WorldWideScience

Sample records for chiropractic practice results

  1. Danish Chiropractic Practice

    DEFF Research Database (Denmark)

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

    Objectives: To develop a contemporary, patient-oriented perspective of chiropractic private practice, as reflected by the setting, practice models and clinical interactions observable in Denmark. Methods: A qualitative point-of-view investigation was conducted making use of participant observation......, 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...... 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...

  2. 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....... CONCLUSIONS: Babies made up most of the Danish chiropractic patients younger than 18 years. Among the older children and the adolescents, musculoskeletal complaints were most common and mostly of a chronic nature. The large number of pediatric patients in chiropractic practices and the paucity of evidence...

  3. The use of diagnostic coding in chiropractic practice

    DEFF Research Database (Denmark)

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

    2015-01-01

    of chiropractors about diagnostic coding and explore the use of it in a chiropractic setting. A secondary aim was to compare the diagnostic coding undertaken by chiropractors and an independent coder. METHOD: A codin exercise based on the International Classification of Primary Care version 2, PLUS extension (ICPC...... of agreement between the chiropractors and the coder was determined and Cohen's Kappa was used to determine the agreement beyond that expected by chance. RESULTS: From the interviews the three emerging themes were: 1) Advantages and disadvantages of using a clinical coding system in chiropractic 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 ICPC-2...

  4. The efficacy of the homoeopathic similimum on musculoskeletal pain in UJ chiropractic students as a result of practicing adjustments

    OpenAIRE

    2013-01-01

    M.Tech. (Homeopathy) Students of Chiropractic, attending the University of Johannesburg (UJ), start the practical component of their training from their third year of study (Bunge & Tyranes, 2007). Each student must be proficient in 250 adjustments (200 of which must be spinal) by the end of their fifth year of study (Fletcher et al., 2005). As these manual manipulations are complex psychomotor skills, they require a good deal of practice to master (Bunge & Tyranes, 2007). Due to the pract...

  5. 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...

  6. 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

  7. 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…

  8. Contemporary chiropractic practice in the UK: a field study of a chiropractor and his patients in a suburban chiropractic clinic

    OpenAIRE

    Hennius, Bjorn J

    2013-01-01

    Background Two recent surveys of chiropractors in Great Britain suggest that there are discrepancies between chiropractic practice as defined in regulatory guidelines and day-to-day chiropractic clinical practice and there is in general a paucity of information regarding the characteristics of contemporary chiropractic practice in the United Kingdom. This field study describes the daily practice of a contemporary British UK-trained chiropractor. Methods The fieldwork took place during the spr...

  9. 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.

  10. Prevalence of hip osteoarthritis in chiropractic practice in denmark

    DEFF Research Database (Denmark)

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

    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 chiroprac......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...

  11. Chiropractic: a critical evaluation.

    Science.gov (United States)

    Ernst, Edzard

    2008-05-01

    Chiropractic was defined by D.D. Palmer as "a science of healing without drugs." About 60,000 chiropractors currently practice in North America, and, worldwide, billions are spent each year for their services. This article attempts to critically evaluate chiropractic. The specific topics include the history of chiropractic; the internal conflicts within the profession; the concepts of chiropractic, particularly those of subluxation and spinal manipulation; chiropractic practice and research; and the efficacy, safety, and cost of chiropractic. A narrative review of selected articles from the published chiropractic literature was performed. For the assessment of efficacy, safety, and cost, the evaluation relied on previously published systematic reviews. Chiropractic is rooted in mystical concepts. This led to an internal conflict within the chiropractic profession, which continues today. Currently, there are two types of chiropractors: those religiously adhering to the gospel of its founding fathers and those open to change. The core concepts of chiropractic, subluxation and spinal manipulation, are not based on sound science. Back and neck pain are the domains of chiropractic but many chiropractors treat conditions other than musculoskeletal problems. With the possible exception of back pain, chiropractic spinal manipulation has not been shown to be effective for any medical condition. Manipulation is associated with frequent mild adverse effects and with serious complications of unknown incidence. Its cost-effectiveness has not been demonstrated beyond reasonable doubt. The concepts of chiropractic are not based on solid science and its therapeutic value has not been demonstrated beyond reasonable doubt.

  12. 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…

  13. Chiropractic Adjustment

    Science.gov (United States)

    ... syndrome) A certain type of stroke (vertebral artery dissection) after neck manipulation Don't seek chiropractic adjustment ... Chiropractic treatment. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2015. Shekelle P, et al. Spinal ...

  14. 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.

  15. Chiropractic Rehabilitation for Adolescent Idiopathic Scoliosis: End-of-Growth and Skeletal Maturity Results

    Science.gov (United States)

    Morningstar, Mark W.; Dovorany, Brian; Stitzel, Clayton J.; Siddiqui, Aatif

    2017-01-01

    The aim of this study was to evaluate the radiographic outcomes obtained in a sample of patients treated with a chiropractic scoliosis-specific exercise program for patients with adolescent idiopathic scoliosis. Patients were treated and subsequently followed through skeletal maturity, and their results were reported in accordance with the SOSORT Consensus Guidelines. A total of 60 patient charts were consecutively selected when they met inclusion criteria. Cobb angle measurements and Risser staging were collected on all images. Using SOSORT criteria, 51.7% of patients achieved curve correction and 38.3% achieved stabilization. In the curve correction group, average total correction was 12.75°. A small number of sampled patients’ curves progressed, with a 13% failure rate based upon patients who dropped out before skeletal maturity combined with those who had progressed at skeletal maturity. Future studies are needed to corroborate these observations. PMID:28243430

  16. Well-being outcomes of chiropractic intervention for lower back pain: a systematic review.

    Science.gov (United States)

    Parkinson, Lynne; Sibbritt, David; Bolton, Philip; van Rotterdam, Joan; Villadsen, Inger

    2013-02-01

    The usefulness of chiropractic for treatment of low back pain is a contentious issue. Chiropractors advocate holism and general well-being as a key principle on which they base their clinical practice, yet the quality of life, lifestyle, health and economic impacts of chiropractic intervention for back pain in adults have rarely been investigated. This article provides an overview of chiropractic principles and practices, together with the results of a systematic review of peer-reviewed publications between 2000 and 2010 retrieved from MEDLINE, CINAHL, EMBASE, AMED and Cochrane Database of Systematic Reviews. This review sought to determine the benefits of chiropractic treatment and care to well-being, and to what extent chiropractic treatment and care improve quality of life. Of 1,165 articles, 12 articles were retained, representing six studies (four randomised controlled trial, two observational) of varying quality. There was a high degree of inconsistency and lack of standardisation in measurement instruments and outcome measures. Three studies reported reduced use of other/extra treatments as a positive outcome; two studies reported a positive effect of chiropractic intervention on pain, and two studies reported a positive effect on disability. The six studies reviewed concentrated on the impact of chiropractic care on physical health and disability, rather than the wider holistic view which was the focus of this study. It is difficult, therefore, to defend any conclusion about the impact of chiropractic intervention on the quality of life, lifestyle, health and economic impact on chiropractic patients presenting with back pain.

  17. 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,…

  18. Chiropractic manipulation for the foot: Diversified chiropractic techniques.

    Science.gov (United States)

    Lawrence, D J

    2001-05-01

    There has been increasing acceptance and development of manual methods in providing for the needs of patients with musculoskeletal dysfunction. Several professions have helped fuel this growth, including the chiropractic profession. To date, there has been only a small amount of collaboration between chiropractors and physical therapists. This paper provides a base foundation for one small part of general chiropractic practice, i.e. procedures used for manipulating the foot. Information is provided about the specific diagnostic procedures used by the chiropractic profession in assessing the joints and soft tissues of the foot, followed by descriptions of a number of chiropractic manipulative techniques drawn from the form of chiropractic in widest usage, Diversified technique. For each technique, information is provided on indications for use, patient position, therapist position, hand placements and procedure. In addition, a short discussion on the genesis of Diversified technique is provided.

  19. Changes in electrical activity in muscles resulting from chiropractic adjustment: a pilot study.

    Science.gov (United States)

    Shambaugh, P

    1987-12-01

    This study examines the effects of chiropractic adjustment on the muscles of the back. Vertebrae that are hypomobile may be held in that state by the erector spinae muscle group; adjusting such vertebrae should result in less muscle tension. By measuring the change in electrical activity, such relaxation can be observed. Hypomobile vertebrae were found by motion palpation. The patient was then placed prone and surface electrodes were placed over the upper trapezius, upper erector spinae (T3-T5), and lumbar erector spinae (L1-L3) muscle groups on both sides of the body. The patient was adjusted using full spine toggle recoil thrusts, and postadjustment readings were taken. Results from this study show that significant changes in muscle electrical activity occur as a consequence of adjusting. On average, a 25% reduction in muscle activity was observed across the 20 subjects tested, while no significant reductions were observed with the control group of 14 subjects. Significant reductions in side-to-side imbalances were also observed.

  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. 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…

  2. 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…

  3. 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…

  4. A focus group study of chiropractic students following international service learning experiences

    Science.gov (United States)

    Boysen, James C.; Salsbury, Stacie A.; Derby, Dustin; Lawrence, Dana J.

    2016-01-01

    Objective: One objective of chiropractic education is to cultivate clinical confidence in novice practitioners. The purpose of this qualitative study was to describe how participation in a short-term international service learning experience changed perceptions of clinical confidence in senior chiropractic students. Methods: Seventeen senior chiropractic students participated in 4 moderated focus group sessions within 4 months after a clinical educational opportunity held in international settings. Participants answered standard questions on how this educational experience may have changed their clinical confidence. Two investigators performed qualitative thematic analysis of the verbatim transcripts to identify core concepts and supporting themes. Results: The core concept was transformation from an unsure student to a confident doctor. The service learning experience allowed students to deliver chiropractic treatment to patients in a real-world setting, engage in frequent repetitions of technical skills, perform clinical decision-making and care coordination, and communicate with patients and other health professionals. Students described increased clinical confidence in 9 competency areas organized within 3 domains: (1) chiropractic competencies including observation, palpation, and manipulation; (2) clinical competencies including problem solving, clinic flow, and decision-making; and (3) communication competencies, including patient communication, interprofessional communication, and doctor–patient relationship. Students recommended that future service learning programs include debriefing sessions similar to the experience offered by these focus groups to enhance student learning. Conclusion: Senior chiropractic students who participated in an international service learning program gained confidence and valuable practical experience in integrating their chiropractic, clinical, and communication skills for their future practices. PMID:27258817

  5. 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

  6. [Chiropractic in general and in low back pain].

    Science.gov (United States)

    Myhrvold, K

    1999-05-30

    The practice of chiropractic was for many years regulated by "The Quack Act" in Norway, and the numbers of chiropractors decreased year by year. They are now authorized health care practitioners with academic training; most Norwegian students attending courses in chiropractic or clinical biomechanics go to European universities. An international council ensures reciprocity and a quality assured academic programme in all recognized colleges of chiropractic. Recent research have broadened our understanding of the biomechanical interrelationship between the nervous system, the musculature and the skeletal articulations. In the early 1990s, several studies documented favourable effect of chiropractic treatment of low back disorders. These studies are now substantiated by new studies, especially concerning cost-effectiveness. Several reports also give evidence that chiropractic manipulation is beneficial especially in combination with light exercise. There are conflicting results concerning the efficacy of varying types of exercise programmes. Patients may benefit from increased cooperation between medical doctors and chiropractors. Most acute low back syndromes should be assessed by the chiropractor in order to prevent chronic illness.

  7. Your First Chiropractic Visit

    Science.gov (United States)

    Healthy Living Patient Information from the American Chiropractic Association Your First Chiropractic Visit You’ve decided to visit a chiropractor, but you’re not quite sure what to expect on your ...

  8. Chiropractic and children

    DEFF Research Database (Denmark)

    Leboeuf-Yde, Charlotte; Hestbæk, Lise

    2010-01-01

    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...... 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...

  9. Chiropractic care for back pain

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000416.htm Chiropractic care for back pain To use the sharing ... discussed in your first session. What Conditions Does Chiropractic Treat Best? Chiropractic treatment is most effective for: ...

  10. 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.

  11. Assessment and risk reduction of infectious pathogens on chiropractic treatment tables

    Directory of Open Access Journals (Sweden)

    Husbands Chris

    2007-06-01

    Full Text Available Abstract Background To investigate the presence of pathogenic microbes on chiropractic treatment tables in one outpatient teaching clinic. Additional aims were to test inexpensive disinfectants on tables that may kill microbes and suggest infection control measures for chiropractic offices, clinics and classrooms. The aim of the study was to assess the presence of pathogenic microbes on treatment tables in one outpatient teaching clinic and determine a simple behavioral model for infection control including table disinfection and accepted hand washing and sanitizing protocols. Methods 10 treatment tables were selected and sampled for possible microbial flora on face and hand pieces. Samples were cultured on MacConky's agar and mannitol salt agar, labeled and incubated for up to 48 hours. Confirmatory testing of microbes to determine if drug resistant flora were present was performed. Among tables tested, 5 were selected to test disinfectants. One-half of the face piece and 1 hand piece were treated with two different wipes and then post-tested for microbes. Results Pathogenic microbes were present on chiropractic treatment tables including methicillin-resistant Staph aureus. Simple disinfectants neutralized the pathogens. A rudimentary disinfection procedure and infection control measures are suggested based on the findings. Conclusion Pathogenic microbes may be present on chiropractic treatment tables and can be effectively killed with proper disinfecting. Hand washing/sanitizing is an important measure in infection control as is table disinfecting. Rudimentary behavioral changes to improve chiropractic clinic infection control are needed. More comprehensive behavioral models are needed. All teaching clinics and private chiropractic offices should adopt infection control practices including routine table disinfecting and hand sanitizing. Effective measures can be put in place at minimal costs. Accrediting bodies of chiropractic institutions

  12. 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.

  13. Health care encounters in Danish chiropractic practice from a consumer perspectives

    DEFF Research Database (Denmark)

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

    2016-01-01

    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...... 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......' and 'a consultation that adds value'. The Internet functions as a tool when choosing/confirming a clinic as appropriate, developing and initial image and managing appointments. The administrative hub appears integral to the shaping of positive consumer experiences outside of the consultation. Clinic...

  14. Spine Care as a Framework for the Chiropractic Identity

    DEFF Research Database (Denmark)

    Schneider, Michael; Murphy, Donald; Hartvigsen, Jan

    2016-01-01

    OBJECTIVE: The purpose of this commentary is to provide an argument for the role and identity of chiropractors as spine care providers within the context of the greater health care system. DISCUSSION: Surveys of the general public and chiropractors indicate that the majority of patients seek...... globally. CONCLUSION: Although the chiropractic profession may debate internally about its professional identity, the chiropractic identity seems to have already been established by society, practice, legislation, and education as a profession of health care providers whose area of expertise is spine care....... chiropractic services for back and neck pain. Insurance company utilization data confirm these findings. Regulatory and legal language found in chiropractic practice acts reveals that most jurisdictions define the chiropractic scope of practice as based on a foundation of spine care. Educational accrediting...

  15. 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…

  16. A Chiropracticness Test

    Directory of Open Access Journals (Sweden)

    Charlton Keith H

    2005-11-01

    Full Text Available Abstract Background There is little homogeneity of opinion in the chiropractic profession about its essence and identity. Matters compromising the establishment of a coherent identity include the issue of vertebral subluxation, philosophy, mercantilism, poverty of qualifications in some chiropractic college faculty, and lack of intellectual productivity in some chiropractic college faculty. Discussion The Chiropractic profession has mislabeled rhetoric, supposition and cant as philosophy, whilst showing sparse evidence for the existence of more than a few chiropractors writing in philosophy as a discipline. There is no evidence for "Chiropractic Philosophy". I propose, however, that a better use of the discipline of philosophy can be of great use to the Chiropractic profession. Various thinkers throughout the ages have written about deduction, induction and falsificationism as methods to discover more reliably the nature of things in the world about us. Each method has strengths and frailties, but some of the latter are insurmountable for our purposes. Summary Using a contrivance of that method which seems most suited, sui generis, for the purpose, I propose a Chiropracticness Test as a tool to assist the search for essence and identity in Chiropractic.

  17. Chiropractic approach to the management of children

    Directory of Open Access Journals (Sweden)

    Miller Joyce

    2010-06-01

    Full Text Available Abstract Background Chiropractic (Greek: done by hand is a health care profession concerned with the diagnosis, treatment and prevention of disorders of the neuromusculoskeletal system and the effects of these disorders on general health. There is an emphasis on manual techniques, including joint adjustment and/or manipulation, with a particular focus on joint subluxation (World Health Organization 2005 or mechanical lesion and restoring function. The chiropractor's role in wellness care, prevention and treatment of injury or illness is based on education in anatomy and physiology, nutrition, exercise and healthy lifestyle counseling as well as referral to other health practitioners. Depending on education, geographic location, scope of practice, as well as consumer preference, chiropractors may assume the role of primary care for families who are pursuing a more natural and holistic approach to health care for their families. Objective To present a perspective on current management of the paediatric patient by members of the chiropractic profession and to make recommendations as to how the profession can safely and effectively manage the paediatric patient. Discussion The chiropractic profession holds the responsibility of ethical and safe practice and requires the cultivation and mastery of both an academic foundation and clinical expertise that distinguishes chiropractic from other disciplines. Research into the effectiveness of chiropractic care for paediatric patients has lagged behind that of adult care, but this is being addressed through educational programs where research is now being incorporated into academic tracks to attain advanced chiropractic degrees. Conclusion Studies in the United States show that over the last several decades, chiropractors are the most common complementary and alternative medicine providers visited by children and adolescents. Chiropractors continue to seek integration with other healthcare providers to

  18. 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...... in 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...

  19. 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…

  20. 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

    reducible disc syndromes followed by facet joint pain, dysfunction and sacroiliac (SI)-joint pain. Classification was inconclusive in 5% of the patients. Differences in pain, activity limitation, and psychological factors were small across subgroups. Within 10 days, 82% were reported to belong to the same......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...... patient characteristics within each subgroup, and (3) to determine the proportion of patients in whom clinicians considered the classification to be unchanged after approximately 10 days. A cohort of 923 LBP patients was included during their first consultation. Patients completed an extensive...

  1. An investigation into the demographics and motivations of students studying for a chiropractic degree.

    Science.gov (United States)

    Yalden, Philip; Cunliffe, Christina; Hunnisett, Adrian

    2013-01-01

    Objective : This research aimed to investigate motivations for studying chiropractic, and to determine what students look for in a course/college and potential barriers to studying chiropractic. Methods : The study design was a cross-sectional survey. Following IRB/Ethical approval, a paper-based questionnaire was distributed to students at McTimoney College of Chiropractic. Demographic data were compared to another chiropractic college in the United Kingdom. Results : The questionnaire response rate was 70.8% (n = 121). Motivating factors for studying chiropractic included a desire to help others (54.5%, n = 66), with 44.6% (n = 54) attracted by chiropractic's holistic, drugless approach to health. Previous help from chiropractic influenced 55.4% (n = 67) and 22.3% (n = 27) felt chiropractic had "changed their life." Just over half of the respondents (55.4%, n = 67) viewed the ability to work while studying as extremely important and 73.6% (n = 89) said they could not have studied chiropractic without this. Conclusion : Previous help from chiropractic care was a common motivation for studying chiropractic. The ability to work while studying was seen as vital by many students and, without it, the vast majority felt they could not have studied chiropractic.

  2. A diachronic study of the language of chiropractic.

    Science.gov (United States)

    Budgell, Brian S; Kwong, Alice; Millar, Neil

    2013-03-01

    This study investigates how the language of chiropractic has changed over time. A collection of material, published up until approximately 1950 and consisting of textbooks, monographs and lecture notes from Canadian Memorial Chiropractic College, was analyzed to identify commonly occurring words and phrases. The results were compared to a corpus of recent articles from the Journal of the Canadian Chiropractic Association. This permitted the identification of words which were over-represented in the historical literature and therefore likely have become somewhat archaic or represent themes which are of less import in the modern chiropractic literature. Words which were over-represented in the historical literature often referred to anatomical, pathological and biomechanical concepts. Conversely, words which were comparatively over-represented in the modern chiropractic literature often referred to concepts of professionalism, the clinical interaction and evidence-based care. A detailed analysis is presented of trends in the use of the conceptually important terms subluxation and adjustment.

  3. 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.

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

    Science.gov (United States)

    Eirikstoft, Heidi; Kongsted, Alice

    2014-02-01

    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 patient characteristics within each subgroup, and (3) to determine the proportion of patients in whom clinicians considered the classification to be unchanged after approximately 10 days. A cohort of 923 LBP patients was included during their first consultation. Patients completed an extensive questionnaire and were examined according to a standardised protocol. Based on the clinical examination, patients were classified into diagnostic subgroups. After approximately 10 days, chiropractors reported whether they considered the subgroup had changed. The most frequent subgroups were reducible and partly reducible disc syndromes followed by facet joint pain, dysfunction and sacroiliac (SI)-joint pain. Classification was inconclusive in 5% of the patients. Differences in pain, activity limitation, and psychological factors were small across subgroups. Within 10 days, 82% were reported to belong to the same subgroup as at the first visit. In conclusion, LBP patients could be classified according to a standardised protocol, and chiropractors considered most patient classifications to be unchanged within 10 days. Differences in patient characteristics between subgroups were very small, and the clinical relevance of the classification system should be investigated by testing its value as a prognostic factor or a treatment effect modifier. It is recommended that this classification system be combined with psychological and social factors if it is to be useful.

  5. Legislative approaches to the regulation of the chiropractic profession.

    Science.gov (United States)

    Chapman-Smith, D A

    1997-01-01

    Traditional and complementary health care services have a growing and significant role in both developed and developing countries. In the United Kingdom the British Medical Association (BMA) has identified five complementary approaches to health care that should now be regarded as "discrete clinical disciplines" because they have "established foundations of training and have the potential for greatest use alongside orthodox medical care". These are acupuncture, chiropractic, herbalism, homeopathy and osteopathy. The BMA recommended that there should be legislation to regulate these disciplines and the Chiropractors' Act enacted in the U.K in 1994. The chiropractic profession was founded in the United States in 1895, and the practice of chiropractic has been regulated in the United States and Canada since the 1920s, in Australia since the late 1940s, in New Zealand and South Africa since the 1960s, and more recently in Asia, Europe, Latin America and elsewhere. Figure 1 lists the countries which currently recognize and regulate the chiropractic profession. Many countries, such as Japan with approximately 10,000 chiropractors with different levels of education, and Trinidad & Tobago with 5 chiropractors who are graduates of accredited chiropractic colleges in North America, are considering legislation. Croatia, with 3 chiropractors, is preparing legislation. Cyprus, with 6 chiropractors, has legislation. Even in countries such as these, where the profession is small, there are compelling public interest arguments for regulation. This is especially true in the 1990s. One reason is the growing incentive for lay healers and others without formal training to use the title "chiropractor" as chiropractic practice gains increasing acceptance. The majority of chiropractic practice involves patients with non- specific or mechanical back and neck pain. The chiropractic approach to management, which includes spinal adjustment or manipulation, other physical treatments, postural

  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. 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.

  8. Chiropractic care and public health

    DEFF Research Database (Denmark)

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

    2012-01-01

    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 children? What ways can doctors of chiropractic stay updated on evidence-based information about vaccines and immunization throughout the lifespan? Can smoking cessation be a prevention strategy for back pain? Does chiropractic have relevance within the VA Health Care System for chronic pain and comorbid...... to public health? What public health roles can chiropractic interns perform for underserved communities in a collaborative environment? Can the chiropractic profession contribute to community health? What opportunities do doctors of chiropractic have to be involved in health care reform in the areas...

  9. Developmental issues in chiropractic: a South African practitioner and patient perspective

    DEFF Research Database (Denmark)

    Myburgh, Corrie; Mouton, Johan

    2007-01-01

    responded that the strengths of the chiropractic profession lie in its social desirability and its health care utility. Two factors seem important in endorsing chiropractic, namely, on the grounds of patient beliefs and philosophical views with respect to health care and the model of practice encountered...... of the 3 domains investigated. Issues such as the apparent lack of conceptual identity of chiropractic; the absence of a coherent, marketable model of chiropractic practice; and poor interprofessional relationships with mainstream health care stakeholders were observed. The issue of integrated public......OBJECTIVE: This study explores pertinent aspects of chiropractic practice in contemporary South Africa in terms of the domains of beliefs, philosophy, professional matters, and education. METHODS: Ten practitioners were purposively sampled. From these, 3 were used as gatekeepers to access 6...

  10. 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.

  11. Characteristics of Veterans Health Administration chiropractors and chiropractic clinics.

    Science.gov (United States)

    Lisi, Anthony J; Goertz, Christine; Lawrence, Dana J; Satyanarayana, Preeti

    2009-01-01

    Chiropractic services have been delivered on station at select Veterans Health Administration (VHA) medical facilities since late 2004. No published data describing the characteristics of VHA chiropractic physicians (chiropractors) and chiropractic clinics exist at a national level. This study was designed to examine elements of the structures of chiropractic services in VHA settings. Web-based survey methods were used to question all chiropractors in VHA facilities (N = 36). Data were obtained from 33 providers, yielding a 91.6% response rate. Most respondents were full-time VHA employees, while others were part-time employees or contractors. Differences were found in prior training, integrated practice, and academic or research experience. Of the respondents, 88% ranked low back pain as the most common patient complaint seen in practice and 79% ranked cervical pain the second most common complaint. Of the new patient consultations, 67.6% originated from primary care, 9.4% from pain management, and 6.2% from physiatry. Most respondents were similar in their reported use of diagnostic and therapeutic procedures, but their reported rates of participation in various facility activities were different. Further work is needed for researchers and policy makers to more fully understand the integration and delivery of chiropractic services in VHA settings.

  12. Exercise prescription: perceptions and physical activity habits in chiropractic students at CMCC

    Science.gov (United States)

    Howitt, Scott; Ethridge, Eric; Nelson, Eric; Gotuaco, Mike; Demello, Louis

    2016-01-01

    Background: Health care practitioner’s physical activity (PA) habits are associated with their likelihood to recommend PA to their patients. The intent of this project is to better understand the Canadian Memorial Chiropractic College (CMCC) students’ perceptions and practices of PA and exercise prescription as this may predict exercise counselling they will provide to future patients. Methods: A 27-item survey was distributed to Canadian Memorial Chiropractic College (CMCC) students (N = 744). The survey determined the proportion of CMCC students that meet the (2012) Canadian Physical Activity Guidelines. Additionally the survey recorded students’ perceptions of PA counselling during patient visits and their own example of maintaining a healthy lifestyle. Results: The response rate for the survey was 46% (N = 343). By using average estimates, it was determined that 72% of the respondents meet the (2012) Canadian Physical Activity Guidelines. 86% of the respondents perceived PA counselling to be usually or always relevant during patient interactions, and approximately 73% believed that exercise counselling is highly relevant to chiropractic practice. Furthermore, at least 88% percent believed that chiropractors must adhere to a healthy lifestyle in order to effectively model a healthy lifestyle to their patients. Conclusions: A high proportion of CMCC students meet PA guidelines, and perceive PA counselling to be highly relevant and important to patient encounters. PMID:28065988

  13. 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.

  14. 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.

  15. 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

  16. 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.

  17. Chiropractic and social justice: a view from the perspective of Beauchamp's principles.

    Science.gov (United States)

    Green, Bart N; Johnson, Claire

    2010-01-01

    Social justice in public health involves the process and product of a community acting to fairly distribute advantages and burdens to improve the health of its population and to reasonably take care of the disadvantaged. Although publications are available about chiropractic public health history, programs, and policy, the potential role of chiropractic in social justice has received little attention. This article discusses Beauchamp's 4 principles of social justice and suggests actions that the chiropractic profession may consider to participate in the practice of social justice in the field of public health.

  18. Sports chiropractic management at the World Ice Hockey Championships

    Directory of Open Access Journals (Sweden)

    Vitiello Andrew L

    2010-12-01

    Full Text Available Abstract Background Ice hockey is an international sport. Injuries occur in a full body fashion, to a number of tissues, commonly through body contact. There is a lack of literature documenting the scope of sports chiropractic practice. Thus, it was the aim to document the type, scope and severity of conditions presenting to, and the treatment provided by, the New Zealand team chiropractor acting as a primary health provider for the duration of the 2007 World Ice Hockey Championships. Methods All conditions presenting were recorded. Diagnosis was recorded along with clinical parameters of injury: injury type, severity, mechanism and whether referral or advanced imaging was required. All treatment provided was continuously recorded, including information on the number of treatments required and the reason, duration, type and location of treatment. Results Players presented for diagnosis of injury 50 times. Muscle (34%, joint (24% and tendon injuries (18% were most common. Players presented with a new injury 76% of the time. Most injuries had been present for less than one week (84%, with 53% occurring through a contact mechanism. Injuries were common at training and match locations. Only two injuries required the player to stop playing or training, both of which were referred for advanced imaging. During the study, 134 treatment consultations were rendered to 45 player injuries. Eighty per-cent of injuries were managed with four or less treatments. Three quarters of treatment was provided at training locations with treatment duration predominantly being between 11-15 minutes (71% and 16-20 minutes (27%. Most treatment delivered was passive in nature (71% although combination active and passive care was provided (27%. Treatment typically involved joint (81% and soft tissue based therapies (81% and was delivered in a full body manner. Conclusions This study documented the injury profile of ice hockey at an international level of competition. It

  19. 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.

  20. Chiropractic management of back pain.

    Science.gov (United States)

    Lall, M

    1983-05-01

    The vast majority of those with back pain respond extremely well to chiropractic spinal manipulation. There are several hundred procedures available to a well trained chiropractor, including high velocity manipulation, mobilisation, soft tissue techniques and pressure point therapy, which may be used to eliminate the need for manipulation under anaesthesia or surgery.

  1. 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...

  2. Caught in the crosshairs: identity and cultural authority within chiropractic.

    Science.gov (United States)

    Villanueva-Russell, Yvonne

    2011-06-01

    In this paper the discourse over identity and cultural authority within the profession of chiropractic in the United States has been analyzed using critical discourse analysis. As the profession struggles to construct one singular image, versions of self must be internally debated and also shaped in consideration of larger, external forces. The dilemma of remaining tied to a marginal professional status must be balanced against considerations of integration. Written texts from chiropractic journals and newspapers are analyzed in a multidimensional approach that considers the rhetorical devices and thematic issues of identity construction; the representation of various voices within the discourse (both heard and unheard); and the extent to which external pressures affect the projection of cultural authority for the profession. A heterogeneous discourse characterized by conflict was found, with discrepancies between everyday chiropractors in actual practice versus academic chiropractors and leaders particularly over the idea, practice and significance of science for the profession.

  3. Dr. Millie Cleveland: chiropractic achiever.

    Science.gov (United States)

    Nash, J

    1998-06-01

    Dr. Mildred Genoa Allison-Cleveland, affectionately known as "Dr. Millie," was an important part of life at Cleveland Chiropractic College for over thirty years, serving first as a clerical assistant, then instructor, administrative assistant, and trusted right hand of her husband, Dr. Carl Cleveland, Jr. Yet Mildred Cleveland, like many other women who have helped the profession grow and survive over the years, has never been the subject of an article in print. In this paper, the author will strive to outline Dr. Mildred Cleveland's accomplishments, as well as to give the reader as clear a picture as possible of the woman who was the wife of one chiropractic pioneer and mother of another.

  4. Chiropractic diagnosis and management of non-musculoskeletal conditions in children and adolescents

    Directory of Open Access Journals (Sweden)

    Miller Joyce

    2010-06-01

    Full Text Available Abstract Background A great deal has been published in the chiropractic literature regarding the response, or lack thereof, of various common pediatric conditions to chiropractic care. The majority of that literature is of low scientific value (that is, case reports or case series. The purpose of this review is to summarize the literature from the point of view of clinicians, rather than researchers, and to discuss some additional detail of the conditions themselves. Methods Databases searched were PubMed, Mantis, Index to Chiropractic Literature, and CINAHL. Keywords were chiropractic paired with colic, crying infant, nocturnal enuresis, asthma, otitis media and attention deficit hyperactivity disorder. Results Most of the published literature centers around case reports or series. The more scientifically rigorous studies show conflicting results for colic and the crying infant, and there is little data to suggest improvement of otitis media, asthma, nocturnal enuresis or attention deficit hyperactivity disorder. Discussion The efficacy of chiropractic care in the treatment of non-musculoskeletal disorders has yet to be definitely proven or disproven, with the burden of proof still resting upon the chiropractic profession.

  5. 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.

  6. A commentary on the implications of medication prescription rights for the chiropractic profession.

    Science.gov (United States)

    Emary, Peter C; Houweling, Taco A W; Wangler, Martin; Burnie, Stephen J; Hood, Katherine J; Erwin, W Mark

    2016-01-01

    There is a growing desire within the chiropractic profession to expand the scope of practice to include limited medication prescription rights for the treatment of spine-related and other musculoskeletal conditions. Such prescribing rights have been successfully incorporated into a number of chiropractic jurisdictions worldwide. If limited to a musculoskeletal scope, medication prescription rights have the potential to change the present role of chiropractors within the healthcare system by paving the way for practitioners to become comprehensive specialists in the conservative management of spine / musculoskeletal disorders. However, if the chiropractic profession wishes to lobby to expand the scope of practice to include limited prescriptive authority, several issues must first be addressed. These would include changes to chiropractic education and legislation, as well as consideration of how such privileges could impact the chiropractic profession on a more theoretical basis. In this commentary, we examine the arguments in favour of and against limited medication prescription rights for chiropractors and discuss the implications of such privileges for the profession.

  7. Chiropractic treatment of low back pain: a prospective survey.

    Science.gov (United States)

    Bronfort, G

    1986-06-01

    The clinical course of low back pain (LBP) during chiropractic treatment has not previously been reported on the basis of a prospective survey. The prospective survey is based on patient questionnaires filled in before treatment was started, as well as 1, 3, 6 and 12 months later. Clinical examination was performed at entry and also 1 month later. Two hundred ninety-eight patients with acute or chronic LBP from ten different chiropractic clinics were selected sequentially for this study. At the time of first contact between these patients and the clinics, the current episode of LBP had lasted less than 1 wk in 30% of the patients and for more than 4 wk in 51%. Sixty-five percent had radiating pain into the lower extremity, and 38% were unable to work. Fifty-three percent of the patients had consulted a medical doctor or had received other types of treatment due to the current episode. Nineteen percent were referred by a medical doctor to the chiropractor. After each period of registration, approximately 75% of the patients reported being free of symptoms or feeling much better. The present study was designed to be compared to a similar investigation carried out in a general medical practice. A clear indication of a more favorable outcome was found in those patients receiving chiropractic treatment when compared to those receiving medical treatment, especially concerning such factors as ability to work, bedrest and use of medication. Only a randomized controlled clinical trial is suited for a direct comparison of the effect and cost of chiropractic and medical treatment of LBP.

  8. 2016 World Federation of Chiropractic/Association of Chiropractic Colleges Education Conference proceedings

    Science.gov (United States)

    2016-01-01

    In October 2016, the World Federation of Chiropractic and Association of Chiropractic Colleges Education Conference was held in Montreal, Canada. This summary provides the titles of the contributed presentations. The full set of abstracts for this meeting are published online at www.journalchiroed.com as an exclusively electronic publication that is part of volume 30, issue 2 (October 2016) of the Journal of Chiropractic Education. PMID:27749117

  9. 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.

  10. 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.

  11. 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.

  12. Case management of chiropractic patients with cervical brachialgia

    DEFF Research Database (Denmark)

    Guenoun, Olivier; Debarle, Michel; Garnesson, Coralie;

    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....

  13. 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

  14. Chiropractic

    Science.gov (United States)

    ... care profession. Chiropractors perform adjustments (manipulations) to the spine or other parts of the body. The goal is to correct alignment problems, ease pain, and support the body's natural ...

  15. 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 ...

  16. 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

  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. Chiropractic and the politics of health care.

    Science.gov (United States)

    O'Neill, A; Willis, E

    1994-09-01

    Musculoskeletal disorders remain a common disability suffered by Australians, but the question of who should treat them remains a contentious issue as the first centenary of the original chiropractic adjustment approaches. This paper, part of a longitudinal study of the role of chiropractic in the Australian health system, analyses this ongoing debate. Recent events are analysed here in this commentary on the politics of health care in this field. These include meta-analysis to evaluate the effectiveness of spinal manipulation for the treatment of lower back pain, recent legal action in the United States, and the recent epistle against Australian chiropractors published by the Australian Medical Association.

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

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    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

  20. 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).

  1. 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…

  2. Pediatric Chiropractic Care: The Subluxation Question And Referral Risk.

    Science.gov (United States)

    Homola, Samuel

    2016-02-01

    Chiropractors commonly treat children for a variety of ailments by manipulating the spine to correct a 'vertebral subluxation' or a 'vertebral subluxation complex' alleged to be a cause of disease. Such treatment might begin soon after a child is born. Both major American chiropractic associations - the International Chiropractic Association and the American Chiropractic Association - support chiropractic care for children, which includes subluxation correction as a treatment or preventive measure. I do not know of any credible evidence to support chiropractic subluxation theory. Any attempt to manipulate the immature, cartilaginous spine of a neonate or a small child to correct a putative chiropractic subluxation should be regarded as dangerous and unnecessary. Referral of a child to a chiropractor for such treatment should not be considered lest a bad outcome harms the child or leads to a charge of negligence or malpractice.

  3. 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

    2006-01-01

    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...

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. Medical Simulation Practices 2010 Survey Results

    Science.gov (United States)

    McCrindle, Jeffrey J.

    2011-01-01

    Medical Simulation Centers are an essential component of our learning infrastructure to prepare doctors and nurses for their careers. Unlike the military and aerospace simulation industry, very little has been published regarding the best practices currently in use within medical simulation centers. This survey attempts to provide insight into the current simulation practices at medical schools, hospitals, university nursing programs and community college nursing programs. Students within the MBA program at Saint Joseph's University conducted a survey of medical simulation practices during the summer 2010 semester. A total of 115 institutions responded to the survey. The survey resus discuss overall effectiveness of current simulation centers as well as the tools and techniques used to conduct the simulation activity

  9. Chiropractic approach to the management of children

    OpenAIRE

    2010-01-01

    Abstract Background Chiropractic (Greek: done by hand) is a health care profession concerned with the diagnosis, treatment and prevention of disorders of the neuromusculoskeletal system and the effects of these disorders on general health. There is an emphasis on manual techniques, including joint adjustment and/or manipulation, with a particular focus on joint subluxation (World Health Organization 2005) or mechanical lesion and restoring function. The chiropractor's role in wellness care, p...

  10. Chiropractic and CAM Utilization: A Descriptive Review

    OpenAIRE

    Meeker William C; Lawrence Dana J

    2007-01-01

    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 inform...

  11. 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;…

  12. Retrospective Demographic Analysis of Patients Seeking Care at a Free University Chiropractic Clinic

    Science.gov (United States)

    Stevens, Gerald; Campeanu, Michael; Sorrento, Andrew T.; Ryu, Jiwoon; Burke, Jeanmarie

    2016-01-01

    Objective The purpose of this study was to describe the demographics, presenting complaints, and health history of new patients seeking treatment at a free chiropractic clinic within a university health center. Methods A retrospective analysis of patient files from 2008 to 2009 was performed for a free student chiropractic clinic in the Buffalo, NY, area. Demographics, presenting complaints, and health history of new patients seeking treatment were recorded. Results There were 343 new chiropractic patient files. Most patients were between the ages of 18 and 30 years (n = 304, 88%) with an almost equal distribution of men (n = 163, 48%) and women (n = 180, 52%). The patients were mostly single (n = 300, 87%). Patients self-reported that their case histories excluded a current medical diagnosis (n = 261, 76%), previous history of disease (n = 216, 63%), allergies (n = 240, 70%), previous surgical procedures (n = 279, 81%), and medication use (n = 250, 73%). The frequencies of spinal complaints were as follows: lumbar spine, n = 176 (51%); cervical spine, n = 78 (23%); and thoracic spine, n = 44 (13%). Maintenance care, headaches, and spine-related upper and lower extremities complaints accounted for the other 13% of patients treated. Half were chronic (n = 172, 50%), and a third were acute (n=108, 31%). Patients averaged 6 chiropractic visits, with 88% having 11 visits or less. Conclusion This study found that new patients seeking care at a free student chiropractic clinic within a university health center in the Buffalo area mainly consisted of young single adults, with chronic lumbar spine complaints with few comorbidities. PMID:27069428

  13. 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…

  14. 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

  15. McTimoney chiropractic: a gentle way with back pain.

    Science.gov (United States)

    Cartlidge, S

    1997-10-01

    There are 1080 chiropractors in the UK today, and almost one-third of these are McTimoney chiropractors. This article outlines the development of McTimoney Chiropractic, which is a particular branch of the chiropractic profession in the UK, taught at the McTimoney Chiropractic College in Abingdon, near Oxford. The McTimoney method is distinguished by its gentle, whole body approach. It aims to correct the alignment of the bones of the spine and other joints of the body, to restore nerve function, to alleviate pain, and to promote natural health. The technique is suitable for the very young as well as the old and frail. In this paper, several nurses-turned-chiropractor offer their personal views. Reference is also made to the McTimoney-Corley technique, which is a similar chiropractic method taught at the Oxford School of Chiropractic, UK.

  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...... 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...

  17. 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.

  18. 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

  19. 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

  20. An independent review of NCCAM-funded studies of chiropractic.

    Science.gov (United States)

    Ernst, Edzard; Posadzki, Paul

    2011-05-01

    To promote an independent and critical evaluation of 11 randomised clinical trials (RCTs) of chiropractic funded by the National Centre for Complementary and Alternative Medicine (NCCAM). Electronic searches were conducted to identify all relevant RCTs. Key data were extracted and the risk of bias of each study was determined. Ten RCTs were included, mostly related to chiropractic spinal manipulation for musculoskeletal problems. Their quality was frequently questionable. Several RCTs failed to report adverse effects and the majority was not described in sufficient detail to allow replication. The criticism repeatedly aimed at NCCAM seems justified, as far as their RCTs of chiropractic is concerned. It seems questionable whether such research is worthwhile.

  1. 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

  2. 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.

  3. Audit and feedback intervention: An examination of differences in chiropractic record-keeping compliance.

    Science.gov (United States)

    Homb, Nicole M; Sheybani, Shayan; Derby, Dustin; Wood, Kurt

    2014-10-01

    Objective : The objective of this study was to investigate the association of a clinical documentation quality improvement program using audit-feedback with clinical compliance to indicators of quality chart documentation. Methods : This was an analysis of differences between adherence to quality indicators of chiropractic record documentation and audit-feedback intervention (feedback report only vs. feedback report with one-on-one educational consultation) at different campuses. Comparisons among groups were analyzed using analysis of variance (ANOVA), Tukey or Dunnett post hoc tests, and Cohen's d effect size estimates. Results : There was a significant increase in the mean percentile compliance in 2 of 5 compliance areas and 1 of 11 compliance objectives. Campus B demonstrated significantly higher levels of compliance relative to campus A and/or campus C in 5 of 5 compliance areas and 7 of 11 compliance objectives. Across-campus comparisons indicated that the compliance area Review (Non-Medicare) Treatment Plan [F(2,18) = 17.537, p importance for clinical compliance practice. Conclusions : Feedback of performance improved compliance to indicators of quality health record documentation, especially when baseline adherence is relatively low. Required educational consultations with clinicians combined with audit-feedback were no more effective at increasing compliance to indicators of quality health record documentation than audit-feedback alone.

  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. 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

  6. Attitudes towards fibromyalgia: A survey of Canadian chiropractic, naturopathic, physical therapy and occupational therapy students

    Directory of Open Access Journals (Sweden)

    Badwall Parminder

    2008-05-01

    Full Text Available Abstract Background The frequent use of chiropractic, naturopathic, and physical and occupational therapy by patients with fibromyalgia has been emphasized repeatedly, but little is known about the attitudes of these therapists towards this challenging condition. Methods We administered a cross-sectional survey to 385 senior Canadian chiropractic, naturopathic, physical and occupational therapy students in their final year of studies, that inquired about attitudes towards the diagnosis and management of fibromyalgia. Results 336 students completed the survey (response rate 87%. While they disagreed about the etiology (primarily psychological 28%, physiological 23%, psychological and physiological 15%, unsure 34%, the majority (58% reported that fibromyalgia was difficult to manage. Respondants were also conflicted in whether treatment should prioritize symptom relief (65% or functional gains (85%, with the majority (58% wanting to do both. The majority of respondents (57% agreed that there was effective treatment for fibromyalgia and that they possessed the required clinical skills to manage patients (55%. Chiropractic students were most skeptical in regards to fibromyalgia as a useful diagnostic entity, and most likely to endorse a psychological etiology. In our regression model, only training in naturopathic medicine (unstandardized regression coefficient = 0.33; 95% confidence interval = 0.11 to 0.56 and the belief that effective therapies existed (unstandardized regression coefficient = 0.42; 95% confidence interval = 0.30 to 0.54 were associated with greater confidence in managing patients with fibromyalgia. Conclusion The majority of senior Canadian chiropractic, naturopathic, physical and occupational therapy students, and in particular those with naturopathic training, believe that effective treatment for fibromyalgia exists and that they possess the clinical skillset to effectively manage this disorder. The majority place high priority

  7. 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......, 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......-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...

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

    Directory of Open Access Journals (Sweden)

    Ni Ni Win

    2015-05-01

    Full Text Available 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 chiropractic students, consisting of three PBL cases for which learning resources were provided and another three PBL cases for which learning resources were not provided. Group discussions were not continuously supervised, since only one facilitator was present. The students’ perceptions of PBL in collaborative groups were assessed with a questionnaire that was divided into three domains: motivation, cognitive skills, and perceived pressure to work. Results: Thirty of the 31 students (97% participated in the study. PBL in collaborative groups was significantly associated with positive responses regarding students’ motivation, cognitive skills, and perceived pressure to work (P<0.05. The students felt that PBL with learning resources increased motivation and cognitive skills (P<0.001. Conclusion: The new PBL implementation described in this study does not require additional instructors or any additional funding. When implemented in a classroom setting, it has pedagogical benefits equivalent to those of small-group sessions. Our findings also suggest that students rely significantly on available learning resources.

  9. Predictors of performance of students in biochemistry in a doctor of chiropractic curriculum.

    Science.gov (United States)

    Shaw, Kathy; Rabatsky, Ali; Dishman, Veronica; Meseke, Christopher

    2014-01-01

    Objective : This study investigated the effect of completion of course prerequisites, undergraduate grade point average (GPA), undergraduate degree, and study habits on the performance of students in the biochemistry course at Palmer College of Chiropractic Florida. Methods : Students self-reported information regarding academic preparation at the beginning of the semester using a questionnaire. Final exam grade and final course grade were noted and used as measures of performance. Multivariate analysis of variance was used to determine if number of prerequisites completed, undergraduate GPA, undergraduate degree, hours spent studying in undergraduate study, and hours spent studying in the first quarter of the chiropractic program were associated significantly with the biochemistry final exam grade or the final grade for the biochemistry course. Results : The number of prerequisites completed, undergraduate degree, hours spent studying in undergraduate study, and hours spent studying in the first quarter of the chiropractic program did not significantly affect the biochemistry final exam grade or the final grade for the biochemistry course, but undergraduate GPA did. Subsequent univariate analysis and Tukey's post hoc comparisons revealed that students with an undergraduate GPA in the 3.5 to 3.99 range earned significantly higher final course grades than students with an undergraduate GPA in the 2.5 to 2.99 range. Conclusion : No single variable was determined to be a factor that determines student success in biochemistry. The interrelationship between the factors examined warrants further investigation to understand fully how to predict the success of a student in the biochemistry course.

