Reactor Fuel Counter (RRFC) system was developed to assay the 235U content in spent Material Test Reactor (MTR) type fuel elements underwater in a spent fuel pool. RRFC assays the 235U content using active neutron coincidence counting and also incorporates an ion chamber for gross gamma-ray measurements. This manual describes RRFC hardware, including detectors, electronics, and performance characteristics

  14. Reference Service Training Manual.

    Science.gov (United States)

    Mielke, John; Young, William

    This manual is primarily designed as an orientation program for librarians new to the Reference Services Division at the State University of New York at Albany University Libraries. It contains practical information and some of the procedures necessary for providing service at the reference desk in these libraries. The appendices provide samples…

  15. Manual on industrial radiography

    International Nuclear Information System (INIS)

    This manual is intended as a source of educational material to personnel seeking certification as industrial radiographers, and as a guide and reference text for educational organizations that are providng courses in industrial radiography. It covers the basic principles of x-ray and gamma radiation, radiation safety, films and film processing, welding, casting and forging, aircraft structures and components, radiographic techniques, and records

  16. NDS EXFOR Manual

    International Nuclear Information System (INIS)

    This manual contains the coding rules and formats and NDS internal compilation rules for the exchange format (EXFOR) for the transmission of nuclear reaction data between national and international nuclear data centres, and for the data storage and retrieval system of the IAEA Nuclear Data Section

  17. SEDAP - user manual

    International Nuclear Information System (INIS)

    SEDAP (System for Experimental Data Processing) provides the scientist with a powerful tool to process various digital data which are sampled during an experiment. SEDAP is a software package based upon FORTRAN 77. The SEDAP-Manual contains all informations that are necessary for the application of SEDAP. It gives a complete description of all user accessible system functions, examples and error messages. (orig.)

  18. Audiology Services Manual.

    Science.gov (United States)

    Gallaudet Coll., Washington, DC. Pre-College Programs.

    The manual describes audiology services offered at the Model Secondary School for the Deaf (MSSD). Components are listed for diagnostic services, instructional services, program development, training, and publications. Testing and reporting procedures for MSSD students are outlined. Testing includes pure-tone air conduction testing, tympanometry,…

  19. Manual for subject analysis

    International Nuclear Information System (INIS)

    This document is one in a series of publications known as the ETDE/INIS Joint Reference Series and also constitutes a part of the ETDE Procedures Manual. It presents the rules, guidelines and procedures to be adopted by centers submitting input to the International Nuclear Information System (INIS) or the Energy Technology Data Exchange (ETDE). It is a manual for the subject analysis part of input preparation, meaning the selection, subject classification, abstracting and subject indexing of relevant publications, and is to be used in conjunction with the Thesauruses, Subject Categories documents and the documents providing guidelines for the preparation of abstracts. The concept and structure of the new manual are intended to describe in a logical and efficient sequence all the steps comprising the subject analysis of documents to be reported to INIS or ETDE. The manual includes new chapters on preparatory analysis, subject classification, abstracting and subject indexing, as well as rules, guidelines, procedures, examples and a special chapter on guidelines and examples for subject analysis in particular subject fields. (g.t.; a.n.)

  20. Operations Policy Manual, 2012

    Science.gov (United States)

    Teacher Education Accreditation Council, 2011

    2011-01-01

    The Teacher Education Accreditation Council's (TEAC's) "Operations Policy Manual" outlines all of TEAC's current policies and procedures related to TEAC members, TEAC administration, and the public, and includes the Bylaws of the Teacher Education Accreditation Council. Contents include: (1) Policies Related to TEAC Members; (2) Policies Related…

  1. Operations Policy Manual, 2010

    Science.gov (United States)

    Teacher Education Accreditation Council, 2010

    2010-01-01

    The Teacher Education Accreditation Council (TEAC) "Operations Policy Manual" outlines all of TEAC's current policies and procedures related to TEAC members, TEAC administration, and the public, and includes the Bylaws of the Teacher Education Accreditation Council, Inc. An index is also included.

  2. Usability Testing of User Manuals

    DEFF Research Database (Denmark)

    Møller, Margrethe H.

    2013-01-01

    Many guidelines and several standards exist for the development of good user manuals. But even though technical writers comply with all guidelines, problems will typically arise when users apply the manual in practice. Therefore, it is useful to have real users test the manual before...... it is published. This article discusses user tests in the form of think-aloud tests, with examples from the research project ”User Manuals for older adults"....

  3. Collaborative Care for Older Adults with low back pain by family medicine physicians and doctors of chiropractic (COCOA: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Goertz Christine M

    2013-01-01

    Full Text Available Abstract Background Low back pain is a prevalent and debilitating condition that affects the health and quality of life of older adults. Older people often consult primary care physicians about back pain, with many also receiving concurrent care from complementary and alternative medicine providers, most commonly doctors of chiropractic. However, a collaborative model of treatment coordination between these two provider groups has yet to be tested. The primary aim of the Collaborative Care for Older Adults Clinical Trial is to develop and evaluate the clinical effectiveness and feasibility of a patient-centered, collaborative care model with family medicine physicians and doctors of chiropractic for the treatment of low back pain in older adults. Methods/design This pragmatic, pilot randomized controlled trial will enroll 120 participants, age 65 years or older with subacute or chronic low back pain lasting at least one month, from a community-based sample in the Quad-Cities, Iowa/Illinois, USA. Eligible participants are allocated in a 1:1:1 ratio to receive 12 weeks of medical care, concurrent medical and chiropractic care, or collaborative medical and chiropractic care. Primary outcomes are self-rated back pain and disability. Secondary outcomes include general and functional health status, symptom bothersomeness, expectations for treatment effectiveness and improvement, fear avoidance behaviors, depression, anxiety, satisfaction, medication use and health care utilization. Treatment safety and adverse events also are monitored. Participant-rated outcome measures are collected via self-reported questionnaires and computer-assisted telephone interviews at baseline, and at 4, 8, 12, 24, 36 and 52 weeks post-randomization. Provider-rated expectations for treatment effectiveness and participant improvement also are evaluated. Process outcomes are assessed through qualitative interviews with study participants and research clinicians, chart audits

  4. Preliminary study into the components of the fear-avoidance model of LBP: change after an initial chiropractic visit and influence on outcome

    Directory of Open Access Journals (Sweden)

    Newell Dave

    2010-07-01

    Full Text Available Abstract Background In the last decade the sub grouping of low back pain (LBP patients according to their likely response to treatment has been identified as a research priority. As with other patient groups, researchers have found few if any factors from the case history or physical examination that are helpful in predicting the outcome of chiropractic care. However, in the wider LBP population psychosocial factors have been identified that are significantly prognostic. This study investigated changes in the components of the LBP fear-avoidance beliefs model in patients pre- and post- their initial visit with a chiropractor to determine if there was a relationship with outcomes at 1 month. Methods Seventy one new patients with lower back pain as their primary complaint presenting for chiropractic care to one of five clinics (nine chiropractors completed questionnaires before their initial visit (pre-visit and again just before their second appointment (post-visit. One month after the initial consultation, patient global impression of change (PGIC scores were collected. Pre visit and post visit psychological domain scores were analysed for any association with outcomes at 1 month. Results Group mean scores for Fear Avoidance Beliefs (FAB, catastrophisation and self-efficacy were all improved significantly within a few days of a patient's initial chiropractic consultation. Pre-visit catastrophisation as well as post-visit scores for catastrophisation, back beliefs (inevitability and self-efficacy were weakly correlated with patient's global impression of change (PGIC at 1 month. However when the four assessed psychological variables were dichotomised about pre-visit group medians those individuals with 2 or more high variables post-visit had a substantially increased risk (OR 36.4 (95% CI 6.2-213.0 of poor recovery at 1 month. Seven percent of patients with 1 or fewer adverse psychological variables described poor benefit compared to 73% of those

  5. Citizen participation manual

    Energy Technology Data Exchange (ETDEWEB)

    1979-08-13

    The Office of Consumer Affairs has the primary responsibility for managing and coordinating the public-participation efforts of the Department of Energy through public meetings, advisory committee participation, and other outreach mechanisms aimed at assuring all citizens an opportunity to participate in the governmental process relating to energy decisions. The Manual outlines the public-participation policy that should be followed by all offices. All offices are directed to observe the guidance in the manual in shaping and conducting public-participation activities, including the public-participation efforts required by DOE Order 2030, Procedures for the Development and Analysis of Regulations, Standards, and Guidelines. Two chapters included are: Determining Public Participation Needs and Public Participation Plan. (MCW)

  6. NDS EXFOR manual

    International Nuclear Information System (INIS)

    EXFOR is the agreed exchange format for the transmission of nuclear reaction data between national and international nuclear data centers for the benefit of nuclear data users in all countries. The IAEA Nuclear Data Section uses the EXFOR system not only for the center-to-center data exchange but also as its data storage and retrieval system. This NDS EXFOR MANUAL therefore contains the agreed EXFOR coding rules and format, supplemented by NDS internal compilation rules. The EXFOR system and the EXFOR nuclear data library with several million data records originate from the cooperation of an increasing number of data centers whose names and addresses can be found inside the Manual. Their contributions and cooperative efforts are gratefully acknowledged. (author)

  7. REBA experimenters' manual

    International Nuclear Information System (INIS)

    The REBA is a high-energy, pulsed electron beam or bremsstrahlung x-ray generator whose operational purpose is to provide an energy source of short duration for conducting experiments, primarily to determine material responses to rapid surface and in-depth deposition of energy. The purpose of this manual is to serve as a basic source of information for prospective users of REBA. Included is a brief discussion of the design and operation of the facility as well as a summary of output characteristics for electron beam modes and environmental data for x-ray operation. The manual also contains a description of the REBA experimental facilities, including geometry of the test cell, instrumentation and data collection capabilities, and services and support available to experimenters

  8. The environmental survey manual

    International Nuclear Information System (INIS)

    The purpose of this manual is to provide guidance to the Survey and Sampling and Analysis teams that conduct the one-time Environmental Survey of the major US Department of Energy (DOE) operating facilities. This manual includes a discussion of DOE's policy on environmental issues, a review of statutory guidance as it applies to the Survey, the procedures and protocols to be used by the Survey teams, criteria for the use of the Survey teams in evaluating existing environmental data for the Survey effort, generic technical checklists used in every Survey, health and safety guidelines for the personnel conducting the Survey, including the identification of potential hazards, prescribed protective equipment, and emergency procedures, the required formats for the Survey reports, guidance on identifying environmental problems that need immediate attention by the Operations Office responsible for the particular facility, and procedures and protocols for the conduct of sampling and analysis

  9. TOKM hardware operation manual

    International Nuclear Information System (INIS)

    This manual describes the detector design features, performance, and operating characteristics of the Tokai-1 spent fuel monitor. The system includes a pair of monitors-one for the primary (normal) fuel transfer chute and one for the by-pass fuel transfer chute. Each monitor contains four independent detector tubes to provide direction of travel and redundancy. There are two ion chambers and two 3He tubes inside each detector package. All of the detectors are used to monitor the presence of spent-fuel gamma rays as the fuel rods pass alongside the detector package. Gamma-ray and neutron detector (GRAND) electronics supply power to the ion chambers and 3He tubes, and the data is collected in the GRAND and the Kontron computer. The system is designed to operate unattended with data pickup by the inspectors on a 90-day period. This manual gives the performance and calibration parameters

  10. Teacher Training Manual (2)

    Institute of Scientific and Technical Information of China (English)

    《英语》(新标准)外方编委

    2005-01-01

    本刊2004年第3期曾刊登由新标准英语外方编委撰写的Teacher Training Manual(1),受到读者的一致好评。为此,本期将继续刊登其余部分,包括:Pronunciation,Learning Styles,Multiple Intelligences和Lesson plans。

  11. X Python reference manual

    OpenAIRE

    Mullender, Sjoerd

    1995-01-01

    This document describes the built-in types, exceptions, and functions of the X windows extension to Python. It assumes basic knowledge about the Python language and access to the X windows documentation. For an informal introduction to the language, see the Python Tutorial. The Python Reference Manual gives a more formal definition of the language. The Python Library Reference describes the built-in and standard modules of Python. This document can be seen as en extension to that document.

  12. OASIS User Manual

    CERN Document Server

    Bojtar, L

    2009-01-01

    The OASIS system has been operational for years now. After a long development the project has reached a state where the number of features it provides exceeds largely what most of its users knows about. The author felt it was time to write a user manual explaining all the functionality of the viewer application. This document is a user manual, concentrating on the functionality of the viewer from the user’s point of view. There are already documents available on the project’s web site about the technical aspects at http://project-oasis.web.cern.ch/project-oasis/presentations.htm . There was an attempt to produce a tutorial on the viewer, but it didn’t get much further than the table of contents, that however is well thought. The structure of this user manual follows the same principle, the basic and most often used features are grouped together. Advanced or less often used features are described in a separate chapter. There is a second organizational principle, features belong to different levels: chann...

  13. Program Management System manual

    International Nuclear Information System (INIS)

    The Program Management System (PMS), as detailed in this manual, consists of all the plans, policies, procedure, systems, and processes that, taken together, serve as a mechanism for managing the various subprograms and program elements in a cohesive, cost-effective manner. The PMS is consistent with the requirements of the Nuclear Waste Policy Act of 1982 and the ''Mission Plan for the Civilian Radioactive Waste Management Program'' (DOE/RW-0005). It is based on, but goes beyond, the Department of Energy (DOE) management policies and procedures applicable to all DOE programs by adapting these directives to the specific needs of the Civilian Radioactive Waste Management program. This PMS Manual describes the hierarchy of plans required to develop and maintain the cost, schedule, and technical baselines at the various organizational levels of the Civilian Radioactive Waste Management Program. It also establishes the management policies and procedures used in the implementation of the Program. These include requirements for internal reports, data, and other information; systems engineering management; regulatory compliance; safety; quality assurance; and institutional affairs. Although expanded versions of many of these plans, policies, and procedures are found in separate documents, they are an integral part of this manual. The PMS provides the basis for the effective management that is needed to ensure that the Civilian Radioactive Waste Management Program fulfills the mandate of the Nuclear Waste Policy Act of 1982. 5 figs., 2 tabs

  14. ETAP user's manual

    International Nuclear Information System (INIS)

    The event tree analysis technique has been used in Probabilistic Safety Assessment for LWRs to delineate various accident scenarios leading to core melt or containment failure and to evaluate their frequencies. This technique often requires manual preparation of event trees with iterative process and time-consuming work in data handling. For the purpose of reducing manual efforts in event tree analysis, we developed a new software package named ETAP (Event Tree Analysis Supporting Program) for event tree analysis. ETAP is an interactive PC-based program which has the ability to construct, update, document, and quantify event trees. Because of its fast running capability to quantify event trees, use of the EATP program can make it easy to perform the sensitivity studies on a variety of system/containment performance issues. This report provides a user's manual for ETAP, which describes the structure, installation, and use of EATP. This software runs on NEC/PC-9800 or compatible PCs that have a 640 KB memory and MS-DOS 2.11 or higher. (author)

  15. CHRPR Operations Manual

    Energy Technology Data Exchange (ETDEWEB)

    Windsor, Bradford T.; Woodring, Mitchell L.; Myjak, Mitchell J.