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

    OpenAIRE

    Stochkendahl Mette; Hestbaek Lise

    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 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 musculosk...

  11. 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.

    2013-01-01

    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 imaging, scheduling......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...... implementation of a MD-DC co-management model. We analyzed the qualitative data using thematic content analysis. Results: Older adults considered LBP co-management by MDs and DCs a positive approach as the professions have complementary strengths. Participants wanted providers who worked in a co-management model...

  12. Chiropractic Treatment of Cervical Trection with artificial Vertigo Effect of 155 Cases%整脊配合人工牵引治疗颈性眩晕155例疗效分析

    Institute of Scientific and Technical Information of China (English)

    栾龙; 闻英奎

    2009-01-01

    Objective:To investigate the incidence of cervical vertigo mechanisms and treatment. Methods :218 cases were divided into two groups, the treatment group of 155 cases, the use of artificial practices and Chiropractic supine traction therapy, the control group of 63 patients using traditional seat manipulation and traction treatment. Results: Efficiency of the treatment group were 98.7%, the control group was 71.4%. The difference between the two groups is statistically significant (P < 0.05 ). Conclusion : Chiropractic practices with artificial supine traction treatment of cervical vertigo alleviate is the most effective way.%探讨颈性眩晕的发病机制与治疗.方法:将218例患者分为两组,治疗组155例,采用整脊手法及人工仰卧位牵引治疗,对照组63例采用传统的推拿手法及坐位牵引治疗.结果:治疗组的有效率98.7%,对照组的有效率71.4%,两组比较差异有统计学意义(P<0.05).结论:整脊手法配合仰卧位牵引是治疗缓解颈性眩晕最有效的方法.

  13. Attitudes of non-practicing chiropractors: a pilot survey concerning factors related to attrition

    Directory of Open Access Journals (Sweden)

    Wyatt Lawrence H

    2010-11-01

    Full Text Available Abstract Background Research into attitudes about chiropractors who are no longer engaged in active clinical practice is non-existent. Yet non-practicing chiropractors (NPCs represent a valid sub-group worthy of study. Aim The purpose of this research was to assess attrition attitudes of NPCs about the chiropractic profession and develop a scale to assess such attitudes. Methods A 48 item survey was developed using the PsychData software. This survey included 35 Likert-style items assessing various aspects of the profession namely financial, educational, psychosocial and political. An internet discussion site where NPCs may be members was accessed for recruitment purposes. Results A total of 70 valid responses were received for analysis. A majority of respondents were male with 66% being in non-practice status for 3 to 5 years and less with 43% indicating that they had graduated since the year 2000. Most respondents were employed either in other healthcare professions and non-chiropractic education. A majority of NPCs believed that business ethics in chiropractic were questionable and that overhead expense and student loans were factors in practice success. A majority of NPCs were in associate practice at one time with many believing that associates were encouraged to prolong the care of patients and that associate salaries were not fair. Most NPCs surveyed believed that chiropractic was not a good career choice and would not recommend someone to become a chiropractor. From this survey, a 12 item scale was developed called the "chiropractor attrition attitude scale" for future research. Reliability analysis of this novel scale demonstrated a coefficient alpha of 0.90. Conclusion The low response rate indicates that findings cannot be generalized to the NPC population. This study nonetheless demonstrates that NPCs attrition attitudes can be assessed. The lack of a central database of NPCs is a challenge to future research. Appropriate

  14. 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.

  15. The chiropractic profession in Denmark 2010-2014

    DEFF Research Database (Denmark)

    Nielsen, Orla Lund; Kongsted, Alice; Christensen, Henrik Wulff

    2015-01-01

    BACKGROUND: The chiropractic profession has been well established in Denmark for several decades with state authorization, partial reimbursement by the state and a formal academic education. Biennial systematic data collections among all chiropractors and clinics have been performed since 2010...... in order to provide exact information on the profession to The Danish Chiropractic Association (DCA). It is the aim of this study to outline the major characteristics and developments of the chiropractic profession in Denmark to make this information accessible to other stakeholders, domestic as well...... as foreign. METHODS: Using contact information from the DCA, two questionnaires were distributed electronically to all individual members of the association actively working as chiropractors and all clinics respectively in 2010, 2012 and 2014. The questions asked were developed for this specific survey...

  16. 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

    BACKGROUND: Research involving chiropractors is evolving and expanding in Europe while resources are limited. Therefore, we considered it timely to initiate a research agenda for the chiropractic profession in Europe. The aim was to identify and suggest priorities for future research in order...... 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...... thought to be most important: 1) cost-effectiveness/economic evaluations, 2) identification of subgroups likely to respond to treatment, and 3) initiation and promotion of collaborative research activities. CONCLUSIONS: This is the first formal and systematic attempt to develop a research agenda...

  17. Test anxiety and academic performance in chiropractic students.

    Science.gov (United States)

    Zhang, Niu; Henderson, Charles N R

    2014-01-01

    Objective : We assessed the level of students' test anxiety, and the relationship between test anxiety and academic performance. Methods : We recruited 166 third-quarter students. The Test Anxiety Inventory (TAI) was administered to all participants. Total scores from written examinations and objective structured clinical examinations (OSCEs) were used as response variables. Results : Multiple regression analysis shows that there was a modest, but statistically significant negative correlation between TAI scores and written exam scores, but not OSCE scores. Worry and emotionality were the best predictive models for written exam scores. Mean total anxiety and emotionality scores for females were significantly higher than those for males, but not worry scores. Conclusion : Moderate-to-high test anxiety was observed in 85% of the chiropractic students examined. However, total test anxiety, as measured by the TAI score, was a very weak predictive model for written exam performance. Multiple regression analysis demonstrated that replacing total anxiety (TAI) with worry and emotionality (TAI subscales) produces a much more effective predictive model of written exam performance. Sex, age, highest current academic degree, and ethnicity contributed little additional predictive power in either regression model. Moreover, TAI scores were not found to be statistically significant predictors of physical exam skill performance, as measured by OSCEs.

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

    Science.gov (United States)

    Hestbaek, Lise; Stochkendahl, Mette Jensen

    2010-06-02

    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.

  19. 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.

  20. 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.

  1. 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.

  2. Chiropractic management of postpartum pubic symphysis diastasis: A case report.

    Science.gov (United States)

    Henry, Lucian

    2015-03-01

    This case report describes the chiropractic management of a 30-year-old female patient with severe postpartum pelvic pain secondary to pubic symphysis diastasis. No literature was found on the chiropractic management of postpartum symphysis pubis diastasis. The existing literature concerning chiropractic care for symphysis pubis dysfunction during pregnancy is limited and indicates a potential benefit. Separation of the pubic symphysis may include ligamentous injury to the sacroiliac joints and may lead to chronic pain. Pubic symphysis separation of 17 millimeters was present on digital radiograph. Management consisted of chiropractic adjustments, trigger point release, electrical stimulation, moist heat, sacroiliac belt, and specific stabilizing exercises. The patient's pain improved immediately following treatment on the initial visit. Pain was reduced from 8/10 VAS at the first visit to 2/10 at the fourth visit. She was able to resume normal activities and reached a final pain level of 1/10. The diastasis was reduced by 7 millimeters at 14-weeks post radiograph for a final separation of just under 10 millimeters. Collaboration between obstetricians, midwives and chiropractors may be warranted.

  3. 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.

  4. 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

  5. Chiropractic manipulative therapy combined with Kinesio Tape™ versus elastic bandage in treatment of chronic lower back pain

    OpenAIRE

    2014-01-01

    M.Tech. (Chiropractic) Chronic lower back pain (LBP) is considered as one of the most prevalent conditions in our society with 70-85% of the population experiencing pain at some point in their lives and 80% having recurrent episodes. The majority of chronic LBP is treated with conservative care, with spinal manipulation being a treatment modality shown to be beneficial resulting in restoration of normal ranges of movement, decrease of muscle spasm and there is an overall biomechanical chan...

  6. Retrospective cost comparison of chiropractic versus medical treatment of back pain in a typical South African mechanised underground mining environment

    OpenAIRE

    2010-01-01

    M. Tech. It is well known internationally that the high prevalence of back pain costs the economies of the world many billions of dollars annually. This has prompted a great deal of research abroad into means of reducing the deleterious economic effects of back pain. One of the results of this research is the realisation that Chiropractic treatment of back pain offers an efficacious and cost effective alternative to the conventional medical treatments currently employed in most countries. ...

  7. Research progress of chiropractic manipulation treatment for lumbar disc herniation%整脊手法治疗腰椎间盘突出症的研究进展

    Institute of Scientific and Technical Information of China (English)

    赵志恒; 张仁倩; 王剑歌; 王雷; 祝贺旗

    2015-01-01

    Chiropractic treatment of lumbar disc herniation is a common practice. Chiropractic operation method of the clinical applica-tion and effect is different. To further explore the clinical application of chiropractic treatment of lumbar disc herniation, in this article we reviewed the development of chiropractic therapy and clinical application of chiropractic technique on lumbar intervertebral disc protru-sion, and new insights were put forward.%整脊是治疗腰椎间盘突出症的常用手法,临床上应用的整脊操作方法各不相同,疗效也各有差异,为了进一步探究整脊治疗腰椎间盘突出症的临床应用。从整脊疗法的发展及整脊技术对腰椎间盘突出症的临床应用等方面进行了评述,对整脊的临床应用进展进行了综述,并提出新的见解。

  8. 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

  9. The probe into the curative effect with the method of chiropractic adding acupuncture%美式脊椎矫正辅以针灸疗法的疗效分析

    Institute of Scientific and Technical Information of China (English)

    蒋伟; 郑星; 黄玲; 李淑宽

    2012-01-01

    Objective To probe into the curative effect with the method of combining the Chinese traditional medicine with the west medicine.that is chiropractic adding acupuncture. Method To choose 450 cases of cervical vertebra and lumbar vertebra and relevance to the chine.use 3 kinds of method, they are single chiropractic and single acupuncture and chiropractic adding acupuncture.gain the evaluation of the curative effect and the period of treatment. Result All of the 3 kinds of method can give the curative effect at the first time.Chiropractic or chiropractic adding acupuncture can disappear symptoms and get the X-ray picture change.Chiropractic adding acupuncture spends the least time. Conclusion The best method is chiropractic adding acupuncture.%目的:探讨美式脊椎矫正法辅以针灸疗法治疗颈椎病、腰椎病、脊椎相关疾病的效果.方法:选择颈椎病、腰椎病、脊椎相关疾病各1 50例,分别采用单纯美式脊椎矫正、单纯针灸、美式脊椎矫正法辅以针灸疗法三种疗法进行治疗,记录疗效和次数.结果:三种疗法均能起效,美式脊椎矫正法和美式脊柱矫正法辅以针灸疗法的效果较好,达到相同效果的治疗次数以美式脊椎矫正辅以针灸疗法最少.结论:美式脊椎矫正同时辅以针灸疗法治疗颈椎病、腰椎病和脊椎相关疾病疗效好、疗程短.

  10. Chiropractic of Recumbent Position Treating Cervical Vertigo%卧位整脊治疗颈性眩晕

    Institute of Scientific and Technical Information of China (English)

    刘立志

    2014-01-01

    Objective:To observe the curative effects in chiropractic of recumbent position treating cervical vertigo. Methods:64 cases of cervical ver-tigo were randomly divided into treatment group and control group, each of 32 cases, respectively with supine chiropractic and routine manipulation therapy, the effects were assessed after a course. Results:The total effective rate of treatment group was 93.75%, significantly higher than that of con-trol group by 75%(P<0.05). Conclusion:Chiropractic of recumbent position treating cervical vertigo is of favorable effects.%目的:观察卧位整脊治疗颈性眩晕的疗效。方法:64例颈性眩晕患者随机分为治疗组和对照组各32例,分别采用卧位整脊治疗和常规推拿治疗,1个疗程后评定疗效。结果:治疗组总有效率为93.75%,显著高于对照组的75%(P<0.05)。结论:卧位整脊治疗颈性眩晕效果良好。

  11. Retropharyngeal tendinitis may be more common than we think: a report on 45 cases seen in Danish chiropractic clinics

    DEFF Research Database (Denmark)

    Hviid, Carsten; Salomonsen, Mette; Gelineck, John;

    2009-01-01

    This study presents information from 45 cases of retropharyngeal tendinitis that were collected in Danish chiropractic clinics.......This study presents information from 45 cases of retropharyngeal tendinitis that were collected in Danish chiropractic clinics....

  12. Practical results from a mathematical analysis of guard patrols

    Energy Technology Data Exchange (ETDEWEB)

    Indusi, Joseph P.

    1978-12-01

    Using guard patrols as a primary detection mechanism is not generally viewed as a highly efficient detection method when compared to electronic means. Many factors such as visibility, alertness, and the space-time coincidence of guard and adversary presence all have an effect on the probability of detection. Mathematical analysis of the guard patrol detection problem is related to that of classical search theory originally developed for naval search operations. The results of this analysis tend to support the current practice of using guard forces to assess and respond to previously detected intrusions and not as the primary detection mechanism. 6 refs.

  13. Horizontal integration of the basic sciences in the chiropractic curriculum.

    Science.gov (United States)

    Ward, Kevin P

    2010-01-01

    Basic science curricula at most chiropractic colleges consist of courses (eg, general anatomy, physiology, biochemistry, etc) that are taught as stand-alone content domains. The lack of integration between basic science disciplines causes difficulties for students who need to understand how the parts function together as an integrated whole and apply this understanding to solving clinical problems. More horizontally integrated basic science curricula could be achieved by several means: integrated Part I National Board of Chiropractic Examiners questions, a broader education for future professors, an increased emphasis on integration within the current model, linked courses, and an integrated, thematic basic science curriculum. Horizontally integrating basic science curricula would require significant efforts from administrators, curriculum committees, and instructional faculty. Once in place this curriculum would promote more clinically relevant learning, improved learning outcomes, and superior vertical integration.

  14. 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,...

  15. 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.

  16. The effects of chiropractic treatment on patients' quality of life

    OpenAIRE

    2012-01-01

    M.Tech. The purpose of this study is to determine whether chiropractic care has an effect on a patient's quality of life using the endpoints of: "the ability to perform general activities of daily living" (patient's level of disability, and restored function) and their "general emotional state" (energy level, depression, interference from emotional problems and feeling of wellness), also how these endpoints affect quality of life. Two hundred and fifty-three subjects participated in this s...

  17. The pedagogical practices in inclusive context: strategies, actions and results

    Directory of Open Access Journals (Sweden)

    Marco Antonio Melo Franco

    2016-10-01

    Full Text Available This research seeks to go beyond the theoretical debate on the integration and inclusion of children with disability. It addresses pedagogical work in the classroom, with the disabled child, in this case, the child with cerebral palsy. This is a qualitative approach and action research that aims to understand the reality investigated and it intervene. Participates in the research a public school that has students with cerebral palsy. The classes were followed weekly during the school year, in order to understand and analyze the process of teaching and learning. In addition, we attempted to intervene and build new teaching practices with teachers. As a result we identified the adoption of pedagogical strategies that consider the individuality of the subjects and their participation in the school community. Strategies were adopted as written economy, reorganization of spaces, change in the form of participation, curriculum adaptation, and adaptation activities, among others.

  18. History of the Royal College of Chiropractic Sports Sciences (Canada): the early years

    Science.gov (United States)

    De Finney, John; Lawson, Gordon; Gryfe, David; Gillis-Lawson, Susan; Crawford, John P.

    2016-01-01

    In 1978 the Canadian Chiropractic Association recognized the need to establish an organization that would prepare chiropractors to treat athletic injuries and promote these services to sports organizations. Dr. Adrian Grice approached three chiropractors to establish such an organization. The Canadian Chiropractic Sports Academy (CCSA) was established in 1978. This was the start of the chiropractic sports movement which has seen chiropractors playing prominent roles as team doctors to professional and amateur teams and athletes and in the delivery of care at major national and international competitions. This paper will show the work done by the original founders of the CCSA which has helped to pave the way to the present level of acceptance of chiropractic sports injury management and performance enhancement and as the progenitor of the Royal College of Chiropractic Sports Sciences Canada. PMID:28065996

  19. History of the Royal College of Chiropractic Sports Sciences (Canada): the early years.

    Science.gov (United States)

    De Finney, John; Lawson, Gordon; Gryfe, David; Gillis-Lawson, Susan; Crawford, John P

    2016-12-01

    In 1978 the Canadian Chiropractic Association recognized the need to establish an organization that would prepare chiropractors to treat athletic injuries and promote these services to sports organizations. Dr. Adrian Grice approached three chiropractors to establish such an organization. The Canadian Chiropractic Sports Academy (CCSA) was established in 1978. This was the start of the chiropractic sports movement which has seen chiropractors playing prominent roles as team doctors to professional and amateur teams and athletes and in the delivery of care at major national and international competitions. This paper will show the work done by the original founders of the CCSA which has helped to pave the way to the present level of acceptance of chiropractic sports injury management and performance enhancement and as the progenitor of the Royal College of Chiropractic Sports Sciences Canada.

  20. 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.

  1. GENERATION OF A COMPOSITE GLASS-METAL ROD: PRACTICAL RESULTS

    Directory of Open Access Journals (Sweden)

    Gridasova Ekaterina Alexandrovna

    2012-10-01

    Full Text Available Glass has a high compressive strength and low impact strength. The strength of glass in compression is a lot higher than the strength of glass in tension, and it varies within the range of 500-1,250 MPa. Whenever the glass is in compression, it can compete with the properties of metal in terms of its strength. The tensile strength of glass under tension is 30-50 MPa. The reason for that is the fact that the strength of glass is strongly dependent on the state of its surface. Methods of increasing the strength of glass have been the subject of research projects implemented at Far Eastern Federal University. The objective is to apply compressive stresses that would prevent any defects in the surface layer and harden the surface to improve the glass resistance to mechanical stresses and isolate it from the environment. Creation of a composite rod made of glass grade C49-1 (3С5Na and steel E235C (ISO standard manufactured through the employment of diffusion bonding represents a practical result of the research. Its analysis has proven the presence of full contact, absence of cracks and poor penetration alongside the welding zone. Microscopy methods of analysis have demonstrated the presence of the transition zone in the points of interface of materials. The results of the spectral analysis prove the penetration of Fe-cations into the glass down to the depth of 30 microns. The chemical analysis of the zone of diffusion proves that the crystalline structure, or fayalite (Fe2SiO4, is formed in the glass. The rod strength analysis has demonstrated its high compressive

  2. Clinical Observation of Radicular Cervical Spondylosis Treated with Innovated Chinese Chiropractic%三小定点整脊技术治疗神经根型颈椎病的临床观察

    Institute of Scientific and Technical Information of China (English)

    张艳伟; 王娟; 王遵来

    2011-01-01

    Objective To explore the clinical efficacy on radicular cervical spondylosis( RCS )treated with the innovated Chinese chiropractic therapy. Methods The clinical data and treatment situations of 120 cases of RCS collected from the outpatients and inpatients in Tianjin Beichen Beimen hospital were retrospectively analyzed. 120 cases were divided randomly into two groups. In an observation group( 80 cases ), the innovated Chinese chiropractic therapy was applied. In a control group( 40 cases ), acupuncture was applied to Jiaji points( Extra ). The duration of treatment was 1 week in two groups. The improvements in clinical symptoms and efficacy were observed after treatment. Results The total effective rate of RCS was 88.8% in observation group,which was remarkably higher than that in control group( 70. 0% ), presenting significant difference in statistics( P < 0. 05 ). Conclusion The innovated Chinese chiropractic therapy can relieve cramps and vascular spasm and improve blood circulation effectively in RCS and this therapy deserves to be promoted in clinical practice.%目的 探讨三小定点整脊技术治疗神经根型颈椎病的临床疗效.方法 采用回顾性分析的方法,分析天津北辰北门医院门诊和住院部收治的120例神经根型颈椎病患者的临床资料及治疗情况.将120例患者随机分为两组,观察组80例,给予三小定点整脊技术治疗;对照组40例,给予夹脊穴针刺治疗.两组疗程均为1周.治疗结束后观察两组临床症状改善情况和疗效.结果 观察组治疗神经根型颈椎病的总有效率88.8%,明显高于对照组的有效率70.0%,两组总有效率比较,差异有统计学意义(P<0.05).结论 通过三小定点整脊技术法治疗神经根型颈椎病,能解除肌肉、血管痉挛,改善血液循环,效果良好,值得临床推广使用.

  3. 综合治脊疗法治疗脊性2型糖尿病的临床研究%Clinical Research on Comprehensive Chiropractic Therapy for Spinal Type 2 Diabetes

    Institute of Scientific and Technical Information of China (English)

    张晓洁; 黄培炯; 黄瑛; 王正和

    2016-01-01

    Objective:To observe the efficacy of comprehensive chiropractic therapy for spinal type 2 diabetes. Methods:100 cases of patients with type 2 diabetes combined with thoracic vertebra dislocation were randomly divided into two groups, the treatment group treated by comprehensive chiropractic therapy on the basis of conventional hypoglycemic therapy, while control group by hypoglycemic therapy according to the doctor's or-der, and the lifestyle intervention was continuous throughout the treatment, evaluated the efficacy after 12 weeks of treatment. Results:After 12 weeks of treatment, the overall response rate and blood glucose compliance rate of treatment group were both significantly higher than those of con-trol group (P<0.05);the improvement of FPG, 2hPG, HbA1c of treatment group were all significantly better than those of control group (P<0.05). Conclusion: Compared with single hypoglycemic therapy, conventional hypoglycemic therapy combined with comprehensive chiropractic therapy can control the blood glucose more effectively, which has a high clinical practice and promotion value.%目的:观察综合治脊疗法治疗脊性2型糖尿病的疗效。方法:将100例2型糖尿病伴胸椎错位(T6~T10)患者随机分为两组,治疗组在常规降糖治疗基础上加用综合治脊疗法,对照组则根据病情遵医嘱应用降糖药物治疗,生活方式干预贯穿于两组患者的治疗始终,治疗12周后评定疗效。结果:治疗12周后,治疗组总有效率及血糖达标率均显著高于对照组(P<0.05);治疗组FPG、2hPG、HbA1c改善程度均显著优于对照组(P<0.05)。结论:常规降糖治疗基础上加用综合治脊疗法治疗2型糖尿病相较于单用降糖治疗能更好地控制血糖,具有较高的临床应用及推广价值。

  4. Spinal cord injury following chiropractic manipulation to the neck.

    Science.gov (United States)

    Chakraverty, Julian; Curtis, Olivia; Hughes, Tom; Hourihan, Margaret

    2011-12-01

    Spinal cord injury is a rare complication of chiropractic treatment. This case report describes a 50-year-old man who developed neurological symptoms a few hours after manipulation (high velocity low amplitude [HVLA] technique) of the cervical spine. Magnetic resonance (MR) imaging of the cervical spine revealed intramedullary high signal at the C2/3 level of the right side of the cervical cord on the T2-weighted images. The potential mechanism of injury and causes of the radiological appearance are discussed.

  5. 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...... without further treatment. CONCLUSION: This case demonstrates the importance of correctly identifying patients with BPPV. This case also demonstrates the successful treatment of BPPV....

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

    DEFF Research Database (Denmark)

    Myburgh, Corrie; Mouton, Johan

    2008-01-01

    OBJECTIVE: The purpose of this study was to capture the experience of key stakeholders regarding the development, structure, and influence of the local education program on the Danish chiropractic profession. METHODS: A gatekeeper was initially interviewed, after which a snowball sampling approach...... a local education, to state-subsidized copayments. "Stakeholder behavior," "boundary work," and "countervailing powers" underscore this example of professionalization; and evidence for secondary legitimization appears evident in the third-party influences, peer association legitimacy, and disciplinary...... led to a further 11 respondents being identified. Semistructured interviews were conducted, and computer-assisted thematic analysis was used to interpret data. RESULTS: Seven themes emerged. Two described pertinent historical aspects during the development of the local education, 4 related to status...

  7. 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 (

  8. 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

  9. 治脊疗法与TENS治疗躯体性耳鸣%Effects of chiropractic vs.transcutaneous electrical stimulation treating somatic tinnitus

    Institute of Scientific and Technical Information of China (English)

    陶泉; 杜青; 周璇; 杨晓颜; 刘刚; 冯宇伟; 毛琳

    2012-01-01

    目的:研究治脊疗法与经皮神经电刺激(TENS)治疗头颈肌紧张引起躯体性耳鸣的差异性.方法:耳鸣患者28例,随机分为2组各14例,治脊组采用治脊疗法,TENS组采用TENS治疗.测定2组治疗前后双侧咀嚼肌、胸锁乳突肌和上斜方肌静态下电位及耳鸣程度.结果:治疗2周后,2组耳鸣侧静态下电位值及耳鸣响度VAS均值均降低(P<0.01,0.05),治脊组较TENS组下降更显著(P<0.05),治脊组总有效率明显高于TENS组(P<0.01).结论:治脊疗法和TENS对头颈肌紧张引起躯体性耳鸣具有治疗作用,且治脊疗法效果更佳.%Objective: To study the differences of chiropractic vs. transcutaneous electrical stimulation (TENS) treating somatic tinnitus caused by muscular tension in the head and neck. Methods-. Twenty-eight cases of tinnitus were randomly divided into chiropractic group and TENS group with fourteen cases in each group. Bilateral static potential in masticatory muscles, sternocleidomastoid and superior trapezius by sEMG and tinnitus loudness were assessed before and after treatment. Results: After two weeks of treatment, static potential and VAS score of tinnitus loudness in both groups were decreased (P<0. 01 or P<0. 05), more significantly in chiropractic group than in TENS group (P<0. 05). The effective rates of chiropractic group was obviously higher than TENS group(P< 0. 01). Conclusion: Somatic tinnitus caused by muscular tension in the head and neck can be improved by chiropractic or TENS treatment, and chiropractic is more satisfactory.

  10. Chiropractic care and public health: answering difficult questions about safety, care through the lifespan, and community action.

    Science.gov (United States)

    Johnson, Claire; Rubinstein, Sidney M; Côté, Pierre; Hestbaek, Lise; Injeyan, H Stephen; Puhl, Aaron; Green, Bart; Napuli, Jason G; Dunn, Andrew S; Dougherty, Paul; Killinger, Lisa Zaynab; Page, Stacey A; Stites, John S; Ramcharan, Michael; Leach, Robert A; Byrd, Lori D; Redwood, Daniel; Kopansky-Giles, Deborah R

    2012-09-01

    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 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 children? What ways can doctors of chiropractic stay updated on evidence-based information about vaccines and immunization throughout the lifespan? Can smoking cessation be a prevention strategy for back pain? Does chiropractic have relevance within the VA Health Care System for chronic pain and comorbid disorders? How can chiropractic use cognitive behavioral therapy to address chronic low back pain as a public health problem? What opportunities exist for doctors of chiropractic to more effectively serve the aging population? What is the role of ethics and the contribution of the chiropractic profession to public health? What public health roles can chiropractic interns perform for underserved communities in a collaborative environment? Can the chiropractic profession contribute to community health? What opportunities do doctors of chiropractic have to be involved in health care reform in the areas of 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?

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

    Directory of Open Access Journals (Sweden)

    Polus Barbara

    2008-04-01

    Full Text Available 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-sectional, population survey on a representative sample of 1,067 adults from the six states and two territories of Australia in 2005 by computer-assisted telephone interviews. The sample was recruited by random digit dialling. Results Over a 12-month period, approximately one in four adult Australians used either acupuncture (9.2%, chiropractic (16.1% or osteopathy (4.6% at least once. It is estimated that, adult Australians made 32.3 million visits to acupuncturists, chiropractors and osteopaths, incurring personal expenditure estimated to be A$1.58 billion in total. The most common conditions treated were back pain and related problems and over 90% of the users of each therapy considered their treatment to be very or somewhat helpful. Adverse events are reported. Nearly one fifth of users were referred to manipulative therapy practitioners by medical practitioners. Conclusion There is substantial use of manipulative therapies by adult Australians, especially for back-related problems. Treatments incur considerable personal expenditure. In general, patient experience is positive. Referral by medical practitioners is a major determinant of use of these manipulative therapies.

  12. Effectiveness and Economic Evaluation of Chiropractic Care for the Treatment of Low Back Pain

    DEFF Research Database (Denmark)

    Blanchette, Marc-André; Stochkendahl, Mette Jensen; Borges Da Silva, Roxane;

    2016-01-01

    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...... 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...

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

    DEFF Research Database (Denmark)

    O'Neill, Lotte Dyhrberg; 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...... test, and an admission interview. METHODS: Data from 105 Chiropractic applicants from the 2007 admission at the University of Southern Denmark were available for analysis. Each admission parameter was double scored using two random, blinded, and independent raters. Variance components for applicant...

  14. Posterior rib fractures in a young infant who received chiropractic care.

    Science.gov (United States)

    Wilson, Paria Majd; Greiner, Mary V; Duma, Elena M

    2012-11-01

    We report on a 21-day-old infant with healing posterior rib fractures that were noted after a chiropractic visit for colic. Chiropractors are the third largest group of health care professionals in the United States, and colic is the leading complaint for pediatric chiropractic care. Rib fractures, specifically when posterior, are traditionally considered to be secondary to nonaccidental trauma. Thorough investigation is necessary to rule out bone fragility and genetic disorders, but patient history is key when evaluating unexplained fractures.

  15. Attitudes towards fibromyalgia: A survey of Canadian chiropractic, naturopathic, physical therapy and occupational therapy students

    OpenAIRE

    Badwall Parminder; Kulkarni Abhaya V; Busse Jason W; Guyatt Gordon H

    2008-01-01

    Abstract Background The frequent use of chiropractic, naturopathic, and physical and occupational therapy by patients with fibromyalgia has been emphasized repeatedly, but little is known about the attitudes of these therapists towards this challenging condition. Methods We administered a cross-sectional survey to 385 senior Canadian chiropractic, naturopathic, physical and occupational therapy students in their final year of studies, that inquired about attitudes towards the diagnosis and ma...

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

    OpenAIRE

    Stason, William B.; Grant A Ritter; Timothy Martin; Jeffrey Prottas; Christopher Tompkins; 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 ...

  17. 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;

    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....

  18. INTEREXAMINER RELIABILITY OF CHIROPRACTIC EVALUATION FOR CERVICAL SPINE PROBLEMS—A Pilot Study

    OpenAIRE

    Tuchin, Peter J.; Hart, Christopher J.; Johnson, Catriona; Colman, Robert; Gee, Adam; Edwards, Ian; Plucknett, Mark; Bonello, Rod

    1996-01-01

    Objective: A pilot study was conducted to determine whether untrained examiners could agree on palpatory findings in the cervical spine. Design: Fifty-three university students, (most of whom were chiropractic students), had their cervical spines examined by seven different chiropractors using their own clinical methods, of which motion palpation was a common, but not standard component. Setting: Chiropractic Centre in Macquarie University. Participants: Volunteer university students. Main Ou...

  19. ACCOUNTING PRACTICES FOR ADJUNSTING THE ENTITY’S RESULTS

    OpenAIRE

    L. CERNUŞCA

    2013-01-01

    An enterprise’s financial result is the main source of information for all those interested in the company’s activity. As a result of being normalized and audited, the information offered by accounting receives the “social recognition”, recognition which allows them to be used to evaluate the enterprise’s activities and performances. Although there are accounting laws, the options and/or the imprecision in the accounting texts allow for the possibility to manipulate the financial result and t...

  20. 捏积疗法在小儿保健中的临床应用分析%Analysis of chiropractic therapy in pediatric care in clinical application

    Institute of Scientific and Technical Information of China (English)

    范丰鹤; 袁安香; 尹华

    2015-01-01

    Objective To study on the clinical application of chiropractic therapy in children with health care in. Methods From January to 2014 October from 2013 in our hospital 26 cases, take the chiropractic therapy, before and after the treatment Resultsand family satisfaction. Results The children in the 1 years after treatment in 1 cases of illness number is more than 6 times, 15 cases of more than 2 times less than 6 times, not more than 10 cases of children s constitution 2 times, signiifcantly improve.Conclusion Chiropractic therapy can signiifcantly improve the physique condition, enhance immunity, it is in clinical use.%目的 研究捏积疗法在小儿保健中的临床应用.方法 抽取2013年1月~2014年10月来我院治疗的26例患儿,采取捏积疗法,比较治疗前后结果以及家属满意度.结果 患儿在治疗后1年内生病次数>6次的1例,2~6次的15例,<2次的10例,患儿体质显著提高.结论 捏积疗法能显著提高患儿的体质状况,增强免疫力,值得在临床上推广使用.

  1. ACCOUNTING PRACTICES FOR ADJUNSTING THE ENTITY’S RESULTS

    Directory of Open Access Journals (Sweden)

    L. CERNUŞCA

    2013-07-01

    Full Text Available An enterprise’s financial result is the main source of information for all those interested in the company’s activity. As a result of being normalized and audited, the information offered by accounting receives the “social recognition”, recognition which allows them to be used to evaluate the enterprise’s activities and performances. Although there are accounting laws, the options and/or the imprecision in the accounting texts allow for the possibility to manipulate the financial result and the content of the financial statements Within the liberty offered by the different source of accounting law, the enterprises can choose between the options which are at the base of presenting the financial statements. The choices made by the enterprise’s management with the purpose of modeling in a legal way, the presentation and the content of the financial statements are known as accounting policy. Within an enterprise, developing the accounting policies represent a primary aspect, because applying these policies determine a high degree of financial information relevance and lead to better management choices.

  2. 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

  3. CONTINUOUS IMPROVEMENT PRACTICE IN LARGE ENTERPRISES: STUDY RESULTS

    Directory of Open Access Journals (Sweden)

    Dorota Stadnicka

    2015-03-01

    Full Text Available Continuous improvement is indispensable for ensuring the company's development and its survival on the constantly changing global market. Continuous improvement is particularly important in the quality and production management systems. A company should deliver a product compliant with a client's requirements in a specified time and at an appropriate price. That is why, continuous improvement refers to different areas of an organization's functioning and it is an integral part of Lean Manufacturing. This article presents the results of the study conducted in production enterprises on a limited area. The aim of the study was the assessment of the implementation of continuous improvement in Lean Manufacturing, and, in particular, employees' involvement in the problem identification and in reporting improvements as well as the way of motivating employees to involve themselves. The authors also tried to identify the factors influencing the elements of a continuous improvement system.

  4. The effect of a sports chiropractic manual therapy intervention on the prevention of back pain, hamstring and lower limb injuries in semi-elite Australian Rules footballers: a randomized controlled trial

    OpenAIRE

    Pollard Henry; Hoskins Wayne

    2010-01-01

    Abstract Background Hamstring injuries are the most common injury in Australian Rules football. It was the aims to investigate whether a sports chiropractic manual therapy intervention protocol provided in addition to the current best practice management could prevent the occurrence of and weeks missed due to hamstring and other lower-limb injuries at the semi-elite level of Australian football. Methods Sixty male subjects were assessed for eligibility with 59 meeting entry requirements and r...

  5. The ethical significance of diagnostic test results in psychology practice.

    Science.gov (United States)

    Shefler, Gaby; Ben Shakhar, Gershon; Bilu, Yoram

    2009-03-01

    "Psychologists base the opinions contained in their recommendations, reports and diagnostic or evaluative statements including forensic testimony on information and techniques sufficient to substantiate their findings". Do expert psychodiagnosticians rely in their professional final reports on the materials and raw data obtained from test materials? How ethical are they in their professional performances? In order to answer this question, expert clinical psychologists were given batteries of psychodiagnostic tests, accompanied by one of two different types of background information, suggesting either a Borderline Personality Disorder, or a Paranoid Personality Disorder. This background information was a full and strongly suggestive story in one experiment, and a mere hypothesis in another. All conditions manifested a confirmation bias: the psychodiagnostic reports were profoundly biased by the background suggestions. The present paper focuses on a content analysis of the reports, and shows that the experts referred very little if at all to the psychodiagnostic materials they received. They were found less professional and as a result- less ethical. The ethical relevance of these findings to the teaching and training of professional psychodiagnosticians is discussed, with an emphasis on the importance of teaching students and interns in clinical psychology to base their diagnostic reports on the test data.

  6. Chiropractic manipulation in low back pain and sciatica: statistical data on the diagnosis, treatment and response of 576 consecutive cases.

    Science.gov (United States)

    Cox, J M; Shreiner, S

    1984-03-01

    A chiropractic multicenter observational pilot study to compile statistics on the examination procedures, diagnosis, types of treatments rendered, results of treatment, number of days of care, and number of treatments required to arrive at a 50% and a maximum clinical improvement was collected on 576 patients with low back and/or leg pain. The purpose was to determine the congenital and developmental changes in patients with low back and/or leg pain, the combinations of such anomalies, the accuracy of orthodox diagnostic tests in assessing low back pain, ergonomic factors affecting onset and, ultimately, the specific difficulty factors encountered in treating the various conditions seen in the average chiropractor's office. For all conditions treated, the average number of days to attain maximum improvement was 43 and the number of visits 19. It was concluded that this study provided useful data for assessment of routine chiropractic office based diagnosis and treatment of related conditions; however, further controlled studies are necessary for validation of specific parameters.

  7. Influence of chiropractic therapy on the growth and intellectual development of 6 months infants%捏脊疗法对6个月婴儿生长及智能发育的影响

    Institute of Scientific and Technical Information of China (English)

    刘文

    2013-01-01

    目的 探讨捏脊疗法对6个月婴儿生长和智能发育的影响.方法 将160例1月龄足月正常婴儿分为捏脊组与对照组,每组各80例.对捏脊组婴儿每天进行捏脊疗法,观察2组婴儿6个月时体质量、身长、头围的增长情况,并对其智能发育进行测评.结果 捏脊组婴儿6个月时体质量、身长的增长均高于对照组,差异有统计学意义,同时捏脊组的智能发育水平也显著高于对照组.结论 捏脊疗法对6个月婴儿的体格发育及智能发育具有明显的促进作用,值得推广.%Objective To investigate the influence of chiropractic therapy on the growth and intellectual development of 6 months infants.Methods 160 cases of 1-month-old full-term normal infants were divided into the chiropractic therapy group and the control group,each group contained 80 samples.Chiropractic therapy was given to the chiropractic therapy group daily.The development of weight,length,head circumference were observed,and the intelligent development for two groups were evaluated at the age of 6 months.Results The weight,body length in the chiropractic therapy group at the sixth month were higher than those in the control group.The intellectual development in the chiropractic therapy group was also higher than that in the control group.Conclusions Chiropractic therapy plays a significant role in promoting the physical and mental development of babies of 6 months,which is worth being promoted.

  8. 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

  9. Clinical Observation on Chiropractic Techniques and Specific Acupoint Therapy on 30 Cases of Cervical Spondylotic Radiculopathy%整脊手法与特定穴疗法治疗神经根型颈椎病30例疗效观察

    Institute of Scientific and Technical Information of China (English)

    魏裕涛; 葛恒; 邵瑛; 魏静妍; 魏佳娜; 陈贤芝

    2013-01-01

    Objective: To observe the curative effects of chiropractic techniques and specific acupoint treating cervical spondylotic radiculopathy. Methods:30 cases of cervical spondylotic radiculopathy were randomly divided into chiropractic group and the specific group, respectively with chi-ropractic techniques and specific acupoint therapy, the clinical efficacy was compared between the two groups. Results:The total effective rate of chi-ropractic group was 93.3%, higher than that of specific group by 80%(P<0.05). Conclusion:The curative effects of chiropractic techniques treating cervical spondylotic radiculopathy are better than that of specific acupoint therapy in short term.%目的:观察整脊手法与特定穴疗法治疗神经根型颈椎病的疗效。方法:将30例神经根型颈椎病患者随机分为整脊组和特定穴组,分别施以整脊手法和特定穴疗法,比较两组临床疗效。结果:整脊组总有效率为93.3%,高于特定穴组的80.0%(P<0.05)。结论:整脊手法在短期内治疗神经根型颈椎病疗效优于特定穴疗法。

  10. Chiropractic Treatment for Gastrointestinal Problems: A Systematic Review of Clinical Trials

    Directory of Open Access Journals (Sweden)

    E Ernst

    2011-01-01

    Full Text Available Many chiropractors believe that chiropractic treatments are effective for gastrointestinal disorders. The aim of the present systematic review was to critically evaluate the evidence from controlled clinical trials supporting or not supporting this notion. Six electronic databases were searched for relevant studies. No limits were applied to language or publication date. Prospective, controlled, clinical trials of any type of chiropractic treatment for any type of gastrointestinal problem, except infant colic, were included. Only two trials were found – one was a pilot study, and the other had reached a positive conclusion; however, both had serious methodological flaws. There is no supportive evidence that chiropractic is an effective treatment for gastrointestinal disorders.

  11. 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

  12. 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.

  13. 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....

  14. Clinical observation on massage, chiropractic therapy and external application of Chinese herbs in the treatment of small joint disorder of thoracic vertebrae (Report of 60 cases)%推拿、整脊配合中药外敷治疗胸椎小关节紊乱60例临床观察

    Institute of Scientific and Technical Information of China (English)

    王惠利

    2013-01-01

    Objective To observe the clinical curative effects of massage, chiropractic therapy and external application of Chinese Herbs in treating small joint disorder of thoracic vertebrae. Methods 60 patients were randomly divided into the treatment group and the control group. The treatment group was given massage, chiropractic therapy and external application of Chinese herbs. The control group was give external application of Chinese herbs. Results The clinical efficacy was compared in two groups, the total curative rate of the treatment group was 93.75%;the total curative rate of the control group was 71.43%. There was significant difference between the 2 groups. The total curative rate in the treatment group was higher than that of the control group (P<0.05). Conclusion Massage, chiropractic therapy and external application of Chinese herbs is a safe and effective way in treating small joint disorder of thoracic vertebrae, and there is no pain, it is worthy to be distributed in clinical practices.%目的:观察推拿、整脊配合中药外敷治疗胸椎小关节紊乱的临床疗效。方法将60例患者随机分为治疗组和对照组,治疗组给予推拿、整脊配合中药外敷治疗,对照组给予中药外敷治疗。结果两组临床疗效比较,治疗组总有效率为93.75%,对照组总有效率为71.43%,差异有统计学意义,治疗组临床疗效总有效率高于对照组(P<0.05)。结论推拿、整脊配合中药外敷治疗胸椎小关节紊乱安全、有效、无痛苦,适合临床推广应用。

  15. THE COLOMBIAN REALITY FROM THE PERSPECTIVE OF BEHAIOVR ANALYSIS: PEACE AS A RESULT OF CULTURAL PRACTICES

    Directory of Open Access Journals (Sweden)

    BLANCA PATRICIA BALLESTEROS DE VALDERRAMA

    2002-01-01

    Full Text Available This article presents the advantage of applying behavior analysis to cultural practices comprehension, considering cultural practices as group behaviors, selected and maintained by social reinforcement contingencies and metacontingencies. The three types of contingencies formulated by Skinner are described, and the principal existing data related to aggressive behavior. A proposal to analyze some relevant aspects to Colombian reality is formulated, and finally, an intent to analyze peace as a result of cultural practices is presented, emphasizing positive reciprocal social processes. Mattaini's (1996 suggestion to graphical representation of cultural practices analysis is applied.

  16. 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...... 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...

  17. Comparative effects of chiropractic adjustment versus chiropractic adjustment combined with static magnetic field therapy on acupuncture points for the treatment of mechanical neck pain

    OpenAIRE

    2014-01-01

    M.Tech. (Chiropractic) Purpose: This study was undertaken in order to demonstrate the effects of static magnetic field therapy on acupuncture points in the treatment of those suffering from mechanical neck pain. Isolated spinal manipulative therapy of the cervical spine was compared to spinal manipulative therapy of the cervical spine in conjunction with magnetic field therapy on acupuncture points using both objective and subjective measurements. Before the execution of this study, it was...

  18. Prevalence of STI related consultations in general practice: results from the second Dutch National Survey of General Practice

    Science.gov (United States)

    van Bergen, Jan EAM; Kerssens, Jan J; Schellevis, Francois G; Sandfort, Theo G; Coenen, Ton J; Bindels, Patrick J

    2006-01-01

    Background The role of the GP in the care of sexually transmitted infections (STIs) is unclear. Aim We studied the prevalence of STI related consultations in Dutch general practice in order to obtain insight into the contribution of the GP in STI control. Design of study A descriptive study. Setting The study took place within the framework of the second Dutch National Survey of General Practice in 2001, a large nationally representative population-based survey. Method During 1 year, data of all patient contacts with the participating GPs were recorded in electronic medical records. Contacts for the same health problem were clustered into disease episodes and their diagnosis coded according to the International Classification of Primary Care. All STI and STI related episodes were analysed. Results In total, 1 524 470 contacts of 375 899 registered persons in 104 practices were registered during 1 year and 2460 STI related episodes were found. The prevalence rate of STI was 39 per 10 000 persons and of STI/HIV related questions 23 per 10 000. More than half of all STIs were found in highly urbanised areas and STIs were overrepresented in deprived areas. Three quarters of all STIs diagnosed in the Netherlands are made in general practice. An important number of other reproductive health visits in general practice offer opportunities for meaningful STI counselling and tailored prevention. Discussion GPs contribute significantly to STI control, see the majority of patients with STI related symptoms and questions and are an important player in STI care. In particular, GPs in urban areas and inner-city practices should be targeted for accelerated sexual health programmes. PMID:16464323

  19. Do side-effects/injuries from yoga practice result in discontinued use? Results of a national survey

    OpenAIRE

    M Kim Holton; Barry, Adam E

    2014-01-01

    Context: Yoga-related injuries are of increasing concern as the use of yoga continues to rise. Aims: The aim of the following study is to examine whether a national sample of yoga practitioners would report discontinued use of yoga due to injury from the practice, assess what injuries resulted in discontinued use, determine what injuries were most common and identify injuries requiring medical attention. Methods: Secondary data analysis of a nationally representative sample of adults in...

  20. 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…

  1. Overview of Clinical Application of Chiropractic Therapy in the Past ten Years

    Institute of Scientific and Technical Information of China (English)

    ZHOU Er-chun

    2004-01-01

    捏脊疗法是推拿常用手法之一,这一疗法具有简、便、验、廉的特点.近年来捏脊疗法临床应用的范围不断扩大,用于治疗的疾病已达数十种.遍及内科、妇科、儿科等各科及预防、保健、美容等方面,临床报道很多.本文收集近十年有关捏脊疗法的文献21篇,在分析了这些文献的基础上从捏脊疗法临床运用的角度进行归纳总结.%Chiropractic therapy is a common massage method of simplicity, convenience, efficacy and low cost. In the past years, chiropractic therapy is increasingly used to treat many diseases in relation to internal medicine, gynecology, pediatrics, medical prevention, healthcare and cosmetology, etc.This paper collects 21 articles concerning chiropractic therapy in the past 10 years, and then sums up the clinical application of chiropractic therapy.

  2. 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…

  3. 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...

  4. 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...

  5. Correlation of Preadmission Organic Chemistry Courses and Academic Performance in Biochemistry at a Midwest Chiropractic Doctoral Program*

    Science.gov (United States)

    McRae, Marc P.

    2010-01-01

    Purpose: Organic chemistry has been shown to correlate with academic success in the preclinical years of medicine, dentistry, and graduate physiology. The purpose of this study is to examine the relationship between undergraduate organic chemistry grades and first-semester biochemistry grades at a Midwest chiropractic doctoral program. Methods: Students enrolled in a first-semester biochemistry course who had completed the prerequisite courses in organic chemistry offered at this same institution were entered into the study. The total grade for each of the three courses was calculated using the midterm and final exam raw scores with a weighting of 50% each. Analysis consisted of obtaining correlation coefficients between the total grades of organic 1 with biochemistry and organic 2 with biochemistry. Using the biochemistry total grade, the students were divided into quartiles and course grades for both organic chemistry 1 and 2 were calculated. Results: For the 109 students in the study, the correlation coefficient between the biochemistry and organic chemistry 1 and biochemistry and organic chemistry 2 courses was r = 0.744 and r = 0.725, respectively. The difference in organic chemistry grades between those in the first and fourth quartiles was 63.2% and 86.9% for organic chemistry 1 (p < .001) and 60.9% and 79.4% for organic chemistry 2 (p < .001). Conclusion: This study shows that organic chemistry can be used as an indicator of future academic success in a chiropractic biochemistry course. Knowledge of such a relationship could prove useful to identify students who may potentially run into academic difficulty with first-year biochemistry PMID:20480012

  6. Clinical observation on treating infantile anorexia by the chiropractic therapy%捏脊疗法对婴幼儿厌食的效果观察

    Institute of Scientific and Technical Information of China (English)

    曾运娥; 李连娣; 温晓寰; 文秋红; 杨红英

    2015-01-01

    Objective: To investigate clinical efficacy of chiropractic therapy on infantile anorexia.Methods: 75 patients were randomly divided into two groups,the control group was given routine western medicine treatment,the treatment group was given the chiropractic treatment,clinical effects in two groups were compared.Results: The efficacy in the treatment group was better (P<0.05),after treatment,The hemoglobin was improved in the treatment group better than control group (P<0.05).Conclusion: The chiropractic therapy for infantile anorexiawas effective,safe and reliable,and was worthy of application.%目的:探讨捏脊疗法对婴幼儿厌食的临床疗效.方法:本组全部患者均为我社区收治的75例婴幼儿厌食患者,随机将其分两组,对照组采取西医治疗,治疗组采取捏脊疗法治疗,比较两组患者的效果.结果:治疗组总有效率显著优于对照组,差异有显著性(P<0.05),治疗后,治疗组患者的血红蛋白改善情况显著优于对照组,差异有显著性(P<0.05).结论:捏脊疗法对婴幼儿厌食临床疗效确实有效,且操作简单、安全可靠,值得推广应用.

  7. Chiropractic Treatment of Clinical Study of Temporo Mandibular Joint Disorder( TMD) Clinical Research%整脊治疗颞下颌关节功能紊乱症临床研究

    Institute of Scientific and Technical Information of China (English)

    陈浩雄; 刘兴利; 李佳; 赵亮; 温清波

    2015-01-01

    目的:探讨整脊治疗颞下颌关节功能紊乱症(TMD)疗效的临床研究.方法:选择TMD患者60例,分为治疗组与对照组各30例.治疗组采用整脊疗法配合一些颈部附近的放松手法(以推拿的点、按、揉手法).对照组采用传统的中医对颞下颌关节附近的放松手法.应用Fricton指数定量评定表分别评定治疗前和治疗后的颞下颌关节功能状况.结果:2组Friction指数评分均较治疗前有好转,差异有统计学意义(P<0.05).治疗组能更有效的降低疼痛程度及改善关节活动功能, 治疗后颞下颌关节功能障碍指数评分较治疗前有明显下降(P<0.01),肌肉压痛指数和Friction指数评分较治疗前明显降低(P<0.01).2组间差异具有统计学意义(P<0.01),治疗组疗效优于对照组.结论:应用整脊治疗颞下颌关节功能紊乱症(TMD)能有效地缓解疼痛,改善颞下颌关节功能状况,值得临床推广应用.%Objective:To investigate the chiropractic treatment of temporo mandibular joint disorder (TMD) clinical research.Meth-ods:Choose 60 patients of temporo mandibular disorders,randomly divided the cases into a treatment group and a control group.Treat-ment group with the use of chiropractic therapy combined with some neck near the relaxation techniques ( to massage point, press, knea-ding manipulation) , while the control group used traditional Chinese medicine in the vicinity of the temporo mandibular joint relaxation technique.Application of Fricton index were used to assess the quantitative assessment of temporo mandibular joint function before and af-ter treatment.Results:The Friction index of two groups were significantly improved, the difference has statistical significance(P<0. 05).Muscle tenderness index and the Friction index was significantly lower than that before treatment(P<0.01), There were significant differences between the two groups (P <0.01), the treatment group was better than control group

  8. Comparison of outcomes in neck pain patients with and without dizziness undergoing chiropractic treatment: a prospective cohort study with 6 month follow-up

    Directory of Open Access Journals (Sweden)

    Humphreys B Kim

    2013-01-01

    Full Text Available Abstract Background The symptom ‘dizziness’ is common in patients with chronic whiplash related disorders. However, little is known about dizziness in neck pain patients who have not suffered whiplash. Therefore, the purposes of this study are to compare baseline factors and clinical outcomes of neck pain patients with and without dizziness undergoing chiropractic treatment and to compare outcomes based on gender. Methods This prospective cohort study compares adult neck pain patients with dizziness (n = 177 to neck pain patients without dizziness (n = 228 who presented for chiropractic treatment, (no chiropractic or manual therapy in the previous 3 months. Patients completed the numerical pain rating scale (NRS and Bournemouth questionnaire (BQN at baseline. At 1, 3 and 6 months after start of treatment the NRS and BQN were completed along with the Patient Global Impression of Change (PGIC scale. Demographic information was also collected. Improvement at each follow-up data collection point was categorized using the PGIC as ‘improved’ or ‘not improved’. Differences between the two groups for NRS and BQN subscale and total scores were calculated using the unpaired Student’s t-test. Gender differences between the patients with dizziness were also calculated using the unpaired t-test. Results Females accounted for 75% of patients with dizziness. The majority of patients with and without dizziness reported clinically relevant improvement at 1, 3 and 6 months with 80% of patients with dizziness and 78% of patients without dizziness being improved at 6 months. Patients with dizziness reported significantly higher baseline NRS and BQN scores, but at 6 months there were no significant differences between patients with and without dizziness for any of the outcome measures. Females with dizziness reported higher levels of depression compared to males at 1, 3 and 6 months (p = 0.007, 0.005, 0.022. Conclusions Neck pain patients with

  9. A study to determine the efficacy of chiropractic manipulation combined with Kinesio® taping in the treatment of chronic lower back pain

    OpenAIRE

    2012-01-01

    M.Tech. (Chiropractic) Chronic lower back pain is a very common condition affecting 60-80% of the worlds’ population at sometime in their lives. Manual therapy, including chiropractic manipulation, has been proven to be very successful in the treatment of chronic lower back pain and reduction in muscle tension. Although chiropractic treatment alone is effective in the treatment of chronic lower back pain, chiropractors often search for adjunctive modalities to enhance the positive outcomes...

  10. Effect of Chiropractic in the treatment of children with recurrent respira-tory tract infections%捏脊疗法治疗小儿反复呼吸道感染的效果

    Institute of Scientific and Technical Information of China (English)

    王波; 吕静

    2015-01-01

    目的:观察小儿反复呼吸道感染经捏脊疗法治疗的临床效果,为临床今后治疗提供参考。方法选择2014年2月~2015年2月中国中医科学院附属广安门医院收治的67例反复呼吸道感染患儿作为研究对象,根据不同治疗方法将其分为捏脊组35例,常规组32例。常规组予以常规药物治疗,捏脊组在常规组基础上结合捏脊疗法。比较两组患儿疗效。结果捏脊组总有效率为97.1%,高于常规组的81.3%,差异有统计学意义(P<0.05);捏脊组发病次数改善率为85.7%,高于常规组(46.8%),差异有高度统计学意义(P<0.01);捏脊组平均病程改善率为77.1%,高于常规组的37.5%,差异有高度统计学意义(P<0.01)。结论捏脊疗法能提高小儿反复性呼吸道感染的临床疗效,且无创、安全、操作简便,患儿更易接受,值得临床应用和进一步研究。%Objective To observe the clinical effect of chiropractic therapy on children with recurrent respiratory tract infection, and provide reference for clinical treatment in the future. Methods From February 2014 to February 2015, 67 cases of children with recurrent respiratory tract infection who were treated in Guang'anmen Hospital, China Acade-my of Chinese Medical Sciences as the research object, according to the different treatment methods they were divided into the chiropractic group (35 cases) and conventional group (32 cases). Children of the conventional group were treat-ed with routine therapy, and children of the chiropractic group were given chiropractic therapy on the basis of conven-tional group. Curative effect of two groups was compared. Results The total effective rate of the chiropractic group was 97.1%, higher than the conventional group (81.3%), the difference was statistically significant (P< 0.05); the improve-ment rate of chiropractic group was 85.7%, higher than the conventional group (46.8%), the difference was statistically significant

  11. A survey of chiropractors practicing in Germany: practice characteristics, professional reading habits, and attitudes and perceptions toward research

    Directory of Open Access Journals (Sweden)

    Hondras Maria A

    2007-05-01

    Full Text Available Abstract Background In 2004, a survey conducted by the European Chiropractor's Union among member countries reported that "there appears to be little interest in research among chiropractors in Germany." However, no research has tested this statement. The objective of this study was to explore the attitudes and perceptions of practicing chiropractors in Germany regarding research, to look at their reading and research habits, and to gather demographic and practice data. Methods A questionnaire was developed and distributed among participants at a seminar held by the German Chiropractors' Association in 2005. The questionnaire was mailed to any members of the association who did not attend the seminar. Results A total of 49 (72% of 68 distributed questionnaires were returned. Forty-five (92% respondents stated they would support research efforts in Germany and 15 (31% declared interest in participating in practiced based research. An average of three hours per week were reportedly spent reading scientific literature by 44 (85% respondents. However, few journals listed by respondents were peer-reviewed and indexed; most were newsletters of chiropractic organizations or free publications. Most participants agreed on the importance of research for the profession, but when asked about the most pressing issue for chiropractic in Germany, legislation and recognition of the profession were the dominant themes. Conclusion The results of this survey show that there is a general interest in supporting and participating in research activities among chiropractors practicing in Germany. Next steps could consist of educating practitioners about the resources available to read and interpret the scientific literature and thus further the understanding of research.

  12. Clinical curative evaluation of three small point chiropractic techniques on lumbar intervertebral disc herniation%三小定点整脊技术对腰椎间盘突出症临床疗效评价研究

    Institute of Scientific and Technical Information of China (English)

    赵志恒; 张仁倩; 王剑歌; 祝贺旗; 王雷

    2014-01-01

    [目的]三小定点整脊技术对腰椎间盘突出症的临床疗效评价。[方法]将90例患有腰椎间盘突出症的患者随机分为两组:即三小定点整脊组和夹脊穴针刺组,分别给予三小定点整脊与夹脊穴针刺治疗,观察腰痛和坐骨神经痛的改善情况。[结果]两组在疗效及症状改善程度上均有较好的表现,且三小定点整脊组优于夹脊穴针刺组。[结论]三小定点整脊技术对腰椎间盘突出症疗效肯定。%Objective To evaluate the clinical efficacy of three small fixed point chiropractic technique for lumbar intervertebral disc herniation. [Methods] The 90 patients with lumbar intervertebral disc herniation were randomly divided into two groups: three small fixed point chiropractic group and Jiaji acupuncture group. The improvement of low back pain and sciatica was observed. [Results] Both groups had a better performance in terms of efficacy and the degree of improvement of symptoms, and the three small fixed point chiropractic group was better than Jiaji acupuncture group. [Conclusion] Efficacy of three small fixed point chiropractic techniques for lumbar intervertebral disc herniation is certain.

  13. 倒悬整脊法治疗112例胸椎后关节紊乱临床疗效观察%Efficacy Observation on Overhanging Chiropractic Therapy for 112 Cases of Thoracic Posterior Articular Disturbance Patients

    Institute of Scientific and Technical Information of China (English)

    皮凌红

    2013-01-01

    目的:探讨倒悬整脊法治疗胸椎后关节紊乱的疗效。方法:将112例患者随机分为治疗组和对照组,治疗组采用倒悬整脊法治疗,对照组采用常规推拿治疗,观察两组临床疗效。结果:治疗组总有效率为96.6%,高于对照组的79.6%(P<0.05)。结论:倒悬整脊法治疗胸椎后关节紊乱疗效确切,值得临床推广。%Objective:To investigate the efficacy of overhanging chiropractic therapy for thoracic posterior articular disturbance. Methods:112 cases of patients were randomly divided into treatment group and control group, the treatment group treated by overhanging chiropractic therapy, while the control group by conventional massage therapy, and observed the efficacy of two groups. Results:The total effective rate in treatment group was 96.6%, which was higher than 79.6%that in control group (P<0.05). Conclusion:Overhanging chiropractic therapy has a significant curative effect on thoracic posterior articular disturbance, while worth clinical promotion.

  14. 美式整脊疗法治疗骶髂关节功能性半脱位疗效观察%Efficacy Observation on American Chiropractic Treatment for Functional Subluxation of Sacroiliac Joint

    Institute of Scientific and Technical Information of China (English)

    唐柯

    2016-01-01

    Objective:To observe and analyze the efficacy of American chiropractic treatment for functional subluxation of sacroiliac joint. Methods:55 cases of patients with functional subluxatino of sacroiliac joint were treated by American chiropractic treatment, and used visual analogue scale (VAS) and the improvement of the flexion-extension activity of sacroiliac joint to evaluate the efficacy. Results:After treatment, the VAS score was significantly lower than that of before treatment (P0.05). Conclusion:American chiropractic treatment can safely and effectively cure functional subluxation of sacroiliac joint.%目的:观察和分析美式整脊技术治疗骶髂关节功能性半脱位的疗效。方法:对55例骶髂关节功能性半脱位进行美式整脊治疗,采用视觉模拟评分法(visual analogue scale VAS)和骶髂关节屈伸活动度改善情况来评定治疗效果。结果:治疗后VAS评分显著低于治疗前(P0.05)。结论:美式整脊疗法能够安全、有效地治疗骶髂关节功能性半脱位。

  15. Frequency of Yoga Practice Predicts Health: Results of a National Survey of Yoga Practitioners

    Directory of Open Access Journals (Sweden)

    Alyson Ross

    2012-01-01

    Full Text Available Background. Yoga shows promise as a therapeutic intervention, but relationships between yoga practice and health are underexplored. Purpose. To examine the relationship between yoga practice and health (subjective well-being, diet, BMI, smoking, alcohol/caffeine consumption, sleep, fatigue, social support, mindfulness, and physical activity. Methods. Cross-sectional, anonymous internet surveys distributed to 4307 randomly selected from 18,160 individuals at 15 US Iyengar yoga studios; 1045 (24.3% surveys completed. Results. Mean age 51.7 (± 11.7 years; 84.2% female. Frequency of home practice favorably predicted (P < .001: mindfulness, subjective well-being, BMI, fruit and vegetable consumption, vegetarian status, sleep, and fatigue. Each component of yoga practice (different categories of physical poses, breath work, meditation, philosophy study predicted at least 1 health outcome (P < .05. Conclusions. Home practice of yoga predicted health better than years of practice or class frequency. Different physical poses and yoga techniques may have unique health benefits.

  16. Clarifying Definitions for the Massage Therapy Profession: the Results of the Best Practices Symposium†

    Science.gov (United States)

    Kennedy, Ann B.; Cambron, Jerrilyn A.; Sharpe, Patricia A.; Travillian, Ravensara S.; Saunders, Ruth P.

    2016-01-01

    Background Massage therapists are at times unclear about the definition of massage therapy, which creates challenges for the profession. It is important to investigate the current definitions and to consider the field as a whole in order to move toward clarity on what constitutes the constructs within the profession. Purpose To determine how a sample of experts understand and describe the field of massage therapy as a step toward clarifying definitions for massage and massage therapy, and framing the process of massage therapy practice. Setting A two-day symposium held in 2010 with the purpose of gathering knowledge to inform and aid in the creation of massage therapy best practice guidelines for stress and low back pain. Participants Thirty-two experts in the field of massage therapy from the United States, Europe, and Canada. Design Qualitative analysis of secondary cross-sectional data using a grounded theory approach. Results Three over-arching themes were identified: 1) What is massage?; 2) The multidimensional nature of massage therapy; and 3) The influencing factors on massage therapy practice. Discussion The data offered clarifying definitions for massage and massage therapy, as well as a framework for the context for massage therapy practice. These clarifications can serve as initial steps toward the ultimate goal of creating new theory for the field of massage therapy, which can then be applied in practice, education, research, and policy. Conclusions Foundational research into how experts in the profession understand and describe the field of massage therapy is limited. Understanding the potential differences between the terms massage and massage therapy could contribute to a transformation in the profession in the areas of education, practice, research, policy and/or regulation. Additionally, framing the context for massage therapy practice invites future discussions to further clarify practice issues. PMID:27648109

  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. Organic farming practices result in compositional shifts in nematode communities that exceed crop-related changes

    NARCIS (Netherlands)

    Quist, Casper W.; Schrama, Maarten; de Haan, Janjo J.; Smant, Geert; Bakker, Jaap; van der Putten, Wim H.; Helder, Johannes

    2016-01-01

    Intensification of conventional agriculture has resulted in a decline of soil ecosystem functioning. Organic agriculture intends to manage soil biota in a manner that is more geared towards adequate cycling of nutrients with minimal losses. Ecological interpretation of agricultural practices-induced

  19. Practice and professional development plans (PPDPs: results of a feasibility study

    Directory of Open Access Journals (Sweden)

    Hocking Paul

    2001-03-01

    Full Text Available Abstract Background Dissatisfaction with uniprofessional education structures as a means of improving the quality of healthcare has led to proposals to develop ways of integrating professional learning and organisational development. Aims Test the feasibility of introducing practice and professional development plans using a centrally sponsored project in Wales. Design Qualitative observational study. Study sample All 541 practices in Wales were alerted to the project and invited to apply. A selection process was suggested to Health Authorities but not always efficiently conducted: 23 practices were selected and 18 participated in the process. Method Central funding was made available to health authorities. The project framework was designed by an educational department and conceptualised as the development of personal portfolios linked to one key organisation change in each practice, facilitated by external consultants who would typically hold workshops or other events. An independent researcher using non-participant observation techniques at workshops and practices undertook documentary analysis and fieldwork in four health authorities. Results Difficulties were encountered with the process of implementing the project: marketing and practice selection inconsistencies delayed the work and it was difficult to recruit practices into the project. The lack of experienced individuals to do the work and practitioner suspicion about perceived 'management' agendas were significant problems. After initial hesitancies most practices appreciated the value of developing wider ownership and commitment to proposed practice changes. Organisations found it difficult to support individual completion of the personal portfolio component of the plans. The ability to develop systems for clinical services was dependent on having already established a culture of effective teamwork in the organisation. Conclusions This work supports the view that organisational

  20. 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...

  1. Equitable Coloring of Graphs. Recent Theoretical Results and New Practical Algorithms

    Directory of Open Access Journals (Sweden)

    Furmańczyk Hanna

    2016-09-01

    Full Text Available In many applications in sequencing and scheduling it is desirable to have an underlaying graph as equitably colored as possible. In this paper we survey recent theoretical results concerning conditions for equitable colorability of some graphs and recent theoretical results concerning the complexity of equitable coloring problem. Next, since the general coloring problem is strongly NP-hard, we report on practical experiments with some efficient polynomial-time algorithms for approximate equitable coloring of general graphs.

  2. Using Evidence Based Practice in LIS Education: Results of a Test of a Communities of Practice Model

    Directory of Open Access Journals (Sweden)

    Joyce Yukawa

    2010-03-01

    Full Text Available Objective ‐ This study investigated the use of a communities of practice (CoP model for blended learning in library and information science (LIS graduate courses. The purposes were to: (1 test the model’s efficacy in supporting student growth related to core LIS concepts, practices, professional identity, and leadership skills, and (2 develop methods for formative and summative assessment using the model.Methods ‐ Using design‐based research principles to guide the formative and summative assessments, pre‐, mid‐, and post‐course questionnaires were constructed to test the model and administered to students in three LIS courses taught by the author. Participation was voluntary and anonymous. A total of 34 students completed the three courses; response rate for the questionnaires ranged from 47% to 95%. The pre‐course questionnaire addressed attitudes toward technology and the use of technology for learning. The mid‐course questionnaire addressed strengths and weaknesses of the course and suggestions for improvement. The post‐course questionnaire addressed what students valued about their learning and any changes in attitude toward technology for learning. Data were analyzed on three levels. Micro‐level analysis addressed technological factors related to usability and participant skills and attitudes. Meso‐level analysis addressed social and pedagogical factors influencing community learning. Macro‐level analysis addressed CoP learning outcomes, namely, knowledge of core concepts and practices, and the development of professional identity and leadership skills.Results ‐ The students can be characterized as adult learners who were neither early nor late adopters of technology. At the micro‐level, responses indicate that the online tools met high standards of usability and effectively supported online communication and learning. Moreover, the increase in positive attitudes toward the use of technology for learning at

  3. Patient with signs and symptoms of myocardial infarction, presenting to a chiropractic office: a case report

    OpenAIRE

    Erfanian, Parham

    2001-01-01

    A 53-year-old female presented to a chiropractic office with signs and symptoms of heart attack (myocardial infarction). Although she was complaining of neck and upper back pain, the cause of her condition was due to an incident of acute myocardial infarction (MI). Other than anterior chest pain, patients with MI could experience pain over lower jaw and teeth, both arms, shoulders, neck, upper back and epigastrium. Recognizing the possible underlying cause of the patient's complaints, and dir...

  4. The effectiveness of chiropractic manipulative therapy and Spidertech therapy in the treatment of chronic neck pain

    OpenAIRE

    2012-01-01

    M.Tech. Purpose: This study aims to compare the effects of Chiropractic manipulative therapy of the cervical spine in conjunction with SpiderTech therapy in the treatment of chronic neck pain with regards to pain, disability and cervical spine range of motion. Method: This study consisted of two groups of 15 participants between the ages of eighteen and forty, ensuring equal male to female and age ratios. The potential participants were examined and accepted according to the inclusion and ...

  5. Chiropractic management of low back pain in a patient with a transfemoral amputation

    Science.gov (United States)

    Illes, Jennifer D.; Maola, Chad J.

    2012-01-01

    Objective The purpose of this case report is to describe the chiropractic management of a patient with a unilateral transfemoral amputation and low back pain (LBP). Clinical Features A 20-year-old woman with right transfemoral amputation and a right upper extremity amputation due to amniotic band syndrome had approximately 40 different prosthetic lower extremities in the prior 20 years. She presented for chiropractic care for LBP (5/10 numeric pain scale) that she experienced after receiving a new right prosthetic leg. The pain increased with walking, attempts to exercise, and lying supine. Physical evaluation revealed asymmetrical leg length (long right limb); restricted left ankle dorsiflexion; restricted lumbopelvic motion; and hypertonicity of the left triceps surae muscle complex as well as the gluteus maximus, quadratus lumborum, and erector spinae bilaterally. Gait examination revealed a right Trendelenberg gait as well as a pattern of left vaulting. The working diagnosis was sacroiliac joint dysfunction, with lumbar facet syndrome secondary to a leg length inequality causing alteration in gait. Intervention and Outcome Chiropractic management included manipulative therapy to the lumbar spine and pelvis, trigger point therapy of hypertonic musculature, and strengthening of pelvic musculature. In addition, the patient's prosthetist shortened her new prosthetic device. After 18 treatments, LBP severity was resolved (0/10); and there was an overall improvement with gait biomechanics. Conclusion This case illustrates the importance of considering leg length inequality in patients with amputations as a possible cause of lower back pain, and that proper management may include adjusting the length of the prosthetic device and strengthening of the hip flexors and abductors, in addition to trigger point therapy and chiropractic manipulation. PMID:23450067

  6. Acupuncture and chiropractic care for chronic pain in an integrated health plan: a mixed methods study

    Directory of Open Access Journals (Sweden)

    DeBar Lynn L

    2011-11-01

    Full Text Available Abstract Background Substantial recent research examines the efficacy of many types of complementary and alternative (CAM therapies. However, outcomes associated with the "real-world" use of CAM has been largely overlooked, despite calls for CAM therapies to be studied in the manner in which they are practiced. Americans seek CAM treatments far more often for chronic musculoskeletal pain (CMP than for any other condition. Among CAM treatments for CMP, acupuncture and chiropractic (A/C care are among those with the highest acceptance by physician groups and the best evidence to support their use. Further, recent alarming increases in delivery of opioid treatment and surgical interventions for chronic pain--despite their high costs, potential adverse effects, and modest efficacy--suggests the need to evaluate real world outcomes associated with promising non-pharmacological/non-surgical CAM treatments for CMP, which are often well accepted by patients and increasingly used in the community. Methods/Design This multi-phase, mixed methods study will: (1 conduct a retrospective study using information from electronic medical records (EMRs of a large HMO to identify unique clusters of patients with CMP (e.g., those with differing demographics, histories of pain condition, use of allopathic and CAM health services, and comorbidity profiles that may be associated with different propensities for A/C utilization and/or differential outcomes associated with such care; (2 use qualitative interviews to explore allopathic providers' recommendations for A/C and patients' decisions to pursue and retain CAM care; and (3 prospectively evaluate health services/costs and broader clinical and functional outcomes associated with the receipt of A/C relative to carefully matched comparison participants receiving traditional CMP services. Sensitivity analyses will compare methods relying solely on EMR-derived data versus analyses supplementing EMR data with

  7. Feasibility of the STarT back screening tool in chiropractic clinics: a cross-sectional study of patients with low back pain

    Directory of Open Access Journals (Sweden)

    Kongsted Alice

    2011-04-01

    Full Text Available Abstract The STarT back screening tool (SBT allocates low back pain (LBP patients into three risk groups and is intended to assist clinicians in their decisions about choice of treatment. The tool consists of domains from larger questionnaires that previously have been shown to be predictive of non-recovery from LBP. This study was performed to describe the distribution of depression, fear avoidance and catastrophising in relation to the SBT risk groups. A total of 475 primary care patients were included from 19 chiropractic clinics. They completed the SBT, the Major Depression Inventory (MDI, the Fear 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 prognostic factors. If the tool proves to predict prognosis in future studies, it would be a relevant alternative in clinical practice to other more comprehensive questionnaires.

  8. OVERCOMING BARRIERS To DIVERSITY IN CHIROPRACTIC PATIENT AND PRACTITIONER POPULATIONS: A COMMENTARY.

    Science.gov (United States)

    Young, Kenneth J

    2015-01-01

    Increasing the diversity of practitioner and patient populations has been identified as a worthy goal in the chiropractic profession, which has predominantly white male practitioners and white female patients in the USA. Toward that end, 'diversity' has been the topic of several papers and was the theme of a 2012 conference of chiropractic educators. However, generally just the microcosm of the interactions of practitioners with patients or teachers with students has been discussed. The macrocosm of larger societal issues and government policies has not been broached. Examples of issues and policies that affect diversity within a profession include portrayals of, and value judgements on diversity by the media and politicians, as well as public funding for healthcare and education. Diversity was defined in this paper to mean differences in race, sex, sexual orientation, economic status, ethnicity, religion and other life circumstances in a population. The purpose of this paper is to raise awareness of evidence that social issues and government policy affect the diversity of practitioners and patients, and to suggest that the barriers to diversity present in these realms be addressed with a cogent, profession-wide effort in order to help increase the diversity of people involved with chiropractic.

  9. Music therapy and chiropractic: an integrative model of tonal and rhythmic spinal adjustment.

    Science.gov (United States)

    Miller, E B; Redmond, P

    1999-03-01

    There is a philosophical basis for the integration of treatment using music therapy and chiropractic. Perception is intimately linked to the nervous system. A relationship between spinal integrity and consciousness does exist. We can see that as spinal distortions diminish and awareness increases, there is a natural attraction toward the higher or more loving state of consciousness. Rhythms of healing and suffering are a key concept in combining music therapy with chiropractic manipulation. Donald Epstein's conceptualization of the rhythmic stages of consciousness corresponding to prescribed physiological patterns serves as a starting point for the use of rhythm in the healing process. Using interactive music, the music therapist can help facilitate a change in the patient's physical or emotional state. This occurs when the practitioner establishes an initial connection or musical validation of the patient's emotional state and assists the healing process by improvising supportive music while suggesting possibilities for resolution. We believe that the power of music can be used as a significant tool in chiropractic work to aid individuals in their healing process.

  10. Treating Thoracic Spine Related Disease Through Chiropractic Technique Combined with Duhuojisheng Decoction%整脊手法配合中药独活寄生汤治疗胸椎相关性疾病

    Institute of Scientific and Technical Information of China (English)

    唐树杰; 刘复奇

    2012-01-01

    目的:观察整脊手法配合中药独活寄生汤治疗胸椎相关性疾病的临床疗效.方法:将386例胸椎相关性疾病病人随机分为治疗组与对照组,每组193例,治疗组施以理筋与膝顶复位手法,并加服独活寄生汤,每日1剂;对照组只行手法治疗.10日为一个疗程,治疗1~2疗程后评定疗效,随访0.5~2.5年,比较两组有效率与复发率.结果:治疗组有效率94.8%,对照组81.3%,治疗组有效率高于对照组(P< 0.05),差异有统计学意义;治疗组复发率8.3%,对照组15.5%,治疗组复发率低于对照组(P<0.05),差异有统计学意义.结论:整脊手法配合中药独活寄生汤治疗胸椎相关性疾病疗效优于单纯整脊手法.%Objective To assess the clinical effectiveness of chiropractic technique combined with Duhuojisheng decoction (Chinese herbal medicine) for treating the thoracic spine related diseases. Methods Three hundred and eighty six cases with thoracic spine related disease were divided into two groups, 193 cases in each group,and the cases in treatment group were treated once a day by chiropractic technique combined with Duhuojisheng decoction, and the control group was treated using chiropractic technique alone. Each therapeutic course lasted for 10 days. The effectiveness was assessed after one or two therapeutic courses. The duration of follow-up was 0.5 to 2.5 years,and the effective rate and recurrence rate were compared between the two groups. Results The effective rate was significantly higher (P < 0.05) in treatment group(94.8%) than that in control group(81.3%),while the recurrence rate was lower in treatment group(8.3%) than that in control group(15.5%) (P < 0.05). Conclusion The clinical effectiveness of chiropractic technique combined with Duhuojisheng decoction was better than of chiropractic technique alone.

  11. Good practices and health policy analysis in European sports stadia: results from the 'Healthy Stadia' project.

    Science.gov (United States)

    Drygas, Wojciech; Ruszkowska, Joanna; Philpott, Matthew; Björkström, Olav; Parker, Mike; Ireland, Robin; Roncarolo, Federico; Tenconi, Maria

    2013-06-01

    Sport plays an important role within society and sports stadia provide significant settings for public health strategies. In addition to being places of mass gathering, stadia are often located in less affluent areas and are traditionally attended by 'harder to reach' communities. Unfortunately sports stadia and the clubs they host are rarely perceived as places that promote healthy lifestyles. Fast food, alcohol and tobacco are commonly advertized, served and consumed during sports games giving the spectators and TV fans contradictory messages concerning healthy choices. As part of a wider programme of work part-funded by the European Union, a study was therefore designed to explore current 'good practice' relating to positive health interventions in sports stadia across a number of European countries. Using a specially designed questionnaire, information about health policies and good practices relating to food offerings in stadia, physical activity promotion among local communities, tobacco policy, positive mental health initiatives, environmental sustainability practices and social responsibility policies were collected in 10 European countries (England and Northern Ireland, Finland, Georgia, Greece, Ireland, Italy, Latvia, Poland, Spain and Sweden) involving 88 stadia. The audit results show that stadia health policies differ considerably between specific countries and sports. Based on the literature analysed, the examples of good practices collected through the study, and the subsequent instigation of a European Healthy Stadia Network, it shows that there is considerable potential for stadia to become health promoting settings.

  12. Practices of Disciplinarity and Interdisciplinarity in Quebec Elementary Schools: Results of Twenty Years of Research

    Directory of Open Access Journals (Sweden)

    Yves Lenoir

    2006-12-01

    Full Text Available This article presents a synthesis of different research projects that have been carried out inthe province of Quebec, Canada over the past 20 years concerning the representations and practices ofelementary teachers regarding the relative importance given to subject matter and the use ofinterdisciplinarity in their teaching practice. The first section will explain the context of the Quebecschool system on a socio-historical and political level and review the emergence of the concept ofinterdisciplinarity in Quebec. The second section will present succinctly the different research projectsthat have been conducted since 1980 and the conceptual framework they were based on. The thirdsection will consider the main results of the various research projects from two angles: first, therepresentations and practices of the teachers regarding interdisciplinarity; secondly, the relativeimportance and role that the teachers give to interdisciplinarity. In the conclusion, we will highlightamong other things the central position teachers give to the role of socialization and their minimalconsideration for the teaching of disciplinary knowledge.

  13. Substance use and dietary practices among students attending alternative high schools: results from a pilot study

    Directory of Open Access Journals (Sweden)

    Hannan Peter J

    2011-04-01

    Full Text Available Abstract Background Substance use and poor dietary practices are prevalent among adolescents. The purpose of this study was to examine frequency of substance use and associations between cigarette, alcohol and marijuana use and selected dietary practices, such as sugar-sweetened beverages, high-fat foods, fruits and vegetables, and frequency of fast food restaurant use among alternative high school students. Associations between multi-substance use and the same dietary practices were also examined. Methods A convenience sample of adolescents (n = 145; 61% minority, 52% male attending six alternative high schools in the St Paul/Minneapolis metropolitan area completed baseline surveys. Students were participants in the Team COOL (Controlling Overweight and Obesity for Life pilot study, a group randomized obesity prevention pilot trial. Mixed model multivariate analyses procedures were used to assess associations of interest. Results Daily cigarette smoking was reported by 36% of students. Cigarette smoking was positively associated with consumption of regular soda (p = 0.019, high-fat foods (p = 0.037, and fast food restaurant use (p = 0.002. Alcohol (p = 0.005 and marijuana use (p = 0.035 were positively associated with high-fat food intake. With increasing numbers of substances, a positive trend was observed in high-fat food intake (p = 0.0003. There were no significant associations between substance use and fruit and vegetable intake. Conclusions Alternative high school students who use individual substances as well as multiple substances may be at high risk of unhealthful dietary practices. Comprehensive health interventions in alternative high schools have the potential of reducing health-compromising behaviors that are prevalent among this group of students. This study adds to the limited research examining substance use and diet among at-risk youth. Trial registration number ClinicalTrials.gov: NCT01315743

  14. MAGNETIC-PULSE CAR BODY PANELS FLATTENING. THEORETICAL ASPECTS AND PRACTICAL RESULTS

    Directory of Open Access Journals (Sweden)

    Yu.V. Batygin

    2016-09-01

    Full Text Available The aim of the article is to provide theoretical and experimental studying of the «induction system with an attractive screen» practical effectiveness with the excited magnetic pulse attractive forces numerical estimation. Originality. For the first time, the theoretical analysis of the electrodynamics process for the «inductor system with attractive screen» at the low frequent assumption were conducted. Methodology of the analysis applied is based on the classic electrodynamics circuits theory. All of the resulted carried out, were obtained as the Maxwell’s differential equation solutions and its behavior was analyzed analytically. Results. The electrodynamics process was analyzed and the principle efficiency of the «induction system with an attractive screen» as an effective tool for magnetic pulse forming of the thin sheet metals was substantiated. The axis distributions of the attractive forces based on the relations been obtained were illuminated graphically. The results of experimental testing of the system in the engineering operation of the external non-contact dents removing on the car body panels samples were presented. Practical value. According to the results of the calculation analyses the fundamental workability of the «inductor system with attractive shield» as an effective magnetic pulse sheet metal part attraction tool was proved. It was shown that the not deep metal surface damages could be worked up by magnetic pulses technologies with a high performance in a short time.

  15. Abnormal ovarian cancer screening test result: women's informational, psychological and practical needs.

    Science.gov (United States)

    Ryan, Patricia Y; Graves, Kristi D; Pavlik, Edward J; Andrykowski, Michael A

    2007-01-01

    Considerable effort has been devoted to the identification of cost-effective approaches to screening for ovarian cancer (OC). Transvaginal ultrasound (TVS) is one such screening approach. Approximately 5-7% of routine TVS screening tests yield abnormal results. Some women experience significant distress after receipt of an abnormal TVS screening test. Four focus groups provided in-depth, qualitative data regarding the informational, psychological, and practical needs of women after the receipt of an abnormal TVS result. Through question and content analytic procedures, we identified four themes: anticipation, emotional response, role of the screening technician, and impact of prior cancer experiences. Results provide initial guidance toward development of interventions to promote adaptive responses after receipt of an abnormal cancer screening test result.

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

    Directory of Open Access Journals (Sweden)

    Lemeunier Nadège

    2011-12-01

    Full Text Available Abstract Introduction The use of automated text messages has made it possible to identify different courses of low back pain (LBP, and it has been observed that pain often fluctuates and that absolute recovery is rather rare. The purpose of this study was to describe the prevalence of pain-free weeks and pain-free periods in subjects with non-specific LBP treated by chiropractors, and to compare subjects from two different countries in these aspects. Methods Data were obtained from two practice-based multicentre prospective outcome studies, one Danish and one Swedish, involving subjects being treated by chiropractors for non-specific LBP. Over 18 weeks, subjects answered a weekly automated text message question on the number of days in the past week that they had experienced bothersome LBP, i.e. a number between 0 and 7. The number of weeks in a row without any LBP at all ("zero weeks" as well as the maximum number of zero weeks in a row was determined for each individual. Comparisons were made between the two study samples. Estimates are presented as percentages with 95% confidence intervals. Results In the Danish and the Swedish populations respectively, 93/110 (85% and 233/262 (89% of the subjects were eligible for analysis. In both groups, zero weeks were rather rare and were most commonly (in 40% of the zero weeks reported as a single isolated week. The prevalence of pain free periods, i.e. reporting a maximum of 0, 1 or 2, or 3-6 zero weeks in a row, were similar in the two populations (20-31%. Smaller percentages were reported for ≥ 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. When this occurred, it was most commonly reported for brief periods only. Hence, recovery in the sense that patients become absolutely pain free is rare, even in a primary

  17. 整脊手法治疗颈性眩晕效果分析%Analysis of the effect of chiropractic manipulation on cervical vertigo

    Institute of Scientific and Technical Information of China (English)

    周杰; 冯薇; 古美颖

    2014-01-01

    目的:观察整脊手法治疗颈源性眩晕的临床疗效。方法抽取262例于2012-01-2013-09在我院接受治疗的颈性眩晕患者,随机分为实验组和对照组,每组131例。对照组口服中药治疗,实验组接受整脊手法治疗,对比2组疗效;手术前后对实验组进行T CD检查,观察其椎动脉血流变化情况。结果实验组有效率高达94.65%,明显高于对照组的72.51%( P<0.05)。实验组患者椎动脉血流变化主要呈分散状态分布。结论整脊手法治疗颈性眩晕具有积极作用,值得临床推广应用。%Objective To analyze the effect of chiropractic manipulation on cervical vertigo .Methods From January 2012 to September 2013 ,262 patients with cervical vertigo in our hospital were selected and randomly divided into experimental group and control group ,with 131cases in each group .The cervical vertigo patients of experimental group were given the tech-nology of chiropractic manipulation ,while the control group used traditional Chinese medicine .The TCD checking was also giv-en to the experimental group .The effects of the two groups and the blood flow changes of vertebral artery were observed and analyzed .Results The treatment efficiency of experimental group was up to 94 .65% ,while that of the control group was only 72 .51% .The results above were considered statistically significant ,P<0 .05 ,and the distribution of data of the blood flow of vertebral artery in the experimental group were decentralized .Conclusion Chiropractic manipulation can effectively improve the therapeutic effect of patients with cervical vertigo ;it is worth to widely spread in clinics after the cause of the illness is fully understood .

  18. 针刺结合整脊疗法治疗颈椎病临床观察%Clinical observation on acupuncture plus chiropractic treatment for cervical spondylosis

    Institute of Scientific and Technical Information of China (English)

    魏文广; 董成伟; 胡卫成; 陆忠

    2015-01-01

    目的:观察通督调阳针刺结合整脊疗法治疗上段颈椎病的疗效。方法:将符合纳入标准的64例患者按随机数字表法随机分观察组和对照组,每组32例。观察组采用通督调阳针刺结合上颈段微调法和腰骶侧扳法整脊手法治疗;对照组采用常规针刺及与观察组相同的整脊治疗。两组均每日治疗1次,连续治疗10次后观察疗效。结果:观察组总有效率为78.1%,对照组为67.5%,两组总有效率差异有统计学意义(P<0.05)。结论:通督调阳针刺结合整脊疗法治疗上段颈椎病疗效优于常规针刺结合整脊疗法。%Objective:To observe the therapeutic effect of Governor Vessel-unblocking and yang-regulating acupuncture plus chiropractic treatment on upper cervical spondylosis. Methods:A total of 64 eligible cases were randomly allocated into an observation group (n=32) and a control group (n=32) according to the random digital table. Cases in the observation group were treated with Governor Vessel-unblocking and Yang-regulating needling method, fine adjustment of the upper cervical spine and lumbosacral Ban-pulling manipulation; cases in the control group were treated with routine acupuncture and same spinal adjustment as the observation group. The treatment was done once a day in both groups. The therapeutic efficacies were observed after 10 times of treatment. Results:The total effective rate was 78.1% in the observation group and 67.5% in the control group. The difference in the total effective rate between the two groups was statistically significant (P<0.05). Conclusion:Governor Vessel-unblocking and yang-regulating acupuncture and regulate yang plus chiropractic therapy is better than routine acupuncture plus chiropractic therapy in the therapeutic effect in the treatment of upper cervical spondylosis.

  19. Discussion on Effect of Chiropractic Therapy for Children with Tourette Syndrome%整脊疗法治疗儿童抽动症效果探讨

    Institute of Scientific and Technical Information of China (English)

    李宁

    2015-01-01

    Objective Tic disorder in children using chiropractic therapy in clinical effect.Methods The selected 40 cases of children with Tourette patients,both pediatric hospital from May 2013 to May 2014 were treated using chiropractic therapy,review of clinical data.Results This study selected 40 cases of children,cured 22 cases,accounting for 55%; effective in 10 cases,accounting for 25%; effective six cases, accounting for 15%; 2 cases,accounting for 5%,total effective rate was 95%. No adverse reactions occur.Conclusion Children tic using chiropractic therapy and improve clinical outcomes,to improve the quality of life of children is significant to ensure normal growth and development of children,with a very positive value.%目的:探讨儿童年抽动症采用整脊疗法治疗临床效果。方法本次选取40例儿童抽动症患者,均为我院儿科2013年5月至2014年5月收治,采用整脊疗法治疗,回顾临床资料。结果本次研究选取的40例患儿,痊愈22例,占55%;显效10例,占25%;有效6例,占15%;无效2例,占5%,临床总有效率为95%。无不良反应发生。结论儿童抽动症采用整脊疗法治疗,提高临床治疗效果,对改善患儿生活质量意义重大,确保患儿正常生长发育,具有非常积极的应用价值。

  20. 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

  1. Epidural analgesia practices for labour: results of a 2005 national survey in Ireland.

    LENUS (Irish Health Repository)

    Fanning, Rebecca A

    2012-02-01

    BACKGROUND AND OBJECTIVE: The last 25 years have seen changes in the management of epidural analgesia for labour, including the advent of low-dose epidural analgesia, the development of new local anaesthetic agents, various regimes for maintaining epidural analgesia and the practice of combined spinal-epidural analgesia. We conducted a survey of Irish obstetric anaesthetists to obtain information regarding the conduct and management of obstetric epidural analgesia in Ireland in 2005. The specific objective of this survey was to discover whether new developments in obstetric anaesthesia have been incorporated into clinical practice. METHODS: A postal survey was sent to all anaesthetists with a clinical commitment for obstetric anaesthesia in the sites approved for training by the College of Anaesthetists, Ireland. RESULTS: Fifty-three per cent of anaesthetists surveyed responded. The majority of anaesthetists (98%) use low-dose epidural analgesia for the maintenance of analgesia. Only 11% use it for test-dosing and 32% for the induction of analgesia. The combined spinal-epidural analgesia method is used by 49%, but two-thirds of those who use it perform fewer than five per month. Patient-controlled epidural analgesia was in use at only one site. CONCLUSION: It appears that Irish obstetric anaesthetists have adopted the low-dose epidural analgesia trend for the maintenance of labour analgesia. This practice is not as widespread, however, for test dosing, the induction of analgesia dose or in the administration of intermittent epidural boluses to maintain analgesia when higher concentrations are used. Since its introduction in 2000, levobupivacaine has become the most popular local anaesthetic agent.

  2. Control of a Shunt Active Power Filter with Neural Networks—Theory and Practical Results

    Science.gov (United States)

    Villalva, Marcelo G.; Filho, Ernesto Ruppert

    This paper presents theoretical studies and practical results obtained with a four-wire shunt active power filter fully controlled with neural networks. The paper is focused on a current compensation method based on adaptive linear elements (adalines), which are powerful and easy-to-use neural networks. The reader will find here an introduction about these networks, an explanatory section about the achievement of Fourier series with adalines, and the full description of an adaline-based selective current compensator. The paper also brings a quick discussion about the use of a feedforward neural network in the current controller of the active filter, as well as simulation and experimental results obtained with the prototype of an active power filter.