    2012-08-21

    proportional to the amplitude, via voltage to pulse width converters (VPW). These time widths are then digitized by a field programmable gate array (FPGA) and transmitted over Ethernet to a data acquisition computer. The CHRPR records the magnitude of each pulse to a continuous event mode file on or each detector and occupancy sensor This manual begins with CHRPR installation instructions, then a section on CHRPR software. Afterward is a brief overview of how the TSA system works, then an explanation of the CHRPR. This manual is meant as a supplement to the TSA VM-250AGN manual, which can be found at http://tsasystems.com/library/manuals/pm700agn-vm250agn_manual.pdf . That manual is the manufacturer’s guide for the installation, programming, and maintenance of the portal system.

  16. MAP user's manual copyright

    International Nuclear Information System (INIS)

    The program MITMAP represents a set of general purpose, two- dimensional, finite element programs for the calculation of magnetic fields. It consists of the program MAP and MAP2DJ. The two programs are used to solve different electromagnetic problems, but they have a common set of subrountines for pre- and postprocessing. Originally separate programs, they have been combined to make modification easier. The manuals, however, will remain separate. The program MAP is described in this manual. MAP is applicable to the class of problems with two-dimensional-planar or axisymmetric - geometries, in which the current density and the magnetic vector potential have only a single nonvanishing component. The single component is associated with the direction that is perpendicular to the plane of the problem and is invariant with respect to that direction. Maxwell's equations can be reduced to a solver diffusion equation in terms of the single, nonvanishing component of the magnetic vector potential for planar problems and to a single component of a vector potential for planar problems and to a single component of a vector diffusion equation for axisymmetric problems. The magnetic permeability appears in the governing equation. The permeability may be a function of the magnetic flux density. In addition, any electrically conducting material present will have eddy currents induced by a time varying magnetic field. These eddy currents must be included in the solution process. This manual provides a description of the structure of the input data and output for the program. There are several example problems presented that illustrate the major program features. Appendices are included that contain a derivation of the governing equations and the application of the finite element method to the solution of the equations

  17. INIS: Database manual

    International Nuclear Information System (INIS)

    This document is one in a series of publications known as the INIS Reference Series. It is intended for users of INIS (International Nuclear Information System) output data on various media (FTP file, CD-ROM, e-mail file, earlier magnetic tape, cartridge, etc.). This manual provides a description of each data element including information on contents, structure and usage as well as historical overview of additions, deletions and changes of data elements and their contents that have taken place over the years. Each record contains certain control data fields (001-009), one, two or three bibliographic levels, a set of descriptors, and zero, one or more abstracts, one in English and optionally one or more in another language. In order to facilitate the description of the system, the sequence of data elements is based on the input or, as it is internally called, worksheet format which differs from the exchange format described in the manual IAEA-INIS-7. A separate section is devoted to each data element and deviations from the exchange format are indicated whenever present. As the Record Leader and the Directory are sufficiently explained in Chapter 3.1 of IAEA-INIS-7, the contents of this manual are limited to control fields and data fields; the detailed explanations are intended to supplement the basic information given in Chapter 3.2 of IAEA-INIS-7. Bibliographic levels are used to identify component parts of a publication, i.e. chapters in a book, articles in a journal issue, conference papers in a proceedings volume. All bibliographic levels contained in a record are given in a control data field. Each bibliographic level identifier appears in the subdirectory with a pointer to its position in the record

  18. Network simulation experiments manual

    CERN Document Server

    Aboelela, Emad

    2011-01-01

    Network Simulation Experiments Manual, Third Edition, contains simulation-based experiments to help students and professionals learn about key concepts in computer networking. The simulation approach provides a virtual environment for a wide range of desirable features, such as modeling a network based on specified criteria and analyzing its performance under different scenarios. The experiments include the basics of using OPNET IT Guru Academic Edition; operation of the Ethernet network; partitioning of a physical network into separate logical networks using virtual local area networks (V

  19. Cliffs User Manual

    CERN Document Server

    Tolkova, Elena

    2014-01-01

    Cliffs is an open-source relative of MOST (Method Of Splitting Tsunamis) numerical model, implemented as described in (Tolkova, 2014, Pure and Appl. Geophys., 171(9), 2289-2314). Cliffs features: Shallow-Water approximation with an option to manipulate numerical dispersion; Use of Cartesian or spherical (lon/lat) coordinates; 1D and 2D configurations; Structured co-located grid with (optionally) varying spacing; Runup on land; Initial conditions or boundary forcing; Grid nesting with one-way coupling; Parallelized with OpenMP; NetCDF format of input/output data. This user manual accompanies Cliffs code distribution.

  20. CMOS circuits manual

    CERN Document Server

    Marston, R M

    1995-01-01

    CMOS Circuits Manual is a user's guide for CMOS. The book emphasizes the practical aspects of CMOS and provides circuits, tables, and graphs to further relate the fundamentals with the applications. The text first discusses the basic principles and characteristics of the CMOS devices. The succeeding chapters detail the types of CMOS IC, including simple inverter, gate and logic ICs and circuits, and complex counters and decoders. The last chapter presents a miscellaneous collection of two dozen useful CMOS circuits. The book will be useful to researchers and professionals who employ CMOS circu

  1. Radioanalytical methods manual

    International Nuclear Information System (INIS)

    This Radioanalytical Methods manual is comprised of 12 chapters. It includes a review of the pertinent literature up to the end of 1982 pertaining to the measurement of the radioactive species listed under the terms of the contract. Included is methodology recommended for the decompositions of soils, tailings, ores, biological samples and air filters. Detailed analytical methodology for the measurement of gross alpha, gross beta, gross gamma, uranium, radium-226, radium-228, lead-210, thorium-232, thorium-230, thorium-228, total thorium, radon-222, radon-220 and radon-219 is presented

  2. Timber designers' manual

    CERN Document Server

    Ozelton, E C

    2008-01-01

    This major reference manual covers both overall and detail design of structural timber, including aspects such as shear deflection, creep, dynamic and lateral stability considerations for flexural members.Available for the first time in paperback, the Third Edition was substantially revised to take account of the many changes since the previous edition was published in 1984. It is based on British Standard BS 5268-2: 2002, which brought design concepts closer to European practice and Eurocode 5.Features of the Third Edition include:* information on bolt values including

  3. Timergenerator circuits manual

    CERN Document Server

    Marston, R M

    2013-01-01

    Timer/Generator Circuits Manual is an 11-chapter text that deals mainly with waveform generator techniques and circuits. Each chapter starts with an explanation of the basic principles of its subject followed by a wide range of practical circuit designs. This work presents a total of over 300 practical circuits, diagrams, and tables.Chapter 1 outlines the basic principles and the different types of generator. Chapters 2 to 9 deal with a specific type of waveform generator, including sine, square, triangular, sawtooth, and special waveform generators pulse. These chapters also include pulse gen

  4. ASSERT-4 user's manual

    International Nuclear Information System (INIS)

    ASSERT-4 is an advanced subchannel code being developed primarily to model single- and two-phase flow and heat transfer in horizontal rod bundles. This manual is intended to facilitate the application of this code to the analysis of flow in reactor fuel channels. It contains a brief description of the thermalhydraulic model and ASSERT-4 solution scheme, and other information required by users. This other information includes a detailed discussion of input data requirements, a sample problem and solution, and information describing how to access and run ASSERT-4 on the Chalk River computers

  5. RADTRAN 6 Technical Manual

    Energy Technology Data Exchange (ETDEWEB)

    Weiner, Ruth F. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Neuhauser, Karen Sieglinde [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Heames, Terence John [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); O' Donnell, Brandon M. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Dennis, Matthew L. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2014-01-01

    This Technical Manual contains descriptions of the calculation models and mathematical and numerical methods used in the RADTRAN 6 computer code for transportation risk and consequence assessment. The RADTRAN 6 code combines user-supplied input data with values from an internal library of physical and radiological data to calculate the expected radiological consequences and risks associated with the transportation of radioactive material. Radiological consequences and risks are estimated with numerical models of exposure pathways, receptor populations, package behavior in accidents, and accident severity and probability.

  6. RADTRAN 6 technical manual.

    Energy Technology Data Exchange (ETDEWEB)

    Weiner, Ruth F.; Neuhauser, Karen Sieglinde; Heames, Terence John; O' Donnell, Brandon M.; Dennis, Matthew L.

    2014-01-01

    This Technical Manual contains descriptions of the calculation models and mathematical and numerical methods used in the RADTRAN 6 computer code for transportation risk and consequence assessment. The RADTRAN 6 code combines user-supplied input data with values from an internal library of physical and radiological data to calculate the expected radiological consequences and risks associated with the transportation of radioactive material. Radiological consequences and risks are estimated with numerical models of exposure pathways, receptor populations, package behavior in accidents, and accident severity and probability.

  7. Optoelectronics circuits manual

    CERN Document Server

    Marston, R M

    1999-01-01

    This manual is a useful single-volume guide specifically aimed at the practical design engineer, technician, and experimenter, as well as the electronics student and amateur. It deals with the subject in an easy to read, down to earth, and non-mathematical yet comprehensive manner, explaining the basic principles and characteristics of the best known devices, and presenting the reader with many practical applications and over 200 circuits. Most of the ICs and other devices used are inexpensive and readily available types, with universally recognised type numbers.The second edition

  8. Optoelectronics circuits manual

    CERN Document Server

    Marston, R M

    2013-01-01

    Optoelectronics Circuits Manual covers the basic principles and characteristics of the best known types of optoelectronic devices, as well as the practical applications of many of these optoelectronic devices. The book describes LED display circuits and LED dot- and bar-graph circuits and discusses the applications of seven-segment displays, light-sensitive devices, optocouplers, and a variety of brightness control techniques. The text also tackles infrared light-beam alarms and multichannel remote control systems. The book provides practical user information and circuitry and illustrations.

  9. Manual of Decolonization

    DEFF Research Database (Denmark)

    Gigone, Fabio

    2010-01-01

    During a residency in Bethlehem, Venice-based design and research studio Salottobuono formulated a 'strategy of subversion' for Israeli settlements in the West Bank. From this comes the elegant Manual of Decolonization; a generic but detailed resource for all post-occupation scenarios. Assessing...... how evacuated and imposed structures can be transformed in collaboration with local stakeholders, the book's plans, models and projections are divided into themes like 'De-parcelling', 'Re-combining' and 'Un-roofing'; landscape, nature and materials are considered at length. The outcome is an open...

  10. California solar data manual

    Energy Technology Data Exchange (ETDEWEB)

    Berdahl, P.; Grether, D.; Martin, M.; Wahlig, M.

    1978-01-01

    Factors that determined the data contents of the manual are presented. Estimates of errors in the data are provided, and the impact of these errors on solar design is discussed. The state is divided into 15 solar zones of roughly similar solar radiation conditions, which are illustrated along with page references to the most relevant solar and climate data. A guide to the data tables and graphs is provided, which are displayed under solar, climate, and sky charts. A guide is given to simplified design methods to predict performance and cost of solar heating and cooling systems. (MHR)

  11. Modern TTL circuits manual

    CERN Document Server

    Marston, R M

    2013-01-01

    Modern TTL Circuits Manual provides an introduction to the basic principles of Transistor-Transistor Logic (TTL). This book outlines the major features of the 74 series of integrated circuits (ICs) and introduces the various sub-groups of the TTL family.Organized into seven chapters, this book begins with an overview of the basics of digital ICs. This text then examines the symbology and mathematics of digital logic. Other chapters consider a variety of topics, including waveform generator circuitry, clocked flip-flop and counter circuits, special counter/dividers, registers, data latches, com

  12. Complementary/alternative therapies for premenstrual syndrome: a systematic review of randomized controlled trials.

    Science.gov (United States)

    Stevinson, C; Ernst, E

    2001-07-01

    Complementary/alternative therapies are popular with women who have premenstrual syndrome. This systematic review was designed to determine whether use of such therapies is supported by evidence of effectiveness from rigorous clinical trials. Trials were located through searching 7 databases and checking the reference lists of articles. Randomized controlled trials investigating a complementary/alternative therapy in women with premenstrual syndrome published in the peer-reviewed literature were included in the review. Twenty-seven trials were included investigating herbal medicine (7 trials), homeopathy (1), dietary supplements (13), relaxation (1), massage (1), reflexology (1) chiropractic (1), and biofeedback (2). Despite some positive findings, the evidence was not compelling for any of these therapies, with most trials suffering from various methodological limitations. On the basis of current evidence, no complementary/alternative therapy can be recommended as a treatment for premenstrual syndrome. PMID:11483933

  13. Radiological control manual. Revision 1

    International Nuclear Information System (INIS)

    This Lawrence Berkeley National Laboratory Radiological Control Manual (LBNL RCM) has been prepared to provide guidance for site-specific additions, supplements and interpretation of the DOE Radiological Control Manual. The guidance provided in this manual is one methodology to implement the requirements given in Title 10 Code of Federal Regulations Part 835 (10 CFR 835) and the DOE Radiological Control Manual. Information given in this manual is also intended to provide demonstration of compliance to specific requirements in 10 CFR 835. The LBNL RCM (Publication 3113) and LBNL Health and Safety Manual Publication-3000 form the technical basis for the LBNL RPP and will be revised as necessary to ensure that current requirements from Rules and Orders are represented. The LBNL RCM will form the standard for excellence in the implementation of the LBNL RPP

  14. Radiological control manual. Revision 1

    Energy Technology Data Exchange (ETDEWEB)

    Kloepping, R.

    1996-05-01

    This Lawrence Berkeley National Laboratory Radiological Control Manual (LBNL RCM) has been prepared to provide guidance for site-specific additions, supplements and interpretation of the DOE Radiological Control Manual. The guidance provided in this manual is one methodology to implement the requirements given in Title 10 Code of Federal Regulations Part 835 (10 CFR 835) and the DOE Radiological Control Manual. Information given in this manual is also intended to provide demonstration of compliance to specific requirements in 10 CFR 835. The LBNL RCM (Publication 3113) and LBNL Health and Safety Manual Publication-3000 form the technical basis for the LBNL RPP and will be revised as necessary to ensure that current requirements from Rules and Orders are represented. The LBNL RCM will form the standard for excellence in the implementation of the LBNL RPP.

  15. Manual evaluation of the diaphragm muscle.

    Science.gov (United States)

    Bordoni, Bruno; Marelli, F; Morabito, B; Sacconi, B

    2016-01-01

    The respiratory diaphragm is the most important muscle for breathing. It contributes to various processes such as expectoration, vomiting, swallowing, urination, and defecation. It facilitates the venous and lymphatic return and helps viscera located above and below the diaphragm to work properly. Its activity is fundamental in the maintenance of posture and body position changes. It can affect the pain perception and emotional state. Many authors reported on diaphragmatic training by using special instruments, whereas only a few studies focused on manual therapy approaches. To the knowledge of the authors, the existing scientific literature does not exhaustively examines the manual evaluation of the diaphragm in its different portions. A complete evaluation of the diaphragm is mandatory for several professional subjects, such as physiotherapists, osteopaths, and chiropractors not only to elaborate a treatment strategy but also to obtain information on the validity of the training performed on the patient. This article aims to describe a strategy of manual evaluation of the diaphragm, with particular attention to anatomical fundamentals, in order to stimulate further research on this less explored field. PMID:27574419

  16. LCS Users Manual

    International Nuclear Information System (INIS)

    The Lower Hybrid Simulation Code (LSC) is a computational model of lower hybrid current drive in the presence of an electric field. Details of geometry, plasma profiles, and circuit equations are treated. Two-dimensional velocity space effects are approximated in a one-dimensional Fokker-Planck treatment. The LSC was originally written to be a module for lower hybrid current drive called by the Tokamak Simulation Code (TSC), which is a numerical model of an axisymmetric tokamak plasma and the associated control systems. The TSC simulates the time evolution of a free boundary plasma by solving the MHD equations on a rectangular computational grid. The MHD equations are coupled to the external circuits (representing poloidal field coils) through the boundary conditions. The code includes provisions for modeling the control system, external heating, and fusion heating. The LSC module can also be called by the TRANSP code. TRANSP represents the plasma with an axisymmetric, fixed-boundary model and focuses on calculation of plasma transport to determine transport coefficients from data on power inputs and parameters reached. This manual covers the basic material needed to use the LSC. If run in conjunction with TSC, the ''TSC Users Manual'' should be consulted. If run in conjunction with TRANSP, on-line documentation will be helpful. A theoretical background of the governing equations and numerical methods is given. Information on obtaining, compiling, and running the code is also provided

  17. Electronic Commerce user manual

    Energy Technology Data Exchange (ETDEWEB)

    1992-04-10

    This User Manual supports the Electronic Commerce Standard System. The Electronic Commerce Standard System is being developed for the Department of Defense of the Technology Information Systems Program at the Lawrence Livermore National Laboratory, operated by the University of California for the Department of Energy. The Electronic Commerce Standard System, or EC as it is known, provides the capability for organizations to conduct business electronically instead of through paper transactions. Electronic Commerce and Computer Aided Acquisition and Logistics Support, are two major projects under the DoD's Corporate Information Management program, whose objective is to make DoD business transactions faster and less costly by using computer networks instead of paper forms and postage. EC runs on computers that use the UNIX operating system and provides a standard set of applications and tools that are bound together by a common command and menu system. These applications and tools may vary according to the requirements of the customer or location and may be customized to meet the specific needs of an organization. Local applications can be integrated into the menu system under the Special Databases Applications option on the EC main menu. These local applications will be documented in the appendices of this manual. This integration capability provides users with a common environment of standard and customized applications.

  18. Electronic Commerce user manual

    Energy Technology Data Exchange (ETDEWEB)

    1992-04-10

    This User Manual supports the Electronic Commerce Standard System. The Electronic Commerce Standard System is being developed for the Department of Defense of the Technology Information Systems Program at the Lawrence Livermore National Laboratory, operated by the University of California for the Department of Energy. The Electronic Commerce Standard System, or EC as it is known, provides the capability for organizations to conduct business electronically instead of through paper transactions. Electronic Commerce and Computer Aided Acquisition and Logistics Support, are two major projects under the DoD`s Corporate Information Management program, whose objective is to make DoD business transactions faster and less costly by using computer networks instead of paper forms and postage. EC runs on computers that use the UNIX operating system and provides a standard set of applications and tools that are bound together by a common command and menu system. These applications and tools may vary according to the requirements of the customer or location and may be customized to meet the specific needs of an organization. Local applications can be integrated into the menu system under the Special Databases & Applications option on the EC main menu. These local applications will be documented in the appendices of this manual. This integration capability provides users with a common environment of standard and customized applications.

  19. MELCOR computer code manuals

    Energy Technology Data Exchange (ETDEWEB)

    Summers, R.M.; Cole, R.K. Jr.; Smith, R.C.; Stuart, D.S.; Thompson, S.L. [Sandia National Labs., Albuquerque, NM (United States); Hodge, S.A.; Hyman, C.R.; Sanders, R.L. [Oak Ridge National Lab., TN (United States)

    1995-03-01

    MELCOR is a fully integrated, engineering-level computer code that models the progression of severe accidents in light water reactor nuclear power plants. MELCOR is being developed at Sandia National Laboratories for the U.S. Nuclear Regulatory Commission as a second-generation plant risk assessment tool and the successor to the Source Term Code Package. A broad spectrum of severe accident phenomena in both boiling and pressurized water reactors is treated in MELCOR in a unified framework. These include: thermal-hydraulic response in the reactor coolant system, reactor cavity, containment, and confinement buildings; core heatup, degradation, and relocation; core-concrete attack; hydrogen production, transport, and combustion; fission product release and transport; and the impact of engineered safety features on thermal-hydraulic and radionuclide behavior. Current uses of MELCOR include estimation of severe accident source terms and their sensitivities and uncertainties in a variety of applications. This publication of the MELCOR computer code manuals corresponds to MELCOR 1.8.3, released to users in August, 1994. Volume 1 contains a primer that describes MELCOR`s phenomenological scope, organization (by package), and documentation. The remainder of Volume 1 contains the MELCOR Users Guides, which provide the input instructions and guidelines for each package. Volume 2 contains the MELCOR Reference Manuals, which describe the phenomenological models that have been implemented in each package.

  20. SYVAC3 manual

    International Nuclear Information System (INIS)

    SYVAC3 (Systems Variability Analysis Code, generation 3) is a computer program that implements a method called systems variability analysis to analyze the behaviour of a system in the presence of uncertainty. This method is based on simulating the system many times to determine the variation in behaviour it can exhibit. SYVAC3 specializes in systems representing the transport of contaminants, and has several features to simplify the modelling of such systems. It provides a general tool for estimating environmental impacts from the dispersal of contaminants. This report describes the use and structure of SYVAC3. It is intended for modellers, programmers, operators and reviewers who deal with simulation codes based on SYVAC3. From this manual they can learn how to link a model with SYVAC3, how to set up an input file, and how to extract results from output files. The manual lists the subroutines of SYVAC3 that are available for use by models, and describes their argument lists. It also gives an overview of how routines in the File Reading Package, the Parameter Sampling Package and the Time Series Package can be used by programs outside of SYVAC3. (author)

  1. MELCOR computer code manuals

    International Nuclear Information System (INIS)

    MELCOR is a fully integrated, engineering-level computer code that models the progression of severe accidents in light water reactor nuclear power plants. MELCOR is being developed at Sandia National Laboratories for the U.S. Nuclear Regulatory Commission as a second-generation plant risk assessment tool and the successor to the Source Term Code Package. A broad spectrum of severe accident phenomena in both boiling and pressurized water reactors is treated in MELCOR in a unified framework. These include: thermal-hydraulic response in the reactor coolant system, reactor cavity, containment, and confinement buildings; core heatup, degradation, and relocation; core-concrete attack; hydrogen production, transport, and combustion; fission product release and transport; and the impact of engineered safety features on thermal-hydraulic and radionuclide behavior. Current uses of MELCOR include estimation of severe accident source terms and their sensitivities and uncertainties in a variety of applications. This publication of the MELCOR computer code manuals corresponds to MELCOR 1.8.3, released to users in August, 1994. Volume 1 contains a primer that describes MELCOR's phenomenological scope, organization (by package), and documentation. The remainder of Volume 1 contains the MELCOR Users Guides, which provide the input instructions and guidelines for each package. Volume 2 contains the MELCOR Reference Manuals, which describe the phenomenological models that have been implemented in each package

  2. SYVAC3 manual

    Energy Technology Data Exchange (ETDEWEB)

    Andres, T.H

    2000-07-01

    SYVAC3 (Systems Variability Analysis Code, generation 3) is a computer program that implements a method called systems variability analysis to analyze the behaviour of a system in the presence of uncertainty. This method is based on simulating the system many times to determine the variation in behaviour it can exhibit. SYVAC3 specializes in systems representing the transport of contaminants, and has several features to simplify the modelling of such systems. It provides a general tool for estimating environmental impacts from the dispersal of contaminants. This report describes the use and structure of SYVAC3. It is intended for modellers, programmers, operators and reviewers who deal with simulation codes based on SYVAC3. From this manual they can learn how to link a model with SYVAC3, how to set up an input file, and how to extract results from output files. The manual lists the subroutines of SYVAC3 that are available for use by models, and describes their argument lists. It also gives an overview of how routines in the File Reading Package, the Parameter Sampling Package and the Time Series Package can be used by programs outside of SYVAC3. (author)

  3. FUGM hardware operation manual

    International Nuclear Information System (INIS)

    This manual describes the detector design features, performance, and operating characteristics of the Fugen reactor gate monitor for monitoring fresh and spent fuel transfers between the core and storage ponds. This system consists of two monitors located at each end of the transfer chute. The larger monitor contains two 3He tubes, two fission chambers, and two ion chambers. The smaller monitor, used for direction of motion redundancy, contains two ion chambers. All detectors provide information for identifying the type, fresh or spent UOX or MOX fuel, and direction of the fuel transfer. The gamma-ray and neutron detector (GRAND-3) electronics package supplies power to the radiation sensors and collects the radiation data for storage on a laptop computer. The system is designed to operate unattended with data collection by the inspectors occurring on 90-day time intervals. This manual also includes radiation data for the six types of fuel transfers and equipment transfers along with the direction of motion information collected during the installation at the Fugen reactor

  4. Energy statistics manual

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2004-07-01

    The Manual is written in a question-and-answer format. The points developed are introduced with a basic question, such as: What do people mean by 'fuels' and 'energy'? What units are used to express oil? How are energy data presented? Answers are given in simple terms and illustrated by graphs, charts and tables. More technical explanations are found in the annexes. The Manual contains seven chapters. The first one presents the fundamentals of energy statistics, five chapters deal with the five different fuels (electricity and heat; natural gas; oil; solid fuels and manufactured gases; renewables and waste) and the last chapter explains the energy balance. Three technical annexes and a glossary are also included. For the five chapters dedicated to the fuels, there are three levels of reading: the first one contains general information on the subject, the second one reviews issues which are specific to the joint IEA/OECD-Eurostat-UNECE questionnaires and the third one focuses on the essential elements of the subject. 43 figs., 22 tabs., 3 annexes.

  5. Camp Health Aide Manual = Manual para trabajadores de salud.

    Science.gov (United States)

    Robinson, June Grube; And Others

    This bilingual manual serves as a textbook for migrant Camp Health Aides. Camp Health Aides are members of migrant labor camps enlisted to provide information about health and social services to migrant workers and their families. The manual is divided into 12 tabbed sections representing lessons. Teaching notes printed on contrasting paper…

  6. Ciencias 2. Manual do Professor (Science Teacher's Manual).

    Science.gov (United States)

    Raposo, Lucilia

    This is the teacher's manual for Ciencias 2, the second in a series of elementary science textbooks for Portuguese-speaking students. The student textbook contains 10 chapters and 57 activities. The teacher's manual presents an explanation of the educational goals and the organization of the content, Topics included are environment, the human,…

  7. Project PAL Resources. Procedures Manual. Tutor Training Manual. Tutor Handbook.

    Science.gov (United States)

    Centre County Vocational-Technical School, Pleasant Gap, PA. CIU 10 Bi-County Development Center for Adults.