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

    Directory of Open Access Journals (Sweden)

    Hannah Kern

    2010-10-01

    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. DOI: 10.2458/azu_jmmss.v1i1.78

  4. Implant removal of osteosynthesis: the Dutch practice. Results of a survey

    Directory of Open Access Journals (Sweden)

    Vos Dagmar

    2012-08-01

    Full Text Available Abstract Background The aim of this survey study was to evaluate the current opinion and practice of trauma and orthopaedic surgeons in the Netherlands in the removal of implants after fracture healing. Methods A web-based questionnaire consisting of 44 items was sent to all active members of the Dutch Trauma Society and Dutch Orthopaedic Trauma Society to determine their habits and opinions about implant removal. Results Though implant removal is not routinely done in the Netherlands, 89% of the Dutch surgeons agreed that implant removal is a good option in case of pain or functional deficits. Also infection of the implant or bone is one of the main reasons for removing the implant (> 90%, while making money was a motivation for only 1% of the respondents. In case of younger patients (p = 0.002. Though the far majority removes elastic nails in children (95%. Most of the participants (56% did not agree that leaving implants in is associated with an increased risk of fractures, infections, allergy or malignancy. Yet in case of the risk of fractures, residents all agreed to this statement (100% whereas staff specialists disagreed for 71% (p  Conclusion This survey indicates that there is no general opinion about implant removal after fracture healing with a lack of policy guidelines in the Netherlands. In case of symptomatic patients a majority of the surgeons removes the implant, but this is not standard practice for every surgeon.

  5. Homeopathic medical practice: Long-term results of a cohort study with 3981 patients

    Directory of Open Access Journals (Sweden)

    Baur Roland

    2005-11-01

    Full Text Available Abstract Background On the range of diagnoses, course of treatment, and long-term outcome in patients who chose to receive homeopathic medical treatment very little is known. We investigated homeopathic practice in an industrialized country under everyday conditions. Methods In a prospective, multicentre cohort study with 103 primary care practices with additional specialisation in homeopathy in Germany and Switzerland, data from all patients (age >1 year consulting the physician for the first time were observed. The main outcome measures were: Patient and physician assessments (numeric rating scales from 0 to 10 and quality of life at baseline, and after 3, 12, and 24 months. Results A total of 3,981 patients were studied including 2,851 adults (29% men, mean age 42.5 ± 13.1 years; 71% women, 39.9 ± 12.4 years and 1,130 children (52% boys, 6.5 ± 3.9 years; 48% girls, 7.0 ± 4.3 years. Ninety-seven percent of all diagnoses were chronic with an average duration of 8.8 ± 8 years. The most frequent diagnoses were allergic rhinitis in men, headache in women, and atopic dermatitis in children. Disease severity decreased significantly (p Conclusion Disease severity and quality of life demonstrated marked and sustained improvements following homeopathic treatment period. Our findings indicate that homeopathic medical therapy may play a beneficial role in the long-term care of patients with chronic diseases.

  6. 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

    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...... for future research are discussed....

  7. Results of Modifying Astronomy Curriculum for Special Needs Students Using Best Practices

    Science.gov (United States)

    Olsen, J. K.; Slater, T. F.

    2008-06-01

    In early 2006, the Lawrence Hall of Science (LHS) conducted a national field-test of a new GEMS space science curriculum package developed for use with middle school students. During this field-test, we modified a subset of the curriculum materials for use by special needs students, to be delivered via computer mediated instruction. These materials were implemented in a subset of the field-test classrooms and LHS collected pre- and post-test data for each unit. This data was analyzed to determine if students in the classrooms using the modified materials scored differently than students in the larger assessment data base. Data was disaggregated to measure the impact on students with special needs, as evidenced by individualized education plans (IEPs). Results suggest that many students, not just those with special needs, demonstrate greater achievement gains using materials modified using the principles of best practice for special needs students.

  8. Practical considerations for the interpretation of microbial testing results based on small numbers of samples.

    Science.gov (United States)

    Hoelzer, Karin; Pouillot, Régis

    2013-11-01

    While adequate, statistically designed sampling plans should be used whenever feasible, inference about the presence of pathogens in food occasionally has to be made based on smaller numbers of samples. To help the interpretation of such results, we reviewed the impact of small sample sizes on pathogen detection and prevalence estimation. In particular, we evaluated four situations commonly encountered in practice. The first two examples evaluate the combined impact of sample size and pathogen prevalence (i.e., fraction of contaminated food items in a given lot) on pathogen detection and prevalence estimation. The latter two examples extend the previous example to consider the impact of pathogen concentration and imperfect test sensitivity. The provided examples highlight the difficulties of making inference based on small numbers of samples, and emphasize the importance of using appropriate statistical sampling designs whenever possible.

  9. SUSTAINABLE SUCCESS IN HIGHER EDUCATION BY SHARING THE BEST PRACTICES AS A RESULT OF BENCHMARKING PROCESS

    Directory of Open Access Journals (Sweden)

    Anca Gabriela Ilie

    2011-11-01

    Full Text Available The paper proposes to review the main benchmarking criteria, based on the quality indicators used by the higher education institutions and to present new indicators of reference as a result of the inter-universities cooperation. Once these indicators are defined, a national database could be created and through benchmarking methods, there could be established the level of national performance of the educational system. Going forward and generalizing the process, we can compare the national educational system with the European one, using the benchmarking approach. The final purpose is that of establishing a group of universities who come together to explore opportunities for benchmarks and best practices sharing on common interest areas in order to create a „quality culture” for the Romanian higher education system

  10. The method of analysis of joint space width measurement results: practical verification

    Science.gov (United States)

    Gilewska, Grażyna

    2006-02-01

    The difficulties in accuracy of performed measurements assessment was appeared when author analyzed measurement results of joint space width on the basis of radiographs. It's followed mainly from accuracy of patient position at X-ray unit. So that to solve this problem author worked out methods of elimination measured data of patients for which variation of measurement results was highest (i.e. lowest repeatability of radiographs execution). In this way we can perform fewer radiographs for the others patients to decrease of mean standard deviation of measured data identified with measuring error. Author checked practical application of methods outlying observation reduction and innovative methods of elimination measured data with excess variance at independence as well as dependence of variables. Elaborated methods were verified on the basis of measurement results of knee-joint width space got from radiographs. Measurements were carried out by two methods: directly on the radiographs as well as indirectly on the digital images of radiographs. Results of examination confirmed legitimacy to using of elaborated methodology and measurement procedures. It's solved important problems from metrology, which have application in many medical departments, especially if it's hard to achieve reduction of random error by increase numbers of measurements. Radiology is such a discipline. There is the most essential to reduce ionizing radiation dose for patient during examinations.

  11. The BirthPlace collaborative practice model: results from the San Diego Birth Center Study.

    Science.gov (United States)

    Swartz; Jackson; Lang; Ecker; Ganiats; Dickinson; Nguyen

    1998-07-01

    birth center and $5,535 for the traditional care group. Final results based on the full study sample (full data available February 1998) details of payor costs such as provider, facility, NICU, and ancillary along with costs from the health care system perspective and patient satisfaction results will be presented.Conclusion: Current results suggest similar morbidity and mortality between the birth center program and traditional care groups, with less resource utilization translating to lower costs in the collaborative practice model. Results suggest that collaborative practice using a freestanding birth center as an adjunct to an integrated perinatal health care system may provide a quality, lower-cost alternative for the provision of perinatal services.

  12. Clinical practice of image-guided spine radiosurgery - results from an international research consortium

    Directory of Open Access Journals (Sweden)

    Guckenberger Matthias

    2011-12-01

    Full Text Available Abstract Background Spinal radiosurgery is a quickly evolving technique in the radiotherapy and neurosurgical communities. However, the methods of spine radiosurgery have not been standardized. This article describes the results of a survey about the methods of spine radiosurgery at five international institutions. Methods All institutions are members of the Elekta Spine Radiosurgery Research Consortium and have a dedicated research and clinical focus on image-guided radiosurgery. The questionnaire consisted of 75 items covering all major steps of spine radiosurgery. Results Strong agreement in the methods of spine radiosurgery was observed. In particular, similarities were observed with safety and quality assurance playing an important role in the methods of all institutions, cooperation between neurosurgeons and radiation oncologists in case selection, dedicated imaging for target- and organ-at-risk delineation, application of proper safety margins for the target volume and organs-at-risk, conformal planning and precise image-guided treatment delivery, and close clinical and radiological follow-up. In contrast, three major areas of uncertainty and disagreement were identified: 1 Indications and contra-indications for spine radiosurgery; 2 treatment dose and fractionation and 3 tolerance dose of the spinal cord. Conclusions Results of this study reflect the current practice of spine radiosurgery in large academic centers. Despite close agreement was observed in many steps of spine radiosurgery, further research in form of retrospective and especially prospective studies is required to refine the details of spinal radiosurgery in terms of safety and efficacy.

  13. Pruritus in hemodialysis patients: Results from the Japanese Dialysis Outcomes and Practice Patterns Study (JDOPPS).

    Science.gov (United States)

    Kimata, Naoki; Fuller, Douglas S; Saito, Akira; Akizawa, Tadao; Fukuhara, Shunichi; Pisoni, Ronald L; Robinson, Bruce M; Akiba, Takashi

    2014-07-01

    Pruritus affects many patients undergoing hemodialysis (HD). In this study, pruritus and its relationship to morbidity, quality of life (QoL), sleep quality, and patient laboratory measures were analyzed in a large sample of Japanese patients undergoing HD. Severity of patient-reported pruritus symptoms experienced during a 4-week period was collected from 6480 Japanese patients undergoing HD in three phases of the Dialysis Outcomes and Practice Patterns Study (DOPPS; 1996-2008; 60-65 study facilities/phase). Adjusted linear and logistic regressions were used to identify associations of pruritus with treatment parameters and QoL outcomes. Adjusted Cox regressions examined the influence of pruritus severity on mortality. Moderate to extreme pruritus was experienced by 44% of prevalent patients undergoing HD in the Japanese Dialysis Outcomes and Practice Patterns Study. Many patient characteristics were significantly associated with pruritus, but this did not explain the large differences in pruritus among facilities (20-70%). Pruritus was slightly less common in patients starting HD than in patients on dialysis >1 year. Patients with moderate to extreme pruritus were more likely to feel drained (adjusted odds ratio = 2.2-5.8, P quality (adjusted odds ratio = 1.9-3.7, P < 0.0001), and have QoL mental and physical composite scores 2.3-6.7 points lower (P < 0.0001) than patients with no/mild pruritus. Pruritus in patients undergoing HD was associated with a 23% higher mortality risk (P = 0.09). The many poor outcomes associated with pruritus underscore the need for better therapeutic agents to provide relief for the 40-50% of prevalent patients undergoing HD substantially affected by pruritus. Pruritus in new patients with end-stage renal disease likely results from uremia or pre-existing conditions (not HD per se), indicating the need to understand development of pruritus before end-stage renal disease.

  14. 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.)

  15. Chiropractic Treatment of Cervicogenic Arrhythmia in 34 Cases%整脊法治疗颈源性心律失常34例

    Institute of Scientific and Technical Information of China (English)

    胡青林

    2013-01-01

      目的:观察整脊法治疗颈源性心律失常的临床疗效.方法:将70例颈源性心律失常患者随机分为治疗组和对照组,治疗组采用定点旋转复位法治疗,对照组采用常规推拿治疗,两各疗程后观察疗效.结果:治疗组总有效率94.1%,对照组总有效率75.0%,治疗组高于对照组(P<0.05).结论:整脊法治疗颈源性心律失常操作安全,疗效显著,值得推广.%Objective: To observe the clinical effect of chiropractic therapy with cervicogenic arrhythmia. Methods: 70 cases of cervi-cogenic arrhythmia patients were randomly divided into treatment group and control group, treatment group were treated with Fixed-point rotation reduction method, while the control group adopted conventional massage therapy, and observed curative effect after two courses. Results: The total effective rate of treatment group was 94.1%, that of control group was 75%, the treatment group was better than treatment group (P<0.05). Conclusion: Chiropractic treatment of cervicogenic arrhythmia is operational safety and obvious curative effect, which is worth if promotion.

  16. Attitudes of Australian chiropractic students toward whole body donation: a cross-sectional study.

    Science.gov (United States)

    Alexander, Michelle; Marten, Mathew; Stewart, Ella; Serafin, Stanley; Štrkalj, Goran

    2014-01-01

    Cadavers play an important role in anatomy education. In Australia, bodies for anatomy education are acquired only through donations. To gain insight into educational dynamics in an anatomy laboratory as well as to facilitate body donation programs and thanksgiving ceremonies, it is important to understand students' attitudes toward body donation. In this cross-sectional study, the attitudes of Macquarie University's first, second, and fifth year chiropractic students toward body donation were investigated. Macquarie University chiropractic students have a four semester long anatomy program, which includes cadaver-based instruction on prosected specimens. A questionnaire was used to record respondents' demographics and attitudes toward body donation: personal, by a relative, and by a stranger. It was found that ethnicity and religion affect attitudes toward body donation, with Australian students being more willing to donate a stranger's body and atheists and agnostics being more willing to donate in general. Furthermore, willingness to donate one's own or a family member's body decreases as year of study increases, suggesting a possible negative impact of exposure to cadavers in the anatomy laboratory. This was only true, however, after controlling for age. Thus, the impact of viewing and handling prosected specimens, which is the norm in anatomy classes in Australia, may not be as strong as dissecting cadavers. It is suggested that anatomists and educators prepare students for cadaver-based instruction as well as exhibit sensitivity to cultural differences in how students approach working with cadavers, when informing different communities about body donation programs and in devising thanksgiving ceremonies.

  17. 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.

  18. 治脊疗法结合中频电治疗糖尿病性尿潴留的临床观察%Clinical observation of chiropractic therapy combined with intermediate frequency electricity in treatment of diabetic neurogen bladde

    Institute of Scientific and Technical Information of China (English)

    丁晓虹; 王潇; 廖军锋; 吕晓宇

    2012-01-01

    目的:观察治脊疗法结合中频电治疗糖尿病性尿潴留的临床疗效.方法:将糖尿病性尿潴留患者68例随机分为两组,实验组35例,采用治脊疗法结合中频电治疗;对照组33例,单纯采用中频电治疗.结果:实验组有效率为82.8%;对照组有效率为60.6%.两组比较差异有统计学意义(P<0.05).结论:治脊疗法结合中频电治疗糖尿病性尿潴留可明显提高疗效.%Objective: To observe the clinical efficacy of chiropractic therapy combined with intermediate frequency electricity in treatment of diabetic neurogen bladde. Methods: Sixty-eight patients with diabetic neurogen bladde were randomly divided into treatment group (n= 35) treated with chiropractic therapy combined with intermediate frequency electricity and control group ( n =33) treated with single intermediate frequency electricity. Results;The effective rate was 82. 8% in treatment group and 60. 6% in control group,with significant difference (P < 0. 05). Conclusion: The chiropractic therapy combined with intermediate frequency electricity might improve the efficacy of treatment for diabetic neurogen bladde.

  19. 三小定点整脊技术治疗腰椎间盘突出症疗效观察%Effect of chiropractic technique with three small fixed-points on lumbar disc herniation

    Institute of Scientific and Technical Information of China (English)

    张国庆; 王遵来; 路金英; 张菲菲

    2013-01-01

    [目的]观察三小定点整脊技术治疗腰椎间盘突出症的疗效.[方法]选取144例(脱落6例,实际完成138例),随机分为观察组72例(2例脱落,实际完成70例),男23例,女47例,采用三小定点整脊技术治疗;对照组72例(4例脱落,实际完成68例),采用牵引法治疗.[结果]两组疗效比较,观察组疗效明显高于对照组(P<0.05),治疗期间无明显不良反应.[结论]三小定点整脊技术可明显改善患者症状,缓解疼痛.%[Objective] To observe the clinical effect of using three targeted efficacy of chiropractic technique in the treatment of lumbar disc herniation. [Methods] The selected 144 patients (exuviation in 6 cases, actually completed in 138 cases) were randomly divided into observation group (72 cases, exfoliation in 2 cases, actually completed in 70 cases ) treated with the three small point chiropractic treatment and control group (72 cases, exfoliation in 4 cases, actual completed in 68 cases ) treated with traction. [Results] The curative effect of treatment group was significantly higher than control group (P<0.05), and it had no apparent adverse reactions during treatment. [Conclusion] The three small point chiropractic techniques can significantly relieve patients' symptoms and pain.

  20. 整脊疗法治疗脊源性跟痛症30例临床疗效%The clinical effect of chiropractic therapy in the treatment of 30 cases of spinal calcaneodynia

    Institute of Scientific and Technical Information of China (English)

    陈斌; 戴国文; 田新宇; 陈兆茹; 王雷空; 杨小康

    2014-01-01

    目的:观察中医整脊结合松解理筋治疗脊源性跟痛症的临床疗效。方法:30例脊源性跟痛症患者,运用中医整脊结合松解理筋治疗,观察其疗效,3个月后随访。结果:治愈12例,临床治愈9例,好转8例,无效1例,总有效率96.6%。结论:中医整脊结合松解理筋治疗脊源性跟痛症疗效显著,该疗法可提高临床疗效,降低复发率。%Objective:To observe the clinical effect of traditional Chinese medicine chiropractic combined with loose tendons and muscles in the treatment of spinal calcaneodynia.Methods:30 patients with spinal calcaneodynia were treated with traditional Chinese medicine chiropractic combined with loose tendons and muscles.The clinical effect was observed.They were given follow-up after 3 months.Results:12 cases were cured;9 cases were clinical cured;8 cases were improved;1 case was ineffective;the total effective rate was 96.6%.Conclusion:The traditional Chinese medicine chiropractic combined with loose tendons and muscles in the treatment of spinal calcaneodynia have significant effect.The therapy can improve the clinical curative effect and reduce the recurrence rate.

  1. 零角度整脊术治疗腰推间盘突出症的临床运用%Clinical application of "Zero-angle" chiropractic technique in the treatment of lumbar disc herniation

    Institute of Scientific and Technical Information of China (English)

    王雷; 王遵来

    2011-01-01

    [Objective] To observe the clinical effect of "Zero-angle" chiropractic technique in the treatment of lumbar disc herniation.[Methods] Differentiated "Zero-angle" chiropractic technique was used to treat the thoracic, lumbar spine and sacrum in 570 cases with lumbar disc herniation. [Results] The total effective rate for IA/L5 protrusion was 99%; for L5/S1 was 98%; for L4/5+L5/S1 was 98%; for IA/5 protrusion combined with merger stenosis was 96%; for L5/S1 protrusion combined with merger stenosis was 96%. [Conclusion]"Zero-angle" chiropractic technique is one of the effective methods of conservative treatment for lumbar disc herniation.%[目的]临床观察零角度整脊术治疗腰椎间盘突出症的疗效.[方法]通过胸椎、腰椎、骶椎零角度整脊术辨证施治治疗腰椎间盘突出症570例.[结果]L4/L5突出总有效率为99%; L5/S1突出总有效率98%; L4/5+L5/S1突出总有效率为98%;L4/5合并椎管狭窄总有效率为96%; L5/S1合并椎管狭窄总有效率为96%.[结论]零角度整脊术是保守治疗腰椎间盘突出症有效方法之一.

  2. Effect of chiropractics combined with swimming therapy on neonatal neurobehavioral development%新生儿捏脊加泳疗法对新生儿行为神经发育的影响

    Institute of Scientific and Technical Information of China (English)

    黄丽玲; 邹文霞; 陈瑶

    2013-01-01

    目的 探讨新生儿捏脊加泳疗对新生儿行为神经发育的影响.方法 将我院住院分娩的116例足月正常新生儿,分为对照组和观察组.观察组沐浴后采取新生儿捏脊加泳疗,对照组仅沐浴,分别于出生后第1天、第5天、第42天进行NBNA评分进行观察对比.结果 新生儿在出生后5天和42天,观察组NBNA评分高于对照组(P<0.05).结论 新生儿捏脊加泳疗可对新生儿神经行为发育有明显的促进作用,值得临床推广.%Objective To explore the effect of chiropractics combined with swimming therapy on neonatal neurobehavioral development.Methods 116 healthy full-term neonates born in our hospital were divided into a study group and a control group.The study group received chiropractics combined with swimming therapy after bathing,while the control group received bathing alone.All the neonates were assessed by the NBNA scale on days 1,5,and 42 after birth.Results The NBNA score was higher in the study group than in the control group on days 5 and42 (P<0.05).Conclusions Chiropractics combined with swimming therapy plays a marked role in acceleration of neonatal neurobehavioral development,thus it is worth popularizing clinically.

  3. 31 Cases of Acupuncture and Chiropractic on Gastroesophageal Reflux Cough%针刺配合捏脊疗法治疗胃食管反流性咳嗽31例

    Institute of Scientific and Technical Information of China (English)

    孙其斌; 肖国民

    2011-01-01

    Objective:To observe effects of acupuncture and chiropractic on gastroesophageal reflux cough. Methods:31 cases were observed by acupuncture combined with chiropractic. Three times a week, Treated for four weeks, the therapeutic effects after one treament courses were observed. Results:8 cases were markedly effective in 31 cases, accounted for 25.8%.11 cases were effective,accounted for 35.5%.9 cases were relieved,accounted for 29.0%.3 cases were ineffective,accounted for 9.7%.And the total effective rate was 90.3%.Conclusion:The acupuncture and chiropractic therapy have definite effect in cure gastroesophageal reflux cough symptoms.%目的:观察针刺配合捏脊疗法治疗胃食管反流性咳嗽的疗效.方法:31例患者均采用针刺配合捏脊疗法进行治疗,每周3次,4周为1个疗程,治疗1个疗程后观察疗效.结果:显效8例,占25.8%;有效11例,占35.5%;缓解9例,占29.0%;无效3例,占9.7%.有效率为90.3%.结论:针刺配合捏脊疗法治疗胃食管反流性咳嗽疗效确切.

  4. Implementation Integrity of Practice-Based Coaching: Preliminary Results from the BEST in CLASS Efficacy Trial

    Science.gov (United States)

    Sutherland, Kevin S.; Conroy, Maureen A.; Vo, Abigail; Ladwig, Crystal

    2015-01-01

    The purpose of this article is to describe the practice-based coaching model used in BEST in CLASS, a Tier-2 classroom-based intervention comprised of evidence-based instructional practices designed to prevent and ameliorate the chronic problem behaviors of young children at risk for the development of emotional/behavioral disorders. Following a…

  5. Embedding evidence-based practice among nursing undergraduates: Results from a pilot study.

    Science.gov (United States)

    André, Beate; Aune, Anne G; Brænd, Jorunn A

    2016-05-01

    Evidence-based practice is currently one of the most important developments in health care. Research in nursing science is rapidly growing; however, translating the knowledge based on this research into clinical practice is often hampered, and may be dependent on reflective skills. The aim of this study was to see how undergraduate nursing students in nursing should increase their skills and knowledge related to evidence-based practice through participation in clinical research projects. A qualitative approach was used in collecting and analyzing the data. Students participated in a pilot clinical research project and a received guidance related to their bachelor thesis. After the project was completed, all students filled in a questionnaire. The students' motivation to participate in this study was reported to be high, but they reported low knowledge related to evidence-based practice. All students reported that their attitude towards evidence-based practice changed in a positive direction during their participation in the project. Evidence-based practice influenced nursing practices by putting more focus on critical thinking, increasing pride and giving a sense of ownership in the clinical field. The curricula and the pedagogical perspectives in nursing education can influence the attitude towards evidence-based practice and skills among nursing bachelor students.

  6. Core Practices for Teaching History: The Results of a Delphi Panel Survey

    Science.gov (United States)

    Fogo, Bradley

    2014-01-01

    Recent education literature and research has focused on identifying effective core teaching practices to inform and help shape teacher education and professional development. Although a rich literature on the teaching and learning of history has continued to develop over the past decade, core practice research has largely overlooked…

  7. Proceduralization, transfer of training and retention of knowledge as a result of output practice

    Directory of Open Access Journals (Sweden)

    Mehrnoosh Fakharzadeh

    2013-11-01

    Full Text Available This study investigated the effect of output practice on the proceduralization, transfer and retention of knowledge on English modals, adopting Anderson's ACT-R model of skill acquisition. A pretest posttest and delayed posttest design was used where the procedural knowledge on production skill was specifically operationalized through the groups’ performance on Dual Task Timed Completion Test and transfer of training was measures through a Dual Task Timed Grammaticality Judgment Test. Two intact classes of intermediate EFL learners were randomly assigned to treatment and control groups. The output group (n= 27 received explicit grammar instruction, a combination of three output tasks including dictogloss, individual text reconstruction, and corrected-close translation, and feedback. The control group (n=25 were just exposed to the identical texts trough listening and reading tasks followed by some questions irrelevant to the target structure. Results showed that on the posttest, three days after the last treatment session, the output group outperformed the control group in both measures of procedural knowledge and transfer of knowledge. As for retention, forty days later, the output group’s performance was still significantly better than that on the pretest. This group also succeeded in retaining its outperformance on both measures of procedural knowledge and transfer of knowledge delayed posttest. The results may help language teachers design more effective activities for the learners considering the institutional constraints.

  8. CODES AND PRACTICES OF IMPLEMENTATION OF CORPORATE GOVERNANCE IN ROMANIA AND RESULTS REPORTING

    Directory of Open Access Journals (Sweden)

    GROSU MARIA

    2011-12-01

    Full Text Available Corporate governance refers to the manner in which companies are directed and controlled. Business management was always guided by certain principles, but the current meaning of corporate governance concerns and the contribution that companies must have the overall development of modern society. Romania used quite late in adopting a code of good practice in corporate governance, being driven, in particular, the privatization process, but also the transfer of control and surveillance of political organizations by the Board of Directors (BD. Adoption of codes of corporate governance is necessary to harmonize internal business requirements of a functioning market economy. In addition, the CEE countries, the European Commission adopted an action plan announcing measures to modernize company law and enhance corporate governance. Romania takes steps in this direction by amending the Company Law, and other regulations, although the practice does not necessarily keep pace with the requirements. This study aims on the one hand, an analysis of the evolution of corporate governance codes adopted in Romania, but also an empirical research of the implementation of corporate governance principles of a representative sample of companies listed on the Bucharest Stock Exchange (BSE. Consider relevant research methodology, because the issuer of the Codes of CG in Romania is BSE listed companies requesting their voluntary implementation. Implementation results are summarized and interpreted at the expense of public reports of the companies studied. Most studies undertaken in this direction have been made on multinational companies which respects the rule of corporate governance codes of countries of origin. In addition, many studies also emphasize the fair treatment of stakeholders rather than on models of governance adopted (monist/dualist with implications for optimizing economic objectives but also social. Undertaken research attempts to highlight on the one

  9. Practical applicability and preliminary results of the Baltic Environmental Satellite Remote Sensing System (SatBaltic)

    Science.gov (United States)

    Wozniak, B.; Ostrowska, M.; Bradtke, K.; Darecki, M.; Dera, J.; Dudzinska-Nowak, J.; Dzierzbicka, L.; Ficek, D.; Furmanczyk, K.; Kowalewski, M.; Krezel, A.; Majchrowski, R.; Paszkuta, M.; Ston-Egiert, J.; Stramska, M.; Zapadka, T.

    2012-04-01

    SatBaltic (Satellite Monitoring of the Baltic Sea Environment) project is being realized in Poland by the SatBaltic Scientific Consortium, specifically appointed for this purpose, which associates four scientific institutions: the Institute of Oceanology PAN in Sopot - coordinator, the University of Gdańsk (Institute of Oceanography), the Pomeranian Academy in Słupsk (Institute of Physics) and the University of Szczecin (Institute of Marine Sciences). We present the first the results of the first year and a half of SatBaltic's implementation. The final result of the project is to be the creation and setting in motion of the SatBaltic Operational System (SBOS), the aim of which is to monitor effectively and comprehensively the state of the Baltic Sea environment using remote sensing techniques. Various aspects of the practical applicability of SBOS to the monitoring of the Baltic ecosystem are discussed. We present some examples of the maps of the various characteristics of the Baltic obtained using the current version of SBOS, including algorithms and models that are still in an unfinished state. At the current stage of research, these algorithms apply mainly to the characteristics of the solar energy influx and the distribution of this energy among the various processes taking place in the atmosphere-sea system, and also to the radiation balance of the sea surface, the irradiance conditions for photosynthesis and the condition of plant communities in the water, sea surface temperature distributions and some other marine phenomena correlated with this temperature. Also given are results of preliminary inspections of the accuracy of the magnitudes shown on the maps.

  10. Analysis of hemoglobin electrophoresis results and physicians investigative practices in Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Syed Riaz Mehdi

    2013-01-01

    Full Text Available Background and Objectives: Riyadh and central province falls in a moderate prevalent zone of hemoglobinopathies in Saudi Arabia. However, it has been observed that the physicians working in Saudi Arabia invariably advise all cases of anemia for hemoglobin electrophoresis (HE. The present work was carried out to study the yield of the HE in Riyadh and the investigative practices of the physicians advising HE. Settings and Design: The study was carried out in the hospitals of King Saud University from 2009 to 2011 in order to assess the yield of HE in referred cases of clinical anemia. Materials and Methods: A total of 1073 cases divided in two groups of males and females had undergone complete blood count and red blood cell morphology. Cellulose acetate HE was performed and all the positive results were reconfirmed on the high performance liquid chromatography (HPLC. The results were analyzed for the type of hemoglobinopathies. For statistical analysis Statistical Package for Social Sciences 15 version (SPSS Inc., Chicago, IL, USA was used. Results: A total of 405 males and 668 females blood samples were included in the present study. 116 (28.5% males and 167 (25% females showed an abnormal pattern on HE. The incidence of beta thalassemia trait was higher in females while sickle cell trait was predominantly seen in males. Red cell indices were reduced considerably in thalassemias, but were unaffected in sickle cell disorders, except those which had concurrent alpha trait. The total yield of HE was 26.6% which was much less than expected. Conclusion: The physicians are advised to rule out iron deficiency and other common causes of anemia before investigating the cases for hemoglobinopathies, which employs time consuming and expensive tests of HE and HPLC.

  11. Summarising and validating test accuracy results across multiple studies for use in clinical practice.

    Science.gov (United States)

    Riley, Richard D; Ahmed, Ikhlaaq; Debray, Thomas P A; Willis, Brian H; Noordzij, J Pieter; Higgins, Julian P T; Deeks, Jonathan J

    2015-06-15

    Following a meta-analysis of test accuracy studies, the translation of summary results into clinical practice is potentially problematic. The sensitivity, specificity and positive (PPV) and negative (NPV) predictive values of a test may differ substantially from the average meta-analysis findings, because of heterogeneity. Clinicians thus need more guidance: given the meta-analysis, is a test likely to be useful in new populations, and if so, how should test results inform the probability of existing disease (for a diagnostic test) or future adverse outcome (for a prognostic test)? We propose ways to address this. Firstly, following a meta-analysis, we suggest deriving prediction intervals and probability statements about the potential accuracy of a test in a new population. Secondly, we suggest strategies on how clinicians should derive post-test probabilities (PPV and NPV) in a new population based on existing meta-analysis results and propose a cross-validation approach for examining and comparing their calibration performance. Application is made to two clinical examples. In the first example, the joint probability that both sensitivity and specificity will be >80% in a new population is just 0.19, because of a low sensitivity. However, the summary PPV of 0.97 is high and calibrates well in new populations, with a probability of 0.78 that the true PPV will be at least 0.95. In the second example, post-test probabilities calibrate better when tailored to the prevalence in the new population, with cross-validation revealing a probability of 0.97 that the observed NPV will be within 10% of the predicted NPV.

  12. Cold chain and consumers’ practices: exploratory results of focus group interviews

    Directory of Open Access Journals (Sweden)

    Stefania Balzan

    2014-12-01

    Full Text Available The aim of this qualitative survey was to gain an insight into the ways consumers purchase, transport and storage fresh and frozen food. In particular, this paper considered consumers’ behaviour and the knowledge they have about cold chain. An explorative study was held using focus group interviews (n. 4 as the method for data collection. The sampling group was composed of 24 consumers (4 males and 20 females and the age ranged from 33 to 78. Data revealed that food safety knowledge is at a fairly good level, however consumer practices in certain cases were inappropriate particularly with respect to transport from the store to home, storage and thaw. Consumers were particularly concerned about frozen food that should not be thawed during shopping or transportation. Knowledge about eggs storage seemed to be dodgy as well. Due to the restricted extent of the sample survey the results cannot be generalized to the whole Italian population; still, this method is particularly useful for discovering not only what people think but why they think that way.

  13. Analysis of curative effect of chiropractic therapy in the treatment of 60 patients with cervical vertigo%整脊疗法治疗颈性眩晕疗效分析60例

    Institute of Scientific and Technical Information of China (English)

    项柏冬; 王成研; 韩春霞

    2016-01-01

    Objective:To study the clinical effects of chiropractic therapy in the treatment of cervical vertigo.Methods:60 patients were all takent chiropractic therapy,through the pendulum ridge spasmolysis,side shaking and positioning chiropractic methods to observe clinical curative effect of patients after treatment and the improvement situation of cervical vertigo symptoms.Results:60 patients after treatment,effective immediately in 37 cases,cured in 49 cases,9 cases improved,and invalid in 2 cases,the total effective rate was 96.7%.The dizziness,headache,tinnitus,nausea and vomiting of all patients after the treatment were significantly improved than before the treatment,after treatment,the score was significantly lower than before treatment(P<0.05).Conclusion:Chiropractic therapy not only can correct the joint reset,but also at the same time can regulate the meridians,so that the effect is more significant,is one of the effective method in the treatment of cervical vertigo.%目的:探讨整脊疗法治疗颈性眩晕的临床疗效。方法:60例患者均采用整脊疗法治疗,通过摆脊解痉、端提摇晃、定位整脊等方法观察所有患者治疗后临床疗效及颈性眩晕症状体症改善情况。结果:60例患者治疗后,即时有效者37例,治愈49例,好转9例,无效2例,总有效率达96.7%。所有患者治疗后眩晕、头痛、耳鸣、恶心和呕吐情况较治疗前有明显好转,治疗后积分明显低于治疗前(P<0.05)。结论:整脊疗法,在纠正关节复位的同时,可调理经脉,从而使疗效更加显著,是治疗颈性眩晕的有效方法之一。

  14. 整脊推拿联合超声波治疗神经根型颈椎病的疗效观察%Efficacy Observation on Chiropractic Massage Combined with Ultrasonic Treating Cervical Spondylotic Radiculopathy

    Institute of Scientific and Technical Information of China (English)

    刘军

    2013-01-01

    目的:观察整脊推拿联合超声波治疗神经根型颈椎病的临床疗效。方法:采用随机数字表法将90例神经根型颈椎病患者随机平均分为三组,推拿组采用整脊推拿治疗,超声组采用超声波治疗,联合组予整脊推拿联合超声波治疗,4周后评价三组临床疗效、症状体征评分、VAS评分及颈椎生理曲度变化情况。结果:联合组的总有效率明显高于推拿组与超声组(P<0.05);联合组症状体征评分、疼痛VAS评分较其他两组低,颈椎生理曲度评分较其他两组高(P<0.05)。结论:整脊推拿联合超声波治疗神经根型颈椎病临床疗效确切,明显改善患者颈椎生理曲度,值得临床推广应用。%Objective:To observe the clinical efficacy of chiropractic massage combined with ultrasonic treating cervical spondylotic radiculopathy. Methods:90 cases of cervical spondylotic radiculopathy were randomly divided into three groups equally with method of random digits table, mas-sage group adopted therapy of chiropractic massage, ultrasonic group treated with ultrasound, combined group treated with chiropractic massage and ultrasonic, to evaluate the clinical efficacy, symptoms and signs scores, VAS score and cervical physiological curvature of three groups after 4 weeks. Results:The total effective rate of combination group was significantly higher than that of massage and ultrasonic group (P<0.05);symptoms and signs score, VAS pain score of combination group, with higher score of cervical physiological curvature, were lower than those of two other groups (P<0.05). Conclusion:Chiropractic massage combined with ultrasonic treating cervical spondylotic radiculopathy is of exact clinical efficacy, signifi-cantly improving the cervical physiological curvature, being worthy of clinical promotion and application.

  15. Chiropractic combined Jideshu Pill in the treatment of lumbar disc herniation%整脊结合脊得舒丸治疗腰椎间盘突出症

    Institute of Scientific and Technical Information of China (English)

    孟庆良; 王振; 谷慧敏; 杜旭召; 周子朋; 郑福增; 郭会卿

    2012-01-01

    目的:观察整脊结合脊得舒丸治疗腰椎间盘突出症的临床疗效.方法:将98例患随机分为对照组和治疗组各49例,对照组采用整脊疗法,治疗组在对照组的基础上加用脊得舒丸治疗,15d为1个疗程.结果:对照组治愈33例,显效5例,有效3例,无效8例,有效率为83.76%;治疗组治愈42例,显效4例,有效2例题,无效1例,有效率为97.95%,两组采取有效率比较,差异有显著性(P<0.05).结论:整脊结合脊得舒丸治疗腰椎间盘突出症疗效确切.%Objective: To observe the clinical effect of chiropractic combined Jideshu Pill in the treatment of lumbar disc herniation. Methods: 98 patients were randomly divided into control and treatment group. 49 patients in control group were treated with chiropractic therapy, the treatment group were treated with chiropractic combined Jideshu Pill, 15 days for treatment course. Results: There were 33 cases cured in control group, of which markedly effective in 5 cases, effective in 3 cases, ineffective in 8 cases, the effective rate was 83.76%; There were 42 cases cured in treatment group, of which markedly effective in 4 cases, effective in 2 cases, ineffective in 1 cases, the effective rate was 97.95%. There were significant difference between the effective rates of two groups (P<0.05). Conclusion: The chiropractic combined Jideshu Pill treatment for lumbar disc herniation is curative.

  16. 捏脊法治疗小儿厌食的应用效果研究与分析%Research on and Analysis of Application of Chiropractic in the Treatment of Infantile Anorexia

    Institute of Scientific and Technical Information of China (English)

    徐红

    2016-01-01

    Objective To explore the application effect of chiropractic in treating infantile anorexia.Methods From July 2015 to July 2016 in the hospital, 72 cases of anorexia in children were selected as the research object, according to randomly divided into control group and study group, 36 cases in each group, the control group were used in the treatment of athletes in the study group, the application of chiropractic therapy, two groups were compared with treatment effect.ResultsThe clinical efficacy of the two groups was compared, the total effective number of study group was 35 cases (97.22%), the total effective number of control group was 28 cases (77.78%), the total number of study group was higher than that of control group (P < 0.05).Conclusion Chiropractic embodies the characteristics of Chinese medicine treatment, the method for the application effect of chiropractic therapy on infantile anorexia can achieve the ideal, not only no adverse reaction, but also can improve the treatment compliance of the children, the higher the value of clinical application.%目的:探讨捏脊法治疗小儿厌食的应用效果。方法选择2015年7月~2016年7月本院接收的72例厌食患儿为研究对象,按照随机抽签法分为对照组和研究组,每组各36例,对照组患儿应用葡萄糖酸锌颗粒治疗,研究组患儿应用捏脊法治疗,比较两组患儿的治疗效果。结果两组患儿临床疗效比较,研究组总有效例数为35例(97.22%),对照组总有效例数为28例(77.78%),研究组治疗组总有效率高于对照组(P<0.05)。结论捏脊法充分体现了中医治疗的特点,将捏脊法用于治疗小儿厌食能取得理想的应用效果,不仅没有不良反应,也能提高患儿治疗依从性,临床应用价值较高。

  17. Instructional Practices in Introductory Geoscience Courses: Results of a National Faculty Survey

    Science.gov (United States)

    MacDonald, R.; Manduca, C. A.; Mogk, D. W.; Tewksbury, B. J.

    2004-12-01

    The NAGT professional development program "On the Cutting Edge" recently surveyed 7000 geoscience faculty in the United States to develop a snapshot of current instructional practices in undergraduate geoscience courses, faculty strategies for learning new content and new teaching approaches, and faculty involvement in the geoscience education community. Over 2200 faculty responded to the survey which was conducted by the American Institute of Physics. Results for introductory courses (814 responses) indicate that lecture is the most common teaching strategy used in courses of all sizes. Many faculty incorporate some interactive activities in their courses. Most commonly, they use questioning, demonstrations, discussions, and in-class exercises. Less common, but not rare, are small group discussion or think-pair-share and classroom debates or role-playing. Activities involving problem solving, using quantitative skills, working with data and primarily literature, and structured collaboration are incorporated by many faculty in introductory courses, suggesting efforts to teach the process of science. Activities in which students address a problem of national or local interest, analyze their own data, or address problems of their own design are less common but not rare. Field experiences are common but not ubiquitous for students in introductory courses. A wide variety of assessment strategies are used in introductory courses of all sizes, including exams, quizzes, problem sets, papers, oral presentations, and portfolios. While papers are used for assessment more extensively in small classes, a significant number of faculty use papers in large classes (greater than 81 students). A majority of faculty use rubrics in grading. Faculty report that in the past two years, approximately one-third have made changes in the content of their introductory courses while just under half have changed the teaching methods they use. While faculty learn about both new content and

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

    DEFF Research Database (Denmark)

    Myburgh, Cornelius

    2016-01-01

    sequence and timing’ and ‘a consultation that adds value’. Discussion The Internet functions as a tool when choosing/confirming a clinic as appropriate, developing and initial image and managing appointments. The administrative hub appears integral to the shaping of positive consumer experiences outside...

  19. Frequency of Yoga Practice Predicts Health: Results of a National Survey of Yoga Practitioners

    OpenAIRE

    Alyson Ross; Erika Friedmann; Margaret Bevans; Sue Thomas

    2012-01-01

    Background. Yoga shows promise as a therapeutic intervention, but relationships between yoga practice and health are underexplored. Purpose. To examine the relationship between yoga practice and health (subjective well-being, diet, BMI, smoking, alcohol/caffeine consumption, sleep, fatigue, social support, mindfulness, and physical activity). Methods. Cross-sectional, anonymous internet surveys distributed to 4307 randomly selected from 18,160 individuals at 15 US Iyengar yoga studios; 10...

  20. What clinical activities do advanced-practice registered dietitian nutritionists perform? Results of a Delphi study.

    Science.gov (United States)

    Brody, Rebecca A; Byham-Gray, Laura; Touger-Decker, Riva; Passannante, Marian R; Rothpletz Puglia, Pamela; O'Sullivan Maillet, Julie

    2014-05-01

    Activities performed by advanced-practice registered dietitian nutritionists (RDNs) have yet to be clearly elucidated. The study aimed to gain consensus on the practice activities of advanced-practice RDNs who provide direct clinical nutrition care. A three-round Delphi study was conducted. Purposive sampling identified 117 RDN experts working as clinicians and/or managers in direct care settings that met inclusion criteria for advanced-level practice. In Round 1, 85 experts provided open-ended advanced-level practice activities linked to the Nutrition Care Process sections. Using content analysis, the responses were coded into activity statements. In Round 2, experts rated the essentiality of these activities. In Round 3, experts re-rated statements not reaching consensus while viewing their previous rating, the group median, and comments. Median ratings of 1.0 to 3.0 were defined as essential, 4.0 were neither essential nor nonessential, and 5.0 to 7.0 were nonessential. Consensus was reached when the interquartile range of responses to each question was <2.0. Seventy-six (89.4%) experts completed all rounds. From 770 comments, 129 activity statements were generated. All statements reached consensus: 97.7% as essential; 0.8% as nonessential; and 1.5% as neither. Of essential activities, 67.5% were highly essential with limited variability (median=1.0; interquartile range≤2.0). Advanced-practice RDNs' tasks are patient-centered and reflect complex care; involve a comprehensive and discriminating approach; are grounded in advanced knowledge and expertise in clinical nutrition; include use of advanced interviewing, education, and counseling strategies; and require communication with patient, families, and the health care team. The high-level of consensus from experts suggest advanced-level clinical nutrition practice exists and can be defined.

  1. Practice-based clinical evaluation of metal-ceramic and zirconia molar crowns: 3-year results.

    Science.gov (United States)

    Rinke, S; Schäfer, S; Lange, K; Gersdorff, N; Roediger, M

    2013-03-01

    This practice-based study evaluates the clinical performance of conventionally luted metal-ceramic and zirconia molar crowns fabricated with pronounced anatomical core design and a prolonged cooling period of the veneering porcelain. Fifty-three patients were treated from 07/2008 until 07/2009 with either metal-ceramic crowns (MCC) (high-noble alloy + low-fusing porcelain) or zirconia crowns (Cercon System, DeguDent, Germany). Forty-nine patients (30 women/19 men) with 100 restorations (metal-ceramic: 48/zirconia: 52, mean observational period: 36·5 ± 6 months) participated in a clinical follow-up examination and were included in the study. Time-dependent survival (in situ criteria), success (event-free restorations) and chipping rates (defects of the veneering ceramics) were calculated according to the Kaplan-Meier method and analysed in relation to the crown fabrication technique, using a Cox regression model (P zirconia: 2) were recorded (survival rate after 3 years: metal-ceramic: 97·6%, zirconia: 95·2%). Of the metal-ceramic restorations, 90·9% remained event-free (two ceramic fractures, one endodontic treatment), whereas the success rate for the zirconia was 86·8% (two ceramic fractures, one endodontic treatment, one secondary caries). No significant differences in survival (P = 0·53), success (P = 0·49) and ceramic fracture rates (P = 0·57) were detected. The combination of a pronounced anatomical core design and a modified firing of the veneering porcelain for the fabrication of zirconia molar crowns resulted in a 3-year survival, success and chipping rate comparable to MCC.

  2. Renegotiating cultural practices as a result of HIV in the eastern region of Malawi.

    Science.gov (United States)

    Banda, Felix; Kunkeyani, Thokozani E

    2015-01-01

    A number of studies have shown that HIV awareness is very high among Malawians and yet infection rates are rising. Local cultural practices have been identified as contributing to this contradictory situation. Using data from 12 focus-group discussions collected in Balaka, Zomba, Machinga and Mangochi, the paper explores the reformulation of nine cultural practices as a preventive measure against HIV. The study reveals that cultural practices that involve sexual acts for completion are mediated through condoms and HIV tests. The study also shows that traditional herbs known for healing ailments are repurposed to symbolise sexual acts. We conclude that the idea of repurposing offers an avenue in which initiation and cleansing rites that involve sexual acts are replaced by other semiotics such as a traditional medicine called mtela. We also conclude that the modifications to cultural practices do not indicate complete abandonment of associated traditions, rather, they constitute the renegotiation of cultural practices and meanings associated with particular rites of passage. Lastly, we propose that a comprehensive prevention programme needs to be part of a wider national HIV-prevention effort combining a women and child rights and empowerment agenda and, critically, lifestyle lessons in a process of cultural renegotiation.