    This document contains the final report of Project PAL (Pennsylvania Adult Literacy), designed to address staff development needs at a Pennsylvania adult literacy center, and three manuals: a tutor training resource manual for use by coordinators in developing a 9.5 hour tutor-training session, a tutor handbook for volunteers, and a coordinator's…

  8. Rivet user manual

    Science.gov (United States)

    Buckley, Andy; Butterworth, Jonathan; Grellscheid, David; Hoeth, Hendrik; Lönnblad, Leif; Monk, James; Schulz, Holger; Siegert, Frank

    2013-12-01

    This is the manual and user guide for the Rivet system for the validation and tuning of Monte Carlo event generators. As well as the core Rivet library, this manual describes the usage of the rivet program and the AGILe generator interface library. The depth and level of description is chosen for users of the system, starting with the basics of using validation code written by others, and then covering sufficient details to write new Rivet analyses and calculational components. Catalogue identifier: AEPS_v1_0 Program summary URL:http://cpc.cs.qub.ac.uk/summaries/AEPS_v1_0.html Program obtainable from: CPC Program Library, Queen’s University, Belfast, N. Ireland Licensing provisions: Standard CPC licence, http://cpc.cs.qub.ac.uk/licence/licence.html No. of lines in distributed program, including test data, etc.: 571126 No. of bytes in distributed program, including test data, etc.: 4717522 Distribution format: tar.gz Programming language: C++, Python. Computer: PC running Linux, Mac. Operating system: Linux, Mac OS. RAM: 20 MB Classification: 11.9, 11.2. External routines: HepMC (https://savannah.cern.ch/projects/hepmc/), GSL (http://www.gnu.org/software/gsl/manual/gsl-ref.html), FastJet (http://fastjet.fr/), Python (http://www.python.org/), Swig (http://www.swig.org/), Boost (http://www.boostsoftware.com/), YAML (http://www.yaml.org/spec/1.2/spec.html) Nature of problem: Experimental measurements from high-energy particle colliders should be defined and stored in a general framework such that it is simple to compare theory predictions to them. Rivet is such a framework, and contains at the same time a large collection of existing measurements. Solution method: Rivet is based on HepMC events, a standardised output format provided by many theory simulation tools. Events are processed by Rivet to generate histograms for the requested list of analyses, incorporating all experimental phase space cuts and histogram definitions. Restrictions: Cannot calculate

  9. 用社会学的观点定性研究澳大利亚的病人、理疗医生及中医师对手法理疗和中医推拿的看法%Perception of patients, physiotherapists and traditional Chinese medicine practitioners towards manual physiotherapy and Tuina (Chinese manipulative therapy) in Australia: a qualitative research

    Institute of Scientific and Technical Information of China (English)

    缪勇

    2011-01-01

    目的:本研究从澳大利亚病人的角度去理解和感受他们对手法治疗的看法,并从中分析手法治疗师们所用的手法特点。方法:本研究采用社会学研究的观点进行定性研究,对在一个特定环境中的服务对象(病人)对治疗服务的特定感受进行调查。本文的主要研究设计是用非结构性访谈,访谈的方法和临床观察方法相结合。本研究纳入了30个符合纳入标准的研究参与者,最后有19名病人,5名中医师参与调研。结果:本研究中,大多数病人是通过新闻媒体和家庭医生的推荐知晓物理治疗的;很多病人在物理治疗师的手法理疗后,希望体验中医推拿。虽然94%的病人对推拿治疗满意,但是很多病人并不能区别推拿和手法理疗在手法技术上的不同。一部分病人认为推拿是一种比较昂贵的治疗选择。大多数治疗师喜欢用比较强的压力性手法作用在肌肉敏感点上,而那些受过推拿正规训练的治疗师则喜欢用比较温和的手法。结论:澳大利亚病人通常将手法理疗作为缓解其疼痛的首选治疗方案。由于缺少恰当的私人医疗保险,病人通常把推拿当作最后的治疗选择。大多数病人参与者比较喜欢类似推拿类的比较温和的手法,不喜欢强性压力性手法。本研究提示病人的感受和需要可能影响治疗的效果,如果手法治疗课程能含有相应的教育内容,鼓励手法治疗师的进一步教育以及鼓励病人参与制定手法治疗方案或许能提高对患者的治疗质量。%Objective:The aim of this study is to gain insight and understanding of the perception of Australian patients toward manual therapies. The study also tries to increase our understanding of manual techniques used by manual therapists. Methods: This is qualitative field research emphasising the sociological perspective, to interpret health services recipients

  10. OSH technical reference manual

    Energy Technology Data Exchange (ETDEWEB)

    1993-11-01

    In an evaluation of the Department of Energy (DOE) Occupational Safety and Health programs for government-owned contractor-operated (GOCO) activities, the Department of Labor`s Occupational Safety and Health Administration (OSHA) recommended a technical information exchange program. The intent was to share written safety and health programs, plans, training manuals, and materials within the entire DOE community. The OSH Technical Reference (OTR) helps support the secretary`s response to the OSHA finding by providing a one-stop resource and referral for technical information that relates to safe operations and practice. It also serves as a technical information exchange tool to reference DOE-wide materials pertinent to specific safety topics and, with some modification, as a training aid. The OTR bridges the gap between general safety documents and very specific requirements documents. It is tailored to the DOE community and incorporates DOE field experience.

  11. Pressure vessel design manual

    CERN Document Server

    Moss, Dennis R

    2013-01-01

    Pressure vessels are closed containers designed to hold gases or liquids at a pressure substantially different from the ambient pressure. They have a variety of applications in industry, including in oil refineries, nuclear reactors, vehicle airbrake reservoirs, and more. The pressure differential with such vessels is dangerous, and due to the risk of accident and fatality around their use, the design, manufacture, operation and inspection of pressure vessels is regulated by engineering authorities and guided by legal codes and standards. Pressure Vessel Design Manual is a solutions-focused guide to the many problems and technical challenges involved in the design of pressure vessels to match stringent standards and codes. It brings together otherwise scattered information and explanations into one easy-to-use resource to minimize research and take readers from problem to solution in the most direct manner possible. * Covers almost all problems that a working pressure vessel designer can expect to face, with ...

  12. AQUABIOS code. Reference manual

    International Nuclear Information System (INIS)

    The model AQUABIOS permits to do an assessment of doses due to the transfer of radionuclides in environment from an outlet as river or water underground. The radioactive releases can be done along as so long time as several millions years. The equations directing the transfer of radionuclides in the different compartments of environment are in the first version of AQUABIOS analytically solved. The solution of these equations permits to obtain the stationary concentration of the radioactivity in environment. This model permits to define an associated scenario to each particular radioactive waste disposal including the special way of transfer through biosphere. Dose and radioactive concentrations must be presented in tables or charts. This model must have evolution in future and this report describes the first level of it release. This report is a reference manual complement of the user's guide

  13. New Oxford style manual

    CERN Document Server

    2012-01-01

    The New Oxford Style Manual brings together two essential reference works in a single volume: New Hart's Rules and the New Oxford Dictionary for Writers and Editors. New Hart's Rules, Oxford's definitive guide to style, consists of 20 chapters that provide authoritative and expert advice on how to prepare copy for publication. Topics covered include how to use italic, roman, and other type treatments, numbers and dates, law and legal references, illustrations, notes and references, and bibliographies. The guidelines are complemented by the New Oxford Dictionary for Writers and Editors, which features 25,000 alphabetically arranged entries giving authoritative advice on those words and names which raise questions time and time again because of spelling, capitalization, hyphenation, or cultural and historical context. Entries give full coverage of recommended spellings, variant forms, confusable words, hyphenation, capitalization, foreign and specialist terms, proper names, and abbreviations. The dictionary a...

  14. Manual on best practices

    DEFF Research Database (Denmark)

    Oxlund, Bjarke

    Der er mange måder at imødegå den globale hiv/aids epidemi på, men ikke alle tilgange virker lige godt. 'Best practices' er blevet lanceret af UNAIDS og andre som et værktøj til at sikre, at kun de mest effektive og virkningsfulde interventioner bliver promoveret i hiv/aids forebyggelse, behandling......, pleje og støtte. Det store spørgsmål er, hvad der kendetegner 'best practice', og hvordan NGOer kan anvende begrebet? Det er blot et af de mange spørgsmål som denne manual om hiv og aids interventioner for og med børn og unge i lavindkomstlande beskæftiger sig med....

  15. FRMAC Assessment Manual

    International Nuclear Information System (INIS)

    The ingestion pathway assessment procedures cited in the current version of the ''RMAC Assessment Manual'', DOE/NV/11718-061 (September 1996) have been superseded by new US Food and Drug Administration (FDA) guidance. This addendum replaces the obsolete procedures with a revised set based on the new guidance released by the FDA in August 1998. This addendum provides an overview of the new guidance, revised assessment methods, and assessment aids. It does not provide a general method of ingestion pathway analysis. The scope is limited to that covered by the new guidance titled, ''Accidental Radioactive Contamination of Human Food and Animal Feeds: Recommendations for State and Local Agencies,'' issued by the FDA in August 1998

  16. Wikipedia the missing manual

    CERN Document Server

    Broughton, John

    2008-01-01

    Want to be part of the largest group-writing project in human history? Learn how to contribute to Wikipedia, the user-generated online reference for the 21st century. Considered more popular than eBay, Microsoft.com, and Amazon.com, Wikipedia servers respond to approximately 30,000 requests per second, or about 2.5 billion per day. It's become the first point of reference for people the world over who need a fact fast.If you want to jump on board and add to the content, Wikipedia: The Missing Manual is your first-class ticket. Wikipedia has more than 9 million entries in 250 languages, over 2

  17. Google The Missing Manual

    CERN Document Server

    Milstein, Sarah; Dornfest, Rael; MacDonald, Matthew

    2008-01-01

    Google.com is one of the most popular sites on the Internet and is used around the world by millions of people every day. Sure, you know how to "Google it" when you're searching for something--anything!--on the Web. It's plenty fast and easy to use. But did you know how much more you could achieve with the world's best search engine by clicking beyond the "Google Search" button? While you can interface with Google in 97 languages and glean results in 35, you can't find any kind of instruction manual from Google. Lucky for you, our fully updated and greatly expanded second edition to the best

  18. Calendf-2002: user manual

    International Nuclear Information System (INIS)

    CALENDF-2002 represents a Fortran-95 update of the 1994 code distribution with emphasize on programming quality and standard, physics and usage improvements. Devised to process multigroup cross-sections it relies on GAUSS quadratures mathematical principle and strength. The followings processes can be handled by the code: moment probability tables and effective cross-sections calculation; regroups pointwise cross sections, probability tables and effective cross-sections; probability table condensation; probability table mix for several isotopes; probability table interpolation; effective cross section based probability table calculations; probability table calculations from effective cross-sections; cross-section comparison, complete energies pointwise cross-section processing and thickness dependant averaged transmission sample calculation. The CALENDF user manual. after having listed all principal code functions, describes sequentially each of them and gives comments on their associated output streams. Installation procedures, test cases and running time platforms comparisons are given in the appendix. (authors)

  19. CALENDF-2010: user manual

    International Nuclear Information System (INIS)

    CALENDF-2010 represents a Fortran-95 update of the 1994, 2001 then 2005 code distribution with emphasise on programming quality and standards, physics and usage improvements. Devised to process multigroup cross-sections it relies on Gauss quadrature mathematical principle and strength. The followings processes can be handled by the code: moment probability table and effective cross-section calculation; pointwise cross section, probability table and effective cross-section regrouping; probability table condensation; probability table mix for several isotopes; probability table interpolation; effective cross section based probability table calculations; probability table calculations from effective cross-sections; cross-section comparison, complete energy pointwise cross-section processing and thickness dependent averaged transmission sample calculation. The CALENDF user manual, after having listed all principal code functions, describes sequentially each of them and gives comments on their associated output streams. Installation procedures, test cases and running time platform comparisons are given in the appendix. (authors)

  20. GRSAC Users Manual

    Energy Technology Data Exchange (ETDEWEB)

    Ball, S.J.; Nypaver, D.J.

    1999-02-01

    An interactive workstation-based simulation code (GRSAC) for studying postulated severe accidents in gas-cooled reactors has been developed to accommodate user-generated input with ''smart front-end'' checking. Code features includes on- and off-line plotting, on-line help and documentation, and an automated sensitivity study option. The code and its predecessors have been validated using comparisons with a variety of experimental data and similar codes. GRSAC model features include a three-dimensional representation of the core thermal hydraulics, and optional ATWS (anticipated transients without scram) capabilities. The user manual includes a detailed description of the code features, and includes four case studies which guide the user through four different examples of the major uses of GRSAC: an accident case; an initial conditions setup and run; a sensitivity study; and the setup of a new reactor model.

  1. GRSAC Users Manual

    International Nuclear Information System (INIS)

    An interactive workstation-based simulation code (GRSAC) for studying postulated severe accidents in gas-cooled reactors has been developed to accommodate user-generated input with ''smart front-end'' checking. Code features includes on- and off-line plotting, on-line help and documentation, and an automated sensitivity study option. The code and its predecessors have been validated using comparisons with a variety of experimental data and similar codes. GRSAC model features include a three-dimensional representation of the core thermal hydraulics, and optional ATWS (anticipated transients without scram) capabilities. The user manual includes a detailed description of the code features, and includes four case studies which guide the user through four different examples of the major uses of GRSAC: an accident case; an initial conditions setup and run; a sensitivity study; and the setup of a new reactor model

  2. FRMAC Operations Manual

    Energy Technology Data Exchange (ETDEWEB)

    Frandsen, K.

    2010-05-01

    In the event of a major radiological incident, the Federal Radiological Monitoring and Assessment Center (FRMAC) will coordinate the federal agencies that have various statutory responsibilities. The FRMAC is responsible for coordinating all environmental radiological monitoring, sampling, and assessment activities for the response. This manual describes the FRMAC’s response activities in a radiological incident. It also outlines how FRMAC fits in the National Incident Management System (NIMS) under the National Response Framework (NRF) and describes the federal assets and subsequent operational activities which provide federal radiological monitoring and assessment of the affected areas. In the event of a potential or existing major radiological incident, the U.S. Department of Energy (DOE), National Nuclear Security Administration Nevada Site Office (NNSA/NSO) is responsible for establishing and managing the FRMAC during the initial phases.

  3. Surface Water Treatment Workshop Manual.

    Science.gov (United States)

    Ontario Ministry of the Environment, Toronto.

    This manual was developed for use at workshops designed to increase the knowledge of experienced water treatment plant operators. Each of the fourteen lessons in this document has clearly stated behavioral objectives to tell the trainee what he should know or do after completing that topic. Areas covered in this manual include: basic water…

  4. Child Nutrition Programs. Administrative Manual.

    Science.gov (United States)

    Utah State Office of Education, Salt Lake City.

    Recognizing the importance of efficient and effective program administration for the success of Utah's Child Nutrition Programs, the State Office of Education developed a manual to assist local program administrators in using the U.S. Department of Agriculture's (USDA's) programs. This document contains Part 1 of the manual's four interrelated…

  5. Dental Chairside Technique. Student's Manual.

    Science.gov (United States)

    Apfel, Maura; Weaver, Trudy Karlene

    This manual is part of a series dealing with skills and information needed by students in dental assisting. The individualized student materials are suitable for classroom, laboratory, or cooperative training programs. This student manual contains four units covering the following topics: local anesthesia; dental office emergencies; oral hygiene;…

  6. Wastewater Treatment I. Instructor's Manual.

    Science.gov (United States)

    California Water Pollution Control Association, Sacramento. Joint Education Committee.

    This instructor's manual provides an outline and guide for teaching Wastewater Treatment I. It consists of nine sections. An introductory note and a course outline comprise sections 1 and 2. Section 3 (the bulk of the guide) presents lesson outlines for teaching the ten chapters of the manual entitled "Operation of Wastewater Treatment Plants."…

  7. Managerial Accounting. Course Administrative Manual.

    Science.gov (United States)

    Central Michigan Univ., Mount Pleasant. Inst. for Personal and Career Development.

    This manual is part of the materials for a college-level programmed course in managerial accounting and intended to aid instructors in helping students to work their way through the self-instructional study guide around which the course is organized. The manual describes the various materials and components used in the self-instructional sequence…

  8. Site security personnel training manual

    International Nuclear Information System (INIS)

    As required by 10 CFR Part 73, this training manual provides guidance to assist licensees in the development of security personnel training and qualifications programs. The information contained in the manual typifies the level and scope of training for personnel assigned to perform security related tasks and job duties associated with the protection of nuclear fuel cycle facilities and nuclear power reactors

  9. CERCLA/superfund orientation manual

    International Nuclear Information System (INIS)

    The manual serves as a program orientation guide and reference document, and it is designed to assist EPA and State personnel involved with hazardous waste remediation, emergency response, and chemical and emergency preparedness. The Manual describes the organizational and operational components of the Superfund Program

  10. Building Academic Vocabulary: Teacher's Manual

    Science.gov (United States)

    Marzano, Robert J.; Pickering, Debra J.

    2005-01-01

    This manual is intended to assist teachers in implementing a comprehensive approach to teaching academic vocabulary at the classroom, school, and district levels. Using the manual's list of 7,923 terms, school and district teams can choose the most important vocabulary terms they want to teach to all students. All vocabulary terms are extracted…

  11. Manual of radioisotope production

    International Nuclear Information System (INIS)

    The Manual of Radioisotope Production has been compiled primarily to help small reactor establishments which need a modest programme of radioisotope production for local requirements. It is not comprehensive, but gives guidance on essential preliminary considerations and problems that may be met in the early stages of production. References are included as an aid to the reader who wishes to seek further in the extensive literature on the subject. In preparing the Manual, which is in two parts, the Agency consulted several Member States which already have long experience in radioisotope production. An attempt has been made to condense this experience, firstly, by setting out the technical and economic considerations which govern the planning and execution of an isotope programme and, secondly, by providing experimental details of isotope production processes. Part I covers topics common to all radioisotope processing, namely, laboratory design, handling and dispensing of radioactive solutions, quality control, measurement and radiological safety. Part II contains information on the fifteen radioisotopes in most common use. These are bromine-82, cobalt-58, chromium-51, copper-64, fluorine-18, gold-198, iodine-131, iron-59, magnesium-28, potassium-42, sodium-24, phosphorus-32, sulphur-35, yttrium-90 and zinc-65. Their nuclear properties are described, references to typical applications are given and published methods of production are reviewed; also included are descriptions in detail of the production processes used at several national atomic energy organizations. No attempt has been made to distinguish the best values for nuclear data or to comment on the relative merits of production processes. Each process is presented essentially as it was described by the contributor on the understanding that critical comparisons are not necessary for processes which have been well tried in practical production for many years. The information is presented as a guide to enable

  12. Nuclear medicine resources manual

    International Nuclear Information System (INIS)

    Over the past decade many IAEA programmes have significantly enhanced the capabilities of numerous Member States in the field of nuclear medicine. Functional imaging using nuclear medicine procedures has become an indispensable tool for the diagnosis, treatment planning and management of patients. However, due to the heterogeneous growth and development of nuclear medicine in the IAEA's Member States, the operating standards of practice vary considerably from country to country and region to region. This publication is the result of the work of over 30 international professionals who have assisted the IAEA in the process of standardization and harmonization. This manual sets out the prerequisites for the establishment of a nuclear medicine service, including basic infrastructure, suitable premises, reliable supply of electricity, maintenance of a steady temperature, dust exclusion for gamma cameras and radiopharmacy dispensaries. It offers clear guidance on human resources and training needs for medical doctors, technologists, radiopharmaceutical scientists, physicists and specialist nurses in the practice of nuclear medicine. The manual describes the requirements for safe preparation and quality control of radiopharmaceuticals. In addition, it contains essential requirements for maintenance of facilities and instruments, for radiation hygiene and for optimization of nuclear medicine operational performance with the use of working clinical protocols. The result is a comprehensive guide at an international level that contains practical suggestions based on the experience of professionals around the globe. This publication will be of interest to nuclear medicine physicians, radiologists, medical educationalists, diagnostic centre managers, medical physicists, medical technologists, radiopharmacists, specialist nurses, clinical scientists and those engaged in quality assurance and control systems in public health in both developed and developing countries

  13. Effect of physical therapy on breast cancer related lymphedema

    DEFF Research Database (Denmark)

    Tambour, Mette; Tange, Berit; Christensen, Robin Daniel Kjersgaard;

    2014-01-01

    BACKGROUND: Physical therapy treatment of patients with lymphedema includes treatment based on the principles of 'Complete Decongestive Therapy' (CDT). CDT consists of the following components; skin care, manual lymphatic drainage, bandaging and exercises. The scientific evidence regarding what...

  14. The development of vaccination perspectives among chiropractic, naturopathic and medical students: a case study of professional enculturation.

    Science.gov (United States)

    McMurtry, Angus; Wilson, Kumanan; Clarkin, Chantalle; Walji, Rishma; Kilian, Brendan C; Kilian, Carney C; Lohfeld, Lynne; Alolabi, Bashar; Hagino, Carol; Busse, Jason W

    2015-12-01

    An important influence on parents' decisions about pediatric vaccination (children under 6 years of age) is the attitude of their health care providers, including complementary and alternative medicine (CAM) providers. Very limited qualitative research exists, however, on how attitudes towards vaccination develop among healthcare professionals in-training. We explored perspective development among three groups of students: medical, chiropractic, and naturopathic. We conducted focus group sessions with participants from each year of study at three different healthcare training programs in Ontario, Canada. Semi-structured and open-ended questions were used to elicit dynamic interaction among participants and explore how they constructed their attitudes toward vaccination at the beginning and part way through their professional training. Analyses of verbatim transcripts of audiotaped interviews were conducted both inductively and deductively using questions structured by existing literature on learning, professional socialization and interprofessional relations. We found five major themes and each theme was illustrated with representative quotes. Numerous unexpected insights emerged within these themes, including students' general open-mindedness towards pediatric vaccination at the beginning of their training; the powerful influence of both formal education and informal socialization; uncritical acceptance of the vaccination views of senior or respected professionals; students' preference for multiple perspectives rather than one-sided, didactic instruction; the absence of explicit socio-cultural tensions among professions; and how divergences among professional students' perspectives result from differing emphases with respect to lifestyle, individual choice, public health and epidemiological factors-rather than disagreement concerning the biomedical evidence. This last finding implies that their different perspectives on pediatric vaccination may be complementary

  15. Symptomatic reactions, clinical outcomes and patient satisfaction associated with upper cervical chiropractic care: A prospective, multicenter, cohort study

    Directory of Open Access Journals (Sweden)

    Hurwitz Eric L

    2011-10-01

    Full Text Available Abstract Background Observational studies have previously shown that adverse events following manipulation to the neck and/or back are relatively common, although these reactions tend to be mild in intensity and self-limiting. However, no prospective study has examined the incidence of adverse reactions following spinal adjustments using upper cervical techniques, and the impact of this care on clinical outcomes. Methods Consecutive new patients from the offices of 83 chiropractors were recruited for this practice-based study. Clinical outcome measures included 1 Neck pain disability index (100-point scale, 2 Oswestry back pain index (100-point scale, 3 11-point numerical rating scale (NRS for neck, headache, midback, and low back pain, 4 treatment satisfaction, and 5 Symptomatic Reactions (SR. Data were collected at baseline, and after approximately 2 weeks of care. A patient reaching sub-clinical status for pain and disability was defined as a follow-up score 30% based on an 11-point numeric rating scale occurring Results A total of 1,090 patients completed the study having 4,920 (4.5 per patient office visits requiring 2,653 (2.4 per patient upper cervical adjustments over 17 days. Three hundred thirty- eight (31.0% patients had SRs meeting the accepted definition. Intense SR (NRS ≥8 occurred in 56 patients (5.1%. Outcome assessments were significantly improved for neck pain and disability, headache, mid-back pain, as well as lower back pain and disability (p 5 million career upper cervical adjustments without a reported incidence of serious adverse event. Conclusions Upper cervical chiropractic care may have a fairly common occurrence of mild intensity SRs short in duration (

  16. TJ-II Library Manual (Version 2)

    International Nuclear Information System (INIS)

    This is a manual of use of the TJ2 Numerical Library that has been developed for making numerical computations of different TJ-II configurations. This manual is a new version of the earlier manual CIEMAT report 806. (Author)

  17. Delineating inflammatory and mechanical sub-types of low back pain: a pilot survey of fifty low back pain patients in a chiropractic setting

    Directory of Open Access Journals (Sweden)

    Riksman Janine S

    2011-02-01

    Full Text Available Abstract Background An instrument known as the Mechanical and Inflammatory Low Back Pain (MAIL Scale was drafted using the results of a previous expert opinion study. A pilot survey was conducted to test the feasibility of a larger study designed to determine the MAIL Scale's ability to distinguish two potential subgroups of low back pain: inflammatory and mechanical. Methods Patients with a primary complaint of low back pain (LBP presenting to chiropractic clinics in Perth, Western Australia were asked to fill out the MAIL Scale questionnaire. The instrument's ability to separate patients into inflammatory and mechanical subgroups of LBP was examined using the mean score of each notional subgroup as an arbitrary cut-off point. Results Data were collected from 50 patients. The MAIL Scale did not appear to separate cases of LBP into the two notionally distinct groups of inflammatory (n = 6 or mechanical (n = 5. A larger "mixed symptom" group (n = 39 was revealed. Conclusions In this pilot study the MAIL Scale was unable to clearly discriminate between what is thought to be mechanical and inflammatory LBP in 50 cases seen in a chiropractic setting. However, the small sample size means any conclusions must be viewed with caution. Further research within a larger study population may be warranted and feasible.

  18. FBR Metallic Materials Test Manual(English Version) (Manual)

    OpenAIRE

    小高 進; 加藤 章一; 吉田 英一

    2003-01-01

    For the development of the fast breeder reactor, this manual describes the method of in-air and in-sodium material tests and the method of organization the data. This Previous manual has revised in accordance with the revision of Japanese Industrial Standard (JIS)and the conversion to the international unit. The test methods of domestic committees such as the VAMAS (Versailles Prject on Advanced Materials and Standards) workshop were also referred. The material test technologies accumula...

  19. Uranium tailings sampling manual

    International Nuclear Information System (INIS)

    The purpose of this manual is to describe the requisite sampling procedures for the application of uniform high-quality standards to detailed geotechnical, hydrogeological, geochemical and air quality measurements at Canadian uranium tailings disposal sites. The selection and implementation of applicable sampling procedures for such measurements at uranium tailings disposal sites are complicated by two primary factors. Firstly, the physical and chemical nature of uranium mine tailings and effluent is considerably different from natural soil materials and natural waters. Consequently, many conventional methods for the collection and analysis of natural soils and waters are not directly applicable to tailings. Secondly, there is a wide range in the physical and chemical nature of uranium tailings. The composition of the ore, the milling process, the nature of tailings depositon, and effluent treatment vary considerably and are highly site-specific. Therefore, the definition and implementation of sampling programs for uranium tailings disposal sites require considerable evaluation, and often innovation, to ensure that appropriate sampling and analysis methods are used which provide the flexibility to take into account site-specific considerations. The following chapters describe the objective and scope of a sampling program, preliminary data collection, and the procedures for sampling of tailings solids, surface water and seepage, tailings pore-water, and wind-blown dust and radon

  20. IAEA safeguards technical manual

    International Nuclear Information System (INIS)

    Part F of the Safeguards Technical Manual is being issued in three volumes. Volume 1 was published in 1977 and revised slightly in 1979. Volume 1 discusses basic probability concepts, statistical inference, models and measurement errors, estimation of measurement variances, and calibration. These topics of general interest in a number of application areas, are presented with examples drawn from nuclear materials safeguards. The final two chapters in Volume 1 deal with problem areas unique to safeguards: calculating the variance of MUF and of D respectively. Volume 2 continues where Volume 1 left off with a presentation of topics of specific interest to Agency safeguards. These topics include inspection planning from a design and effectiveness evaluation viewpoint, on-facility site inspection activities, variables data analysis as applied to inspection data, preparation of inspection reports with respect to statistical aspects of the inspection, and the distribution of inspection samples to more than one analytical laboratory. Volume 3 covers generally the same material as Volumes 1 and 2 but with much greater unity and cohesiveness. Further, the cook-book style of the previous two volumes has been replaced by one that makes use of equations and formulas as opposed to computational steps, and that also provides the bases for the statistical procedures discussed. Hopefully, this will help minimize the frequency of misapplications of the techniques

  1. FormFlavor Manual

    CERN Document Server

    Evans, Jared A

    2016-01-01

    This manual describes the usage and structure of FormFlavor, a Mathematica-based tool for computing a broad list of flavor and CP observables in general new physics models. Based on the powerful machinery of FeynArts and FormCalc, FormFlavor calculates the one-loop Wilson coefficients of the dimension 5 and 6 Standard Model effective Lagrangian entirely from scratch. These Wilson coefficients are then evolved down to the low scale using one-loop QCD RGEs, where they are transformed into flavor and CP observables. The last step is accomplished using a model-independent, largely stand-alone package called FFObservables that is included with FormFlavor. The SM predictions in FFObservables include up-to-date references and accurate current predictions. Using the functions and modular structure provided by FormFlavor, it is straightforward to add new observables. Currently, FormFlavor is set up to perform these calculations for the general, non-MFV MSSM, but in principle it can be generalized to arbitrary FeynArts...