  3. 针灸配合整脊手法在腰椎间盘突出症治疗中的临床疗效观察%The clinical efficacy of acupuncture and chiropractic techniques in the treatment of lumbar disc herniation

    Institute of Scientific and Technical Information of China (English)

    肖宏; 肖峰; 郭筱秋

    2013-01-01

    Objective To study the clinical efficacy of acupuncture and chiropractic techniques in the treatment of lumbar disc herniation. Methods 90 cases patients with lumbar disc herniation from January 2010 to April 2013 in our hospital were studied. They were randomly divided into experimental and control groups, 45 patients in each group. Control group were used chiropractic treatment to patients, the experimental group were used acupuncture and chiropractic techniques to treat the patient. Results After treatment, the symptom scores of the experimental group was significantly higher than the control group, the clinical total effective rate of the experimental group patients was significantly higher than the control group. Conclusion The clinical efficacy of acupuncture and chiropractic techniques in the treatment of lumbar disc herniation is significant, worthy of clinical application.%目的:研究针灸配合整脊手法在腰椎间盘突出症治疗中的临床疗效。方法将2010年1月-2013年4月我院90例腰椎间盘突出患者随机分为两组各45例。对照组采用整脊疗法,实验组采用针灸配合整脊手法。结果治疗后,实验组各项症状评分明显高于对照组,临床总有效率明显高于对照组,组间差异有统计学意义。结论针灸配合整脊手法在腰椎间盘突出症治疗中的临床疗效显著,值得推广应用。

  4. 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

  5. Does Professional Development Change Teaching Practice? Results from a Three-Year Study.

    Science.gov (United States)

    Porter, Andrew C.; Garet, Michael S.; Desimone, Laura; Yoon, Kwang Suk; Birman, Beatrice F.

    This report, the third in a series of reports from the longitudinal evaluation of the Eisenhower Professional Development Program, examines the effects of professional development on improving classroom teaching practice. The Eisenhower Professional Development Program, Title II of the Elementary and Secondary Education Act, is the federal…

  6. Alitretinoin and acitretin in severe chronic hand eczema; results from a retrospective daily practice study

    NARCIS (Netherlands)

    Politiek, Klaziena; Christoffers, Wietske Andrea; Coenraads, Pieter-Jan; Schuttelaar, Marie-Louise Anna

    2016-01-01

    Acitretin has been used off-label for years to treat chronic hand eczema, but acitretin is less often prescribed as alitretinoine was approved. This study evaluates both retinoids in a daily practice cohort of patients with severe chronic hand eczema in terms of drug survival and reasons for discont

  7. Building pathology in the Netherlands – main problems and results through research and practice.

    NARCIS (Netherlands)

    Thomsen, A.F.

    2014-01-01

    This report is dedicated to the main problems of building pathologies in the Netherlands and the main solutions through research and practice as questioned by the CIB W086 Building Pathology Commission for its 2014 meeting in Sao Paulo, Brazil. Objective is to contribute to the Research Roadmap 2014

  8. Cerebral aneurysm treatment in India: Results of a national survey regarding practice patterns in India

    Directory of Open Access Journals (Sweden)

    Sudheer Ambekar

    2016-01-01

    Conclusion: Our study demonstrates the prevailing practice patterns in the management of IAs in India. Surgical clipping is the preferred treatment of choice for anterior circulation aneurysms and EVT for aneurysms along the posterior circulation. Corticosteroids and prophylactic "triple-H" therapy are still used by a large proportion of physicians.

  9. Distance Education Practices: Summary Results of the AACRAO February 2015 60 Second Survey

    Science.gov (United States)

    American Association of Collegiate Registrars and Admissions Officers (AACRAO), 2015

    2015-01-01

    The February 2015 American Association of Collegiate Registrars and Admissions Officers (AACRAO) "60 Second Survey" asked respondents to identify whether or not their institution offers distance education, and if so, to answer additional questions about distance education course practices. The survey received 838 unique institutional…

  10. FERPA Training Practices: Results of the AACRAO January 2016 60 Second Survey

    Science.gov (United States)

    American Association of Collegiate Registrars and Admissions Officers (AACRAO), 2016

    2016-01-01

    The January 2016 American Association of Collegiate Registrars and Admissions Officers (AACRAO) "60 Second Survey" focused on institutional Family Educational Rights and Privacy Act (FERPA) training practices and measuring the level of interest in an AACRAO-developed online FERPA training module. The survey received 878 usable responses.…

  11. Results of the experience with the use of varenicline in daily practice using intensive monitoring

    NARCIS (Netherlands)

    Oosterhuis, I.; Harmark, L.; Van Puijenbroek, E.

    2013-01-01

    Background: Although a concise overview of Adverse Drug Reactions (ADRs) of varenicline is known, little is known about the time related information about ADRs of varenicline such as for example latencies. Objectives: To gain insight in the experience and safety of varenicline in daily practice as r

  12. The place of female sexual dysfunction in the urological practice : Results of a Dutch Survey

    NARCIS (Netherlands)

    Bekker, Milou; Beck, Jacky; Putter, Hein; van Driel, Mels; Pelger, Rob; Nijeholt, August Lycklama A.; Elzevier, Henk

    2009-01-01

    Introduction. Female sexual dysfunction (FSD) is a highly prevalent and often underestimated problem. There is a strong association between urological complaints and FSD. Aims. The purpose of this survey was to evaluate how Dutch urologists address FSD in their daily practice. Methods. We performed

  13. [Benchmarking projects examining patient care in Germany: methods of analysis, survey results, and best practice].

    Science.gov (United States)

    Blumenstock, Gunnar; Fischer, Imma; de Cruppé, Werner; Geraedts, Max; Selbmann, Hans-Konrad

    2011-01-01

    A survey among 232 German health care organisations addressed benchmarking projects in patient care. 53 projects were reported and analysed using a benchmarking development scheme and a list of criteria. None of the projects satisfied all the criteria. Rather, examples of best practice for single aspects have been identified.

  14. Research on Chiropractic Manipulation for Small Joint Disorder of Thoracic Vertebrae%整脊手法治疗胸椎小关节紊乱的临床研究

    Institute of Scientific and Technical Information of China (English)

    陈扬声; 黄飞麒; 赵晓

    2013-01-01

    Objective: To investigate the efficacy of treating thoracodorsal pain caused by small joint disorder of thoracic vertebrae with chiropractic manipulation. Methods: According to the different incidence of thoracic segments, adopted a different approach for corrective treatment. Results: In all cases, the total effective rate was 97%. Conclusion: The proper and reasonable use of chiroprac-tic manipulation can quickly relieve the symptoms and signs of small joint disorder of thoracic vertebrae and receive a good result.%  目的:探讨整脊手法纠正胸椎小关节紊乱所致的胸背痛的临床疗效。方法:根据胸椎发病节段的不同,采用不同的手法进行矫正治疗。结果:本组病例总有效率达97%。结论:恰当运用合理的整脊复位手法,可迅速解除胸椎小关节紊乱的症状和体征,收到良好效果。

  15. KINEMATIC ANALYSIS OF THE POSTERIOR ELEMENT OF LUMBAR SPINE IN ROTATORY CHIROPRACTIC

    Institute of Scientific and Technical Information of China (English)

    侯筱魁; 董凡; 戴克戎; 汤荣光; 魏晋兵

    1993-01-01

    Rotatory chiropractic is one of the key manipulations in the treatment of low-er backache. The present paper reports the kinematic changes in the posterior element oflumbar spine during rotatory manipulation, using motion segments of lumbar spine fromfresh cadavers as specimens and an electromechanical system for the measurements. Theanalysis of the angle-displacement curve and the load-angle curve reveals that rotatorychiropractic is a kind of complicated 3-D. 6-degree-of-freedom motion. Correctmanipulation may adjust the volume of the nerve root canal and relax the articulation be-tween the upper and lower joint processes so as to relieve the adhesion of the enclosuresin the nerve root canal and relieve the adhesion of the facet joints, and bring aboutimprovement of local circulation and amelioration of symptoms.

  16. Understanding CMMI Measurement Capabilities & Impact on Performance: Results from the 2007 SEI State of the Measurement Practice Survey

    Science.gov (United States)

    2016-06-30

    Practice Survey New this year • Screening question to identify respondents whose organizations develop software but rarely if ever do measurement...Questions about — Resources & infrastructure devoted to measurement — Practices to ensure data quality & integrity — Value added by doing measurement — The...University Project & Organizational Measurement Results Reported2 Business Growth & Profitability ML1&DK ML2 ML3 ML4&5 N = 70 N = 55 N = 45 N = 51

  17. Use of osteopathic or chiropractic services among people with back pain: a UK population survey.

    Science.gov (United States)

    Ong, Chi-Keong; Doll, Helen; Bodeker, Gerard; Stewart-Brown, Sarah

    2004-05-01

    Questionnaires covering health and the use of complementary, alternative and conventional health services were mailed to a random sample of 14 868 adults aged 18-64 years living in four counties of England in 1997. The present study examined the use of osteopathy/chiropractic among the 15% (n = 1377) of respondents reporting back pain. Osteopaths/chiropractors were seen by 13.4% (n = 184) of respondents with back pain during the past 3 months compared with 9.8% (n = 135) who consulted physiotherapists. The presence of back pain and non-manual social class were the strongest predictors of consultation with both types of practitioner. Women, older respondents, non-smokers and those who exercised for 30 minutes at least once a week were more likely to use osteopathy/chiropractic. The only other significant predictor of physiotherapy use was desire for more physical exercise. While those reporting back pain had Short-Form 36 (SF-36) scores suggesting very significant levels ofdisability, respondents with back pain who consulted osteopaths/chiropractors reported better health in all dimensions of the SF-36 than those using physiotherapy services. Although they reported worse pain scores than people not consulting any practitioners, their mental health, physical functioning, energy and health perception were better. It is impossible to disentangle cause and effect in this cross-sectional study, but the data suggest that people who can afford to pay are more likely to choose osteopath/chiropractor treatments than physiotherapy. The possibility that osteopath/chiropractor treatment has a generalised positive effect on health, allowing people with back pain to function better than those not receiving such treatment, warrants further investigation.

  18. [Pharmacists' Behavior in Clinical Practice: Results from a Questionnaire Survey of Pharmacy Students].

    Science.gov (United States)

    Nakada, Akiko; Akagawa, Keiko; Yamamoto, Hitomi; Kato, Yasuhisa; Yamamoto, Toshinori

    2016-01-01

    A questionnaire survey was performed to obtain pharmacy students' impressions of pharmacists' behavior, to classify these based on professionalism, and to analyze the relationship between these experiences and students' satisfaction with their clinical practice in Japan. The questionnaire was answered by 327 5th-year pharmacy school students upon completing clinical practice at community pharmacies from 2011 to 2012. They rated their satisfaction with their clinical practice using a 6-point Likert scale, and provided descriptions of their experience such as, "This health provider is professional", or "What a great person he/she is as a health provider". We counted the words and then categorized the responses into 10 traits, as defined by the American Pharmaceutical Association Academy of Students of Pharmacy-American Association of Colleges of Pharmacy, Council of Deans Task Force on Professionalism 1999, using text mining. We analyzed the relationship between their experiences with respectful persons, and satisfaction, using the Mann-Whitney U-test (significance level<0.05). Most students (337 of 364, 92.6%) reported experiences with respectful health providers. These students experienced significantly more satisfaction than did other students (p<0.001). We analyzed 343 sentences written by 261 students, using text mining analysis after excluding unsuitable responses. The word most used was "patient" (121 times). Many students noted their impression that the pharmacists had answered patients' questions. Of the 10 trait categories, "professional knowledge and skills" was mentioned most often (151 students).

  19. Results of ultrasonic disintegration of sewage sludge in practice; Ergebnisse des Praxiseinsatzes der Schlammdesintegration mittels Ultraschall

    Energy Technology Data Exchange (ETDEWEB)

    Friedrich, E. [IWE-Ingenieurgesellschaft fuer Wasser und Entsorgung mbH, Radebeul (Germany); Friedrich, H. [Fraunhofer-Institut fuer Keramische Technologien und Sinterwerkstoffe (IKTS), Dresden (Germany); Hielscher, H. [Hielscher GmbH, Teltow (Germany)

    1999-07-01

    Using high-performance ultrasonic sludge disintegration in different stages of sewage and sludge treatment is found to be an innovative approach for reducing the accruing amounts of sewage sludge in terms of both mass and volume. By means of practical tests with sludge disintegration at sewage treatment plants, its effects are demonstrated. (orig.) [German] Der Einsatz einer Hochleistungs-Ultraschalltechnik zur Schlammdesintegration in verschiedenen Stufen der Abwasser- und Schlammbehandlung zeigt sich als innovativer Loesungsweg zur weitestgehenden massenmaessigen sowie volumenmaessigen Minimierung des Klaerschlammanfalles. An Hand von Einsatzerprobungen der Desintegration in der Klaeranlagenpraxis werden die Effekte der Desintegration vorgestellt. (orig.)

  20. Colorectal cancer screening practices of primary care providers: results of a national survey in Malaysia.

    Science.gov (United States)

    Norwati, Daud; Harmy, Mohamed Yusoff; Norhayati, Mohd Noor; Amry, Abdul Rahim

    2014-01-01

    The incidence of colorectal cancer has been increasing in many Asian countries including Malaysia during the past few decades. A physician recommendation has been shown to be a major factor that motivates patients to undergo screening. The present study objectives were to describe the practice of colorectal cancer screening by primary care providers in Malaysia and to determine the barriers for not following recommendations. In this cross sectional study involving 132 primary care providers from 44 Primary Care clinics in West Malaysia, self-administered questionnaires which consisted of demographic data, qualification, background on the primary care clinic, practices on colorectal cancer screening and barriers to colorectal cancer screening were distributed. A total of 116 primary care providers responded making a response rate of 87.9%. About 21% recommended faecal occult blood test (FOBT) in more than 50% of their patients who were eligible. The most common barrier was "unavailability of the test". The two most common patient factors are "patient in a hurry" and "poor patient awareness". This study indicates that colorectal cancer preventive activities among primary care providers are still poor in Malaysia. This may be related to the low availability of the test in the primary care setting and poor awareness and understanding of the importance of colorectal cancer screening among patients. More awareness programmes are required for the public. In addition, primary care providers should be kept abreast with the latest recommendations and policy makers need to improve colorectal cancer screening services in health clinics.

  1. The effect of quality management practices on operational and business results in the petroleum industry in Iran

    Science.gov (United States)

    Mellat Parast, Mahour

    The trend toward globalization has challenged management thinking, organizational practices, and the ways companies interact with their customers and suppliers as well as with other segments of society. One such practice, Total Quality Management (TQM), has emerged as a management paradigm for enhancing organizational performance and profitability, to the extent that it has been regarded as "the second industrial revolution" (Kanji, 1990). Despite extensive research in quality management, little empirical research has been done on this in an international context, especially in the Middle East. This study attempts to investigate: (1) the relationship among quality management constructs based on the Malcolm Baldrige National Quality Award; and (2) the effect of quality management practices on operational and business results in the petroleum industry. A validated and reliable survey instrument was used for the study to collect data from 31 project managers/consultants in the petroleum industry in Iran. The results of the correlation analysis show that top management support is the major driver of quality management, which significantly correlates with other quality management practices. It was also found that customer orientation is not significantly correlated with external quality results (profitability). A regression analysis indicated top management support, employee training, and employee involvement as the three statistically significant variables in explaining the variability in internal quality results. Furthermore, it was found that internal quality results was statistically significant in explaining the variability of external quality results.

  2. 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

  3. Risk management policies and practices regarding radio frequency electromagnetic fields: results from a WHO survey

    Science.gov (United States)

    Dhungel, Amit; Zmirou-Navier, Denis; van Deventer, Emilie

    2015-01-01

    This study aims to describe current risk management practices and policies across the world in relation to personal exposures from devices emitting radiofrequency fields, environmental exposures from fixed installations and exposures in the work environment. Data from 86 countries representing all WHO regions were collected through a survey. The majority of countries (76.8 %) had set exposure limits for mobile devices, almost all (90.7 %) had set public exposure limits for fixed installations and 76.5 % had specified exposure limits for personnel in occupational settings. A number of other policies had been implemented at the national level, ranging from information provisions on how to reduce personal exposures and restrictions of usage for certain populations, such as children or pregnant women to prevention of access around base stations. This study suggests that countries with higher mobile subscriptions tend to have set radiofrequency exposure limits for mobile devices and to have provisions on exposure measurements about fixed installations. PMID:25394650

  4. Chronic disease management in general practice: results from a national study.

    LENUS (Irish Health Repository)

    Darker, C

    2012-04-01

    The aim of this study was to provide baseline data on chronic disease management (CDM) provision in Irish general practice (GP). The survey instrument was previously used in a study of primary care physicians in 11 countries, thus allowing international comparisons. The response rate was 72% (380\\/527).The majority of GPs (240\\/380; 63%) reported significant changes are needed in our health care system to make CDM work better. Small numbers of routine clinical audits are being performed (95\\/380; 25%). Irish GPs use evidence based guidelines for treatment of diabetes (267\\/380; 71%), asthma \\/ COPD (279\\/380; 74%) and hypertension (297\\/380; 79%), to the same extent as international counterparts. Barriers to delivering chronic care include increased workload (379\\/380; 99%), lack of appropriate funding (286\\/380; 76%), with GPs interested in targeted payments (244\\/380; 68%). This study provides baseline data to assess future changes in CDM.

  5. Empirical Evidence on the Link Between Compliance with Governance of Best Practice and Firms' Operating Results

    Directory of Open Access Journals (Sweden)

    Tek B. Lama

    2012-12-01

    Full Text Available This study provides robust evidence in support of the agency theory argument that corporate governancematters for a firm’s operating performance. Using the corporate governance ratings as the governance proxyfrom Horwath 2006 Corporate Governance Report (mid-sized Australian ASX companies andMid-CapCorporate Governance Report 2007 (The University of Newcastle 2006; 2007, I examine 60 sample firms toreveal that a firm’s governance is positively and significantly related to firm performance as measured by returnon equity, earning yield and return on assets. This study extends the findings of these two reports which founda disturbing trend in the corporate governance practice of Australian mid-cap companies – both a decrease incompanies with excellent corporate governance, and an increase in companies with significant corporategovernance deficiencies. The findings of this study suggest that those mid-size companies who have allowedcorporate governance to deteriorate have adversely affected their shareholder returns.

  6. 'Bolam' to 'Montgomery' is result of evolutionary change of medical practice towards 'patient-centred care'.

    Science.gov (United States)

    Lee, Albert

    2017-01-01

    The Supreme Court judgement in 'Montgomery v Lanarkshire Health Board' has caused a change in the law concerning the duty of doctors on disclosure of information to patients regarding risks. The law now requires a doctor to take reasonable care to ensure that the patient is aware of any material risks involved in any recommended treatment, and of any reasonable alternative or variant treatments. Are doctors totally removed from the protective shield even if the practice is accepted by a reasonable body of medical opinion previously laid down by 'Bolam' with the recent Supreme Court decision in the 'Montgomery' case? This paper questions whether the 'Bolam' principle needs to be discarded or re-interpreted in the modern context of health care. Adopting 'patient-centred' care to unfold the 'significant risks' attached to patients would align with the evolving changes in medical law. It should be the changing context of health care driving the evolving change of law.

  7. Chiropractor perceptions and practices regarding interprofessional service delivery in the Danish primary care context

    DEFF Research Database (Denmark)

    Myburgh, Corrie; Christensen, Henrik Wulff; Fogh-Schultz, Anders Lyck

    2014-01-01

    For the past 20 years, chiropractors have enjoyed access to the Danish health care system and have been free to build integrated health care delivery partnerships. An electronic survey of chiropractic clinics around Denmark was conducted in order to observe interprofessional practice trends. From...... practice to be important and as a group, perceive themselves to be offering such models of service provision. Medical practitioners are perceived as desirable, but under utilized partners....

  8. [Inhuman practices in gynecology in national socialism and its victims. Study of concrete results].

    Science.gov (United States)

    Stauber, M; Kindermann, G

    1994-08-01

    In our opinion German gynaecology has failed to adequately face what came to pass during the Nazi period. This can be proved objectively, for there is no evidence that, after 1945, gynaecology had in any way cared to take notice--either thermatically or medically--of the thousands of victims of inhuman practices such as forced termination of pregnancy, compulsory sterilisation and the like. During the past 50 years recollections of enforced sterilisations, compulsory abortions, deliberate and hence criminal negligence and problematic approaches in research and teaching were almost completely banished from the area of conscious awareness and largely suppressed or silently ignored. Most of the medical directors of Departments of Gynaecology of German universities shared this view whenever they were questioned on the connections between gynaecology and Nazism. Now that two generations have passed it seems possible to examine and explore with less guilt feelings and shame the immensely fateful rôle of gynaecology in that context. Accent should be on the fate of the victims of that period. To bring back these events to memory, however, does not permit to conceal the part played by the physicians committing of these inhuman Nazi crimes. Data collected from a psychosomatically oriented examination of victims exemplify that to concretely recall gynaecology during Nazism a1-so offers a chance in several respects. One of the possibilities in this context is to signal "late apology" and regret to patients who had been victims, in one's own area of work, after one has psychically worked over their fate. Besides, a gynaecological-psychosomatic expertise will help e.g. that compulsorily sterilised women are granted financial aid that has at long last become a legal possibility and can be applied for since 1980. However, the relevant patient records do show very clearly that the inhuman practice of gynaecology during the so-called "Third Reich" was not only a collective problem

  9. Comment on Pearl: Practical implications of theoretical results for causal mediation analysis.

    Science.gov (United States)

    Imai, Kosuke; Keele, Luke; Tingley, Dustin; Yamamoto, Teppei

    2014-12-01

    Mediation analysis has been extensively applied in psychological and other social science research. A number of methodologists have recently developed a formal theoretical framework for mediation analysis from a modern causal inference perspective. In Imai, Keele, and Tingley (2010), we have offered such an approach to causal mediation analysis that formalizes identification, estimation, and sensitivity analysis in a single framework. This approach has been used by a number of substantive researchers, and in subsequent work we have also further extended it to more complex settings and developed new research designs. In an insightful article, Pearl (2014) proposed an alternative approach that is based on a set of assumptions weaker than ours. In this comment, we demonstrate that the theoretical differences between our identification assumptions and his alternative conditions are likely to be of little practical relevance in the substantive research settings faced by most psychologists and other social scientists. We also show that our proposed estimation algorithms can be easily applied in the situations discussed in Pearl (2014). The methods discussed in this comment and many more are implemented via mediation, an open-source software (Tingley, Yamamoto, Hirose, Keele, & Imai, 2013).

  10. ST-segment Elevation Myocardial Infarction Resulting from Stent Thrombosis in Contemporary Real-World Practice.

    Science.gov (United States)

    Kanei, Yumiko; Nallu, Kishore; Makker, Parth; Behuria, Supreeti; Fox, John

    2017-03-01

    Stent thrombosis (ST) is a rare but devastating complication after percutaneous coronary intervention. Newer generation drug-eluting stents (DES) and newer antiplatelet therapies have been shown to decrease the incidence of ST, but we continue to observe ST-segment elevation myocardial infarction (STEMI) due to ST in contemporary practice. A retrospective analysis of 527 patients who presented with STEMI was performed; 57 patients (11%) with angiographically confirmed ST were compared with the patients with STEMI due to de novo lesion. The type of previous stent, the timing of ST, and the use of antiplatelet therapy were reviewed in patients with ST. Patients with ST had higher prevalence of comorbid conditions, such as hypertension, diabetes mellitus, and coronary artery disease, and had lower left ventricular ejection fraction (37 ± 5 vs. 44 ± 16%, p = 0.0011). There was no difference in in-hospital mortality (2 vs. 4%, p = 0.7082). ST was seen most commonly as "very late" (56%), and with previous second-generation DES (40%). Eighty-two percent of patients among early ST, compared with 22% of patients with very late ST were on dual antiplatelet therapy (DAPT). In 12% of patients, ST happened after DAPT was stopped by physician for procedures. ST is seen in a variety of clinical settings with the most common presentation being very late ST and in second-generation DES, which most likely represent the growing population with previous second-generation stents.

  11. Control of the Maya AUV in the vertical and horizontal planes: Theory and practical results

    Digital Repository Service at National Institute of Oceanography (India)

    Maurya, P.; Desa, E; Pascoal, A.; Barros, E; Navelkar, G.S.; Madhan, R.; Mascarenhas, A.A.M.Q.; Prabhudesai, S.; Afzulpurkar, S.; Gouveia, Ashwin; Naroji, S.; Sebastiao, l.

    model of the AUV obtained by resorting to analytical and semi-empirical methods. Details of system implementation are given and the results of tests with the prototype vehicle are discussed. The paper concludes with a discussion of the interaction...

  12. Selling falsehoods? A cross-sectional study of Canadian naturopathy, homeopathy, chiropractic and acupuncture clinic website claims relating to allergy and asthma

    Science.gov (United States)

    Murdoch, Blake; Carr, Stuart; Caulfield, Timothy

    2016-01-01

    Objective To identify the frequency and qualitative characteristics of marketing claims made by Canadian chiropractors, naturopaths, homeopaths and acupuncturists relating to the diagnosis and treatment of allergy and asthma. Design Cross-sectional study. Setting Canada. Data set 392 chiropractic, naturopathic, homeopathic and acupuncture clinic websites located in 10 of the largest metropolitan areas in Canada, as identified using 400 Google search results. Duplicates were not excluded from data analysis. Main outcome measures Mention of allergy, sensitivity or asthma, claim of ability to diagnose allergy, sensitivity or asthma, claim of ability to treat allergy, sensitivity or asthma, and claim of allergy, sensitivity or asthma treatment efficacy. Tests and treatments promoted were noted as qualitative examples. Results Naturopath clinic websites have the highest rates of advertising at least one of diagnosis, treatment or efficacy for allergy or sensitivity (85%) and asthma (64%), followed by acupuncturists (68% and 53%, respectively), homeopaths (60% and 54%) and chiropractors (33% and 38%). Search results from Vancouver, British Columbia were most likely to advertise at least one of diagnosis, treatment or efficacy for allergy or sensitivity (72.5%) and asthma (62.5%), and results from London, Ontario were least likely (50% and 40%, respectively). Of the interventions advertised, few are scientifically supported; the majority lack evidence of efficacy, and some are potentially harmful. Conclusions The majority of alternative healthcare clinics studied advertised interventions for allergy and asthma. Many offerings are unproven. A policy response may be warranted in order to safeguard the public interest. PMID:27986744

  13. Environmental strategies and their motives and results in Slovenian business practice

    Directory of Open Access Journals (Sweden)

    Barbara Čater

    2009-11-01

    Full Text Available The results of a survey on 153 Slovenian manufacturing companies show that companies implement environmental strategies primarily as a refl ection of the commitment of their top management, followed by public concern, regulatory forces and expected competitive advantage. They report a relatively high level of implementation of the corporate environmental strategy while, among functional strategies, environmental issues are most commonly included in the production and marketing strategies, followed by purchasing and personnel strategies. Large companies develop and execute environmental strategies to a greater extent than small companies. The results also reveal a positive but very weak relationship between environmental strategies and company performance.

  14. Colonoscopy results are not enhanced by use of magnet endoguide in specialist practice

    DEFF Research Database (Denmark)

    Bak-Christensen, Anders; Knudsen, Elisabeth; Hendel, Jakob;

    2013-01-01

    screening. UPD has been proposed as a tool for optimization of results and reduction of patient discomfort. In this study, we aimed to qualify the debate by examining the success rate and patient discomfort in an unselected colonoscopy population referred to specialist clinics with experienced investigators...

  15. Incentive Pay Programs Do Not Affect Teacher Motivation or Reported Practices: Results from Three Randomized Studies

    Science.gov (United States)

    Yuan, Kun; Le, Vi-Nhuan; McCaffrey, Daniel F.; Marsh, Julie A.; Hamilton, Laura S.; Stecher, Brian M.; Springer, Matthew G.

    2013-01-01

    This study drew on teacher survey responses from randomized experiments exploring three different pay-for-performance programs to examine the extent to which these programs motivated teachers to improve student achievement and the impact of such programs on teachers' instruction, number of hours worked, job stress, and collegiality. Results showed…

  16. Cardiogenetic counseling : An overview of results and daily practice after 15 years experience

    NARCIS (Netherlands)

    Hofman, Nynke; Kolder, Iris; Alders, Marielle; Mannens, Marcel; Tan, Hanno; Van Langen, Irene; Wilde, Arthur

    2012-01-01

    Introduction: We evaluated the results of 15 years of cardiogenetic counseling in the Academic Medical Center (AMC). Methods: We retrospectively analyzed all families who were counseled between 1996 and 2011 with a suspected inherited arrhythmia syndrome including primary electrical diseases, cardio

  17. 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;

    2012-01-01

    OBJECTIVE: The musculoskeletal system is a common but often overlooked cause of chest pain. The purpose of the present study is to evaluate the relative effectiveness of 2 treatment approaches for acute musculoskeletal chest pain: (1) chiropractic treatment that included spinal manipulation and (2......) 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...

  18. Comparison of pattern VEP results acquired using CRT and TFT stimulators in the clinical practice.

    Science.gov (United States)

    Nagy, Balázs Vince; Gémesi, Szabolcs; Heller, Dávid; Magyar, András; Farkas, Agnes; Abrahám, György; Varsányi, Balázs

    2011-06-01

    There are several electrophysiological systems available commercially. Usually, control groups are required to compare their results, due to the differences between display types. Our aim was to examine the differences between CRT and LCD/TFT stimulators used in pattern VEP responses performed according to the ISCEV standards. We also aimed to check different contrast values toward thresholds. In order to obtain more precise results, we intended to measure the intensity and temporal response characteristics of the monitors with photometric methods. To record VEP signals, a Roland RetiPort electrophysiological system was used. The pattern VEP tests were carried out according to ISCEV protocols on a CRT and a TFT monitor consecutively. Achromatic checkerboard pattern was used at three different contrast levels (maximal, 75, 25%) using 1° and 15' check sizes. Both CRT and TFT displays were luminance and contrast matched, according to the gamma functions based on measurements at several DAC values. Monitor-specific luminance parameters were measured by means of spectroradiometric instruments. Temporal differences between the displays' electronic and radiometric signals were measured with a device specifically built for the purpose. We tested six healthy control subjects with visual acuity of at least 20/20. The tests were performed on each subject three times on different days. We found significant temporal differences between the CRT and the LCD monitors at all contrast levels and spatial frequencies. In average, the latency times were 9.0 ms (±3.3 ms) longer with the TFT stimulator. This value is in accordance with the average of the measured TFT input-output temporal difference values (10.1 ± 2.2 ms). According to our findings, measuring the temporal parameters of the TFT monitor with an adequately calibrated measurement setup and correcting the VEP data with the resulting values, the VEP signals obtained with different display types can be transformed to be

  19. Evaluation of Anti-Nuclear antibody test results in clinical practice

    Directory of Open Access Journals (Sweden)

    Nevreste Çelikbilek

    2015-06-01

    Full Text Available Objective: Aim of this study is to evaluate anti-nuclear antibody (ANA test results obtained between 2009 and 2011. Methods: Of a totally 5068 cases tested for ANA by indirect immunofluorescence method (IIFA, randomly chosen 982 ANA-positive cases were reviewed in terms of gender, level and pattern of fluorescence, anti-dsDNA (anti-double stranded DNA and anti-extractable nuclear antigen (ENA profile. Anti-dsDNA levels and anti-ENA profiles were determined by enzyme linked immune assay (ELISA and immune-blotting (IB, respectively. Results: Sex distribution of ANA positive patients was determined as 756 (77% females and 226 (23% males. Fifty per cent of the cases were from rheumatology department, 20% from gastroenterology and 30% from other units. Fluorescence levels were considered borderline or weak positive in 62.6% of the samples. The most frequent patterns were homogeneous (23%, speckled (22%, homogeneous-speckled (15.5% and nucleolar (13.5%. Anti-dsDNA were studied in 759 ANA positive patients and 66 (8.7% samples were found positive, being 44 of them (68.8% with homogeneous pattern and the rest with speckled, nucleolar, nuclear dots, centromeric or midbody patterns. Totally 131 (31.6% of 414 samples studied for anti-ENA profile were found positive. The first four frequent profiles were SSA (34.4%, SSA-SSB (16.8%, Scl70 (16% and Sm/RNP (9.2%. Conclusion: Our results are similar with the current related literature. It is known that autoantibodies can be detectable before clinical symptoms being apparent, especially in SLE. Therefore, borderline or weak fluorescence levels should also be reported and the patients having them should be followed-up carefully. J Microbiol Infect Dis 2015;5(2: 63-68

  20. [Practice report: the process-based indicator dashboard. Visualising quality assurance results in standardised processes].

    Science.gov (United States)

    Petzold, Thomas; Hertzschuch, Diana; Elchlep, Frank; Eberlein-Gonska, Maria

    2014-01-01

    Process management (PM) is a valuable method for the systematic analysis and structural optimisation of the quality and safety of clinical treatment. PM requires a high motivation and willingness to implement changes of both employees and management. Definition of quality indicators is required to systematically measure the quality of the specified processes. One way to represent comparable quality results is the use of quality indicators of the external quality assurance in accordance with Sect. 137 SGB V—a method which the Federal Joint Committee (GBA) and the institutions commissioned by the GBA have employed and consistently enhanced for more than ten years. Information on the quality of inpatient treatment is available for 30 defined subjects throughout Germany. The combination of specified processes with quality indicators is beneficial for the information of employees. A process-based indicator dashboard provides essential information about the treatment process. These can be used for process analysis. In a continuous consideration of these indicator results values can be determined and errors will be remedied quickly. If due consideration is given to these indicators, they can be used for benchmarking to identify potential process improvements.

  1. PV Performance Modeling Methods and Practices: Results from the 4th PV Performance Modeling Collaborative Workshop.

    Energy Technology Data Exchange (ETDEWEB)

    Stein, Joshua [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2017-03-01

    In 2014, the IEA PVPS Task 13 added the PVPMC as a formal activity to its technical work plan for 2014-2017. The goal of this activity is to expand the reach of the PVPMC to a broader international audience and help to reduce PV performance modeling uncertainties worldwide. One of the main deliverables of this activity is to host one or more PVPMC workshops outside the US to foster more international participation within this collaborative group. This report reviews the results of the first in a series of these joint IEA PVPS Task 13/PVPMC workshops. The 4th PV Performance Modeling Collaborative Workshop was held in Cologne, Germany at the headquarters of TÜV Rheinland on October 22-23, 2015.

  2. 穴位注射结合捏脊疗法治疗阳虚型不寐临床观察%Acupoint Injection Combined with Chiropractic Therapy in the Treatment of Insomnia with Yang Deficiency Type

    Institute of Scientific and Technical Information of China (English)

    苏晶; 高潇; 袁洪超; 邢艳丽; 董施秋

    2014-01-01

    目的:观察穴位注射结合捏脊疗法治疗阳虚型不寐临床疗效。方法:将符合纳入标准的70例患者随机分为3组,治疗组采用刺五加注射液风府穴穴位注射结合捏脊;针刺组采用常规取穴;对照组采用艾司唑仑口服。结果:治疗组总有效率(95.83%)高于针刺组(82.60%)及对照组(78.26%)(P<0.05)。与本组治疗前比较,三组均可降低PSQI评分( P<0.05);与针刺组和对照组治疗后比较,治疗组PSQI评分显著降低,具有统计学差异( P<0.01)。结论:刺五加注射液风府穴穴位注射结合捏脊疗法能有效改善阳虚失眠患者睡眠状况。%Objective:To observe the curative effect of the combined treatment of Fengfu point injection with ac -anthopanax and chiropractic therapy on Yang deficiency insomnia .Methods:70 patients were randomly divid-ed into three groups ,in the treatment group 24 patients received acupoint injection of Acanthopanax at Feng-fupoint and Chiropractic therapy ,in the acupuncture group 23 patients received conventional acupuncture ther-apy,in the control group 23 patients had estazolam tablets .Results:The total effective rate of the treatment group was significantly higher than the acupuncture group and the control group ( P<0 .05 ) .Conclusion:The clinical research results show that the combined treatment of point injection and chiropractic therapy can dra -matically boost the sleep quality of patients with Yang deficiency insomnia .

  3. Survey results of the training, nutrition, and mental preparation of triathletes: practical implications of findings.

    Science.gov (United States)

    Dolan, Shawn H; Houston, Melinda; Martin, Scott B

    2011-07-01

    Although triathlon is growing in popularity at a remarkable rate, it has not been extensively studied. The aims of this research were to identify preparation strategies used by triathletes and to categorize these strategies according to gender and consultation with triathlon coaches. Survey data collected from 401 triathletes (207 males, 194 females) revealed training, nutritional, and mental preparation habits. Most participants engaged in strength training, consumed food and/or fluids during and after training, set training and competition goals, and applied mental preparation strategies during training and the hour before racing. Water was the most commonly consumed fluid; positive self-talk was the most used mental strategy. Participants were more likely to consult with a triathlon coach than a nutrition or sport psychology professional. Athletes with more years of experience in triathlon and those competing in longer distances were more likely to consult a triathlon coach. Female triathletes were more likely than male triathletes to train with others, use mental preparation strategies, and report feeling anxious before competitions. More male triathletes reported using nutritional supplements during training than their female counterparts. These findings add to the limited research base on triathletes' training habits, and hopefully will help guide practitioners who work with this group. The results provide guidance for collaborative efforts among training, nutrition, and mental health professionals to best support triathletes.

  4. Consumer home refrigeration practices: results of a web-based survey.

    Science.gov (United States)

    Kosa, Katherine M; Cates, Sheryl C; Karns, Shawn; Godwin, Sandria L; Chambers, Delores

    2007-07-01

    To reduce bacterial growth and to ensure the quality and safety of food products, the U.S. Department of Agriculture and the U.S. Food and Drug Administration advise consumers to clean their refrigerators regularly, use a refrigerator thermometer, and keep refrigerator temperatures at 40 degrees F (4.4 degrees C) or below. We conducted a nationally representative Web-enabled survey (n = 2,060) to collect data on refrigerator thermometer ownership, home refrigerator temperatures, and the frequency of home refrigerator cleaning. We stratified the sample to provide results for pregnant women, older adults (60 years or older), and the remaining population. About half of all respondents had cleaned their refrigerators at least 1 month before the survey. Only 11% of all respondents had a thermometer in their refrigerator before the survey. Older adults (77.5%) were more likely than the remaining population (70.4%) to have their refrigerators at the recommended temperature (P refrigerator thermometers and to have their refrigerators at a recommended temperature (P refrigerator thermometer were more likely to have their refrigerators at the recommended temperature than were respondents who did not previously own a thermometer (P refrigerated foods at home.

  5. ARRESTING OF COMPLICATED HYPERTENSIVE CRISES IN THE PHYSICIAN’S PRACTICE: URAPIDIL VALUE AND STUDY RESULTS

    Directory of Open Access Journals (Sweden)

    G. P. Arutyunov

    2011-01-01

    Full Text Available Aim. To compare the efficacy and safety of urapidil (i/v solution 5 mg/ml in 5 and 10 ml ampoules and enalaprilat (i/v solution 1.25 mg/ml in 1 ml ampoules in the treatment of complicated hypertensive crises in patients with arterial hypertension, 1-3 degrees. Material and methods. Patients with complicated hypertensive crisis (n=70 were included into the comparative randomized study. Patients were randomized for treatment with urapidil (the initial dose 12.5 mg; if there was no effect after 15 minutes it was possible to re-infused urapidil 12.5 mg or enalaprilat (the initial dose 1.25 mg. The frequency of target blood pressure (BP achievement, BP and heart rate dynamics, as well as safety of treatment were evaluated in groups during 6 hours. Results. The frequency of target BP achievement in the urapidil treatment group was higher than this in enalaprilat group (96.7 vs 73.3%; p<0.001, for the first hour systolic BP (SBP in the urapidil group reduced from 210.5±13.6 to 157.8±8.3 mmHg (p<0.05, and diastolic BP (DBP - from 115.7±8.5 to 86.9±9.1 mmHg (p<0.05. In the enalaprilat group in the first hour SBP reduced from 208.1 to 182.5 mmHg (p<0.05, DBP — from 114.8 to 95.0 mmHg (p<0.05. During next 6 hours the urapidil group demonstrated longer lasting antihypertensive effect in comparison with enalaprilat. Both drugs did not have a significant effect on heart rate and showed no significant adverse events. In next 72 hours no one acute vascular event was registered in the patients of both groups. Conclusion. Urapidil is an effective and safe drug for arresting of complicated hypertensive crises. Its efficacy is not inferior to this of enalaprilat.

  6. Clinical research on treating discogenic low back pain by chiropractic manipulation%理筋整脊手法治疗椎间盘源性腰痛的临床研究

    Institute of Scientific and Technical Information of China (English)

    王冠

    2016-01-01

    Objective: To investigate clinical effects of chiropractic manipulation on discogenic low back pain. Methods: 160 subjects were randomly divided into two groups, 80 cases in each group. The experimental group received chiropractic manipulation; the control group was treated by traditional massage plus traction. Clinical effects and the VAS score in groups were compared. Results: The total efifciency in the experimental group was 97.5%, and in the control group was 71.25%, with a statistically signiifcant difference. VAS scores in groups were signally decreased, and those in the control group were lower (P<0.05). Conclusion: Chiropractic manipulation showed positive effects, with no adverse reaction, and was worthy of promotion.%目的:探讨理筋整脊手法治疗椎间盘源性腰痛的临床效果。方法:将160例患者完全随机分配入治疗组和对照组各80例。对照组采用传统推拿加牵引法治疗,治疗组采用理筋整脊手法治疗,对其临床疗效和VAS评分进行比较。结果:治疗组总有效率为97.5%,对照组总有效率为71.25%,差异具有明显统计学意义;治疗后两组VAS 评分较治疗前明显降低(P<0.05),且治疗组VAS评分低于对照组(P<0.05)。结论:理筋整脊手法治疗椎间盘源性腰痛疗效肯定,无不良反应,值得推广应用。

  7. Efficacy on Chiropractic Gun Combined with Chinese Massage Treating Lumbar Disc Herniation%美式脊椎矫正枪联合中医推拿治疗腰椎间盘突出症疗效

    Institute of Scientific and Technical Information of China (English)

    林健

    2013-01-01

    目的:观察美式脊椎矫正枪(整脊枪)联合中医推拿治疗腰椎间盘突出症的临床疗效。方法:76例腰椎间盘突出症患者随机分为治疗组和对照组各38例,治疗组采用整脊枪联合推拿治疗,对照组仅接受中医推拿治疗,观察两组临床疗效。结果:治疗组直腿抬高试验角度明显高于对照组(P<0.05);治疗组愈显率为89.47%,明显高于对照组的73.68%(P<0.05)。结论:整脊枪联合中医推拿治疗腰椎间盘突出症效果显著,值得临床推广应用。%Objective:To observe the clinical effect of American Spinal corrective gun (chiropractic gun) and Chinese massage treating lumbar disc herniation. Methods:76 cases of lumbar disc herniation were randomly divided into treatment group and control group with each of 38 cases, treat-ment group was treated with chiropractic gun and massage, control group only adopted Chinese massage, to observe the clinical efficacy of two groups. Results:Straight-leg raising test angle of treatment group was significantly higher than that of control group (P<0.05);effective rate of treat-ment group was 89.47%, significantly higher than that of control group by 73.68%(P<0.05). Conclusion:Effects of chiropractic gun combined with massage treating lumbar disc herniation are significant, being worthy of clinical promotion and application.

  8. 整脊治疗膝关节骨性关节炎急性期的疗效观察%Efficacy Observation on Acute Stage of Knee Osteoarthritis with Chiropractic Therapy

    Institute of Scientific and Technical Information of China (English)

    陈小砖; 陈淑惠

    2013-01-01

    Objective:To investigate the effects of chiropractic therapy on acute stage of knee osteoarthritis. Methods:60 cases of knee osteoarthritis in acute stage were randomly divided into treatment group and control group with each of 30 cases, treatment group received chiropractic and local conventional treatment on knee joint, control group with conventional manipulation treatment on knee joint, to evaluate the knee joint function, pain degree and curative effects of two groups after 3 months. Results:The total effective rate of treatment group was 90%, significantly higher than that of control group by 73.3%(P<0.05);improvements of pain degree and knee joint function in treatment group were better than those in control group (P<0.05). Conclusion:Chiropractic therapy significantly reduces the pain of osteoarthritis knee in acute stage, and improves the overall function of knee joint.%目的:探讨整脊疗法对膝关节骨性关节炎急性期的作用。方法:60例膝关节骨性关节炎急性期患者随机分为治疗组和对照组各30例,治疗组予整脊及膝关节局部常规手法治疗,对照组采用膝关节局部常规手法治疗,3个月后评价两组膝关节功能、疼痛度及疗效。结果:治疗组总有效率90.0%,明显高于对照组的73.3%(P<0.05);治疗组疼痛度及膝关节功能改善情况均优于对照组(P<0.05)。结论:整脊疗法明显减轻膝关节骨性关节炎急性期关节疼痛,改善膝关节整体功能。

  9. 醒脑开窍针法治疗卒中后抑郁症临床疗效%Clinical Effect of Acupuncture Combined with Chiropractic on Sequela of Apoplexy

    Institute of Scientific and Technical Information of China (English)

    贾军丽

    2015-01-01

    目的:分析醒脑开窍针法在中风后抑郁症的治疗中的应用效果。方法:2012年5月—2014年12月,我院共收治200例中风后抑郁症患者,按照随机的方式将其列入观察组与对照组,每组各为100例。两组均使用氟西汀进行临床治疗,在此基础上,观察组加用醒脑开窍针法。对比分析两组患者的治疗效果。结果:两组患者的治疗有效率和HAMD评分相比,观察组要显著优于对照组,比较差异有显著性的统计学的意义(P<0.05);两组患者均不存在明显的不良反应。结论:应用醒脑开窍针法对卒中后抑郁症进行治疗可以有效地提高治疗有效率,且不存在严重不良反应。%Objective: To observe the application and analyze the effect of acupuncture combined with chiropractic in the treatment of sequela of apoplexy. Methods: 200 cases with sequelae of stroke patients were selected randomly from our hospital and divided into two groups as an observation group and a control group,100 cases in each group. Patients in both groups were treated with acupuncture treatment, on the basis of this,patients in the observation group were given chiropractic treatment. The therapeutic effects of the two groups were compared. Results: After the treatment, the effective rate of the observation group (93%) was significantly better than that of the control group (75%), there was statistically significant difference (P<0.05) without adverse reactions in the patients in both groups during the treatment. Conclusion: The acupuncture combined with chiropractic has significant effect on sequela of apoplexy, which is, safe. So it is worthy of promotion.