  2. Exercise and manual physiotherapy arthritis research trial (EMPART): a multicentre randomised controlled trial.

    LENUS (Irish Health Repository)

    French, Helen P

    2009-01-01

    Osteoarthritis (OA) of the hip is a major cause of functional disability and reduced quality of life. Management options aim to reduce pain and improve or maintain physical functioning. Current evidence indicates that therapeutic exercise has a beneficial but short-term effect on pain and disability, with poor long-term benefit. The optimal content, duration and type of exercise are yet to be ascertained. There has been little scientific investigation into the effectiveness of manual therapy in hip OA. Only one randomized controlled trial (RCT) found greater improvements in patient-perceived improvement and physical function with manual therapy, compared to exercise therapy.

  3. Manual on indoor air quality

    Energy Technology Data Exchange (ETDEWEB)

    Diamond, R.C.; Grimsrud, D.T.

    1983-12-01

    This reference manual was prepared to assist electric utilities in helping homeowners, builders, and new home buyers to understand a broad range of issues related to indoor air quality. The manual is directed to technically knowledgeable persons employed by utility companies - the customer service or marketing representative, applications engineer, or technician - who may not have specific expertise in indoor air quality issues. In addition to providing monitoring and control techniques, the manual summarizes the link between pollutant concentrations, air exchange, and energy conservation and describes the characteristics and health effects of selected pollutants. Where technical information is too lengthy or complex for inclusion in this volume, reference sources are given. Information for this manual was gathered from technical studies, manufacturers' information, and other materials from professional societies, institutes, and associations. The aim has been to provide objective technical and descriptive information that can be used by utility personnel to make informed decisions about indoor air quality issues.

  4. Surface Environmental Surveillance Procedures Manual

    Energy Technology Data Exchange (ETDEWEB)

    Hanf, RW; Dirkes, RL

    1990-02-01

    This manual establishes the procedures for the collection of environmental samples and the performance of radiation surveys and other field measurements. Responsibilities are defined for those personnel directly involved in the collection of samples and the performance of field measurements.

  5. UK Punched Card Reference Manuals

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Documentation for using and reading punched cards kept at the UK Met Office. Includes five Marine and one upper air manual, dated from 1953-1981.

  6. Medicare Prescription Drug Benefit Manual

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Part D Prescription Drug Benefit Manual (PDBM) is user guide to Part D Prescription Drug Program. It includes information on general provisions, benefits,...

  7. Transportation security personnel training manual

    International Nuclear Information System (INIS)

    This volume is the instructor's manual for the training of SNM guards. Covered are: self-defense, arrest authority, civil liability, report writing, stress, tactics, and situational training scenarios

  8. [The Pulsair manual noncontact tonometer].

    Science.gov (United States)

    Bartos, D; Skopový, M

    1991-02-01

    The authors present a report on their own experience with a manual contact-free tonometer Pulsair of Keeler Co. Ais compared with results obtained by means of the manual aplanation Perkins tonometer of Clement Clarke International Ltd. in the group of patients with IOP under 2,8 kPa the arithmetic means of four readings, the scatter of mean values and standard deviations assessed by both methods were not significant. Correlation coefficient 0.92 (p less than 0.001). In the group of patients with glaucoma and hypertonics with IOP of 2.93 kPa and more the arithmetic means of four readings were significantly higher (at the 1% level) in contact-free tonometry. Correlation coefficient 0.95 (p less than 0.001). The authors emphasize the main advantage of the contact-free manual tonometer: safety, rapid procedure, objectivity, accuracy, manual use. PMID:1913887

  9. Transportation security personnel training manual

    International Nuclear Information System (INIS)

    Objective of this manual is to train security personnel to protect special nuclear materials and nuclear facilities against theft and sabotage as required by 10 CFR Part 73. This volume contains the introduction and rationale

  10. Forest Pest Control. Manual 94.

    Science.gov (United States)

    Missouri Univ., Columbia. Agricultural Experiment Station.

    This training manual provides information needed to meet the minimum EPA standards for certification as a commercial applicator of pesticides in forest pest control. The text discusses disease problems, insects, and herbicide use in both established forests and nurseries. (CS)

  11. Manual on indoor air quality

    International Nuclear Information System (INIS)

    This reference manual was prepared to assist electric utilities in helping homeowners, builders, and new home buyers to understand a broad range of issues related to indoor air quality. The manual is directed to technically knowledgeable persons employed by utility companies - the customer service or marketing representative, applications engineer, or technician - who may not have specific expertise in indoor air quality issues. In addition to providing monitoring and control techniques, the manual summarizes the link between pollutant concentrations, air exchange, and energy conservation and describes the characteristics and health effects of selected pollutants. Where technical information is too lengthy or complex for inclusion in this volume, reference sources are given. Information for this manual was gathered from technical studies, manufacturers' information, and other materials from professional societies, institutes, and associations. The aim has been to provide objective technical and descriptive information that can be used by utility personnel to make informed decisions about indoor air quality issues

  12. State Energy Program Operations Manual

    Energy Technology Data Exchange (ETDEWEB)

    Office of Building Technology, State and Community Programs

    1999-03-17

    The State Energy Program Operations Manual is a reference tool for the states and the program officials at the U.S. Department of Energy's Office of Building Technology, State and Community Programs and Regional Support Offices as well as State Energy Offices. The Manual contains information needed to apply for and administer the State Energy Program, including program history, application rules and requirements, and program administration and monitoring requirements.

  13. The operation and maintenance manual

    International Nuclear Information System (INIS)

    The Operating Manual is one of many technical documents which the nuclear power plant operator needs for ensuring safe operation. For the operating staff, however, there is only one document, namely the Operating Manual. It contains, appropriately arranged, the necessary system and other diagrams, drawings, lists, licensing documents and similar material, which are necessary for understanding the design, for testing, for obtaining the operating licence and for the operation of individual systems and of the entire plant. (orig./RW)

  14. Mechanical therapy for low back pain.

    Science.gov (United States)

    Guild, Donald Grant

    2012-09-01

    Physical therapy and manual medicine for low back pain encompass many different treatment modalities. There is a vast variety of techniques that physical therapists commonly use in the treatment of low back pain. Some of the therapies include, but are certainly not limited to, education, exercise, lumbar traction, manual manipulation, application of heat, cryotherapy, and ultrasonography. Many of these approaches are discussed specifically in this article. PMID:22958560

  15. 46 CFR 109.121 - Operating manual.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Operating manual. 109.121 Section 109.121 Shipping COAST... § 109.121 Operating manual. (a) Each unit must have on board an operating manual approved by the Coast Guard as meeting the requirements of this section. (b) The operating manual must be available to,...

  16. 14 CFR 21.308 - Quality manual.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Quality manual. 21.308 Section 21.308... manual. Each applicant for or holder of a PMA must provide a manual describing its quality system to the FAA for approval. The manual must be in the English language and retrievable in a form acceptable...

  17. 14 CFR 183.53 - Procedures manual.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Procedures manual. 183.53 Section 183.53... manual. No ODA Letter of Designation may be issued before the Administrator approves an applicant's procedures manual. The approved manual must: (a) Be available to each member of the ODA Unit; (b) Include...

  18. ACT Plan: Technical Manual. 2013/2014

    Science.gov (United States)

    ACT, Inc., 2013

    2013-01-01

    This manual contains information about the American College Test (ACT) Plan® program. The principal focus of this manual is to document the Plan program's technical adequacy in light of its intended purposes. This manual supersedes the 2011 edition. The content of this manual responds to requirements of the testing industry as established in the…

  19. 46 CFR 134.170 - Operating manual.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Operating manual. 134.170 Section 134.170 Shipping COAST... LIFTBOATS § 134.170 Operating manual. (a) Each liftboat must have aboard an operating manual approved by the Coast Guard as complying with this section. (b) The operating manual must be available to, and...

  20. 25 CFR 175.5 - Operations manual.

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Operations manual. 175.5 Section 175.5 Indians BUREAU OF... Provisions § 175.5 Operations manual. (a) The Area Director shall establish an operations manual for the... Director shall amend the operations manual as needed. (b) The public shall be notified by the Area...

  1. Manual for medical problems of radiation protection

    International Nuclear Information System (INIS)

    The manual deals comprehensively and topically with the theoretical and practical fundamentals of radiation protection of the population considering the present knowledge in the fields of radiobiology and radiation protection medicine. The subject is covered under the following headings: (1) physics of ionizing radiations, (2) biological radiation effects, (3) the acute radiation syndrome, (4) medical treatment of the acute radiation syndrome, (5) combined radiation injuries, and (6) prophylaxis and therapy of injuries caused by fission products of nuclear explosions. The book is of interest to medical doctors, medical scientists, and students in medicine who have to acquire special knowledge in the field of radiation protection and it is of value as a reference book in daily routine

  2. A comparative analysis of chiropractic and general practitioner patients in North America: Findings from the joint Canada/United States survey of health, 2002–03

    Directory of Open Access Journals (Sweden)

    Chiang Lu-May

    2006-04-01

    Full Text Available Abstract Background Scientifically rigorous general population-based studies comparing chiropractic with primary-care medical patients within and between countries have not been published. The objective of this study is to compare care seekers of doctors of chiropractic (DCs and general practitioners (GPs in the United States and Canada on a comprehensive set of sociodemographic, quality of life, and health-related variables. Methods Data are from the Joint Canada/U.S. Survey of Health (JCUSH, 2002–03, a random sample of adults in Canada (N = 3505 and the U.S. (N = 5183. Respondents were categorized according to their pattern of health-care use in the past year. Distributions, percentages, and estimates (adjusted odds ratios weighted to reflect the complex survey design were produced. Results Nearly 80% of respondents sought care from GPs; 12% sought DC care. Compared with GP only patients, DC patients in both countries tend to be under 65 and white, with arthritis and disabling back or neck pain. U.S. DC patients are more likely than GP only patients to be obese and to lack a regular doctor; Canadian DC patients are more likely than GP only patients to be college educated, to have higher incomes, and dissatisfied with MD care. Compared with seekers of both GP and DC care, DC only patients in both countries have fewer chronic conditions, take fewer drugs, and have no regular doctor. U.S. DC only patients are more likely than GP+DC patients to be uninsured and dissatisfied with health care; Canadian DC only patients are more likely than GP+DC patients to be under 45, male, less educated, smokers, and not obese, without disabling back or neck pain, on fewer drugs, and lacking a regular doctor. Conclusion Chiropractic and GP patients are dissimilar in both Canada and the U.S., with key differences between countries and between DC patients who do and do not seek care from GPs. Such variation has broad and potentially far-reaching health policy and

  3. First step in managing bulimia nervosa: controlled trial of therapeutic manual.

    OpenAIRE

    Treasure, J.; U Schmidt; Troop, N; Tiller, J.; Todd, G.; Keilen, M.; Dodge, E.

    1994-01-01

    OBJECTIVE--To test the short term efficacy of a self directed treatment manual for bulimia nervosa. DESIGN--Randomised controlled trial of the manual against cognitive behavioural therapy and a waiting list. SETTING--Tertiary referral centre. SUBJECTS--81 consecutive referrals presenting with bulimia nervosa or atypical bulimia nervosa. MAIN OUTCOME MEASURES--Frequency of binge eating, vomiting, and other behaviours to control weight as well as abstinence from these behaviours. RESULTS--Cogni...

  4. 手工作业对长期住院精神分裂症患者生活满意度的影响%Effect of Manual Occupational Therapy on Life Satisfaction Rating in Long-term Hospitalized Schizophrenic Patients

    Institute of Scientific and Technical Information of China (English)

    张献强; 高云; 朱艳玲

    2011-01-01

    目的:探讨手工作业治疗对长期住院精神分裂症患者生活满意度的影响.方法:60例长期住院的精神分裂症患者随机分为研究组和对照组各30例,均给予药物控制,并参入社区内的日常生活技能训练及健康教育等.研究组患者同时增加手工作业训练,包括缝纫、钉纽扣、剪裁等.训练前后采用生活满意度评定量表(LSR)和阴性症状量表(SANS)评分评定患者对生活的满意度及精神症状改善情况.结果:治疗6个月后,研究组与治疗前及对照组比较,LSR评分明显提高,SANS评分明显降低(P<0.05,0.01);对照组治疗前后各项评分变化不明显.结论:手工作业治疗对改善长期住院精神分裂症患者阴性症状,提高患者对生活技能的满意度等有明显促进作用.%Objective: To explore the effect of manual occupational therapy on life quality for the long-term hospitalized schizophrenic patients. Methods: Sixty cases of long-term hospitalized schizophrenic patients were randomly divided into study group and control group. All patients in both two groups were given medical treatment, and participated in skill training of daily life in the community and health education, etc. The patients in study group were also given manual occupational therapy, including sewing, buttoning and paper cutting, etc. Life satisfaction and improvement of spiritual symptoms were assessed by using the Life Satisfaction Rating Scale (LSR) and Scale for the Assessment of Negative Symptoms (SANS) before and after treatment. Results: After treatment for 6 months,LSR scores were significantly increased, and SANS scores were significantly reduced in study group as compared with those before treatment and in control group (P<0.05, 0.01). There was no significant difference in the scores in control group before and after treatment. Conclusion: The manual process can significantly improve the negative symptoms and the quality of life in long-term in

  5. Methane measurements manual; Handbok metanmaetningar

    Energy Technology Data Exchange (ETDEWEB)

    Holmgren, Magnus Andreas (SP Technical research institute of Sweden, Boraas (Sweden))

    2011-02-15

    Emissions to air in different parts of the system may arise in biogas plants, where there is biological treatment of organic matter by anaerobic degradation, and during upgrading of biogas to vehicle fuel. There are mainly four reasons why these emissions must be minimized. These are safety, greenhouse gas emissions, economy and smell. This manual gathers experience of several years of work with measurement of methane emissions from biogas and upgrading facilities. This work has been done mainly in the context of Swedish Waste Management's system of voluntary commitment. The purpose of this manual is to standardize methods and procedures when methane measurements are carried out so that the results are comparable between different providers. The main target group of the manual is measurement consultants performing such measurements. Calculation template in Excel is part of the manual, which further contributes to the measurements evaluated in a standardized way. The manual contains several examples which have been calculated in the accompanying Excel template. The handbook also contains a chapter mainly intended for facility staff, in which implementation of accurate leak detection is described, and where there are hints of a system of so-called intermediate inspections to detect leaks in time

  6. Perspectives of older adults on co-management of low back pain by doctors of chiropractic and family medicine physicians: a focus group study

    DEFF Research Database (Denmark)

    Lyons, K. J.; Salsbury, S. A.; Hondras, M. A.; Jones, M. E.; Andresen, A. A.; Goertz, C. M.