  10. 风池穴穴位注射配合整脊手法治疗偏头痛疗效观察%Observation of curative effect of acupoint injection of fengchi combined with chiropractic manipulation on migraine

    Institute of Scientific and Technical Information of China (English)

    温鸿源; 廖广婧

    2013-01-01

    Objective To investigate the curative effect of acupoint injection of fengchi combined with chiropractic manipulation on migraine. Methods 100 cases of patients with cervical migraine in our hospital were selected and randomly divided into control group and treatment group(50 cases in each group).The acupoint injection of fengchi was used in the control group,and the acupoint injection of fengchi combined with chiropractic manipulation was used in the treatment group.The curative effect of each group was observed and analyzed. Results The curative effect of the treatment group was significantly better than that of the control group.The total effective rate of the control group was 76%,while that was 92% in the treatment group.The comparison of the total effective rate between the two groups was statistically significant(P < 0.05). Conclusion The treatment of acupoint injection of fengchi combined with chiropractic manipulation on cervical migraine has characteristics of higher cure rate,better curative effect and shorter treatment course,which is worthy of clinical popularization and application.%  目的探讨风池穴穴位注射配合整脊手法治疗偏头痛的疗效。方法选取我院收治的颈部偏头痛患者100例,随机分为对照组50例、治疗组50例。对照组采取风池穴穴位注射,治疗组在采取风池穴穴位注射的基础上配合整脊手法治疗。观察各组的疗效效果,并对此进行分析。结果治疗组治疗后的效果显著优于对照组;对照组的总有效率为76%,而治疗组的总有效率为92%,差异具有统计学意义(P<0.05)。结论采取风池穴穴位注射配合整脊手法治疗颈部偏头痛具有治愈率更高、疗效更佳、疗程时间更短等特点,值得临床推广应用。

  11. 捏脊疗法治疗小儿哮喘非发作期临床观察%Clinical effects of chiropractic therapy on remission stage pediatric asthma

    Institute of Scientific and Technical Information of China (English)

    陈偶英; 李英; 钟捷; 帅云飞

    2013-01-01

    目的 观察捏脊疗法治疗小儿哮喘非发作期的临床疗效.方法 将68例哮喘非发作期小儿随机分为两组,治疗组34例给予捏脊疗法,2次/d;对照组34例给予口服酮替芬2次/d,30 d为1疗程,疗程结束后6个月对两组临床疗效进行观察.结果 治疗组总有效率为82.35%,明显优于对照组疗效总有效率58.82% (P<0.05),两组治疗后症状评分总和比较,治疗组治疗前、后症状评分总和比较,差异均具有统计学意义(P<0.05).结论 在小儿哮喘非发作期给予捏脊治疗对预防哮喘发作有积极影响,值得临床推广.%Objective To observe and evaluate the efficacy of chiropractic therapy on remission stage pediatric asthma.Methods 68 children with remission stage asthma were randomly divided into treatment group and control group with 34 in each group.Treatment group was treated with chiropractic therapy while control group was treated with oral ketotifen.The clinical effects of 2 groups were observed and compared after 6 months since the end of treatment.Results The total effective rate was 82.35% in treatment group,which was significantly higher than 58.82% in of control group (P<0.05).After treatment symptom score sum were different between 2 groups with statistic significances (P<0.05).In treatment group,the difference of symptom score sum was statistically significant before and after treatment (P<0.05).Conclusion Chiropractic therapy is effective for children with remission stage asthma.

  12. Cervical mimic coronary artery disease treated by tuina and chiropractic therapy in 30 cases%推拿配合整脊手法治疗颈型类冠心病30例

    Institute of Scientific and Technical Information of China (English)

    叶勇

    2012-01-01

    Objective To observe the clinical efficacy of tuina and chiropractic therapy in treating cervical mimic coronary artery disease. Methods Treatment group were treated by tuina and chiropractic therapy and control group were treated by traditional tuina therapy. The clinical efficacy? Score of symptoms and signs 、cervical vertebra physiology degree of curve were observed and compared between two groups. Results The total effective rate was 90.0% in treatment group and 66. 67% in control group after 1 treatment course,two groups of the difference was statistically significant (P<0.05); There was a statistically significant difference in the score of symptoms and signs and cervical vertebra physiology degree of curve between two groups after 1 treatment course(P<0.05). Conclusion Tuina and chiropractic therapy is effective to treat cervical mimic coronary artery disease.%目的 观察推拿配合颈椎整脊手法治疗颈型类冠心病的临床疗效.方法 试验组采用推拿配合颈椎整脊手法调整,对照组采用传统推拿手法,1个疗程后比较临床疗效、症状、体征积分及颈椎生理曲度.结果 2组治疗后,试验组总有效率90.0%,对照组总有效率66.67%,两组比较有显著性差异(P<0.05);症状、体征积分比较、颈椎生理曲度比较均有显著性差异(P<0.05).结论 推拿手法配合颈椎整脊手法治疗颈型类冠心病优于单纯推拿手法.

  13. Influence of chiropractic therapy on serum gastrin and motilin in premature infants%中医捏脊对早产儿胃肠激素分泌的影响

    Institute of Scientific and Technical Information of China (English)

    吴开锋; 陈佳; 刘亿荣; 陈慧青; 向建文

    2016-01-01

    目的 探讨捏脊疗法对早产儿胃肠激素分泌的影响.方法 90例早产儿随机分为治疗组42例和对照组48例,治疗组给予常规治疗并配合捏脊疗法,对照组单纯进行常规治疗,测定治疗前后血清胃泌素(gastrin,GAS)和胃动素(motilin,MOT)的水平.结果 治疗组早产儿治疗后GAS、MOT分别为(98.27±26.67) pg/ml、(362.43±36.13) pg/ml,对照组治疗后GAS、MOT分别为(83.54±24.51) pg/ml、(335.27±31.87) pg/ml;治疗组早产儿血清GAS、MOT水平比对照组明显增高,差异有统计学意义(P<0.05).结论 捏脊治疗能促进早产儿GAS、MOT的分泌,对早产儿胃肠动力促进作用.%Objective To investigate the influence of chiropractic therapy on serum gastrin and motilin in premature infants.Methods 90 premature infants were randomly divided into treatment group (42 cases) and control group (48 cases).Treatment group was treated with chiropractic therapy and conventional therapy,and control group was treated with conventional therapy.Serum gastrin (GAS) and motilin (MOT) were measured before and after treatment.Results The levels of GAS,MOT of treatment group after treatment were (98.27±26.67) pg/ml and (362.43±36.13)pg/ml,those of control group were (83.54±24.51)pg/ml and (335.27±31.87)pg/ml,those of treatment group were significantly higher than those of control group (P<0.05).Conclusion Chiropractic therapy can increase GAS and MOT levels of premature infants.

  14. An Examination of Growing Trends in Land Tenure and Conservation Practice Adoption: Results from a Farmer Survey in Iowa

    Science.gov (United States)

    Varble, Sarah; Secchi, Silvia; Druschke, Caroline Gottschalk

    2016-02-01

    Tenants and part-owners are farming an increasing number of acres in the United States, while full-owners are farming fewer acres. This shift in ownership is a potential cause for concern because some previous research indicated that tenant and part-owner farmers were less likely to adopt conservation practices than farmers who owned the land they farmed. If that trend persists, ownership changes would signal a national drop in conservation adoption. Here we examine this issue using a survey of agricultural operators in the Clear Creek watershed in Iowa, a state with intensive agricultural production. We compare adoption of conservation practices, and preferences for conservation information sources and communication channels, between farmers who rent some portion of the land they farm (tenants and part-owners) and farmers who own all of the land they farm (full-owners). We find that renters are more likely to practice conservation tillage than full-owners, though they are less likely to rotate crops. In addition, renters report using federal government employees (specifically, Natural Resource Conservation Service and Farm Service Agency) as their primary sources of conservation information, while full-owners most frequently rely on neighbors, friends, and County Extension. These findings are significant for conservation policy because, unlike some past research, they indicate that renters are not resistant to all types of conservation practices, echoing recent studies finding an increase in conservation adoption among non-full-owners. Our results emphasize the importance of government conservation communication and can inform outreach efforts by helping tailor effective, targeted conservation strategies for owners and renters.

  15. Measuring the economic value of alternative clam fishing management practices in the Venice Lagoon: results from a conjoint valuation application

    Science.gov (United States)

    Nunes, Paulo A. L. D.; Rossetto, Luca; de Blaeij, Arianne

    2004-11-01

    This article focuses on the economic valuation of alternative clam management practices in the Venice Lagoon. The proposed valuation method is characterized by the design of a survey questionnaire applied to the fishermen population. In each questionnaire, two fishing alternatives are described. The respondent is asked to choose one of them. This valuation method, referred in the article as conjoint valuation, gives sufficient flexibility to set, alter, and combine the valuation of different clam management practices. Furthermore, this approach presents an important advantage to the well-known contingent valuation method since it makes the monetary valuation of each management attribute possible. Estimation results show that all three attributes used in the questionnaire to describe and value different clam management practices—price of the annual permit and fishing technological system—are statistically robust, indicating that fishermen bear a utility change whenever these attributes change. In particular, fishermen's willingness to pay for a larger clam fishing area ranges between 568 and 811 € per year. In addition, an individual's willingness to pay for a fishing practice exclusively based on the vibrant rake system ranges between 1005 and 2456 €. Finally, the adoption of a clam fish management practice in the Venice Lagoon that is exclusively based on the use of manual rakes, which is associated with the lowest damage to the lagoon ecosystem, will represent a welfare loss of 5904 € per fisherman per year. Combining such a value estimate with the total number of fishermen currently operating in the Lagoon of Venice, the welfare loss associated with the adoption of this type of clam management policy amounts to 11.8 € million per year. This figure can be regarded as an upper bound to the cost of implementation of a clam fishing system anchored in the use of manual, ecosystem friendly rakes.

  16. An Examination of Growing Trends in Land Tenure and Conservation Practice Adoption: Results from a Farmer Survey in Iowa.

    Science.gov (United States)

    Varble, Sarah; Secchi, Silvia; Druschke, Caroline Gottschalk

    2016-02-01

    Tenants and part-owners are farming an increasing number of acres in the United States, while full-owners are farming fewer acres. This shift in ownership is a potential cause for concern because some previous research indicated that tenant and part-owner farmers were less likely to adopt conservation practices than farmers who owned the land they farmed. If that trend persists, ownership changes would signal a national drop in conservation adoption. Here we examine this issue using a survey of agricultural operators in the Clear Creek watershed in Iowa, a state with intensive agricultural production. We compare adoption of conservation practices, and preferences for conservation information sources and communication channels, between farmers who rent some portion of the land they farm (tenants and part-owners) and farmers who own all of the land they farm (full-owners). We find that renters are more likely to practice conservation tillage than full-owners, though they are less likely to rotate crops. In addition, renters report using federal government employees (specifically, Natural Resource Conservation Service and Farm Service Agency) as their primary sources of conservation information, while full-owners most frequently rely on neighbors, friends, and County Extension. These findings are significant for conservation policy because, unlike some past research, they indicate that renters are not resistant to all types of conservation practices, echoing recent studies finding an increase in conservation adoption among non-full-owners. Our results emphasize the importance of government conservation communication and can inform outreach efforts by helping tailor effective, targeted conservation strategies for owners and renters.

  17. Using spirometry results in occupational medicine and research: Common errors and good practice in statistical analysis and reporting

    Directory of Open Access Journals (Sweden)

    Wagner N

    2006-01-01

    Full Text Available Spirometry appears to be a simple and inexpensive method to measure disorders of the respiratory tract. In reality however, a simple spirometry test requires knowledge and skill to correctly conduct and evaluate the test and its results. This review addresses common misunderstandings in using, evaluating and reporting spirometry results in Occupational Health practice, clinical medicine and research. Results of spirometry need to be evaluated in relation to reference values. The factory medical officer has to decide first whether the test was technically correctly executed and is acceptable for medical interpretation. The next step is to compare results of the individual to published reference values. A 10% reduction of reference values for North Indians and Pakistanis and a 12 to 13% reduction for South Indians is recommended when Caucasian reference tables are used. In occupational health practice the worker′s spirometry performance over time needs to be considered. Common errors in reporting summarized results, for instance from groups of workers, are the incorrect use of tests of significance and incorrect presentation of aggregated spirometry results. The loss of respiratory function is recommended as an indicator of difference between two groups. That way, early changes in function can seen without waiting for a drop of function below the usually used 80%-of-predicted limit. This procedure increases the sensitivity of medical surveillance. In research the more precise Lower Limit of Normal should be calculated and used. Correct reference equations, good patient coaching, decision on the technical quality (acceptability of each spirometry test and critical re-evaluation of the machine′s readout are essential parts of a correct spirometry test. A good understanding how results are calculated is crucial for further statistical evaluation.

  18. 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

    2016-05-06

    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.

  19. 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

    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. When...

  20. Incident somatic comorbidity after psychosis: results from a retrospective cohort study based on Flemish general practice data

    Directory of Open Access Journals (Sweden)

    Truyers Carla

    2011-11-01

    Full Text Available Abstract Background Psychotic conditions and especially schizophrenia, have been associated with increased morbidity and mortality. Many studies are performed in specialized settings with a strong focus on schizophrenia. Somatic comorbidity after psychosis is studied, using a general practice comorbidity registration network. Methods Hazard ratios are presented resulting from frailty models to assess the risk of subsequent somatic disease after a diagnosis of psychosis compared to people without psychosis matched on practice, age and gender. Diseases studied are cancer, physical trauma, diabetes mellitus, gastrointestinal disorders, joint disorders, irritable bowel syndrome, general infections, metabolic disorders other than diabetes, hearing and vision problems, anemia, cardiovascular disease, alcohol abuse, lung disorders, mouth and teeth problems, sexually transmitted diseases. Results Significant higher risks after a diagnosis of psychosis were found for the emergence of diabetes, physical trauma, gastrointestinal disorders, alcohol abuse, chronic lung disease and teeth and mouth problems. With regard to diabetes, by including the type of antipsychotic medication it is clear that the significant overall effect was largely due to the use of atypical antipsychotic medication. No significant higher risk was seen for cancer, joint conditions, irritable bowel syndrome, general infections, other metabolic conditions, hearing/vision problems, anaemia, cardiovascular disease or diabetes, in case no atypical antipsychotic medication was used. Conclusion Significantly higher morbidity rates for some somatic conditions in patients with psychosis are apparent. People with a diagnosis of psychosis benefit from regular assessments for the emergence of somatic disorders and risk factors, including diabetes in case of atypical antipsychotic medication.

  1. 整脊手法配合小圆枕治疗神经根型颈椎病的临床研究%Clinical Study of Chiropractic Technique Combined With Small Pillow for Treating Cervical Spondylotic Radiculopathy

    Institute of Scientific and Technical Information of China (English)

    朱震芳

    2013-01-01

    目的:观察整脊手法配合小圆枕治疗神经根型颈椎病的临床疗效.方法:将86例神经根型颈椎病患者,随机分为对照组和治疗组,每组各43例.对照组采用软组织松解手法治疗;治疗组在对照组的基础上加用整脊手法配合小圆枕治疗.结果:对照组有效率为72%,治疗组有效率为95%,两组有效率比较,差异有统计学意义(P<0.05).结论:整脊手法配合小圆枕治疗神经根型颈椎病,可有效改善或解除神经根受到刺激与压迫.%Objective: To analyze the clinical effect of chiropractic technique combined with a small pillow for treating cervical spondyl ic radiculopathy. Methods:86 cases of nerve root type of cervical spondylosis patients randomly divided into treatment group and cont group, each group of 43 cases. The control group using soft tissue release technique treatment; the treatment group was treated with c ropractic technique combined with a small pillow treatment t on the basis ofhe control group. Results:In the control group was 49% ,1 effective rate of treatment group was 72% , the difference was statistically significant ( P < 0. 05). Conclusion: Chiropractic combir treatment of small pillow for treatment of cervical spondylosis of nerve root stimulation and oppression, can effectively improve or reli< nerve root.

  2. Needle knife with lumbar spinal chiropractic therapy for knee osteoarthritis combined lumbar joints staggered joints clinical observation%针刀配合腰椎整脊疗法治疗膝骨关节炎合并腰椎小关节错缝临床观察

    Institute of Scientific and Technical Information of China (English)

    孙利伟; 王方; 孙刚; 李鹤; 徐仕富; 高建波

    2013-01-01

      Objective: to observe the needle knife with lumbar spinal chiropractic therapy for treatment of knee osteoarthritis. Methods:retrospective between December 2010 and December 2010, knee osteoarthritis treated were 60 cases of patients with combined knee osteoarthritis combined lumbar joints staggered joints ,treatment group 30 cases with lumbar spinal chiropractic to needle knife therapy for knee osteoarthritis treatment, control group 30 cases of Celecoxib Capsules treatment, the knee joint as observation indexes to assess pain and joint mobility. Results: after 4 weeks follow-up treatment, treatment group total effectiveness 94.3%, control group total effective rate was 70.0%. Conclusion: needle knife with lumbar spinal chiropractic therapy for knee osteoarthritis clinical effect is remarkable, is worth further research and promotion.%  目的:观察针刀配合腰椎整脊疗法治疗膝骨关节炎的临床效果。方法:回顾2010年12月至2012年12月收治的膝骨关节炎合并腰椎小节错缝的患者60例,治疗组30例予针刀配合腰椎整脊疗法治疗膝骨关节炎治疗,对照组30例西乐葆治疗,将膝关节疼痛和关节活动度作为观察指标进行评定。结果:治疗四周后随访,治疗组总有效率94.3%,对照组总有效率70.0%。结论:针刀配合腰椎整脊疗法治疗膝骨关节炎临床效果显著,值得进一步研究和推广。

  3. The cost-effectiveness of point of care testing in a general practice setting: results from a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Briggs Nancy E

    2010-06-01

    Full Text Available Abstract Background While point of care testing (PoCT for general practitioners is becoming increasingly popular, few studies have investigated whether it represents value for money. This study aims to assess the relative cost-effectiveness of PoCT in general practice (GP compared to usual testing practice through a pathology laboratory. Methods A cost-effectiveness analysis based on a randomized controlled trial with 4,968 patients followed up for 18 months and fifty-three general practices in urban, rural and remote locations across three states in Australia. The incremental costs and health outcomes associated with a clinical strategy of PoCT for INR, HbA1c, lipids, and ACR were compared to those from pathology laboratory testing. Costs were expressed in year 2006 Australian dollars. Non-parametric bootstrapping was used to generate 95% confidence intervals. Results The point estimate of the total direct costs per patient to the health care sector for PoCT was less for ACR than for pathology laboratory testing, but greater for INR, HbA1c and Lipids, although none of these differences was statistically significant. PoCT led to significant cost savings to patients and their families. When uncertainty around the point estimates was taken into account, the incremental cost-effectiveness ratio (ICER for PoCT was found to be unfavourable for INR, but somewhat favourable for ACR, while substantial uncertainty still surrounds PoCT for HbA1c and Lipids. Conclusions The decision whether to fund PoCT will depend on the price society is willing to pay for achievement of the non-standard intermediate outcome indicator. Trial registration Australian New Zealand Clinical Trial Registry ACTRN12605000272695

  4. Flow situations during everyday practice in a medical hospital ward. Results from a study based on experience sampling method

    Directory of Open Access Journals (Sweden)

    Ejlertsson Göran

    2011-02-01

    Full Text Available Abstract Background Nursing is a constant balance between strain and stimulation and work and health research with a positive reference point has been recommended. A health-promoting circumstance for subjective experience is flow, which is a psychological state, when individuals concurrently experience happiness, motivation and cognitive efficiency. Flow situations can be identified through individuals' estimates of perceived challenge and skills. There is, to the best of our knowledge, no published study of flow among health care staff. The aim of this study was to identify flow-situations and study work-related activities and individual factors associated with flow situations, during everyday practice at a medical emergency ward in Sweden, in order to increase the knowledge on salutogenic health-promoting factors. Methods The respondents consisted of 17 assistant nurses and 14 registered nurses, who randomly and repeatedly answered a small questionnaire, through an experience sampling method, during everyday nursing practice. The study resulted in 497 observations. Flow situations were defined as an exact match between a high challenge and skill estimation and logistic regression models were used to study different variables association to flow situations. Results The health care staff spent most of its working time in individual nursing care and administrative and communicative duties. The assistant nurses were more often occupied in individual nursing care, while the registered nurses were more involved in medical care and administrative and communicative duties. The study resulted in 11.5% observations of flow situations but the relative number of flow situations varied between none to 55% among the participants. Flow situations were positively related to medical care activities and individual cognitive resources. Taking a break was also positively associated with flow situations among the assistant nurses. Conclusions The result showed

  5. Practices to "Avoid" in Out-of-School Time Programs. Research-to-Results Brief. Publication #2010-03

    Science.gov (United States)

    Moore, Kristin Anderson; Collins, Ashleigh; Bronte-Tinkew, Jacinta

    2010-01-01

    Perhaps one of the fastest ways to improve the quality of out-of-school time programs would be to replace practices that individuals know do not work with practices that appear to be more effective. In this brief, the authors highlight lessons from an expanding body of knowledge about specific program practices that should be avoided or minimized…

  6. Four sexually transmitted infections (STIs) in Belgian general practice: first results (2013–2014) of a nationwide continuing surveillance study

    Science.gov (United States)

    Boffin, N; Moreels, S; Deblonde, J; Van Casteren, V

    2017-01-01

    Objectives To describe and explore data from the surveillance of chlamydia, syphilis, gonorrhoea and genital warts by the Belgian Network of Sentinel General Practices (SGP) over the first 2 years (2013 and 2014) and to estimate the incidence of these 4 sexually transmitted infections (STIs). A special focus is put on data quality. Design Retrospective observational study. Setting General practices from the nationwide representative SGP network. Outcome measures Agreement between data distributions by year, agreement between SGP-based incidence and incidence based on mandatory notification, missingness of patient age or gender and incompleteness of sexual risk history of patients. Results 306 new STI episodes were reported from 298 patients, corresponding with an episode-based incidence of 91.9/100 000 (95% CI 81.9 to 102.8) general practice patients, with almost half of it due to chlamydia. The incidence of chlamydia in men was significantly higher in 2014 than in 2013. Population characteristics were similarly distributed in 2013 and 2014. The SGP-based incidence of gonorrhoea and syphilis in Flanders were in agreement with the incidence based on mandatory notification of cases. Patient age or gender was missing from 35 episodes (11.4%). Independent determinants of missingness of patient age or gender were the Flemish region (OR 3.46; 95% CI 1.02 to 11.73) and genital warts infection (OR 2.23; 95% CI 1.07 to 4.63). An incomplete sexual risk history was reported for 54.6% STI episodes. The odds for an incomplete sexual history were higher for older patients (OR 1.72; 95% CI 1.06 to 2.76) and for patients infected with syphilis, gonorrhoea or co-infection(s) (OR 1.71; 95% CI 1.03 to 2.83). Conclusions Incompleteness of reports about patients with STI sexual risk histories is important from the perspective of quality of data and of quality of care. Together with the low rates of both HIV testing and discussion of partner notification, this suggests that a

  7. The influence of cranium,spinal and TMJ chiropractic on the infant breastfeeding and body weight%头颅、脊柱及颞下颌关节按摩对新生儿母乳喂养及体重的影响

    Institute of Scientific and Technical Information of China (English)

    钱静芳

    2013-01-01

    目的:观察头颅、脊柱及颞下颌关节按摩对新生儿母乳喂养及体重的影响.方法:将120新生儿随机分为观察组和对照组各60例,两组新生儿均接受常规护理,观察组在此基础上接受头颅、脊柱及颞下颌关节按摩.结果:观察组新生儿含接乳头、吮吸力、吞咽动作及母乳喂养满意度方面均高于对照组(P<0.05);42 d时观察组新生儿体重明显高于对照组(P<0.05).结论:头颅、脊柱及颞下颌关节按摩对新生儿母乳喂养及体重增加有明显的促进作用,值得推广应用.%Objective:To observe the influence of cranium,spinal and temporomandibular joint (TMJ) chiropractic on the infant breastfeeding and body weight. Methods: 120 infants were randomly divided into observation group and control group,60 cases in each group,the neonatus of two groups were all received routine nursing,on the basic of the observaion group received cranium, spinal and TMJ chiropractic. Results: In observation group,the performance of infant latching on nipple, sucking force, swallowing movements and breastfeeding satisfaction were better than those in the control group ( P < 0.05 ). When the forty - second day,the infant body weight gain in chiropractic group was obviously higher than that in the control group (P <0.05). Conclusion;Cranium, spinal and TMJ chiropractic can remarkably improve the infant breastfeeding and body weight gain,it is worthy of popularization and application.

  8. Curative Observations of Acupuncture Combined with Chiropractic on Treating Lumbar Intervertebral Disc Herniation of Blood Stasis Type%针刺结合整脊治疗血瘀型腰椎间盘突出症的疗效观察

    Institute of Scientific and Technical Information of China (English)

    黄政德; 胡艳影; 梁斌

    2013-01-01

    To observe the therapeutic effect of acupunture combined with chiropractic for patients with blood stasis type Lumbar Disc Herniation (LDH).Methods:90 cases were randomly divided into three groups:acupuncture combined with chiropractic therapy group (groupA),single acupuncture controlled group (groupB),single chiropractic controlled group (groupC),30 cases each.Treament once a day,ten times for a course of treament,clinical observation of two courses.Results:1.JOA score contrast,group A and B and C group were compared,all had very significant difference (P <0.01) ; B,C group contrast,no significant difference (P >0.05) ; 2.The total effective rate were compared,and no significant difference (P >0.05) ; Cure rate contrast:group A and B and C group were compared,all had significant difference (P <0.05) ; B,C group contrast,no significant difference (P >0.05).Conclusion:Clinical efficacy of combined acupuncture and chiropractic has a marked therapeutic effect on lumbar intervertebral disc herniation of blood stasis type.%目的:观察针刺结合整脊治疗血瘀型腰椎间盘突出症(LDH)的临床疗效.方法:将90例患者随机分为3组:针刺结合整脊治疗组(A组)、单纯针刺对照组(B组)、单纯整脊对照组(C组),各30例.每天治疗1次,10次为1个疗程,临床观察2个疗程.结果:①JOA评分对比,A组分别与B、C组对比,均有非常显著性差异(P<0.01);B、C组对比,无显著性差异(P>0.05);②各组总有效率相比较,无显著性差异(均P>0.05);治愈率对比:A组分别与B、C组对比,均有显著性差异(P<0.05);B、C组对比,无显著性差异(P>0.05).结沦:针刺结合整脊疗法治疗血瘀型腰椎间盘突出症的临床疗效显著.

  9. [Treatment of depressive patients in private practice--empirical results, health political and social conditions and recommendations].

    Science.gov (United States)

    Goesmann, Cornelia; Bühren, Astrid; Neuy-Bartmann, Astrid

    2007-09-01

    Although depression and symptoms of depression belong to the most common disorders in private practice, affected patients are not always diagnosed as early as possible in Germany and often not sufficiently treated. In order to improve the care for persons with depression it is necessary that family doctors are prepared to guide these patients with empathy, treat them adequately pharmacologically both in respect to the depression and to all other somatic aspects and to refer them in time to specialists for psychiatry, psychosomatic medicine or psychotherapy. Political and social conditions that have pathogenic effects should be changed and the shortage of psychotherapy needs to be overcome. In future, the integrated care in ambulant and clinical settings will probably be successful, first trials and test setups have shown good results.

  10. A Standards-Based Professional Development Program and the Resulting Impact on Two Sixth Grade Teachers' Classroom Practices

    Science.gov (United States)

    Bereki, Debra Lynn

    In 2000, California introduced science content standards as part of an across the curriculum reform. This presented a special challenge for elementary teachers due to an increased emphasis on math and language arts, and limited science background and resources. This two year qualitative study looks at a professional development program that resulted from collaboration between a university and an elementary school district. The program brought sixth grade elementary teachers together with scientists (geologists) and a science educator to develop a quality sixth grade science curriculum aligned to the California content standards. This multiple-case embedded study included an analysis of how these standards were addressed during the program, and the impact of this professional development on two teachers' classroom practices. The results of this study indicate that the geologists and the science educator played different but complementary roles in the professional development program. Furthermore, the professional development disproportionately focused on the Earth science standards, and this correlated to a disproportionate focus on these standards in the classrooms of the two teachers studied. Finally, the results indicate that as these two teachers implemented their new science units, they progressed through the initial stages of teacher change as outlined by change models described in the literature. However, they did not reach the final stage of change that involves complete confidence in their knowledge and being satisfied with the implementation of their science units.

  11. Diagnosing asthma in general practice with portable exhaled nitric oxide measurement – results of a prospective diagnostic study

    Directory of Open Access Journals (Sweden)

    Laux Gunter

    2009-03-01

    Full Text Available Abstract Background To evaluate the sensitivity, specificity and predictive values of fractional exhaled nitric oxide (FENO for the diagnosis of asthma in general practice. Methods Prospective diagnostic study with 160 patients attending 10 general practices for the first time with complaints suspicious of obstructive airway disease (OAD. Patients were referred to a lung function laboratory for diagnostic investigation. The index test was FENO measured with a portable FENO analyser based on electrochemical sensor. The reference standard was the Tiffeneau ratio (FEV1/VC as received by spirometric manoeuvre and/or results of bronchial provocation. Bronchial provocation with methacholine was performed to determine bronchial hyper-responsiveness (BHR in the event of inconclusive spirometric results. Results 88 (55% were female; their average age was 43.9 years. 75 (46.9% patients had asthma, 25 (15.6% had COPD, 8 (5.0% had an overlap of COPD and asthma, and 52 (32.5% had no OAD. At a cut-off level of 46 parts per billion (ppb (n = 30; 18.8%, sensitivity was 32% (95%CI 23–43%, specificity 93% (95%CI 85–97%, positive predictive value (PPV 80% (95%CI 63–91%, negative predictive value (NPV 61% (95%CI 52–69% when compared with a 20% fall in FEV1 from the baseline value (PC20 after inhaling methacholine concentration ≤ 16 mg/ml. At 76 ppb (n = 11; 6.9% specificity was 100% (95%CI 96–100% and PPV was 100% (95%CI 72–100. At a cut-off level of 12 ppb (n = 34; 21.3%, sensitivity was 90% (95%CI 79–95%, specificity 25% (95%CI 17–34%, PPV 40% (95%CI 32–50, NPV 81% (95%CI 64–91% when compared with a 20% fall of FEV1 after inhaling methacholine concentration ≤ 4 mg/ml. Three patients with unsuspicious spirometric results have to be tested with FENO to save one bronchial provocation test. Conclusion Asthma could be ruled in with FENO > 46 ppb. Mild and moderate to severe asthma could be ruled out with FENO ≤ 12 ppb. FENO measurement with

  12. Results of a survey among GP practices on how they manage patient safety aspects related to point-of-care testing in every day practice.

    NARCIS (Netherlands)

    Vries, C. de; Doggen, C.J.M.; Hilbers, E.; Verheij, R.; IJzerman, M.; Geertsma, R.; Kusters, R.

    2015-01-01

    Background Point-of-care (POC) tests are devices or test strips that can be used near or at the site where care is delivered to patients, enabling a relatively fast diagnosis. Although many general practitioners (GPs) in the Netherlands are using POC tests in their practice, little i

  13. Results of a survey among GP practices on how they manage patient safety aspects related to point-of-care testing in every day practice

    NARCIS (Netherlands)

    Vries, de Claudette; Doggen, Carine; Hilbers, Ellen; Verheij, Robert; IJzerman, Maarten; Geertsma, Robert; Kusters, Ron

    2015-01-01

    Background Point-of-care (POC) tests are devices or test strips that can be used near or at the site where care is delivered to patients, enabling a relatively fast diagnosis. Although many general practitioners (GPs) in the Netherlands are using POC tests in their practice, little is known on how t

  14. Comparing propensity score methods for creating comparable cohorts of chiropractic users and non-users in older, multiply comorbid Medicare patients with chronic low back pain

    Science.gov (United States)

    Weeks, William B; Tosteson, Tor D; Whedon, James M; Leininger, Brent; Lurie, Jon D; Swenson, Rand; Goertz, Christine M; O’Malley, Alistair J

    2015-01-01

    Objective Patients who use complementary and integrative health services like chiropractic manipulative treatment (CMT) often have different characteristics than patients who do not, and these differences can confound attempts to compare outcomes across treatment groups, particularly in observational studies when selection bias may occur. The purposes of this study were to provide an overview on how propensity scoring methods can be used address selection bias by balancing treatment groups on key variables and to use Medicare data to compare different methods for doing so. Methods We described 2 propensity score methods (matching and weighting). Then we used Medicare data from 2006-2012 on older, multiply comorbid patients who had a chronic low back pain episode to demonstrate the impact of applying methods on the balance of demographics of patients between 2 treatment groups (those who received only CMT and those who received no CMT during their episodes). Results Before application of propensity score methods, patients who used only CMT had different characteristics from those who did not. Propensity score matching diminished observed differences across the treatment groups at the expense of reduced sample size. However, propensity score weighting achieved balance in patient characteristics between the groups and allowed us to keep the entire sample. Conclusions While propensity score matching and weighting have similar effects in terms of balancing covariates, weighting has the advantage of maintaining sample size, preserving external validity, and generalizing more naturally to comparisons of 3 or more treatment groups. Researchers should carefully consider which propensity score method to use, as using different methods can generate different results. PMID:26547763

  15. Using a Class to Conduct a Carbon Inventory: A Case Study with Practical Results at Macalester College

    Science.gov (United States)

    Wells, Christopher W.; Savanick, Suzanne; Manning, Christie

    2009-01-01

    Purpose: The purpose of this paper is to discuss the practical realities of using a college seminar to fulfill the carbon audit requirement for signatories to the American College and University Presidents Climate Commitment (ACUPCC) and presents evidence of this approach's advantages as an educational and practical tool.…

  16. Knowledge of asthma guidelines: results of a UK General Practice Airways Group (GPIAG) web-based 'Test your Knowledge' quiz.

    Science.gov (United States)

    Pinnock, Hilary; Holmes, Steve; Levy, Mark L; McArthur, Ruth; Small, Iain

    2010-06-01

    A web-based questionnaire, comprising 11 multiple choice questions, tested the knowledge of visitors to the General Practice Airways Group (GPIAG) online summary of the British Asthma guideline. On average, the 413 respondents answered less than half the questions correctly. GP scores were significantly lower than practice nurses. Improving clinicians' knowledge of asthma is a prerequisite for improving management.

  17. Crossing New Uncharted Territory: Shifts in Academic Identity as a Result of Modifying Teaching Practice in Undergraduate Mathematics

    Science.gov (United States)

    Kensington-Miller, Barbara; Sneddon, Jamie; Stewart, Sepideh

    2014-01-01

    The changes in academic identity a teacher may undergo, as they modify their teaching practice, will vary depending on their experiences and the support they receive. In this paper, we describe the shifts in academic identity of two lecturers, a mathematician and a mathematics educator, as they both made changes to their teaching practice by…

  18. US Urban Elementary Teachers' Knowledge and Practices in Teaching Science to English Language Learners: Results from the first year of a professional development intervention

    Science.gov (United States)

    Santau, Alexandra O.; Secada, Walter; Maerten-Rivera, Jaime; Cone, Neporcha; Lee, Okhee

    2010-10-01

    The study examined US elementary teachers' knowledge and practices in four key domains of science instruction with English language learning (ELL) students. The four domains included: (1) teachers' knowledge of science content, (2) teaching practices to promote scientific understanding, (3) teaching practices to promote scientific inquiry, and (4) teaching practices to support English language development during science instruction. The study was part of a larger five-year research and development intervention aimed at promoting science and literacy achievement of ELL students in urban elementary schools. It involved 32 third grade, 21 fourth grade, and 17 fifth grade teachers participating in the first-year implementation of the intervention. Based on teachers' questionnaire responses and classroom observation ratings, results indicated that (1) teachers' knowledge and practices were within the bounds of acceptability but short of reform-oriented practices and (2) grade-level differences existed, especially between Grades 3 and 5.

  19. 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.

  20. [A case of long thoracic nerve palsy, with winged scapula, as a result of prolonged exertion on practicing archery].

    Science.gov (United States)

    Shimizu, J; Nishiyama, K; Takeda, K; Ichiba, T; Sakuta, M

    1990-08-01

    Reports of isolated long thoracic nerve palsy are rare in Japan. We reported a case of isolated long thoracic nerve palsy, resulted from recurrent injury to the nerve. Muscle CT and electrodiagnostic study were useful for confirming diagnosis of this cases. This patient was a student aged 20 years, with nothing of importance in his family or past history. After he started practicing archery, winging of left scapula was gradually developed. Physical examination revealed weakness and atrophy of left serratus anterior muscle. There was no wasting and weakness of other should girdle muscles. Hematochemical tests were normal, except slight hyperthyroidism. Radiography and myelography of the cervical spine were normal. Muscle CT of upper thoracic level demonstrated atrophy of left serratus anterior muscle, and no abnormality were found in other muscles. Electromyogram of the left serratus anterior revealed discrete activity of reduced amplitude, and fibrillation potentials and positive sharp waves. Conduction time for left long thoracic nerve was prolonged, and amplitude of the evoked response was small and there were temporal dispersion. Muscle CT and electrodiagnostic studies were suggestive of neuroapraxia of left long thoracic nerve. Over stretching or compression during exercises may be responsible for the damage to the long thoracic nerve.

  1. Preparation by mandatory E-modules improves learning of practical skills : A quasi-experimental comparison of skill examination results

    NARCIS (Netherlands)

    Kwant, Kelly J.; Custers, Eugene J F M; Jongen-Hermus, Femke J.; Kluijtmans, Manon

    2015-01-01

    Background: Until recently, students at UMC Utrecht Faculty of Medicine prepared for practical skills training sessions by studying recommended literature and making written assignments, which was considered unsatisfactory. Therefore, mandatory e-modules were gradually introduced as substitute for t

  2. Incident somatic comorbidity after psychosis: Results from a retrospective cohort study based on Flemish general practice data

    NARCIS (Netherlands)

    C. Truyers (Carla); F. Buntinx (Frank); J. de Lepeleire (Jan); M. de Hert (Marc); R. van Winkel (Ruud); B. Aertgeerts (Bert); S. Bartholomeeusen (Stefaan); E.M.E.H. Lesaffre (Emmanuel)

    2011-01-01

    textabstractBackground: Psychotic conditions and especially schizophrenia, have been associated with increased morbidity and mortality. Many studies are performed in specialized settings with a strong focus on schizophrenia. Somatic comorbidity after psychosis is studied, using a general practice co

  3. Do general practitioners adhere to the guideline on infectious conjunctivitis? Results of the Second Dutch National Survey of General Practice

    Directory of Open Access Journals (Sweden)

    Schellevis François G

    2007-09-01

    Full Text Available Abstract Background In 1996 the guideline 'The Red Eye' was first published by the Dutch College of General Practitioners. The extent to which general practitioners adhere to this guideline is unclear. Recently, data on the management of infectious conjunctivitis by general practitioners became available from the Second Dutch National Survey of General Practice. We measured the age-specific incidence of infectious conjunctivitis, described its management by Dutch general practitioners, and then compared these findings with the recommendations made in the guideline. Methods In 2001, over a 12-month period, data from all patient contacts with 195 general practitioners were taken from electronic medical records. Registration was episode-oriented; all consultations dealing with the same health problem were grouped into disease episodes. Data concerning all episodes of infectious conjunctivitis (ICPC-code F70 and sub codes were analysed. Results Over one year, 5,213 new and recurrent episodes of infectious conjunctivitis were presented to general practitioners from a population of N = 375,899, resulting in an overall incidence rate of 13.9 per 1000 person-years, varying from more than 80/1000 py in children up to one-year old, to less than 12/1000 py in children over the age of 4. Topical ophthalmic ointments were prescribed in 87% of the episodes, of which 80% was antibiotic treatment. Fusidic acid gel was most frequently prescribed (69%. In most episodes general practitioners did not adhere to the guideline. Conclusion In 2001, the management of infectious conjunctivitis by Dutch general practitioners was not in accordance with the recommendations of the consensus-based guideline published five years previously, despite its wide distribution. In 2006 this guideline was revised. Its successful implementation requires more than distribution alone. Probably the most effective way to achieve this is by following a model for systemic implementation.

  4. Results of practical application of questionnaire to determine the level of dentophobia and dynamics in the doctor— patient relationship

    Directory of Open Access Journals (Sweden)

    Savina Е.А.

    2013-09-01

    Full Text Available Objective: to develop a questionnaire for assessing the level of dentophobia and dynamics of the relationship in the «doctor-patient» in the course of treatment and to conduct its clinical trials. Material and Methods. 90 patients aged 26-56 years with chronic generalized periodontitis have been examined. The research has been conducted by Hospital Anxiety and depression (HADS questionnaire to determine the level of dentophobia; psychophysiological testing was carried out on the hardware-software complex (APC «NS-Psychotest» (LLC «Neurosoft», Russia, Ivanovo, 2007. Clinical examination included examination of the mouth and the index of assessment of hard tissue of teeth and peri-odontal tissue: a defining simplified oral hygiene index (UIG, sulcus bleeding index (IR, gingival index (PMA. The survey was carried out before the treatment and 3 months after the treatment. Statistical analysis was performed in the program Statistica. Using non-parametric methods (Wilcoxon test, criterion A2, Spearman correlation coefficient. Statistically significant differences with p < 0,05 were considered. Results. The development of the questionnaire was carried out in accordance with all generally accepted standards. The initial testing was performed easily by patients. During the clinical trials visible results of the proposed questionnaire were obtained that proved its sensitivity to the changes in dental and psychological status of the oral cavity. Conclusion. The practical application of the questionnaire determines the level of dentophobia during the first visit. The data of the questionnaire identify the differentiated deontological approach. It improves the relationship with the patient, reduces his level of dentophobia. The reduced dentophobia promotes compliance and psychologically comfortable communication in the doctor-patient system, which also contributes to the prevention of emotional burn out among dentists.

  5. Do general practitioners adhere to the guideline on infectious conjunctivitis? Results of the Second Dutch National Survey of General Practice

    Science.gov (United States)

    Rietveld, Remco P; ter Riet, Gerben; Bindels, Patrick JE; Schellevis, François G; van Weert, Henk CPM

    2007-01-01

    Background In 1996 the guideline 'The Red Eye' was first published by the Dutch College of General Practitioners. The extent to which general practitioners adhere to this guideline is unclear. Recently, data on the management of infectious conjunctivitis by general practitioners became available from the Second Dutch National Survey of General Practice. We measured the age-specific incidence of infectious conjunctivitis, described its management by Dutch general practitioners, and then compared these findings with the recommendations made in the guideline. Methods In 2001, over a 12-month period, data from all patient contacts with 195 general practitioners were taken from electronic medical records. Registration was episode-oriented; all consultations dealing with the same health problem were grouped into disease episodes. Data concerning all episodes of infectious conjunctivitis (ICPC-code F70 and sub codes) were analysed. Results Over one year, 5,213 new and recurrent episodes of infectious conjunctivitis were presented to general practitioners from a population of N = 375,899, resulting in an overall incidence rate of 13.9 per 1000 person-years, varying from more than 80/1000 py in children up to one-year old, to less than 12/1000 py in children over the age of 4. Topical ophthalmic ointments were prescribed in 87% of the episodes, of which 80% was antibiotic treatment. Fusidic acid gel was most frequently prescribed (69%). In most episodes general practitioners did not adhere to the guideline. Conclusion In 2001, the management of infectious conjunctivitis by Dutch general practitioners was not in accordance with the recommendations of the consensus-based guideline published five years previously, despite its wide distribution. In 2006 this guideline was revised. Its successful implementation requires more than distribution alone. Probably the most effective way to achieve this is by following a model for systemic implementation. PMID:17868475

  6. EVALUATION OF SAFETY AND EFFECTIVENESS OF HYLAN GF-20 IN PATIENTS WITH KNEE OSTEOARTHRITIS IN REAL LIFE PRACTICE: PRELIMINARY RESULTS

    Directory of Open Access Journals (Sweden)

    G. V. Kuropatkin

    2016-01-01

    Full Text Available Combined conservative treatment of osteoarthritis includes intra-articular injections of hyaluronic acid. The paper presents the interim results of a prospective observational multicenter non-comparative study conducted in accordance with routine clinical practice to assess the safety and effectiveness of Hylan GF-20 in patients with knee osteoarthritis. The primary objective of the study is to assess walking and rest pain severity by WOMAC VA3.1 scale after 26 weeks and 52 weeks compared to the baseline. To date, 42 patients completed the study (71.43% women, 28.57% men, patients mean age is 59.79 years. After intraarticular injection of Hylan GF-20 patients were examined after 3, 6 and 12 months. After 3 months a positive clinical response was observed: pain severity decreased by 51.31% (p<0,001 on WOMAC A, joint stiffness decreased by 51.02% (p<0,001 on WOMAC B, daily life difficulties decreased by 42.03% (p<0,001 on WOMAC C. The same tendency was observed in the following periods. By week 52 pain severity reduced by 53.25% (p<0,001 on WOMAC A, joint stiffness by 41.63% (p<0,001 on WOMAC B, daily life difficulties -by 47.55% (p<0.001 on WOMAC C. Level of clinical response didn't correlate with the osteoarthritis stage. Therapy resulted in improvement of life quality of patients with knee osteoarthritis by 36% (p<0,001 according to the questionnaire EQ-5D. The general patients status according to physicians improved by 33.96% (p<0,001 on VAS, and by 45.91% (p<0,001 according to patients response on VAS. By week 52 of follow-up 11,90% of patients demonstrated a decrease in required concomitant therapy of osteoarthritis. Given the chronic nature of the osteoarthritis it's the most important that the therapeutic effect of Hylan GF-20 maintains until week 52. The above results confirm the efficiency of intraar-ticular injection of hyaluronic acid in patients with knee osteoarthritis especially in early disease stage.

  7. Impetigo: incidence and treatment in Dutch general practice in 1987 and 2001: results from two national surveys.

    NARCIS (Netherlands)

    Koning, S.; Mohammedamin, R.S.A.; Wouden, J.C. van der; Suijlekom-Smit, L.W.A. van; Schellevis, F.G.; Thomas, S.

    2006-01-01

    Background: Impetigo is a common skin infection in children. The epidemiology is relatively unkown, and the choice of treatment is subject to debate. Objective: The objective of our study was to determine the incidence and treatment of impetigo in Dutch general practice, and to assess trends between

  8. Practices to "Foster" in Out-of-School Time Programs. Research-to-Results Brief. Publication #2010-02

    Science.gov (United States)

    Moore, Kristin Anderson; Bronte-Tinkew, Jacinta; Collins, Ashleigh

    2010-01-01

    A lot has been learned about effective approaches to realizing intended out-of-school time program outcomes. As program practitioners consider fostering evidence-based practices, program administrators, staff, and stakeholders must keep in mind that it is difficult to change behavior overnight, even among children. Efforts to improve outcomes for…

  9. Exploring the gap between the practical and theoretical world of ERP implementations: results of a global survey.

    NARCIS (Netherlands)

    Catersels, R.; Helms, R.W.; Batenburg, R.

    2010-01-01

    This paper describes the differences between the theoretical world of ERP researchers and the practical world of ERP consultants. A survey was held among 129 ERP consultants to explore their opinion and experience with regard to a number of subjects that have been researched in many papers, such as

  10. Farmers' knowledge and perception of cotton pests and pest control practices in Benin: results of a diagnostic study

    NARCIS (Netherlands)

    Sinzogan, A.A.C.; Huis, van A.; Kossou, D.K.; Jiggins, J.L.S.; Vodouhè, S.

    2004-01-01

    Cotton production constraints in Benin as perceived by farmers were studied from May to July 2003. The knowledge, perceptions and practices of farmers growing cotton under different pest management regimes were analysed. The methods used were open and semi-structured interviews with groups and indiv

  11. Use of Alternate Assessment Results in Reporting and Accountability Systems: Conditions for Use Based on Research and Practice. Synthesis Report.

    Science.gov (United States)

    Quenemoen, Rachel; Rigney, Susan; Thurlow, Martha

    State assessment systems must address both technical and policy issues as assessments and accountability practices are developed and implemented. These technical and policy issues have been expanded from traditional large-scale assessment to new alternative assessment approaches required by law and developed in every state. The primary purpose of…

  12. Clinical practice of defibrillator implantation after myocardial infarction: impact of implant time: results from the PreSCD II Registry†

    Science.gov (United States)

    Völler, Heinz; Kamke, Wolfram; Klein, Helmut U.; Block, Michael; Reibis, Rona; Treusch, Sven; Contzen, Klaus; Wegscheider, Karl

    2011-01-01

    Aims Current guidelines recommend implantable cardioverter-defibrillator (ICD) therapy for primary prevention of sudden cardiac death in patients with the reduced left ventricular function (LVEF ≤30%) not earlier than 40 days after myocardial infarction (MI). The aim of the prospective Prevention of Sudden Cardiac Death II (PreSCD II) registry was to investigate the clinical practice of ICD therapy in post-MI patients and to assess the impact on survival. Methods and results 10 612 consecutive patients (61 ± 12 years, 76% male) were enrolled 4 weeks or later after MI in 19 cardiac rehabilitation centres in Germany from December 2002 to May 2005. All patients with left ventricular ejection fraction (LVEF) ≤40% (n = 952) together with a randomly selected group of patients with preserved left ventricular function (n = 1106) were followed for 36 months. Cox proportional hazard models were used to correlate ICD implantation and survival with baseline characteristics. Of all patients studied, 75.9% were enrolled within 4–8 weeks, 10.7% more than 1 year after MI. Pre-specified Group 1 with an LVEF ≤30% consisted of 269 patients (2.5%), Group 2 with LVEF 31–40% of 727 patients (6.9%), and Group 3 with LVEF >40% of 1148 randomly selected patients from the cohort of 9616 patients with preserved LV function. After 36 months, only 142 patients (6.9%) had received an ICD; 82 (31.7%) of Group 1, 49 (7%) of Group 2, and 11 (1%) in Group 3. The ICD was implanted in 47% of all patients within 1 year after their index MI. Implantable cardioverter-defibrillator patients were predominantly characterized by low ejection fraction, but also by several other independent risk factors. Patients who received an ICD had an adjusted 44% lower mortality (hazard ratio 0.56, 95% confidence intervals 0.32–1.01; P = 0.053) than comparable patients without ICD therapy. All cause mortality of ICD recipients was significantly lower if the ICD was implanted later than 11 months after acute

  13. [Evidence-based medicine. 1. The transfer of research results to clinical practice. The Italian Group for Evidence-Based Medicine-GIMBE].

    Science.gov (United States)

    Cartabellotta, A

    1998-03-01

    Evidence-based Medicine, born officially in November 1992, during last five years is grown everywhere, showing its power to influence virtually all aspects of health care: clinical practice, medical education, patient information and health policy. Because of the raising interest also in Italy for the new paradigm of clinical practice, "Recently Progress in Medicina" launches a series of articles with the aim of giving to physicians tools and skills for searching, critically appraising and implementing in their own decisions the best results of clinical research. For a better explanation of practical aspects of Evidence-based Medicine, the first article discusses about several obstacles existing in transferring correctly and timely the results of research into clinical practice, and about the potential role of Evidence-based Medicine in the evolution of the medical art and the health systems of the third millennium.

  14. Interprofessional practices of physiotherapists working with adults with low back pain in Québec’s private sector: results of a qualitative study

    Science.gov (United States)

    2014-01-01

    Background Collaboration and interprofessional practices are highly valued in health systems, because they are thought to improve outcomes of care for persons with complex health problems, such as low back pain. Physiotherapists, like all health providers, are encouraged to take part in interprofessional practices. However, little is known about these practices, especially for private sector physiotherapists. This study aimed to: 1) explore how physiotherapists working in the private sector with adults with low back pain describe their interprofessional practices, 2) identify factors that influence their interprofessional practices, and 3) identify their perceived effects. Methods Participants were 13 physiotherapists, 10 women/3 men, having between 3 and 21 years of professional experience. For this descriptive qualitative study, we used face-to-face semi-structured interviews and conducted content analysis encompassing data coding and thematic regrouping. Results Physiotherapists described interprofessional practices heterogeneously, including numerous processes such as sharing information and referring. Factors that influenced physiotherapists’ interprofessional practices were related to patients, providers, organizations, and wider systems (e.g. professional system). Physiotherapists mostly viewed positive effects of interprofessional practices, including elements such as gaining new knowledge as a provider and being valued in one’s own role, as well as improvements in overall treatment and outcome. Conclusions This qualitative study offers new insights into the interprofessional practices of physiotherapists working with adults with low back pain, as perceived by the physiotherapists’ themselves. Based on the results, the development of strategies aiming to increase interprofessionalism in the management of low back pain would most likely require taking into consideration factors associated with patients, providers, the organizations within which they

  15. Engineering change management report 2012: Survey results on causes and effects, current practice, problems, and strategies in Brazil

    DEFF Research Database (Denmark)

    Chucholowski, Nepomuk; Langer, Stefan; Ferreira, Marcelo Gitirana Gomes

    management of engineering changes is a crucial precondition for Brazilian companies to successfully compete not only on the fast growing Brazilian market, but also on the world market which becomes more interesting due to the rising industrial power of Brazil. To achieve improvements in engineering change...... management practice, industry and universities need to work together. In this report the main findings of our study on Engineering Change Management (ECM) in Brazilian companies are presented, which indicate possible solution strategies and further research needs. Our survey aimed on the investigation...... of current practice, the biggest challenges and potential strategies of engineering change management. A total of 55 Brazilian companies from a broad range of industry sectors and company sizes participated from December 2011 until January 2012 in the survey which was elaborated and conducted by members...

  16. 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

  17. Enlightenment by Chiropractic's developing mode%由脊骨神经医学发展模式引发的思考

    Institute of Scientific and Technical Information of China (English)

    王辉昊; 张明才; 詹红生

    2011-01-01

    在治疗脊柱相关疾病时,中医脊柱推拿疗法与脊骨神经医学存在一定相似之处,但自身也保持着鲜明的特色.虽然中医脊柱推拿疗法的"骨错缝、筋出槽"与脊骨神经医学的"椎体半脱位"均未形成定论,但脊骨神经医学已经与WHO开展正式合作,并且形成指导其进一步规范化推广.相对而言,中医脊柱推拿疗法有着成熟理论体系和良好临床疗效,却难以作为正规医疗方式走向世界.本文通过对中医脊柱推拿疗法的基本理论与临床思维进行分析,旨在通过分析中医脊柱推拿疗法的不足之处,借鉴脊骨神经医学之优势,对中医脊柱推拿疗法之推广分析和探讨,希望为相关领城提供参考.%Traditional Chinese spinal manipulative therapy (TCSMT) and Chiropractic are similar in treating related with spinal disease,but they keep different characteristics of themselves. Although Chiropractic's "Subluxation" and TCSMT's "Jin Chu Cao and Gu Cuo Feng" theory have not be widely recognized,yet Chiropractic has already have official cooperation with WHO, and has launched "WHO Basis of Chiropractic Training and Security Guide" which would promote the project further research. Comparatively,TCSMT has mature theoretical system and satisfactory clinical effectiveness,but it's hard to global spreading formally and legally. By means of cogitation of the TCSMT'S basic theories and clinical applications, this paper aims to analyze the inadequacy aspects of it,and hope to borrow some Chiropractic's advantage to TCSMT's global spreading. And I wish this paper could be helpful for relative doctors and researchers.

  18. Diarrhoea in general practice: when should a Clostridium difficile infection be considered? Results of a nested case-control study.

    Science.gov (United States)

    Hensgens, M P M; Dekkers, O M; Demeulemeester, A; Buiting, A G M; Bloembergen, P; van Benthem, B H B; Le Cessie, S; Kuijper, E J

    2014-12-01

    Clostridium difficile infections (CDIs) are frequent in hospitals, but also seem to increase in the community. Here, we aim to determine the incidence of CDI in general practice and to evaluate current testing algorithms for CDI. Three Dutch laboratories tested all unformed faeces (12,714) for C. difficile when diagnostic testing (for any enteric pathogen) was requested by a general practitioner (GP). Additionally, a nested case-control study was initiated, including 152 CDI patients and 304 age and sex-matched controls. Patients were compared using weighted multivariable logistic regression. One hundred and ninety-four samples (1.5%) were positive for C. difficile (incidence 0.67/10,000 patient years). This incidence was comparable to that of Salmonella spp. Compared with diarrhoeal controls, CDI was associated with more severe complaints, underlying diseases, antibiotic use and prior hospitalization. In our study, GPs requested a test for C. difficile in 7% of the stool samples, thereby detecting 40% of all CDIs. Dutch national recommendations advise testing for C. difficile when prior antibiotic use or hospitalization is present (18% of samples). If these recommendations were followed, 61% of all CDIs would have been detected. In conclusion, C. difficile is relatively frequent in general practice. Currently, testing for C. difficile is rare and only 40% of CDI in general practice is detected. Following recommendations that are based on traditional risk factors for CDI, would improve detection of CDI.

  19. Consumer knowledge, storage, and handling practices regarding Listeria in frankfurters and deli meats: results of a Web-based survey.

    Science.gov (United States)

    Cates, Sheryl C; Morales, Roberta A; Karns, Shawn A; Jaykus, Lee-Ann; Kosa, Katherine M; Teneyck, Toby; Moore, Christina M; Cowen, Peter

    2006-07-01

    Proper storage and handling of refrigerated ready-to-eat foods can help reduce the risk of listeriosis. A national Web-based survey was conducted to measure consumer awareness and knowledge of Listeria and to estimate the prevalence of the U.S. Department of Agriculture-recommended consumer storage and handling practices for frankfurters and deli meats. The demographic characteristics of consumers who are unaware of Listeria and who do not follow the recommended storage guidelines were also assessed. In addition, predictive models were developed to determine which consumers engage in risky storage practices. Less than half of the consumers surveyed were aware of Listeria, and most of those aware were unable to identify associated food vehicles. Awareness was lower among adults 60 years of age and older, an at-risk population for listeriosis, and individuals with relatively less education and lower incomes. Most households safely stored and prepared frankfurters. Most households stored unopened packages of vacuum-packed deli meats in the refrigerator within the U.S. Department of Agriculture-recommended storage guidelines (deli meats and freshly sliced deli meats for longer than the recommended time (< or =5 days). Men, more-educated individuals, and individuals living in metropolitan areas were more likely to engage in risky storage practices. This study identified the need to develop targeted educational initiatives on listeriosis prevention.

  20. 捏脊疗法缓解骨折术后患者腹胀、便秘及尿潴留的效果%Effect of chiropractic therapy on flatulence, constipation and urinary retention for fracture patients

    Institute of Scientific and Technical Information of China (English)

    赵玉英; 赵玉洁

    2012-01-01

    Objective To study the effect of chiropractic therapy on flatulence,constipation and urinary retention for fracture patients.Methods Totals of 200 fracture patients with flatulence,constipation and urinary retention were randomly divided into experiment group and control group with 100 cases in each group.The control group received routine treatment and care,while the experiment group received chiropractic therapy and routine treatment and care.Then,the remission of flatulence,constipation and urinary retention in two groups were observed and compared.Results After intervention,in the experiment group the total effectual rates of flatulence,constipation and urinary retention were 74.4%,62.0%,69.6% respectively and the effective rates were 20.9%,38.0%,21.7%,respectively,while the total effectual rates in the control group were 35.7%,31.0%,32.1% and the effective rates were 42.9%,47.0%,35.7% respectively,and the differences were statistically significant(x2 =5.246,4.618,4.023;P <0.05).Conclusions Chiropractic therapy for patients can effectively remit their flatulence,constipation and urinary retention,and this method is sample,has little side effect and can be easily accepted by patients.%目的 探讨捏脊疗法对骨折术后患者腹胀、便秘和尿潴留的治疗作用.方法 将200例骨折术后并发腹胀、便秘、尿潴留的患者按随机数字法随机分为试验组和对照组,每组100例.对照组给予常规治疗护理,试验组在常规治疗护理的基础上加用捏脊疗法.比较两组患者腹胀、便秘、尿潴留的缓解情况.计数资料采用x2检验,等级资料采用Ridit分析.结果 干预后,试验组患者腹胀、便秘、尿潴留缓解显效率分别为74.4%,62.0%,69.6%,有效率分别为20.9%,38.0%,21.7%;对照组显效率分别为35.7%,31.0%,32.1%,有效率分别为42.9%,47.0%,35.7%;两组比较差异均有统计学意义(x2分别为5.246,4.618,4.023;P均<0

  1. 捏脊疗法在治疗消化道慢性炎症疾病的临床应用%Clinical application of chiropractic therapy in the treatment of gastrointestinal chronic inflammatory diseases

    Institute of Scientific and Technical Information of China (English)

    林小兰; 唐勇; 李珍

    2012-01-01

    目的 研究捏脊疗法在治疗消化道慢性炎症性疾病的应用,并探讨其相关原理.方法 将120例慢性消化道炎症性疾病患者随机分为对照组和治疗组,每组各60例.对照组采用常规治疗方法;治疗组除采取常规治疗方法外另外再采用捏脊疗法治疗.比较两组患者的便血、消化不良、便秘、腹痛、腹泻等症状的改善情况.结果 对照组中,共有25例便血,22例消化不良,16例腹泻,13例腹痛,8例便秘.经治疗后症状消失46例,改善17例,无变化或加重21例.而治疗组中,共有28例便血,21例消化不良,17例腹痛,14例腹泻,6例便秘.经治疗后症状消失72例、改善11例、无变化或加重3例.治疗组的总体症状改善率(96.51%)高于对照组(75.00%),差异有统计学意义(P<0.05).结论 对于消化道慢性炎症性疾病,在常规疗法基础上加用捏脊疗法可以明显提高治疗效果,减少相关症状发生.%Objective To study the clinical application of chiropractic therapy in the treatment of gastrointestinal chronic inflammatory diseases, and to explore its associated principles. Methods 120 cases of patients with chronic gastrointestinal inflammatory disease were randomly divided into control group and treatment group, each group had 60 cases. The control group received conventional treatment methods. Addition to the conventional treatment methods, the treatment group received chiropractic treatment. Compare between the two groups to improve the situation of the patient's blood in the stool, indigestion, constipation, abdominal pain, diarrhea symptoms. Results In the control group, a total of 25 cases of blood in the stool, and 22 cases of indigestion, diarrhea in 16 cases, 13 cases of abdominal pain, 8 cases of constipation, symptoms disappeared of 46 cases, to improve the 17 cases, no change or increase the 21 cases after treatment. In the experimental group, a total of 28 cases of blood in the stool, 21 cases of

  2. Patient Safety Culture in Nephrology Nurse Practice Settings: Results by Primary Work Unit, Organizational Work Setting, and Primary Role.

    Science.gov (United States)

    Ulrich, Beth; Kear, Tamara

    2015-01-01

    Patient safety culture is critical to the achievement of patient safety. In 2014, a landmark national study was conducted to investigate patient safety culture in nephrology nurse practice settings. In this secondary analysis of data from that study, we report the status of patient safety culture by primary work unit (chronic hemodialysis unit, acute hemodialysis unit, peritoneal dialysis unit) and organizational work setting (for-profit organization, not-for-profit organization), and compare the perceptions of direct care nurses and managers/administrators on components of patient safety culture.

  3. Knowledge, Beliefs and Practices Regarding Antiretroviral Medications for HIV Prevention: Results from a Survey of Healthcare Providers in New England.

    Directory of Open Access Journals (Sweden)

    Douglas S Krakower

    Full Text Available Antiretroviral treatment for HIV-infection before immunologic decline (early ART and pre-exposure chemoprophylaxis (PrEP can prevent HIV transmission, but routine adoption of these practices by clinicians has been limited.Between September and December 2013, healthcare practitioners affiliated with a regional AIDS Education and Training Center in New England were invited to complete online surveys assessing knowledge, beliefs and practices regarding early ART and PrEP. Multivariable models were utilized to determine characteristics associated with prescribing intentions and practices.Surveys were completed by 184 practitioners. Respondent median age was 44 years, 58% were female, and 82% were white. Among ART-prescribing clinicians (61% of the entire sample, 64% were aware that HIV treatment guidelines from the Department of Health and Human Services recommended early ART, and 69% indicated they would prescribe ART to all HIV-infected patients irrespective of immunologic status. However, 77% of ART-prescribing clinicians would defer ART for patients not ready to initiate treatment. Three-fourths of all respondents were aware of guidance from the U.S. Centers for Disease Control and Prevention recommending PrEP provision, 19% had prescribed PrEP, and 58% of clinicians who had not prescribed PrEP anticipated future prescribing. Practitioners expressed theoretical concerns and perceived practical barriers to prescribing early ART and PrEP. Clinicians with higher percentages of HIV-infected patients (aOR 1.16 per 10% increase in proportion of patients with HIV-infection, 95% CI 1.01-1.34 and infectious diseases specialists (versus primary care physicians; aOR 3.32, 95% CI 0.98-11.2 were more likely to report intentions to prescribe early ART. Higher percentage of HIV-infected patients was also associated with having prescribed PrEP (aOR 1.19, 95% CI 1.06-1.34, whereas female gender (aOR 0.26, 95% CI 0.10-0.71 was associated with having not

  4. Application of rivaroxaban in clinical practice: results of a prospective observational study XANTUS in patients with atrial fibrillation

    Directory of Open Access Journals (Sweden)

    S. G. Kanorskii

    2016-01-01

    Full Text Available In XANTUS study the safety and efficacy of factor Xa inhibitor rivaroxaban were evaluated in routine clinical practice in patients with non-valvular atrial fibrillation. In consecutive patients who started treatment with rivaroxaban, all adverse events were recorded every 3 months for 1 year. Conclusions of major bleeding, symptomatic thromboembolic complications (stroke, systemic embolism, transient ischemic attack, and myocardial infarction and death from all causes were centrally adjudicated. In total 6784 patients were treated with rivaroxaban at 311 centers in Europe, Israel, and Canada, on average, 329 days. The mean CHADS2 and CHA2DS2-VASc scores were 2.0 and 3.4, respectively. Treatmentemergent major bleeding occurred in 128 patients (2.1 events per 100 patient-years, 118 (1.9 events per 100 patient-years died, and 43 (0.7 events per 100 patient-years suffered a stroke. XANTUS is the first international, prospective, observational study to describe the use of rivaroxaban in a broad non-valvular atrial fibrillation patient population. Rates of stroke and major bleeding were low in patients receiving rivaroxaban in routine clinical practice.

  5. Relationships among moral distress, level of practice independence, and intent to leave of nurse practitioners in emergency departments: results from a national survey.

    Science.gov (United States)

    Trautmann, Jennifer; Epstein, Elizabeth; Rovnyak, Virginia; Snyder, Audrey

    2015-01-01

    The aims of this research study were to investigate moral distress among emergency department (ED) nurse practitioners (NPs) and examine relationships between moral distress and level of practice independence as well as intent to leave a position. Moral distress has been studied regarding registered nurses and physicians (MDs) but less so in NPs. It is important to explore moral distress in NPs because they tread a unique path between nursing and physician roles. Moral distress may play a significant role in staff nurses' intention to leave practice, and level of practice independence is found to have a relationship with NPs' intention to leave. A convenience sample of ED NPs was obtained from a mailing list of a national nursing specialty organization, the Emergency Nurses Association. Using a correlational design, survey methods assessed moral distress with the Moral Distress Scale-Revised (MDS-R), level of practice independence with the Dempster Practice Behavior Scale, and intent to leave with self-report. Correlational and regression analyses of data were conducted to characterize moral distress among ED NPs and associations between moral distress, level of practice independence, and intent to leave. Results found ED NPs do experience moral distress with poor patient care results from inadequate staff communication and working with incompetent coworkers in their practice. The MDS-R was a significant predictor of intention to leave among respondents. This study is the first of its kind to explore moral distress in ED NPs. Results suggest moral distress influences ED NPs' intent to leave their position. Further studies are needed to explore the findings from this research and to formulate interventions to alleviate moral distress in ED NPs and improve retention in the clinical setting.

  6. Variation in infection prevention practices in dialysis facilities: results from the national opportunity to improve infection control in ESRD (End-Stage Renal Disease) project.

    Science.gov (United States)

    Chenoweth, Carol E; Hines, Stephen C; Hall, Kendall K; Saran, Rajiv; Kalbfleisch, John D; Spencer, Teri; Frank, Kelly M; Carlson, Diane; Deane, Jan; Roys, Erik; Scholz, Natalie; Parrotte, Casey; Messana, Joseph M

    2015-07-01

    OBJECTIVE To observe patient care across hemodialysis facilities enrolled in the National Opportunity to Improve Infection Control in ESRD (end-stage renal disease) (NOTICE) project in order to evaluate adherence to evidence-based practices aimed at prevention of infection. SETTING AND PARTICIPANTS Thirty-four hemodialysis facilities were randomly selected from among 772 facilities in 4 end-stage renal disease participating networks. Facility selection was stratified on dialysis organization affiliation, size, socioeconomic status, and urban/rural status. MEASUREMENTS Trained infection control evaluators used an infection control worksheet to observe 73 distinct infection control practices at the hemodialysis facilities, from October 1, 2011, through January 31, 2012. RESULTS There was considerable variation in infection control practices across enrolled facilities. Overall adherence to recommended practices was 68% (range, 45%-92%) across all facilities. Overall adherence to expected hand hygiene practice was 72% (range, 10%-100%). Compliance to hand hygiene before and after procedures was high; however, during procedures hand hygiene compliance averaged 58%. Use of chlorhexidine as the specific agent for exit site care was 19% overall but varied from 0% to 35% by facility type. The 8 checklists varied in the frequency of perfect performance from 0% for meeting every item on the checklist for disinfection practices to 22% on the arteriovenous access practices at initiation. CONCLUSIONS Our findings suggest that there are many areas for improvement in hand hygiene and other infection prevention practices in end-stage renal disease. These NOTICE project findings will help inform the development of a larger quality improvement initiative at dialysis facilities.

  7. Clinical Study on Treating the Patients with Ankylosing Spondylitis at Early and Medium Stages by Chiropractic and Meridian Manipulations%整脊经筋手法治疗强直性脊柱炎早中期患者临床研究

    Institute of Scientific and Technical Information of China (English)

    刘渊; 孙雪莲; 周红海

    2014-01-01

    目的:探讨整脊经筋手法治疗早中期强直性脊柱炎患者的临床疗效。方法:将27例确诊为早中期强直性脊柱炎患者随机分为整脊经筋手法组(手法组)15例、柳氮磺吡啶结肠溶胶囊组(药物组)12例,共治疗4周,分别于治疗前和治疗后观察2组患者脊柱生物力学活动度、VAS评分和ESR、CRP等风湿3项。结果:手法组在改善脊柱生物力学活动度方面优于药物组,但对于血沉等生化指标的改善不如药物组。结论:整脊经筋手法在脊柱生物力学改善方面效果确实可靠,其操作简单适应性广,不失为一种可推广的疗法。%Objective: To survey clinical effects of chiropractic and meridian manipulations in treating the pa-tients with ankylosing spondylitis at early and medium stages. Methods: All 27 patients were randomized into 15 cases in the group of chiropractic and meridian manipulations (manipulation group) and 12 cases in sulfasalazine capsules group (drug group), for four weeks, the activity of spine biomechanics, VAS, ESR, CRP and other indexes in both groups were observed before and after treating. Results: Manipulation group was superior to drug group in improving the activity of spine biomechanics, but not as well as drug group in improving biochemical indexes such as ESR. Conclusion: Chiropractic and meridian manipulations are reliable in improving spine biomechanics, the op-eration is simple and feasible, and it should be spread.

  8. 龙氏治脊疗法结合针刺治疗椎动脉型颈椎病60例临床观察%Clinical observation on treating 60 cases of cervical spondylosis of vertebral artery type by acupuncture plus the Long’s chiropractic therapy

    Institute of Scientific and Technical Information of China (English)

    谭周纯; 洪文

    2016-01-01

    目的:观察龙氏治脊疗法结合针刺治疗椎动脉型颈椎病的临床疗效。方法:将120例椎动脉型颈椎病患者随机分为两组,治疗组采取龙氏治脊疗法结合针灸治疗。对照组采取针刺治疗。结果:治疗组痊愈率与总有效率分别为50.00%和91.67%。而对照组痊愈率与总有效率则分别为26.67%和68.33%。两组比较,差异均有显著性意义(P<0.05),治疗组疗效优于对照组。结论:龙氏治脊疗法结合针刺治疗椎动脉型颈椎病疗效明显优于单用针刺,值得临床进一步推广应用。%Objective: To observe clinical efcacy of acupuncture plus the Long’s chiropractic therapy on cervical spondylosis of vertebral artery type. Methods: 120 patients were randomly divided into two groups; the treatment group was given acupuncture plus the Long’s chiropractic therapy. The control group was treated by acupuncture. Results: The efciency and the total efciency were 50.00%and 91.67% respectively in the treatment group; and were 26.67% and 68.33% respectively in the control group (P<0.05); and efcacy in the treatment group was better. Conclusion: Acupuncture plus the Long’s chiropractic therapy on cervical spondylosis of vertebral artery type shows a good effect, and is worthy of promotion.

  9. Clinical Research of Small Needle-knife Combined with Chiropractic Manipulative Therapy in Treating Nerve Root Type Cervical Spondylopathy%小针刀配合整脊手法治疗神经根型颈椎病的临床研究

    Institute of Scientific and Technical Information of China (English)

    王顺兴; 黄泳

    2012-01-01

    Objective:To explore the clinical curative effects of applying small needle-knife combined with chiropractic manipulation therapy in treating nerve root cervical spondylopathy. Methods;82 cases of nerve root type cervical spondylopathy patients were divided into the small needle-knife group and the combination treatment group,with each group of 41 patients. The small needle-knife group was treated by small needle-knife; the combination treatment group was treated by small needle-knife combined with chiropractic manipulative treatment methods. Results;The recovery effects of patients' disease condition after treatment in the combination treatment group was obviously superior to the small needle-knife group; improved degree of VAS score was significantly greater than the small needle-knife group; number of adverse reactions are obviously less than that of the small needle-knife group; recurrence rate was significantly lower than that of small group. Conclusion: The application of small needle-knife combined with chiropractic manipulation has distinctly clinical curative effects in treating nerve root type cervical spondylopathy.%目的:探讨应用小针刀联合整脊手法治疗神经根型颈椎病的临床疗效.方法:将82例神经根型颈椎病患者分为对照组和治疗组,每组41例.对照组采用小针刀治疗;治疗组采用小针刀与整脊手法联合方法治疗.结果:治疗组治疗后病情好转效果明显优于对照组;VAS评分的改善幅度明显优于对照组;出现不良反应的人数明显少于对照组;复发率明显低于对照组.结论:小针刀联合整脊手法治疗神经根型颈椎病临床效果明显.

  10. Efficacy Observation on Chiropractic with Release of Closed Type and Traction Treating Cervical Spondylotic Radiculopathy*%闭合型松解配合牵引下整脊治疗神经根型颈椎病的疗效观察

    Institute of Scientific and Technical Information of China (English)

    沈彤; 章瑛; 尹伦辉; 梁伟坚; 敖晓龙; 谌凌燕; 何巍

    2013-01-01

    Objective: To observe clinic effects of chiropractic with release of closed type and traction treating cervical spondylotic radiculopathy. Methods: 60 cases of patients with cervical spondylosis radiculopathy were randomly divided into treatment group and control group, treatment group received therapy of chiropractic with release of closed type and traction , and control group adopt-ed release of closed type and traction treatment, to compare with two groups of clinical efficacy and condition of pain scores before and after treatment. Results: the total effective rate of treatment group was 93.3%, higher than 80% of control group (P<0.05); The pain scores of two groups after treatment both decreased significantly (P<0.05), but the pain scores of treatment group after treat-ment were lower (P<0.05). Conclusion: Therapeutic effects on chiropractic with release of closed type and traction treating cervical spondylotic radiculopathy are distinct and operational safety, which is worthy of clinical promotion.%  目的:观察闭合型松解配合牵引下整脊治疗神经根型颈椎病的临床疗效.方法:将60例神经根型颈椎病患者随机分为治疗组及对照组,治疗组采用闭合型松解配合牵引下整脊治疗,对照组采用闭合型松解配合单纯牵引治疗,对比两组的临床疗效及治疗前后疼痛积分情况.结果:治疗组总有效率93.3%,高于对照组的80.0%(P<0.05);两组治疗后的疼痛积分均明显降低(P<0.05),但治疗组治疗后的疼痛积分低于对照组(P<0.05).结论:闭合型松解配合牵引下整脊治疗神经根型颈椎病临床疗效显著,操作安全,值得临床推广.

  11. Effective observation on treating 53 cases of cervical spondylosis of vertebral artery type with the Pingxuan decoction plus chiropractic%平眩汤联合整脊推拿治疗椎动脉型颈椎病53例的临床疗效观察

    Institute of Scientific and Technical Information of China (English)

    陈荣凯

    2016-01-01

    Objective: To observe clinical efficacy of the Pingxuan decoction plus chiropractic on cervical spondylosis of vertebral artery type. Methods: 53 patients in our hospital were divided into the control group (27 cases) and the observation group (26 cases). The control group was treated by chiropractic; the observation group was given the Pingxuan decoction more. Clinical efficiency in two groups was compared. Results: The total efficiency in the observation group was 96.30%, and 57.69% in the control group. Satisfactory rate in the observation group was 100.00%, and 61.54% in the control group (P﹤0.05). Conclusion: The Pingxuan decoction plus chiropractic on cervical spondylosis of vertebral artery type could relieve clinical symptoms, decrease adverse effects, and was worthy of promotion.%目的::观察分析平眩汤联合整脊推拿治疗椎动脉型颈椎病的临床疗效。方法:选取我院2013年7月-2015年7月收治的椎动脉型颈椎病患者53例为对象,随机分为对照组和观察组,对照组27例,观察组26例。对照组采用传统的推拿治疗,观察组采用平眩汤联合整脊推拿治疗,比较分析两组患者的临床治疗效果。结果:观察组总有效率为96.30%,对照组为57.69%(P﹤0.05);观察组治疗满意度为100.00%,对照组为61.54%(P﹤0.05)。结论:采用平眩汤联合整脊推拿治疗椎动脉型颈椎病,能减轻患者的临床症状,且不良反应发生率较低,具有临床推广价值。

  12. Treatment of adolescent idiopathic scoliosis by high-qualitive traction and Chinese medicine fumigation combined with chiropractic manipulation%优值牵引、中药熏蒸联合整脊手法治疗青少年特发性腰椎侧凸

    Institute of Scientific and Technical Information of China (English)

    张梦雨; 鲍铁周; 宋永伟; 李洋

    2016-01-01

    Objective: To observe the clinical effect of high-qualitive traction and Chinese medicine fumigation combined with chiropractic manipulation in the treatment of adolescent idiopathic scoliosis. Method: 48 patients with adolescent idiopathic scoliosis between February 2013 and March 2015 from were treated with high-qualitive traction and Chinese medicine fumigation combined with chiropractic manipulation. The VAS score, ODI score and Cobb change were compared before and after treatment. Result: After the treatment, the VAS score, ODI score and Cobb angle were decreased, and the difference between the three indicators were statistically significant(P<0.01). Conclusion: The treatment of AIS with high-qualitive traction and Chinese medicine fumigation combined with chiropractic manipulation can effectively improve the functional activity of patients, reduce the pain of patients with the advantages of simple operation, less injury and high safety.%目的:观察优值牵引、中药熏蒸联合整脊手法治疗青少年特发性腰椎侧凸的临床疗效。方法:2013年2月—2015年3月采用优值牵引、中药熏蒸联合整脊手法治疗青少年特发性脊柱侧弯患者48例,对比治疗前后患者VAS疼痛评分、ODI评分及Cobb角的变化。结果:疗程结束后患者的VAS疼痛评分、ODI评分及Cobb角均减小,且三项指标治疗前后差异具有统计学意义(P<0.01)。结论:优值牵引、中药熏蒸联合整脊手法治疗 AIS,可有效地改善患者功能活动,减轻患者疼痛,具有操作简便、无创安全等特点。

  13. 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.

  14. The influence of age at disease onset on disease activity and disability: results from the Ontario Best Practices Research Initiative.

    Science.gov (United States)

    Ruban, T N; Jacob, B; Pope, J E; Keystone, E C; Bombardier, C; Kuriya, B

    2016-03-01

    This study aims to compare characteristics between late-onset rheumatoid arthritis (RA) and young-onset RA and determine the association between age at disease onset and disease severity. We cross-sectionally studied 971 patients at the time of entry into the Ontario Best Practices Research Initiative, a registry of RA patients followed up in routine care. We restricted patients to ≤5 years of disease duration. Late-onset RA was defined as an onset ≥60 years of age and young-onset RA <60 years. Group differences were compared, and multivariate linear regression models were used to test the influence of age at onset on Disease Activity Score in 28 Joints with erythrocyte sedimentation rate (DAS28-ESR), Clinical Disease Activity Index (CDAI), and Health Assessment Questionnaire (HAQ) scores. The swollen joint count (6.2 vs. 5.3), acute phase reactants (C-reactive protein (CRP) 17.4 vs. 11.8 mg/L, ESR 30.6 vs. 21.5 mm/h), and comorbidity burden were higher in late-onset RA compared to young-onset RA (p < 0.01). Mean DAS28-ESR (4.6 vs. 4.3) and HAQ (1.2 vs. 1.1) scores were higher in late-onset RA patients (p < 0.05). Late-onset RA patients received more initial disease-modifying antirheumatic drug (DMARD) monotherapy and corticosteroids in comparison to greater DMARD/biologic combination therapy in young-onset RA patients (p < 0.05). Adjusted multivariate analyses showed that late-onset RA was independently associated with higher mean DAS28-ESR and HAQ scores, but not CDAI. Late-onset RA patients have greater disease activity that may contribute to disability early in the disease course. Despite this, initial treatment consists of less combination DMARD and biologic use in late-onset RA patients. This may have implications for future response to therapy and development of joint damage, disability, and comorbidities in this group.

  15. Characterisation of patients receiving moxifloxacin for acute bacterial rhinosinusitis in clinical practice: results from an international, observational cohort study.

    Directory of Open Access Journals (Sweden)

    Ralph Mösges

    Full Text Available We conducted a prospective, non-controlled, multi-centre Phase IV observational cohort study of patients with acute bacterial rhinosinusitis who were treated with moxifloxacin in clinical practice in 19 countries in Asia Pacific, Europe and the Middle East. With the data collected we evaluated the presentation and course of the current disease episode, particularly in terms of the principal clinical signs and symptoms of acute rhinosinusitis and diagnostic procedures. A final assessment of moxifloxacin therapy was made to evaluate the impact of the sinusitis episode on activities of daily life and on sleep disturbance, and to evaluate the clinical outcome of treatment. A total of 7,090 patients were enrolled, of whom 3909 (57.6% were included in the valid for clinical outcome and safety population. Regional differences were observed in the main symptoms of acute rhinosinusitis and, according to several characteristics, disease episodes appeared to be more severe in patients in Europe than in the Asia Pacific or Middle East regions. The sinusitis episode impacted on daily living for mean (SD periods of 3.6 (3.2, 4.6 (3.9 and 3.1 (3.0 days and disturbed sleep for 3.6 (3.2, 4.6 (3.9 and 3.1 (3.0 nights in the Asia Pacific, Europe and Middle East regions, respectively. With moxifloxacin treatment, the mean (SD time to improvement of symptoms was 3.0 (1.5, 3.4 (1.6 and 3.2 (1.5 days, and the time to resolution of symptoms was 4.8 (2.6 days, 5.7 (2.4 days and 5.5 (2.5 days, in the Asia Pacific, Europe and Middle East regions, respectively. In conclusion, acute rhinosinusitis remains a substantial health burden with significant impact on patients' quality of life, and there are differences between global regions in the clinical presentation, diagnosis and clinical course of disease episodes. Moxifloxacin was an effective and well-tolerated treatment option in the overall population.ClinicalTrials.gov Identifier: NCT00930488.

  16. 孙其斌主任医师捏脊疗法经验小结%Chief Physician SUN Qibin′s Experience of Using Chiropractic Therapy

    Institute of Scientific and Technical Information of China (English)

    孙力; 尚亚婷; 邓灵芝; 孙其斌(指导)

    2013-01-01

    Chief Physician SUN Qibin′s clinical experiences were reviewed by applying chiropractic therapy to the pain of loin and the back, gastrointestinal problems, gynecological disease insomnia, cough due to gastroin-testinal reflux and others.%从治疗腰背部疼痛、肠胃疾病、妇科疾病、失眠症、胃食管反流性咳嗽几方面小结孙其斌主任医师运用捏脊疗法的临床经验。

  17. [Quality and quality development in medical practices--epidemiological results of the accompanying evaluation of the new KBV quality management system].

    Science.gov (United States)

    Streuf, Roland; Diel, Franziska; Gibis, Bernhard; Blumenstock, Gunnar; Selbmann, Hans-Konrad

    2006-01-01

    The motivation for quality management has now reached medical and psychotherapeutic practices. This is partly due to exogenous factors, including regulatory requirements such as Sect. 135a SGB V (German Book of Social Code) demanding the implementation and further development of internal quality management from both out-patient and in-patient healthcare providers. The National Association of SHI-Accredited Physicians in Germany (KBV), along with several regional associations, responded to these internal demands and external requirements by developing the quality management system "Quality and Development in Practices (QEP)". Assisted by an independent institute, 61 selected practices participated in the pilot study. The pilot phase included five interview rounds held between April and November 2004 with 60 practices taking part. The results describe practitioners' expectations for the current state of and the demand for internal quality management. Only one in five practices expects improvements from the implementation of quality management in the area of healthcare processes and management. The improvement of organizational processes, patients' safety and patient outcomes are considered more important. In a self-assessment procedure which included 73 targets with 236 verifications from the quality target catalogue a distinct potential for quality improvement has been revealed. The greatest need for improvement has been identified in cases where quality management defines specific requirements for the practices. These include: treatment pathways, patient information, risk management, case discussions and instruction, quality improvement, regulations and quality measurement. Even practices with advanced quality development activities were able to detect some potential for improvement with the application of the QEP catalogue. In order to attain 15 selected quality targets with 45 verifications, the practices were provided with tools like sample documents and

  18. Sustainable Permaculture systems demonstration in the high mountain desert region of New Mexico -- results of five years practice

    Energy Technology Data Exchange (ETDEWEB)

    Lawrence, V. [Apache Creek Ranch, Santa Fe, NM (United States)

    1997-12-31

    This paper reports on five years of results in the Permaculture restoration of a mountain drylands ranch outside Santa Fe, New Mexico. Dramatic results have been produced in the areas of erosion control, pastureland restoration, wild species propagation, aquaculture, riparian zone (wetland) restoration, edible landscape design and installation methodologies. Recently completed work includes a grant-financed (US Fish and Wildlife Service Partners for Wildlife Program) replanting and redevelopment of the entire riparian zone of the ranch and the design and development of a trout-spawning pond system that is self contained and self-purifying, with circulation through a structured wetland provided by a photovoltaic pumping system. The paper presents the design philosophy, overall design strategy and significant details of specific strategies, projects, and systems.

  19. Sustainable permaculture systems demonstration in the high mountain desert region of New Mexico -- results of three years practice

    Energy Technology Data Exchange (ETDEWEB)

    Lawrence, V. [EarthLink, Santa Fe, NM (United States)

    1995-11-01

    This paper reports on three years of results in the Permaculture restoration of a mountain drylands ranch outside Santa Fe, New Mexico which receives less than 11 inches rainfall/year. Dramatic results have been produced in the areas of erosion control, pastureland restoration, wild species propagation, aquaculture, riparian zone (wetland) restoration, edible landscape design and installation methodologies. Additionally, significant work has been performed in the area of youth education and community development. Current work includes a grant-financed (US Fish and Wildlife Service ``Partners for Wildlife`` Program) replanting and redevelopment of the entire riparian zone of the ranch and the design and development of a trout-spawning pond system that is self contained and self-purifying, with circulation through a structured wetland provided by a photovoltaic pumping system. This paper presents the design philosophy, overall design strategy and significant details of specific strategies, projects, and systems.

  20. MODARIA WG5: Towards a practical guidance for including uncertainties in the results of dose assessment of routine releases

    Energy Technology Data Exchange (ETDEWEB)

    Mora, Juan C. [Centro de Investigaciones Energeticas, Medioambientales y Tecnologicas - CIEMAT (Spain); Telleria, Diego [International Atomic Energy Agency - IAEA (Austria); Al Neaimi, Ahmed [Emirates Nuclear Energy Corporation - ENEC (United Arab Emirates); Blixt Buhr, Anna Ma [Vattenfall AB (Sweden); Bonchuk, Iurii [Radiation Protection Institute - RPI (Ukraine); Chouhan, Sohan [Atomic Energy of Canada Limited - AECL (Canada); Chyly, Pavol [SE-VYZ (Slovakia); Curti, Adriana R. [Autoridad Regulatoria Nuclear - ARN (Argentina); Da Costa, Dejanira [Instituto de Radioprotecao e Dosimetria - IRD (Brazil); Duran, Juraj [VUJE Inc (Slovakia); Galeriu, Dan [Horia Hulubei National Institute of Physics and Nuclear Engineering - IFIN-HH (Romania); Haegg, Ann- Christin; Lager, Charlotte [Swedish Radiation Safety Authority - SSM (Sweden); Heling, Rudie [Nuclear Research and Consultancy Group - NRG (Netherlands); Ivanis, Goran; Shen, Jige [Ecometrix Incorporated (Canada); Iosjpe, Mikhail [Norwegian Radiation Protection Authority - NRPA (Norway); Krajewski, Pawel M. [Central Laboratory for Radiological Protection - CLOR (Poland); Marang, Laura; Vermorel, Fabien [Electricite de France - EdF (France); Mourlon, Christophe [Institut de Radioprotection et de Surete Nucleaire - IRSN (France); Perez, Fabricio F. [Belgian Nuclear Research Centre - SCK (Belgium); Woodruffe, Andrew [Federal Authority for Nuclear Regulation - FANR (United Arab Emirates); Zorko, Benjamin [Jozef Stefan Institute (Slovenia)

    2014-07-01

    MODARIA (Modelling and Data for Radiological Impact Assessments) project was launched in 2012 with the aim of improving the capabilities in radiation dose assessment by means of acquisition of improved data for model testing, model testing and comparison, reaching consensus on modelling philosophies, approaches and parameter values, development of improved methods and exchange of information. The project focuses on areas where uncertainties remain in the predictive capability of environmental models, emphasizing in reducing associated uncertainties or developing new approaches to strengthen the evaluation of the radiological impact. Within MODARIA, four main areas were defined, one of them devoted to Uncertainty and Variability. In this area four working groups were included, Working Group 5 dealing with the 'uncertainty and variability analysis for assessments of radiological impacts arising from routine discharges of radionuclides'. Whether doses are estimated by using measurement data, by applying models, or through a combination of measurements and calculations, the variability and uncertainty contribute to a distribution of possible values. The degree of variability and uncertainty is represented by the shape and extent of that distribution. The main objective of WG5 is to explore how to consider uncertainties and variabilities in the results of assessment of doses in planned situations for controlling the impact of routine releases from radioactive and nuclear installations to the environment. The final aim is to produce guidance for the calculation of uncertainties in these exposure situations and for the presentation of such results to the different stakeholders. To achieve that objective the main tasks identified were: to find tools and methods for uncertainty and variability analysis applicable to dose assessments in routine radioactive discharges, to define scenarios where information on uncertainty and variability of parameters is available

  1. Strengths-based recruitment and development a practical guide to transforming talent management strategy for business results

    CERN Document Server

    Bibb, Sally

    2016-01-01

    Strengths-Based Recruitment and Development explains how and why strengths-based recruitment (SBR) is having a transformational impact on performance in top companies like Saga, Gap, Starbucks and SABMiller. By shifting the focus from what people can do (competency-based recruitment) to what they naturally enjoy doing, or SBR, these companies have reported results which include a 50% drop in staff turnover, 20% increase in productivity and a 12% increase in customer satisfaction within a matter of months. It is no wonder that organizations in many sectors are adopting this new and powerful approach to improve performance, customer satisfaction and competitive edge. Strengths-Based Recruitment and Development includes case studies and interviews with executive board level leaders. These provide rare insight into how they implemented strengths approaches in their organizations to improve the bottom line and performance. The book shows how strengths-based talent management goes beyond simply recruiting the righ...

  2. Quality initiatives: improving patient flow for a bone densitometry practice: results from a Mayo Clinic radiology quality initiative.

    Science.gov (United States)

    Aakre, Kenneth T; Valley, Timothy B; O'Connor, Michael K

    2010-03-01

    Lean Six Sigma process improvement methodologies have been used in manufacturing for some time. However, Lean Six Sigma process improvement methodologies also are applicable to radiology as a way to identify opportunities for improvement in patient care delivery settings. A multidisciplinary team of physicians and staff conducted a 100-day quality improvement project with the guidance of a quality advisor. By using the framework of DMAIC (define, measure, analyze, improve, and control), time studies were performed for all aspects of patient and technologist involvement. From these studies, value stream maps for the current state and for the future were developed, and tests of change were implemented. Comprehensive value stream maps showed that before implementation of process changes, an average time of 20.95 minutes was required for completion of a bone densitometry study. Two process changes (ie, tests of change) were undertaken. First, the location for completion of a patient assessment form was moved from inside the imaging room to the waiting area, enabling patients to complete the form while waiting for the technologist. Second, the patient was instructed to sit in a waiting area immediately outside the imaging rooms, rather than in the main reception area, which is far removed from the imaging area. Realignment of these process steps, with reduced technologist travel distances, resulted in a 3-minute average decrease in the patient cycle time. This represented a 15% reduction in the initial patient cycle time with no change in staff or costs. Radiology process improvement projects can yield positive results despite small incremental changes.

  3. Techniques, tools and best practices for ligand electron-density analysis and results from their application to deposited crystal structures.

    Science.gov (United States)

    Pozharski, Edwin; Weichenberger, Christian X; Rupp, Bernhard

    2013-02-01

    As a result of substantial instrumental automation and the continuing improvement of software, crystallographic studies of biomolecules are conducted by non-experts in increasing numbers. While improved validation almost ensures that major mistakes in the protein part of structure models are exceedingly rare, in ligand-protein complex structures, which in general are most interesting to the scientist, ambiguous ligand electron density is often difficult to interpret and the modelled ligands are generally more difficult to properly validate. Here, (i) the primary technical reasons and potential human factors leading to problems in ligand structure models are presented; (ii) the most common categories of building errors or overinterpretation are classified; (iii) a few instructive and specific examples are discussed in detail, including an electron-density-based analysis of ligand structures that do not contain any ligands; (iv) means of avoiding such mistakes are suggested and the implications for database validity are discussed and (v) a user-friendly software tool that allows non-expert users to conveniently inspect ligand density is provided.