    2013-01-01

    systems that allowed exchange of health information between clinics, and practice settings where providers worked in one location. Perceived barriers to the co-management of LBP included the financial costs associated with receiving care from multiple providers concurrently, duplication of tests or...... by MDs and DCs. Older adults considered patient-centered communication, collegial interdisciplinary interactions between these providers, and administrative supports such as scheduling systems and health record sharing as key components for successful LBP co-management.......Background: While older adults may seek care for low back pain (LBP) from both medical doctors (MDs) and doctors of chiropractic (DCs), co-management between these providers is uncommon. The purposes of this study were to describe the preferences of older adults for LBP co-management by MDs and DCs...

  7. Feasibility of the STarT back screening tool in chiropractic clinics: a cross-sectional study of patients with low back pain

    DEFF Research Database (Denmark)

    Kongsted, Alice; Johannesen, Else; Leboeuf-Yde, Charlotte

    2011-01-01

    Avoidance Beliefs Questionnaire (FABQ), and the Coping Strategies Questionnaire. Associations between the continuous scores of the psychological questionnaires and the SBT were tested by means of linear regression, and the diagnostic performance of the SBT in relation to the other questionnaires was...... described in terms of sensitivity, specificity and likelihood ratios.In this cohort 59% were in the SBT low risk, 29% in the medium risk and 11% in high risk group. The SBT risk groups were positively associated with all of the psychological questionnaires. The SBT high risk group had positive likelihood...... ratios for having a risk profile on the psychological scales ranging from 3.8 (95% CI 2.3 - 6.3) for the MDI to 7.6 (95% CI 4.9 - 11.7) for the FABQ. The SBT questionnaire was feasible to use in chiropractic practice and risk groups were related to the presence of well-established psychological...

  8. Sierra Structural Dynamics Theory Manual

    Energy Technology Data Exchange (ETDEWEB)

    Reese, Garth M. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2015-10-19

    Sierra/SD provides a massively parallel implementation of structural dynamics finite element analysis, required for high fidelity, validated models used in modal, vibration, static and shock analysis of structural systems. This manual describes the theory behind many of the constructs in Sierra/SD. For a more detailed description of how to use Sierra/SD , we refer the reader to Sierra/SD, User's Notes . Many of the constructs in Sierra/SD are pulled directly from published material. Where possible, these materials are referenced herein. However, certain functions in Sierra/SD are specific to our implementation. We try to be far more complete in those areas. The theory manual was developed from several sources including general notes, a programmer notes manual, the user's notes and of course the material in the open literature. This page intentionally left blank.

  9. The MARI mini-manual

    International Nuclear Information System (INIS)

    This document is designed to get you started planning your experiment and analysing your data. More detailed information is available from other reports. Reports exist on the sample environment equipment, on some of the data analysis routines such as HOMER, FRILLS, and the S(Q,E) analysis routines, and on programs such as GENIE. Copies of these manuals can be obtained from your local contact, although copies are kept in the instrument cabin. A PUNCH manual can be found in the cabin and contains information on the Instrument Control Program (ICP) and sample environment controls via CAMAC. (author)

  10. Motorola Xoom The Missing Manual

    CERN Document Server

    Gralla, Preston

    2011-01-01

    Motorola Xoom is the first tablet to rival the iPad, and no wonder with all of the great features packed into this device. But learning how to use everything can be tricky-and Xoom doesn't come with a printed guide. That's where this Missing Manual comes in. Gadget expert Preston Gralla helps you master your Xoom with step-by-step instructions and clear explanations. As with all Missing Manuals, this book offers refreshing, jargon-free prose and informative illustrations. Use your Xoom as an e-book reader, music player, camcorder, and phoneKeep in touch with email, video and text chat, and so

  11. Droid X The Missing Manual

    CERN Document Server

    Gralla, Preston

    2011-01-01

    Get the most from your Droid X right away with this entertaining Missing Manual. Veteran tech author Preston Gralla offers a guided tour of every feature, with lots of expert tips and tricks along the way. You'll learn how to use calling and texting features, take and share photos, enjoy streaming music and video, and much more. Packed with full-color illustrations, this engaging book covers everything from getting started to advanced features and troubleshooting. Unleash the power of Motorola's hot new device with Droid X: The Missing Manual. Get organized. Import your contacts and sync wit

  12. Manual on decontamination of surfaces

    International Nuclear Information System (INIS)

    The manual is intended for those who are responsible for the organization and implementation of decontamination programmes for facilities where radioactive materials are handled mainly on a laboratory scale. It contains information and guidelines on practical methods for decontaminating working spaces, equipment, laboratory benches and protective clothing. Useful information is also provided on the removal of loose skin contamination from personnel by mild, non-medical processes. Methods of removing skin contamination needing medical supervision, or of internal decontamination, which is entirely a medical process, are not covered in this manual. Large-scale decontamination of big nuclear facilities is also considered as outside its scope

  13. ARIES NDA Robot operators' manual

    International Nuclear Information System (INIS)

    The ARIES NDA Robot is an automation device for servicing the material movements for a suite of Non-destructive assay (NDA) instruments. This suite of instruments includes a calorimeter, a gamma isotopic system, a segmented gamma scanner (SGS), and a neutron coincidence counter (NCC). Objects moved by the robot include sample cans, standard cans, and instrument plugs. The robot computer has an RS-232 connection with the NDA Host computer, which coordinates robot movements and instrument measurements. The instruments are expected to perform measurements under the direction of the Host without operator intervention. This user's manual describes system startup, using the main menu, manual operation, and error recovery

  14. Matematica 2. Manual do Professor (Mathematics 2. Teacher's Manual).

    Science.gov (United States)

    D'Alu, Maria Jose Miranda de Sousa

    This teacher's manual accompanies a mathematics textbook for second graders, written in Portuguese. Developed from objectives set forth by the National Portuguese Materials Development Center, it follows closely the objectives and methodology of major curricula used in schools of the United States. Consideration was given to the Portuguese child's…

  15. Processing Accounts Payable Invoices. Student Manual and Instructor's Manual.

    Science.gov (United States)

    McElveen, Peggy C.

    Supporting performance objective 38 of the V-TECS (Vocational-Technical Education Consortium of States) Secretarial Catalog, both a set of student materials and an instructor's manual on processing accounts payable invoices are included in this packet, which is one of a series. The student materials include ten invoices and receiving documents and…

  16. Policy and procedure manual: keeping a high quality manual.

    Science.gov (United States)

    Sulzbach, L M; Stivale, D A

    1990-12-01

    Policy and procedure manuals are now commonly used in hospitals. The policy and procedure manual provides critical care nurses with a wealth of information. Policies are developed to guide the staff to perform nursing care adequately. Together policies and the corresponding procedures let critical care nurses know how to proceed to meet the organisation and the unit goals. As critical care expands the number of policies increases, which may make it more difficult to find a specific policy quickly. Critical care nurses need to look at other solutions for communicating some necessary pieces of information and check to make sure that policy is stated briefly, to the point and logical. It is also necessary to check to see if the information included in the manual is policy and associated procedures. If it is drug information, equipment usage, standards of care, or patient/family teaching material it could be incorporated in a different format or separate manual. As care givers nurses must monitor policies and procedures that are written and make sure they are simple to read, logically written, and easy to find. PMID:2273237

  17. PNNL Hoisting and Rigging Manual

    Energy Technology Data Exchange (ETDEWEB)

    Haynie, Todd O.; Fullmer, Michael W.

    2008-12-29

    This manual describes the safe and cost effective operation, inspection, maintenance, and repair requirements for cranes, hoists, fork trucks, slings, rigging hardware, and hoisting equipment. It is intended to be a user's guide to requirements, codes, laws, regulations, standards, and practices that apply to Pacific Northwest National Laboratory (PNNL) and its subcontractors.

  18. Quality assurance manual: Volume 1

    International Nuclear Information System (INIS)

    Stanford Linear Accelerator Center (SLAC) is a DOE-supported research facility that carries out experimental and theoretical research in high energy physics and developmental work in new techniques for particle acceleration and experimental instrumentation. The purpose of this manual is to describe SLAC quality assurance policies and practices in various parts of the Laboratory

  19. COE1 Calorimeter Operations Manual

    Energy Technology Data Exchange (ETDEWEB)

    Santi, Peter Angelo [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2015-12-15

    The purpose of this manual is to describe the operations of the COE1 calorimeter which is used to measure the thermal power generated by the radioactive decay of plutonium-bearing materials for the purposes of assaying the amount of plutonium within the material.

  20. SES2D user's manual

    International Nuclear Information System (INIS)

    SES2D is an interactive graphics code designed to generate plots of equation of state data from the Los Alamos National Laboratory Group T-4 computer libraries. This manual discusses the capabilities of the code. It describes the prompts and commands and illustrates their use with a sample run

  1. Attrition Cost Model Instruction Manual

    Science.gov (United States)

    Yanagiura, Takeshi

    2012-01-01

    This instruction manual explains in detail how to use the Attrition Cost Model program, which estimates the cost of student attrition for a state's higher education system. Programmed with SAS, this model allows users to instantly calculate the cost of attrition and the cumulative attrition rate that is based on the most recent retention and…

  2. Sludge Digestion Manual; Handboek Slibgisting

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2011-09-15

    This manual offers a guideline for developing, designing, optimizing and operating sludge digestion installations based on sewage sludge. It also offers tools for solving operation problems [Dutch] Het Handboek is een leidraad voor het ontwikkelen, ontwerpen, optimaliseren en bedrijven van slibgistingsinstallaties voor zuiveringsslib. Ook geeft het handvatten voor het oplossen van operationele problemen.

  3. Mosquito and Blackfly Category Manual.

    Science.gov (United States)

    Bowman, James S.; And Others

    This manual provides information needed to meet the standards for pesticide applicator certification. Section one is concerned with the morphology, life cycle and breeding areas of mosquitoes and the diseases resulting from their presence. The second section covers similar categories in relation to the black fly population. Calculation methods and…

  4. Eddy current manual, volume 2

    International Nuclear Information System (INIS)

    This report on eddy current testing is divided into three sections: (a) Demonstration of Basic Principles, (b) Practical (Laboratory) Tests and, (c) Typical Certification Questions. It is intended to be used as a supplement to ΣEddy Current Manual, Volume 1Σ (AECL-7523) during CSNDT Foundation Level II and III courses

  5. Sierra Leone Temne Language Manual.

    Science.gov (United States)

    Peace Corps, Washington, DC.

    A language guide to Temne is designed for Peace Corps volunteers serving in Sierra Leone. It contains introductory sections about the Temnes and Temne phonology and orthography, teacher notes on the use of the manual, and 12 lessons. Each lesson consists of a dialogue or narrative, notes on classroom presentation, vocabulary and useful phrases,…

  6. Manual tracking in three dimensions.

    NARCIS (Netherlands)

    Mrotek, L.A.; Gielen, C.C.A.M.; Flanders, M.

    2006-01-01

    Little is known about the manual tracking of targets that move in three dimensions. In the present study, human subjects followed, with the tip of a hand-held pen, a virtual target moving four times (period 5 s) around a novel, unseen path. Two basic types of target paths were used: a peanut-shaped

  7. Manual for Cyclic Triaxial Test

    DEFF Research Database (Denmark)

    Shajarati, Amir; Sørensen, Kris Wessel; Nielsen, Søren Kjær; Ibsen, Lars Bo

    This manual describes the different steps that is included in the procedure for conducting a cyclic triaxial test at the geotechnical Laboratory at Aalborg University. Furthermore it contains a chapter concerning some of the background theory for the static triaxial tests. The cyclic/dynamic tria...

  8. Outdoor Education Manual. Part II.

    Science.gov (United States)

    Colorado City Independent School District, Texas.

    Many of the articles included in this supplement to the original "Outdoor Education Manual" were submitted by classroom teachers in Ontario. Major areas covered are photography in outdoor education, enrichment of the curriculum through use of the school yard, canoe tripping, winter activities, and forestry. Suggested activities in each of these…

  9. Aquatic Pest Control. Manual 99.

    Science.gov (United States)

    Missouri Univ., Columbia. Agricultural Experiment Station.

    This training manual provides information needed to meet the minimum EPA standards for certification as a commercial applicator of pesticides in the aquatic pest control category. The text discusses various water use situations; aquatic weed identification; herbicide use and effects; and aquatic insects and their control. (CS)

  10. Microforms Policy and Procedures Manual.

    Science.gov (United States)

    Eichhorn, Sara, Comp.

    This manual formulates guidelines and serves as a policy document for microforms service at the Microforms Desk of the Government Publications and Microforms Department of the University of California, Irvine. Introductory materials include a description of the nature of the service and statements of its objectives and policies for dealing with…

  11. Electrostatic Precipitator (ESP) TRAINING MANUAL

    Science.gov (United States)

    The manual assists engineers in using a computer program, the ESPVI 4.0W, that models all elements of an electrostatic precipitator (ESP). The program is a product of the Electric Power Research Institute and runs in the Windows environment. Once an ESP is accurately modeled, the...

  12. Manual for reactor produced radioisotopes

    International Nuclear Information System (INIS)

    Radioisotopes find extensive applications in several fields including medicine, industry, agriculture and research. Radioisotope production to service different sectors of economic significance constitutes an important ongoing activity of many national nuclear programmes. Radioisotopes, formed by nuclear reactions on targets in a reactor or cyclotron, require further processing in almost all cases to obtain them in a form suitable for use. Specifications for final products and testing procedures for ensuring quality are also an essential part of a radioisotope production programme. The International Atomic Energy Agency (IAEA) has compiled and published such information before for the benefit of laboratories of Member States. The first compilation, entitled Manual of Radioisotope Production, was published in 1966 (Technical Reports Series No. 63). A more elaborate and comprehensive compilation, entitled Radioisotope Production and Quality Control, was published in 1971 (Technical Reports Series No. 128). Both served as useful reference sources for scientists working in radioisotope production worldwide. The 1971 publication has been out of print for quite some time. The IAEA convened a consultants meeting to consider the need for compiling an updated manual. The consultants recommended the publication of an updated manual taking the following into consideration: significant changes have taken place since 1971 in many aspects of radioisotope production; many radioisotopes have been newly introduced while many others have become gradually obsolete; considerable experience and knowledge have been gained in production of important radioisotopes over the years, which can be preserved through compilation of the manual; there is still a need for a comprehensive manual on radioisotope production methods for new entrants to the field, and as a reference. It was also felt that updating all the subjects covered in the 1971 manual at a time may not be practical considering the

  13. Radiological control technician: Training program management manual

    International Nuclear Information System (INIS)

    This manual defines and describes the DOE Radiological Control Technician Core Training Program qualification and training process, material development requirements, standards and policies, and administration. The manual applies to Radiological Control Technician Training Programs at all DOE contractor sites

  14. Users Manual for the FEHMN application

    International Nuclear Information System (INIS)

    The user's manual documents the use of the Yucca Mountain Site Characterization Projects Finite element heat and mass transfer code (FEHMN) application. The manual covers: Program considerations, data files, input data, output, system interface, and examples

  15. 21 CFR 886.1770 - Manual refractor.

    Science.gov (United States)

    2010-04-01

    ... DEVICES OPHTHALMIC DEVICES Diagnostic Devices § 886.1770 Manual refractor. (a) Identification. A manual... error of the eye. (b) Classification. Class I (general controls). The device is exempt from...

  16. 21 CFR 872.6855 - Manual toothbrush.

    Science.gov (United States)

    2010-04-01

    ... DEVICES DENTAL DEVICES Miscellaneous Devices § 872.6855 Manual toothbrush. (a) Identification. A manual... remove adherent plaque and food debris from the teeth to reduce tooth decay. (b) Classification. Class...

  17. 46 CFR 97.12-5 - Manual.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Manual. 97.12-5 Section 97.12-5 Shipping COAST GUARD...-5 Manual. The manual on the “Stowage of Bulk Cargoes Such as Ore, Ore Concentrates, and Similar... compliance with the requirements of § 97.12-1(a). 1 Copies of this manual are on file at Coast...

  18. US Department of Energy Radiological Control Manual

    International Nuclear Information System (INIS)

    This manual establishes practices for the conduct of radiological control activities. The Manual states DOE's positions and views on the best courses of action currently available in the area of radiological controls. Accordingly, the provisions in the Manual should be viewed by contractors as an acceptable technique, method or solution for fulfilling their duties and responsibilities. This Manual shall be used by DOE in evaluating the performance of its contractors. (VC)

  19. Your First Chiropractic Visit

    Science.gov (United States)

    ... examination procedures such as blood pres- sure, pulse, respiration, and temperature, the examina- tion will include specific ... heat, trac- tion, soft-tissue massage, and rehabilitative exercises, may also be used. When Will I Feel ...

  20. Danish Chiropractic Practice

    DEFF Research Database (Denmark)

    Myburgh, Cornelius; Boyle, Eleanor; Christensen, Henrik Wulff

    , face-to-face interviews and video analysis. Data was analysed for content and thematic emergence. Results: A purposive sampling framework yielded 11 clinic sites, representative of prevalent practice models. Data collected over a 6-month period included interviews with 60 patients, 22 health care...... professionals and 12 administrative staff. These were supplemented with video recordings of 33 clinical interactions. Health care encounters potentially start before patients enter clinics as individuals search websites to identify a suitable environment. In this regard modern, ‘cosy’ clinics are often favoured....... Danish chiropractors rarely function in a mono-professional setting, thus patients typically encounter one or more non-chiropractor during their treatment. Administrative staff is integral to the functioning of multi-disciplinary clinics, but also appear to function as ‘informal’ sources of information...

  1. Chiropractic: An Introduction

    Science.gov (United States)

    ... Events Multimedia (Video, Images, and Audio) NCCIH Clinical Digest A monthly newsletter with evidence-based information on ... require a viewer such as the free Adobe Reader . NCCIH Pub No.: D403 Date Created: November 2007 ...

  2. AFM-CMM integrated instrument user manual

    DEFF Research Database (Denmark)

    Marinello, Francesco; Bariani, Paolo

    This manual gives general important guidelines for a proper use of the integrated AFM-CMM instrument. More information can be collected reading: • N. Kofod Ph.D thesis [1]; • P. Bariani Ph.D thesis [2]; • Dualscope DME 95-200 operation manuals [3]; • SPIP help [4] • Stitching software user manual...

  3. 14 CFR 21.441 - Procedure manual.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Procedure manual. 21.441 Section 21.441... manual. (a) No DAS may exercise any authority under this subpart unless it submits, and obtains approval of, a procedure manual containing— (1) The procedures for issuing STCs; and (2) The names,...

  4. 46 CFR 197.420 - Operations manual.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 7 2010-10-01 2010-10-01 false Operations manual. 197.420 Section 197.420 Shipping... GENERAL PROVISIONS Commercial Diving Operations Operations § 197.420 Operations manual. (a) The diving supervisor shall— (1) Provide an operations manual to the person-in-charge prior to commencement of...

  5. 16 CFR 1211.14 - Instruction manual.

    Science.gov (United States)

    2010-01-01

    ... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Instruction manual. 1211.14 Section 1211.14... STANDARD FOR AUTOMATIC RESIDENTIAL GARAGE DOOR OPERATORS The Standard § 1211.14 Instruction manual. (a) General. (1) A residential garage door operator shall be provided with an instruction manual....

  6. 33 CFR 157.49 - Instruction manual.

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Instruction manual. 157.49... Vessel Operation § 157.49 Instruction manual. The master of a tank vessel shall ensure that the instruction manual under § 157.23 is available and used when the cargo or ballast systems are operated....

  7. 33 CFR 127.305 - Operations Manual.

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Operations Manual. 127.305... Waterfront Facilities Handling Liquefied Natural Gas Operations § 127.305 Operations Manual. Each Operations Manual must contain— (a) A description of the transfer system including mooring areas,...

  8. 33 CFR 385.28 - Operating Manuals.

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Operating Manuals. 385.28 Section... Processes § 385.28 Operating Manuals. (a) General provisions. (1) The Corps of Engineers and the non-Federal..., develop Operating Manuals to ensure that the goals and purposes of the Plan are achieved. (2)...

  9. 33 CFR 127.1305 - Operations Manual.

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Operations Manual. 127.1305... Waterfront Facilities Handling Liquefied Hazardous Gas Operations § 127.1305 Operations Manual. Each Operations Manual must contain— (a) A description of each liquid-transfer system and vapor transfer...

  10. 33 CFR 127.307 - Emergency Manual.

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Emergency Manual. 127.307 Section... Waterfront Facilities Handling Liquefied Natural Gas Operations § 127.307 Emergency Manual. Each Emergency Manual must contain— (a) LNG release response procedures, including contacting local...

  11. Radiology Aide. Instructor Key [and] Student Manual.

    Science.gov (United States)

    Hartwein, Jon; Dunham, John

    This manual can be used independently by students in secondary health occupations programs or by persons receiving on-the-job training in a radiology department. The manual includes an instructor's key that provides answers to the activity sheets and unit evaluations. The manual consists of the following five units: (1) orientation to radiology;…

  12. KDYNA user's manual

    Energy Technology Data Exchange (ETDEWEB)

    Levatin, J.A.L.; Attia, A.V.; Hallquist, J.O.

    1990-09-28

    This report is a complete user's manual for KDYNA, the Earth Sciences version of DYNA2D. Because most features of DYNA2D have been retained in KDYNA much of this manual is identical to the DYNA2D user's manual.

  13. Regulatory manual for staging of cancer by CT

    International Nuclear Information System (INIS)

    The exact level for staging and making decisions about therapy that will be applied to cancer patients at the Servicio de Radiologia e Imagenes Medicas has been important for the Hospital Calderon Guardia. A template of report or manual has been suggested, with the information necessary for staging a particular type of cancer by analyzing the tomography of the patient. The TNM International System has been used to design the template of report, with a specific technical language and terminology unified theme for the oncologist and radiologist. This system is abstracted in the sixth edition of oncological staging manual of the American Joint Committee and its atlas; resources already acquired, and the helical CT scanner. The experience of the radiologist is critical, because he will be responsible to fill the document.

  14. Environment, safety, and health manual, closeout report

    International Nuclear Information System (INIS)

    A coordination draft of the Environment, Safety, and Health (ES and H) manual was submitted on 2 September 1975. Comments provided by Operational Safety personnel were being incorporated by a task team when the effort was terminated on 31 October 1975. This report documents the development history of the manual and provides a status of the manual up to the time the efforts were discontinued. Also discussed are issues which effect completion of the manual. Additionally a plan for completion of the manual is suggested

  15. Internal dosimetry technical basis manual

    International Nuclear Information System (INIS)

    The internal dosimetry program at the Savannah River Site (SRS) consists of radiation protection programs and activities used to detect and evaluate intakes of radioactive material by radiation workers. Examples of such programs are: air monitoring; surface contamination monitoring; personal contamination surveys; radiobioassay; and dose assessment. The objectives of the internal dosimetry program are to demonstrate that the workplace is under control and that workers are not being exposed to radioactive material, and to detect and assess inadvertent intakes in the workplace. The Savannah River Site Internal Dosimetry Technical Basis Manual (TBM) is intended to provide a technical and philosophical discussion of the radiobioassay and dose assessment aspects of the internal dosimetry program. Detailed information on air, surface, and personal contamination surveillance programs is not given in this manual except for how these programs interface with routine and special bioassay programs

  16. Hanford whole body counting manual

    International Nuclear Information System (INIS)

    This document, a reprint of the Whole Body Counting Manual, was compiled to train personnel, document operation procedures, and outline quality assurance procedures. The current manual contains information on: the location, availability, and scope of services of Hanford's whole body counting facilities; the administrative aspect of the whole body counting operation; Hanford's whole body counting facilities; the step-by-step procedure involved in the different types of in vivo measurements; the detectors, preamplifiers and amplifiers, and spectroscopy equipment; the quality assurance aspect of equipment calibration and recordkeeping; data processing, record storage, results verification, report preparation, count summaries, and unit cost accounting; and the topics of minimum detectable amount and measurement accuracy and precision. 12 refs., 13 tabs

  17. Hanford whole body counting manual

    Energy Technology Data Exchange (ETDEWEB)

    Palmer, H.E.; Brim, C.P.; Rieksts, G.A.; Rhoads, M.C.

    1987-05-01

    This document, a reprint of the Whole Body Counting Manual, was compiled to train personnel, document operation procedures, and outline quality assurance procedures. The current manual contains information on: the location, availability, and scope of services of Hanford's whole body counting facilities; the administrative aspect of the whole body counting operation; Hanford's whole body counting facilities; the step-by-step procedure involved in the different types of in vivo measurements; the detectors, preamplifiers and amplifiers, and spectroscopy equipment; the quality assurance aspect of equipment calibration and recordkeeping; data processing, record storage, results verification, report preparation, count summaries, and unit cost accounting; and the topics of minimum detectable amount and measurement accuracy and precision. 12 refs., 13 tabs.

  18. Internal dosimetry technical basis manual

    Energy Technology Data Exchange (ETDEWEB)

    1990-12-20

    The internal dosimetry program at the Savannah River Site (SRS) consists of radiation protection programs and activities used to detect and evaluate intakes of radioactive material by radiation workers. Examples of such programs are: air monitoring; surface contamination monitoring; personal contamination surveys; radiobioassay; and dose assessment. The objectives of the internal dosimetry program are to demonstrate that the workplace is under control and that workers are not being exposed to radioactive material, and to detect and assess inadvertent intakes in the workplace. The Savannah River Site Internal Dosimetry Technical Basis Manual (TBM) is intended to provide a technical and philosophical discussion of the radiobioassay and dose assessment aspects of the internal dosimetry program. Detailed information on air, surface, and personal contamination surveillance programs is not given in this manual except for how these programs interface with routine and special bioassay programs.

  19. ISE System Development Methodology Manual

    Energy Technology Data Exchange (ETDEWEB)

    Hayhoe, G.F.

    1992-02-17

    The Information Systems Engineering (ISE) System Development Methodology Manual (SDM) is a framework of life cycle management guidelines that provide ISE personnel with direction, organization, consistency, and improved communication when developing and maintaining systems. These guide-lines were designed to allow ISE to build and deliver Total Quality products, and to meet the goals and requirements of the US Department of Energy (DOE), Westinghouse Savannah River Company, and Westinghouse Electric Corporation.

  20. Guidance manual for constructed wetlands.

    OpenAIRE

    Ellis, John Bryan; Shutes, R. Brian E.; Revitt, D. Mike

    2003-01-01

    This Guidance Manual was produced to provide up to date information on the design, costs, construction, operation and maintenance of constructed wetlands used for the treatment of highway runoff. Information is provided on the different types of wetlands and their mode of operation, the design and planting of a wetland system and the retrofitting of treatment structures, the performance and costs of wetlands and their operation and maintenance requirements. The benefits of wetlands in encoura...