  4. Morbidity by tuberculosis in the Jiu Valley: relation with diagnostic practice and the impact on therapeutic results

    Science.gov (United States)

    PETRE, NICOLAE; HOMORODEAN, DANIELA; POP, CARMEN MONICA

    2017-01-01

    Background and aim In the last two and a half decades the dynamics of tuberculosis has been modelled by social and economic conditions, with consequences on the life style, and effects on the onset and evolution of the disease. The Jiu Valley is an area with social problems: mining, mines closing down and ceasing activity, poverty. We looked for a relationship between changes of life style in the Jiu Valley and the dynamics of tuberculosis. Methods We studied 528 patients who asked for medical services in different hospitals in the Jiu Valley between 2010–2013. We structurally characterized this group, we identified the characteristics of life style, and we assessed the health state, in particular the relation with tuberculosis. Results We found out that the quality of life was influenced by the health state, especially by tuberculous disease. Quality of life was influenced by the life style, professional factors and their long term consequences. The study evidenced a strong relationship between apparently very different factors such as life style, professional factors on one side and those characterizing tuberculosis. Conclusions We report the first detailed epidemiological data on tuberculosis in an economically poor area, the Jiu Valley.

  5. Evidence supporting primary prevention of cardiovascular diseases with statins: Gaps between updated clinical results and actual practice.

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    Bruckert, Eric; Ferrières, Jean

    2014-03-01

    The use of pharmacological lipid-lowering intervention in individuals with hypercholesterolaemia and known cardiovascular disease or diabetes/chronic kidney disease is well established. Current European Society of Cardiology guidelines recommend immediate initiation of drugs in adjunct to lifestyle intervention in these patients at high or very high cardiovascular risk. In these clinical settings, statins are generally chosen as the first-choice drug intervention, in consideration of the robust evidence showing a reduction in all-cause mortality and major adverse cardiac events (MACE). In contrast, primary prevention with statins, even in the subset of patients at high-risk of cardiovascular events, is not well implemented. This might be related to a lack of public awareness regarding the actual risk associated with prolonged exposure to high concentrations of low-density lipoprotein cholesterol (LDL-C) and uncertainties in the clinical evidence coming from the earliest trials in this patient subset. However, recent observational studies suggest that lowering LDL-C earlier in life and for a longer duration can substantially decrease the burden of cardiovascular disease and mortality. Moreover, results from recent well-conducted large meta-analyses of randomized clinical trials showed that primary prevention with statins reduced all-cause mortality by 14% and MACE by > 20% - findings similar to those observed for the use of statins in secondary prevention. Recently published American Heart Association/American College of Cardiology guidelines on the treatment of blood cholesterol emphasize that primary prevention using high-dose statins in individuals with LDL-C ≥ 190 mg/dL induces a benefit in atherosclerotic cardiovascular risk reduction that clearly exceeds the potential for adverse effects. We aim in this review to discuss the new data that advocate the use of statins in primary prevention earlier and more frequently, putting the efficacy evidence into

  6. Alcohol consumption in patients with cardiovascular diseases (results of the survey of cardiac patients in outpatient practice

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    O. D. Ostroumova

    2015-12-01

    Full Text Available Aim. To study the frequency and characteristics of alcohol use in outpatients with cardiovascular diseases and to determine their preferences regarding the help in limiting alcohol consumption.Material and methods. Voluntary and anonymous survey using AUDIT-C and CAGE questionnaires was conducted in 199 patients. The data of 182 patients (82 women and 100 men, mean age 56.4±5.8 years was included in the analysis.Results. Arterial hypertension (70%, heart rhythm disorders (25%, ischemic heart disease (20%, functional class I-II chronic heart failure (21% predominated among all clinical entities. Positive AUDIT-C test was found in 30% of men and 7.3% of women. 17% of men and 23.2% of women did not use alcohol at all. Positive responses to all 4 questions of the CAGE test were given by 3% of men and none of women, positive answers to 3 questions – by 15% of men and none of women, to 2 questions - by 17% of men and 11% of women. Positive answer to the question about the need to reduce alcohol consumption was given by 36% of men and 13.4% of women.Conclusion. Simultaneous testing using AUDIT-C and CAGE questionnaires in outpatients with cardiovascular diseases allows identifying a subgroup of patients (more in men who have a potential problem with an excessive alcohol consumption and need to reduce the intake of alcoholic beverages.

  7. Caspofungin Use in Daily Clinical Practice for Treatment of Invasive Aspergillosis: Results of a Prospective Observational Registry

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    Chandwani Sheenu

    2010-06-01

    Full Text Available Abstract Background A prospective observational registry assessed real world experience with caspofungin monotherapy or combination therapy for the initial or salvage treatment of proven or probable invasive aspergillosis (IA. Methods Data were collected from April 2006 to September 2007 for patients treated with caspofungin for a single episode of IA. Clinical effectiveness was categorized as favorable (complete or partial or unfavorable (stable disease or failure at the end of caspofungin therapy (EOCT. Results Consecutive patients (n = 103 with proven or probable IA (per EORTC/MSG criteria were identified from 11 countries. Malignancy (76.7%, neutropenia (64.1%, allogeneic hematopoietic stem cell transplantation (HSCT, 22.3%, solid organ transplantation (8.7%, autologous HSCT (4.9%, and HIV/AIDS (2.9% were the most common underlying conditions. Most patients (84.5% had pulmonary IA. Aspergillus fumigatus was the most frequently isolated species. The majority of patients received caspofungin monotherapy (82.5% primarily as salvage therapy (82.4%. The main reason for switching to salvage therapy was clinical failure of the first-line therapy (69%. A favorable response at EOCT was seen in 56.4% (57/101 of patients overall, including 56.5% (48/85 and 56.3% (9/16 of patients receiving caspofungin monotherapy and combination therapy, respectively. Favorable response rates in clinically relevant subgroups were: malignancy, 51.9% (41/79; allogeneic HSCT, 56.5% (13/23; and neutropenia at time of hospitalization, 53.0% (35/66. There was a 72.3% (73/101 survival at 7 days after EOCT. Serious adverse events related to caspofungin were reported in 4 cases (3.9%; 3 patients (2.9% discontinued treatment due to an adverse event related to caspofungin. Conclusions Caspofungin was both effective and well tolerated among high-risk patient groups such as those with neutropenia and active malignancies.

  8. Alcohol consumption in patients with cardiovascular diseases (results of the survey of cardiac patients in outpatient practice

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    O. D. Ostroumova

    2015-01-01

    Full Text Available Aim. To study the frequency and characteristics of alcohol use in outpatients with cardiovascular diseases and to determine their preferences regarding the help in limiting alcohol consumption.Material and methods. Voluntary and anonymous survey using AUDIT-C and CAGE questionnaires was conducted in 199 patients. The data of 182 patients (82 women and 100 men, mean age 56.4±5.8 years was included in the analysis.Results. Arterial hypertension (70%, heart rhythm disorders (25%, ischemic heart disease (20%, functional class I-II chronic heart failure (21% predominated among all clinical entities. Positive AUDIT-C test was found in 30% of men and 7.3% of women. 17% of men and 23.2% of women did not use alcohol at all. Positive responses to all 4 questions of the CAGE test were given by 3% of men and none of women, positive answers to 3 questions – by 15% of men and none of women, to 2 questions - by 17% of men and 11% of women. Positive answer to the question about the need to reduce alcohol consumption was given by 36% of men and 13.4% of women.Conclusion. Simultaneous testing using AUDIT-C and CAGE questionnaires in outpatients with cardiovascular diseases allows identifying a subgroup of patients (more in men who have a potential problem with an excessive alcohol consumption and need to reduce the intake of alcoholic beverages.

  9. The relieving pain and numbness effects of minimally invasive therapy of soft tissue combined with traction chiropractic on the treatment of cervical spondylotic radiculopathy%软组织微创配合牵引下整脊对神经根型颈椎病的镇痛止麻效果

    Institute of Scientific and Technical Information of China (English)

    沈彤; 尹伦辉; 章瑛; 梁伟坚; 敖晓龙; 谌凌燕; 何巍

    2013-01-01

    Objective To observe the effect of relieving pain and numbness of minimally invasive therapy of soft tissue combined with traction chiropractic in the treatment of cervical spondylotic radiculopathy.Methods 60 patients were randomly divided into a minimally invasive therapy of soft tissue combined with traction chiropractic treatment group and minimally invasive therapy of soft tissue combined with pure traction control group with 30 cases in each group.Traction chiropractic and pure traction were all carried out for 9 times.Minimally invasive therapy of soft tissue was carried out for 3 times.The scores of the symptoms and signs of the pain on neck、shoulder and arm,neck tenderness and numbness were compared between two groups before and after treatment and on the 3rd month after treatment.Results The scores of the symptoms and signs of two groups were all improved as compared with those before treatment (P < 0.05),but the total effect in treatment group improved more than those in the conrtrol group(P < 0.05).Conclusion Minimally invasive therapy of soft tissue combined with traction chiropractic is a safe method in relieving the symptoms of the pain on neck,shoulder and arm,neck tenderness and numbness.%目的 观察软组织微创配合牵引下整脊对神经根型颈椎病的镇痛止麻效果.方法 选60例合格的神经根型颈椎病患者,随机分为软组织微创配合牵引下整脊治疗组及软组织微创配合单纯牵引对照组各30例.牵引下整脊及单纯牵引各治疗9次,软组织微创治疗3次.分析治疗前后及随访3个月后两组颈肩臂疼痛、颈部压痛及麻木症状体征积分的变化.结果 两组治疗后及随访3个月后症状体征积分均有改善(P<0.05),治疗组的症状体征积分改善优于对照组(P<0.05).结论 软组织微创配合牵引下整脊在减轻神经根型颈椎病颈肩臂疼痛、颈部压痛及麻木症状方面疗效显著,操作安全.

  10. Engagement of patients in religious and spiritual practices: Confirmatory results with the SpREUK-P 1.1 questionnaire as a tool of quality of life research

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    Matthiessen Peter F

    2005-09-01

    Full Text Available Abstract Background Quality of life is a multidimensional construct composed of functional, physical, emotional, social and spiritual well-being. In order to examine how patients with severe diseases view the impact of spirituality and religiosity on their health and how they cope with illness, we have developed the SpREUK questionnaire. We deliberately avoided the intermingling of attitudes, convictions and practices, and thus addressed the distinct forms and frequencies of spiritual/religious practices in an additional manual, the SpREUK-P questionnaire. Methods The SpREUK-P was designed to differentiate spiritual, religious, existentialistic and philosophical practices. It was tested in a sample of 354 German subjects (71% women; 49.0 ± 12.5 years. Half of them were healthy controls, while among the patients cancer was diagnosed in 54%, multiple sclerosis in 22%, and other chronic diseases in 23%. Reliability and factor analysis of the inventory were performed according to the standard procedures. Results We confirmed the structure and consistency of the previously described 18-item SpREUK-P manual and improved the quality of the current construct by adding several new items. The new 25-item SpREUK-P 1.1 (Cronbach's alpha = 0.8517 has the following scales: (1 conventional religious practice (CRP, (2 existentialistic practice (ExP, (3 unconventional spiritual practice (USP, (4 nature/environment-oriented practice (NoP, and (5 humanistic practice (HuP. Among the tested individuals, the highest engagement scores were found for HuP and NoP, while the lowest were found for the USP. Women had significantly higher scores for ExP than male patients. With respect to age, the engagement in CRP increases with increasing age, while the engagement in a HuP decreased. Individuals with a Christian orientation and with a religious and spiritual attitude had the highest engagement scores for CRP, while the engagement in an USP was high with respect to a

  11. Imparting carrier status results detected by universal newborn screening for sickle cell and cystic fibrosis in England: a qualitative study of current practice and policy challenges

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    Ulph Fiona

    2007-12-01

    Full Text Available Abstract Background Universal newborn screening for early detection of children affected by sickle cell disorders and cystic fibrosis is currently being implemented across England. Parents of infants identified as carriers of these disorders must also be informed of their baby's result. However there is a lack of evidence for most effective practice internationally when doing so. This study describes current or proposed models for imparting this information in practice and explores associated challenges for policy. Methods Thematic analysis of semi-structured interviews with Child Health Coordinators from all English Health Regions. Results Diverse methods for imparting carrier results, both within and between regions, and within and between conditions, were being implemented or planned. Models ranged from result by letter to in-person communication during a home visit. Non-specialists were considered the best placed professionals to give results and a similar approach for both conditions was emphasised. While national guidance has influenced choice of models, other factors contributed such as existing service structures and lack of funding. Challenges included uncertainty about guidance specifying face to face notification; how best to balance allaying parental anxiety by using familiar non-specialist health professionals with concerns about practitioner competence; and extent of information parents should be given. Inadequate consideration of resource and service workload was seen as the main policy obstacle. Clarification of existing guidance; more specific protocols to ensure consistent countrywide practice; integration of the two programmes; and 'normalising' carrier status were suggested as improvements. Conclusion Differing models for communicating carrier results raise concerns about equity and clinical governance. However, this variation provides opportunity for evaluation. Timely and more detailed guidance on protocols with

  12. Decreased management of genital warts in young women in Australian general practice post introduction of national HPV vaccination program: results from a nationally representative cross-sectional general practice study.

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    Christopher Harrison

    Full Text Available OBJECTIVES: Since the introduction of Australia's human papillomavirus vaccination program, the management rate of genital warts in sexual health clinics and private hospitals has decreased in women of vaccine-eligible age. However, most genital warts in Australia are managed in general practice. This study examines whether a similar decrease occurred in Australian general practice after the introduction of the program. METHODS: Analysis of a nationally representative cross-sectional database of Australian general practice activity (1,175,879 patient encounters with 11,780 general practitioners. Genital warts management rates were estimated for the periods before and after introduction of the program (Pre-program, July 2002-June 2006; Post-program, July 2008-June 2012. Control conditions included genital herpes and gardnerella/bacterial vaginosis in female patients and genital herpes and urethritis in male patients. Trends in management rates by year, pre-vaccine (July 2000-June 2007 and post-vaccine (July 2007-June 2012 were also calculated. RESULTS: Management rate of genital warts among women potentially covered by program (aged 15-27 years decreased by 61% from 4.33 per 1,000 encounters in the Pre-program period to 1.67 in the Post-program period. Trend analysis of the post-vaccine period showed, among women of vaccine eligible age, a significant year-on-year reduction in the rate of genital warts management (p<0.0001 and a significant increase in the management rate of control conditions per year (p<0.0001. For all other age-sex groups there was no significant change in the management rate of genital warts between the Pre- and Post-program periods. CONCLUSION: The large decrease in general practice management of genital warts in women of vaccine-eligible age highlights the success of the program in the wider community.

  13. Series: The research agenda for general practice/family medicine and primary health care in Europe. Part 2. Results: Primary care management and community orientation.

    Science.gov (United States)

    Hummers-Pradier, Eva; Beyer, Martin; Chevallier, Patrick; Eilat-Tsanani, Sophia; Lionis, Christos; Peremans, Lieve; Petek, Davorina; Rurik, Imre; Soler, Jean Karl; Stoffers, Henri Ejh; Topsever, Pinar; Ungan, Mehmet; van Royen, Paul

    2010-03-01

    At the WONCA Europe conference 2009 the recently published 'Research Agenda for General Practice/Family Medicine and Primary Health Care in Europe' was presented. It is a background paper and reference manual, providing advocacy of general practice/family medicine (GP/FM) in Europe. The Research Agenda summarizes the evidence relating to the core competencies and characteristics of the WONCA Europe definition of GP/FM, and its implications for general practitioners/family doctors, researchers and policy makers. The European Journal of General Practice publishes a series of articles based on this document. In a first article, background, objectives, and methodology were discussed. In this second article, the results for the core competencies 'primary care management' and 'community orientation' are presented. Though there is a large body of research on various aspects of 'primary care management', it represents a very scattered rather than a meta view. Many studies focus on care for specific diseases, the primary/secondary care interface, or the implications of electronic patient records. Cost efficiency or process indicators of quality are current outcomes. Current literature on community orientation is mainly descriptive, and focuses on either care for specific diseases, or specific patient populations, or on the uptake of preventive services. Most papers correspond poorly to the WONCA concept. For both core competencies, there is a lack of research with a longitudinal perspective and/or relevant health or quality of life outcomes as well as research on patients' preferences and education for organizational aspects of GP/FM.

  14. Effectiveness of an educational intervention to improve child feeding practices and growth in rural China: updated results at 18 months of age.

    Science.gov (United States)

    Zhang, Jingxu; Shi, Ling; Chen, Da-Fang; Wang, Jing; Wang, Yan

    2013-01-01

    Inappropriate complementary feeding practices have led to, in part, significant disparities in growth and nutritional status between rural and urban children in China. A cluster-randomised, controlled trial was implemented in Laishui, China to assess the effectiveness of an educational intervention on caregivers' feeding practices and children's growth. Eight townships were randomly assigned to the intervention or control. Five hundred ninety-nine healthy infants were enrolled at 2-4 months old, and were followed up at ages 6, 9, 12, 15 and 18 months. The intervention group received information on enhanced home-prepared recipes and food preparation and hygiene through group training, counselling and home visit. Key outcomes were children's physical growth, caregivers' knowledge and behaviours on complementary feeding, and the infant and child feeding index (ICFI). Analysis was by intention to treat. The intervention group achieved better knowledge and practices related to complementary feeding, and significantly higher ICFI scores at each follow-up point. Children in the intervention group achieved higher z-scores for weight-for-age (WAZ) and weight-for-height (WHZ) than the control (0.18 vs. 0.01 and 0.49 vs. 0.19, respectively) at 18 months old, and were less likely to have stunted growth (odds ratio = 0.71, 95% confidence interval: 0.53-0.94). Mixed model showed that the intervention group achieved significantly better linear growth over time, including WAZ (P = 0.016), WHZ (P = 0.030) and HAZ (P = 0.078). These results indicated that an educational intervention delivered through local health services can enhance caregivers' knowledge and practices of complementary feeding and ultimately improve children's growth.

  15. Are ICD-10 codes appropriate for performance assessment in asthma and COPD in general practice? Results of a cross sectional observational study

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    Wensing Michel

    2005-02-01

    Full Text Available Abstract Background The increasing prevalence and impact of obstructive lung diseases and new insights, reflected in clinical guidelines, have led to concerns about the diagnosis and therapy of asthma and COPD in primary care. In Germany diagnoses written in medical records are used for reimbursement, which may influence physicians' documentation behaviour. For that reason it is unclear to what respect ICD-10 codes reflect the real problems of the patients in general practice. The aim of this study was to assess the appropriateness of the recorded diagnoses and to determine what diagnostic information is used to guide medical treatment. Methods All patients with lower airway symptoms (n = 857 who had attended six general practices between January and June 2003 were included into this cross sectional observational study. Patients were selected from the computerised medical record systems, focusing on ICD-10-codes concerning lower airway diseases (J20-J22, J40-J47, J98 and R05. The performed diagnostic procedures and actual medication for each identified patient were extracted manually. Then we examined the associations between recorded diagnoses, diagnostic procedures and prescribed treatment for asthma and COPD in general practice. Results Spirometry was used in 30% of the patients with a recorded diagnosis of asthma and in 58% of the patients with a recorded diagnosis of COPD. Logistic regression analysis showed an improved use of spirometry when inhaled corticosteroids were prescribed for asthma (OR = 5.2; CI 2.9–9.2 or COPD (OR = 4.7; CI 2.0–10.6. Spirometry was also used more often when sympathomimetics were prescribed (asthma: OR = 2.3; CI 1.2–4.2; COPD: OR = 4.1; CI 1.8–9.4. Conclusions This study revealed that spirometry was used more often when corticosteroids or sympathomimetics were prescribed. The findings suggest that treatment was based on diagnostic test results rather than on recorded diagnoses. The documented ICD-10 codes

  16. Effects of psychosocial stimulation on improving home environment and child-rearing practices: results from a community-based trial among severely malnourished children in Bangladesh

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    Nahar Baitun

    2012-08-01

    Full Text Available Abstract Background Parenting programmes are effective in enhancing parenting practices and child development. This study evaluated the effects of a intervention with psychosocial stimulation (PS on the quality of the home environment and mothers’ child-rearing practices in a community-based trial with severely malnourished Bangladeshi children. Method Severely underweight children (n = 507, 6–24 months of age, were randomly assigned to five groups: PS; food supplementation (FS; PS + FS; clinic-control (CC; and, hospital-control (CH. PS included fortnightly follow-up visits for six months at community clinics where a play leader demonstrated play activities and gave education on child development and child rearing practices. FS comprised cereal-based supplements (150–300 kcal/day for three months. All groups received medical care, micronutrient supplements and growth monitoring. Mothers were given the Home Observation for Measurement of the Environment (HOME inventory and a questionnaire on parenting at baseline and after six months to assess the outcome. Results 322 children completed the study. After six months of intervention the PS + FS and PS groups benefitted in the total HOME score (depending on the comparison group, effect sizes varied from 0.66 to 0.33 SD The PS + FS and PS groups also benefitted in two HOME subscales: maternal involvement (effect sizes: 0.8 to 0.55 SD and play materials, (effect sizes: 0.46 to 0.6 SD, and child-rearing practices scores (effect size: 1.5 to 1.1 SD. The PS + FS group benefitted 4.0 points in total HOME score compared with CH, 4.8 points compared with CC and 4.5 points compared with FS (p  Conclusions Child-rearing practices of mothers of severely malnourished children and the quality of their home environment can be improved through community-based psychosocial stimulation with or without food supplementation. This may be of importance to promote child development.

  17. Patients with Postpartum Depression in Gynaecological Practices in Germany – Results of a Representative Survey of Local Gynaecologists about Diagnosis and Management

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    Pawils, S.; Metzner, F.; Wendt, C.; Raus, S.; Shedden-Mora, M.; Wlodarczyk, O.; Härter, M.

    2016-01-01

    Theoretical Background and Current Issues: For the sake of pre-emptive child protection it is necessary to recognise signs of postpartum depression (PPD) in pregnant women and young mothers as early as possible and to initiate adequate assistance. Because of their high acceptance, especially in the phases of pregnancy and birth, the local gynaecologists offer ideal prerequisites for access to the parents. This study evaluates the current status of diagnosis and management of PPD in gynaecological practices. Material and Methods: In a representative German nation-wide questionnaire survey taking the regional distribution into account n = 3000 local gynaecologists were selected at random and contacted by post. The questionnaire addressed their approaches to the diagnosis and management of PPD as well as the encountered barriers. Results: Among the n = 1034 participating gynaecologists (response rate: 35 %) half of them dealt actively with PPD; 16 % used a questionnaire for this purpose. Consultation by the gynaecologist (84 %) or referral to therapists or hospitals (86 %) were among the most common interventions in the management of PPD. A need for improvement in the management of women with PPD was recognised equally often. As barriers the gynaecologists mentioned above all the lack of time, the low reimbursements for consultations and the lack of effective treatment options. Predictors for an active anamnesis were found to be female gender of the gynaecologist, possession of an additional psychosomatic qualification and practice located in an urban catchment area or state of the former West Germany. Conclusion: The results clearly demonstrate a high acceptance for the management of PPD by gynaecologists as well as the need for further action to improve the care of patients with PPD in gynaecological practices. PMID:27582583

  18. Environmental management of the OSBAT 24'' oil pipeline: reached practical results; Gestao ambiental do Oleoduto OSBAT 24{sup :} resultados praticos alcancados

    Energy Technology Data Exchange (ETDEWEB)

    Serra, Ricardo N.; Garibaldi, Celia M.; Kagawa, Adriana; Serra, Maira B.; Oliveira, Flavio M. de; Perim, Leandro A. [LENC - Laboratorio de Engenharia e Consultoria Ltda., Cotia, SP (Brazil); Baptista, Sidney L. [PETROBRAS, Rio de Janeiro, RJ (Brazil)

    2008-07-01

    The main objective of this article is to present considerations about the practical results obtained over the implementation of specialized technical services for environmental monitoring and control of the work of maintenance of OSBAT 24'' pipeline, located in a stretch of about 32 km from the Aquatic Terminal of Sao Sebastiao - SP (TASSE) to the district Camburi. This area is characterized by intense environmental complexity by the presence of the Serra do Mar State Park, under enormous natural diversity of preserved Mata Atlantica forest, contrasting with a considerable pole of urban sprawl whose population growth rates (4.66% pa) and economic they are above the average for the Sao Paulo State. The presentation of results considers the practical implementation of the package of environmental management tools used and seek verification of the scope and quality of the following items: general Review of care as environmental registers occurred at different periods (eg monthly, bimonthly, half, etc.); survey of the nature of environmental registers; environmental registers recovered; cases of non-compliance and the main control measures implemented; evaluation of environmental performance; recommendations and learning. (author)

  19. Shared decision making for prostate cancer screening: the results of a combined analysis of two practice-based randomized controlled trials

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    Sheridan Stacey L

    2012-11-01

    Full Text Available Abstract Background Professional societies recommend shared decision making (SDM for prostate cancer screening, however, most efforts have promoted informed rather than shared decision making. The objective of this study is to 1 examine the effects of a prostate cancer screening intervention to promote SDM and 2 determine whether framing prostate information in the context of other clearly beneficial men’s health services affects decisions. Methods We conducted two separate randomized controlled trials of the same prostate cancer intervention (with or without additional information on more clearly beneficial men’s health services. For each trial, we enrolled a convenience sample of 2 internal medicine practices, and their interested physicians and male patients with no prior history of prostate cancer (for a total of 4 practices, 28 physicians, and 128 men across trials. Within each practice site, we randomized men to either 1 a video-based decision aid and researcher-led coaching session or 2 a highway safety video. Physicians at each site received a 1-hour educational session on prostate cancer and SDM. To assess intervention effects, we measured key components of SDM, intent to be screened, and actual screening. After finding that results did not vary by trial, we combined data across sites, adjusting for the random effects of both practice and physician. Results Compared to an attention control, our prostate cancer screening intervention increased men’s perceptions that screening is a decision (absolute difference +41%; 95% CI 25 to 57% and men’s knowledge about prostate cancer screening (absolute difference +34%; 95% CI 19% to 50%, but had no effect on men’s self-reported participation in shared decisions or their participation at their preferred level. Overall, the intervention decreased screening intent (absolute difference −34%; 95% CI −50% to −18% and actual screening rates (absolute difference −22%; 95% CI −38 to

  20. SatBałtyk - A Baltic environmental satellite remote sensing system - an ongoing project in Poland. Part 2: Practical applicability and preliminary results

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    Bogdan Woźniak

    2011-11-01

    Full Text Available This paper is the second part of the description of the first stage of the SatBałtyk project's implementation. Part 1 (Woźniak et al. 2011, in this issue presents the assumptions and objectives of SatBałtyk and describes the most important stages in the history of our research, which is the foundation of this project. It also discusses the operation and general structure of the SatBałtyk system. Part 2 addresses various aspects of the practical applicability of the SatBałtyk Operational System to Baltic ecosystem monitoring. Examples are given of the Baltic's characteristics estimated using the preliminary versions of the algorithms in this Operational System. At the current stage of research, these algorithms apply mainly to the characteristics of the solar energy influx and the distribution of this energy among the various processes taking place in the atmosphere-sea system, and also to the radiation balance of the sea surface, the irradiance conditions for photosynthesis and the condition of plant communities in the water, sea surface temperature distributions and some other marine phenomena correlated with this temperature. Monitoring results obtained with these preliminary algorithms are exemplified in the form of distribution maps of selected abiotic parameters of the Baltic, as well as structural and functional characteristics of this ecosystem governed by these parameters in the Baltic's many basins. The maps cover practically the whole area of the Baltic Sea. Also given are results of preliminary inspections of the accuracy of the magnitudes shown on the maps. In actual fact, the errors of these estimates are relatively small. The further practical application of this set of algorithms (to be gradually made more specific is therefore entirely justified as the basis of the SatBałtyk system for the effective operational monitoring of the state and functioning of Baltic ecosystems. This article also outlines the plans for extending

  1. Risk-based immunization policies and tuberculosis screening practices for animal care and research workers in the United States: survey results and recommendations.

    Science.gov (United States)

    Weigler, Benjamin J; Cooper, Donna R; Hankenson, F Claire

    2012-01-01

    A national survey was conducted to assess immunization practices and tuberculosis screening methods for animal care and research workers in biomedical settings throughout the United States. Veterinarians (n = 953) were surveyed via a web-based mechanism; completed surveys (n = 308) were analyzed. Results showed that occupational health and safety programs were well-developed, enrolling veterinary, husbandry, and research staff at rates exceeding 90% and involving multiple modalities of health assessments and risk communication for vaccine-preventable diseases. Most (72.7%) institutions did not store serum samples from animal research personnel. More than half of the institutions housed nonhuman primates and maintained tuberculosis screening programs, although screening methods varied. Immunization protocols included various recommended or required vaccines that differed depending on job duties, type of institution, and nature of scientific programs. A single case of an identified vaccine-preventable illness in a laboratory worker was noted. Tetanus toxoid was the predominant vaccine administered (91.7%) to animal care and research workers, followed by hepatitis B (54.8%), influenza (39.9%), and rabies (38.3%). For some immunization protocols, an inconsistent rationale for administration was evident. Indications that animal care and research workers are unprotected from work-related etiologic agents did not emerge from this survey; rather, existing guidelines from the Advisory Committee on Immunization Practices and available biologics seem sufficient to address most needs of the laboratory animal research community. Institutions should commit to performance-based standards in parallel with context-specific risk assessment methods to maintain occupational health and safety programs and practices appropriate to their needs.

  2. NASA/DOD Aerospace Knowledge Diffusion Research Project. Report 31: The technical communications practices of US aerospace engineers and scientists: Results of the phase 1 SME mail survey

    Science.gov (United States)

    Pinelli, Thomas E.; Barclay, Rebecca O.; Kennedy, John M.

    1994-01-01

    The U.S. government technical report is a primary means by which the results of federally funded research and development (R&D) are transferred to the U.S. aerospace industry. However, little is known about this information product in terms of its actual use, importance, and value in the transfer of federally funded R&D. To help establish a body of knowledge, the U.S. government technical report is being investigated as part of the NASA/DOD Aerospace Knowledge Diffusion Research Project. In this report, we summarize the literature on technical reports and provide a model that depicts the transfer of federally funded aerospace R&D via the U.S. government technical report. We present results from our investigation of aerospace knowledge diffusion vis-a-vis the U.S. government technical communications practices of U.S. aerospace engineers and scientists affiliated with, not necessarily belonging to, the Society of Manufacturing Engineers (SME).

  3. Can a simulation-based training program impact the use of evidence based routine practices at birth? Results of a hospital-based cluster randomized trial in Mexico

    Science.gov (United States)

    Fritz, Jimena; Walker, Dilys M.; Cohen, Susanna; Angeles, Gustavo; Lamadrid-Figueroa, Hector

    2017-01-01

    Background In Mexico, although the majority of births are attended in hospitals, reports have emerged of obstetric violence, use of unsafe practices, and failure to employ evidence-based practices (EBP). Recent attention has refocused global efforts towards provision of quality care that is both patient-centered and evidence-based. Scaling up of local interventions should rely on strong evidence of effectiveness. Objective To perform a secondary analysis to evaluate the impact of a simulation and team-training program (PRONTO) on the performance of EBP in normal births. Methods A pair-matched cluster randomized controlled trial of the intervention was designed to measure the impact of the program (PRONTO intervention) on a sample of 24 hospitals (12 hospitals received the PRONTO training and 12 served as controls) in the states of Chiapas, Guerrero, and Mexico. We estimated the impact of receiving the intervention on the probability of birth practices performance in a sample of 641 observed births of which 318 occurred in the treated hospitals and 323 occurred in control hospitals. Data was collected at 4 time points (baseline, 4th, 8th and 12th months after the training). Women were blinded to treatment allocation but observers and providers were not. Estimates were obtained by fitting difference-in-differences logistic regression models considering confounding variables. The trial is registered at clinicaltrials.gov: # NCT01477554. Results Significant changes were found following the intervention. At 4 months post-intervention an increase of 20 percentage points (p.p.) for complete Active Management of Third Stage of Labor (AMTSL) (p = 0.044), and 16 p.p. increase for Skin-to-Skin Contact (p = 0.067); at 12 months a 25 p.p. increase of the 1st step of AMTSL (p = 0.026) and a 42 p.p. increase of Delayed Cord Clamping (p = 0.004); at 4 months a 30 (p = 0.001) and at 8 months a 22 (p = 0.010) p.p. decrease for Uterine Sweeping. Conclusions The intervention has an

  4. The research agenda for general practice/family medicine and primary health care in Europe. Part 3. Results: person centred care, comprehensive and holistic approach.

    Science.gov (United States)

    Van Royen, Paul; Beyer, Martin; Chevallier, Patrick; Eilat-Tsanani, Sophia; Lionis, Christos; Peremans, Lieve; Petek, Davorina; Rurik, Imre; Soler, Jean Karl; Stoffers, Henri E J H; Topsever, Pinar; Ungan, Mehmet; Hummers-Pradier, Eva

    2010-06-01

    The recently published 'Research Agenda for General Practice/Family Medicine and Primary Health Care in Europe' summarizes the evidence relating to the core competencies and characteristics of the Wonca Europe definition of GP/FM, and its implications for general practitioners/family doctors, researchers and policy makers. The European Journal of General Practice publishes a series of articles based on this document. In a first article, background, objectives, and methodology were discussed. In a second article, the results for the two core competencies 'primary care management' and 'community orientation' were presented. This article reflects on the three core competencies, which deal with person related aspects of GP/FM, i.e. 'person centred care', 'comprehensive approach' and 'holistic approach'. Though there is an important body of opinion papers and (non-systematic) reviews, all person related aspects remain poorly defined and researched. Validated instruments to measure these competencies are lacking. Concerning patient-centredness, most research examined patient and doctor preferences and experiences. Studies on comprehensiveness mostly focus on prevention/care of specific diseases. For all domains, there has been limited research conducted on its implications or outcomes.

  5. Incidence rates and management of urinary tract infections among children in Dutch general practice: results from a nation-wide registration study

    Directory of Open Access Journals (Sweden)

    Schellevis François G

    2006-04-01

    Full Text Available Abstract Background We aimed to investigate incidence rates of urinary tract infections in Dutch general practice and their association with gender, season and urbanisation level, and to analyse prescription and referral in case of urinary tract infections. Method During one calendar year, 195 general practitioners in 104 practices in the Netherlands registered all their patient contacts. This study was performed by the Netherlands Institute for Health Services Research (NIVEL in 2001. Of 82,053 children aged 0 to 18 years, the following variables were collected: number of episodes per patient, number of contacts per episode, month of the year in which the diagnosis of urinary tract infection was made, age, gender, urbanisation level, drug prescription and referral. Results The overall incidence rate was 19 episodes per 1000 person years. The incidence rate in girls was 8 times as high as in boys. The incidence rate in smaller cities and rural areas was 2 times as high as in the three largest cities. Throughout the year, incidence rates varied with a decrease in summertime for children at the age of 0 to 12 years. Of the prescriptions, 66% were in accordance with current guidelines, but only 18% of the children who had an indication were actually referred. Conclusion This study shows that incidence rates of urinary tract infections are not only related to gender and season, but also to urbanisation. General practitioners in the Netherlands frequently do not follow the clinical guidelines for urinary tract infections, especially with respect to referral.

  6. Incidence rates and management of urinary tract infections among children in Dutch general practice: results from a nation-wide registration study

    Science.gov (United States)

    Kwok, Wing-Yee; de Kwaadsteniet, Marjolein CE; Harmsen, Mirjam; van Suijlekom-Smit, Lisette WA; Schellevis, François G; van der Wouden, Johannes C

    2006-01-01

    Background We aimed to investigate incidence rates of urinary tract infections in Dutch general practice and their association with gender, season and urbanisation level, and to analyse prescription and referral in case of urinary tract infections. Method During one calendar year, 195 general practitioners in 104 practices in the Netherlands registered all their patient contacts. This study was performed by the Netherlands Institute for Health Services Research (NIVEL) in 2001. Of 82,053 children aged 0 to 18 years, the following variables were collected: number of episodes per patient, number of contacts per episode, month of the year in which the diagnosis of urinary tract infection was made, age, gender, urbanisation level, drug prescription and referral. Results The overall incidence rate was 19 episodes per 1000 person years. The incidence rate in girls was 8 times as high as in boys. The incidence rate in smaller cities and rural areas was 2 times as high as in the three largest cities. Throughout the year, incidence rates varied with a decrease in summertime for children at the age of 0 to 12 years. Of the prescriptions, 66% were in accordance with current guidelines, but only 18% of the children who had an indication were actually referred. Conclusion This study shows that incidence rates of urinary tract infections are not only related to gender and season, but also to urbanisation. General practitioners in the Netherlands frequently do not follow the clinical guidelines for urinary tract infections, especially with respect to referral. PMID:16584577

  7. Early predictors of the long-term outcome of low back pain - results of a 22-year prospective cohort study from general practice

    DEFF Research Database (Denmark)

    Lonnberg, F.; Pedersen, P.; Siersma, V.

    2010-01-01

    , use of painkillers for low back pain, use of health care providers, impairments due to low back pain and unfitness for work caused by low back pain. The influence of the predictors was assessed by relative risks. RESULTS: After 22 years, four out of five patients still experienced low back pain...... consulting the GP for the first time regarding an episode of low back pain have excess poor outcome 22 years later and, if so, whether the best predictors are data based on the symptoms, clinical signs or work history. The design of the study is a 22-year follow-up of an inception cohort of 78 patients...... with low back pain. The setting of the study is a single general practice in a suburb of Copenhagen, Denmark. METHODS: Selected predictors were separated into pain characteristics, clinical signs and indicators related to the work history. Outcome measures were the 1-year period prevalence of low back pain...

  8. NASA/DOD Aerospace Knowledge Diffusion Research Project. Report 24: The technical communications practices of US aerospace engineers and scientists: Results of the phase 1 SAE mail survey

    Science.gov (United States)

    Pinelli, Thomas E.; Barclay, Rebecca O.; Kennedy, John M.

    1994-01-01

    The U.S. government technical report is a primary means by which the results of federally funded research and development (R&D) are transferred to the U.S. aerospace industry. However, little is known about this information product in terms of its actual use, importance, and value in the transfer of federally funded R&D. To help establish a body of knowledge, the U.S. government technical report is being investigated as part of the NASA/DOD Aerospace Knowledge Diffusion Research Project. In this report, we summarize the literature on technical reports and provide a model that depicts the transfer of federally funded aerospace R&D via the U.S. government technical report. We present results from our investigation of aerospace knowledge diffusion vis-a-vis the U.S. government technical report, and present the results of research that investigated aerospace knowledge diffusion vis-a-vis the technical communications practices of U.S. aerospace engineers and scientists affiliated with the Society of Automotive Engineers (SAE).

  9. NASA/DOD Aerospace Knowledge Diffusion Research Project. Report 33: The technical communications practices of US aerospace engineers and scientists: Results of the phase 1 AIAA mail survey

    Science.gov (United States)

    Pinelli, Thomas E.; Barclay, Rebecca O.; Kennedy, John M.

    1995-01-01

    The U.S. government technical report is a primary means by which the results of federally funded research and development (R&D) are transferred to the U.S. aerospace industry. However, little is known about this information product in terms of its actual use, importance, and value in the transfer of federally funded R&D. To help establish a body of knowledge, the U.S. government technical report is being investigated as part of the NASA/DOD Aerospace Knowledge Diffusion Research Project. In this report, we summarize the literature on technical reports and provide a model that depicts the transfer of federally funded aerospace R&D via the U.S. government technical report. We present results from our investigation of aerospace knowledge diffusion vis-a-vis the U.S. government technical report, and present the results of research that investigated aerospace knowledge diffusion vis-a-vis the technical communications practices of U.S. aerospace engineers and scientists who are members of the American Institute of Aeronautics and Astronautics (AIAA).

  10. Series: The research agenda for general practice/family medicine and primary health care in Europe. Part 4. Results: specific problem solving skills.

    Science.gov (United States)

    Hummers-Pradier, Eva; Beyer, Martin; Chevallier, Patrick; Eilat-Tsanani, Sophia; Lionis, Christos; Peremans, Lieve; Petek, Davorina; Rurik, Imre; Soler, Jean Karl; Stoffers, Henri Ejh; Topsever, Pinar; Ungan, Mehmet; van Royen, Paul

    2010-09-01

    The 'Research Agenda for General Practice/Family Medicine and Primary Health Care in Europe' summarizes the evidence relating to the core competencies and characteristics of the Wonca Europe definition of GP/FM, and its implications for general practitioners/family doctors, researchers and policy makers. The European Journal of General Practice publishes a series of articles based on this document. The previous articles presented background, objectives, and methodology, as well results on 'primary care management' and 'community orientation' and the person-related core competencies of GP/FM. This article reflects on the general practitioner's 'specific problem solving skills'. These include decision making on diagnosis and therapy of specific diseases, accounting for the properties of primary care, but also research questions related to quality management and resource use, shared decision making, or professional education and development. Clinical research covers most specific diseases, but often lacks pragmatism and primary care relevance. Quality management is a stronghold of GP/FM research. Educational interventions can be effective when well designed for a specific setting and situation. However, their message that 'usual care' by general practitioners is insufficient may be problematic. GP and their patients need more research into diagnostic reasoning with a step-wise approach to increase predictive values in a setting characterized by uncertainty and low prevalence of specific diseases. Pragmatic comparative effectiveness studies of new and established drugs or non-pharmaceutical therapy are needed. Multi-morbidity and complexity should be addressed. Studies on therapy, communication strategies and educational interventions should consider impact on health and sustainability of effects.

  11. Mobile Technology and Social Media in the Clinical Practice of Young Radiation Oncologists: Results of a Comprehensive Nationwide Cross-sectional Study

    Energy Technology Data Exchange (ETDEWEB)

    Bibault, Jean-Emmanuel, E-mail: jebibault@gmail.com [Academic Radiation Oncology Department, Oscar Lambret Center, Lille (France); French Society of Young Radiation Oncologists (SFjRO), Centre Antoine-Béclère, Paris (France); Leroy, Thomas [Academic Radiation Oncology Department, Oscar Lambret Center, Lille (France); French Society of Young Radiation Oncologists (SFjRO), Centre Antoine-Béclère, Paris (France); Blanchard, Pierre [Academic Radiation Oncology Department, Gustave Roussy Institute, Villejuif Cedex (France); Biostatistics and Epidemiology Department, Gustave Roussy, Villejuif Cedex (France); Biau, Julian [Radiation Oncology Department, Jean-Perrin Center, Clermont-Ferrand cedex (France); French Society of Young Radiation Oncologists (SFjRO), Centre Antoine-Béclère, Paris (France); Cervellera, Mathilde [Radiation Oncology Department, Jean-Godinot Center, Reims (France); French Society of Young Radiation Oncologists (SFjRO), Centre Antoine-Béclère, Paris (France); Diaz, Olivia [Radiation Oncology Department, Lyon Sud University Hospital, Pierre-Bénite Cedex (France); French Society of Young Radiation Oncologists (SFjRO), Centre Antoine-Béclère, Paris (France); Faivre, Jean Christophe [Academic Radiation Oncology and Brachytherapy Departement, Alexis-Vautrin Center, Avenue de Bourgogne, 54511 Vandoeuvre-lès-Nancy (France); French Society of Young Radiation Oncologists (SFjRO), Centre Antoine-Béclère, Paris (France); and others

    2014-09-01

    Purpose: Social media and mobile technology are transforming the way in which young physicians are learning and practicing medicine. The true impact of such technologies has yet to be evaluated. Methods and Materials: We performed a nationwide cross-sectional survey to better assess how young radiation oncologists used these technologies. An online survey was sent out between April 24, 2013, and June 1, 2013. All residents attending the 2013 radiation oncology French summer course were invited to complete the survey. Logistic regressions were performed to assess predictors of use of these tools in the hospital on various clinical endpoints. Results: In all, 131 of 140 (93.6%) French young radiation oncologists answered the survey. Of these individuals, 93% owned a smartphone and 32.8% owned a tablet. The majority (78.6%) of the residents owning a smartphone used it to work in their department. A total of 33.5% had more than 5 medical applications installed. Only 60.3% of the residents verified the validity of the apps that they used. In all, 82.9% of the residents had a social network account. Conclusions: Most of the residents in radiation oncology use their smartphone to work in their department for a wide variety of tasks. However, the residents do not consistently check the validity of the apps that they use. Residents also use social networks, with only a limited impact on their relationship with their patients. Overall, this study highlights the irruption and the risks of new technologies in the clinical practice and raises the question of a possible regulation of their use in the hospital.

  12. Children's eating behavior, feeding practices of parents and weight problems in early childhood: results from the population-based Generation R Study

    Directory of Open Access Journals (Sweden)

    Jansen Pauline W

    2012-10-01

    Full Text Available Abstract Background Weight problems that arise in the first years of life tend to persist. Behavioral research in this period can provide information on the modifiable etiology of unhealthy weight. The present study aimed to replicate findings from previous small-scale studies by examining whether different aspects of preschooler’s eating behavior and parental feeding practices are associated with body mass index (BMI and weight status -including underweight, overweight and obesity- in a population sample of preschool children. Methods Cross-sectional data on the Child Eating Behaviour Questionnaire, Child Feeding Questionnaire and objectively measured BMI was available for 4987 four-year-olds participating in a population-based cohort in the Netherlands. Results Thirteen percent of the preschoolers had underweight, 8% overweight, and 2% obesity. Higher levels of children’s Food Responsiveness, Enjoyment of Food and parental Restriction were associated with a higher mean BMI independent of measured confounders. Emotional Undereating, Satiety Responsiveness and Fussiness of children as well as parents’ Pressure to Eat were negatively related with children’s BMI. Similar trends were found with BMI categorized into underweight, normal weight, overweight and obesity. Part of the association between children’s eating behaviors and BMI was accounted for by parental feeding practices (changes in effect estimates: 20-43%, while children’s eating behaviors in turn explained part of the relation between parental feeding and child BMI (changes in effect estimates: 33-47%. Conclusions This study provides important information by showing how young children’s eating behaviors and parental feeding patterns differ between children with normal weight, underweight and overweight. The high prevalence of under- and overweight among preschoolers suggest prevention interventions targeting unhealthy weights should start early in life. Although

  13. 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

  14. How Do Continence Nurses Address Sexual Function and a History of Sexual Abuse in Daily Practice? Results of a Pilot Study

    NARCIS (Netherlands)

    Bekker, Milou D.; Van Driel, Mels F.; Pelger, Rob C. M.; Nijeholt, Guus A. B. Lycklama A.; Elzevier, Henk W.

    2011-01-01

    Introduction. There is a strong association between urological complaints, sexual dysfunction, and history of sexual abuse (SA), and it is unknown whether urological continence nurses integrate this knowledge in their daily practice. Aim. To evaluate how, in their daily practice, Dutch urological co

  15. Problems, Visions and Concerns of Pre-Service Music and General Education Teachers in Greece Resulting from Their Teaching Practice in Music

    Science.gov (United States)

    Kokkidou, May; Dionyssiou, Zoe; Androutsos, Polyvios

    2014-01-01

    This study explores music education teaching practice in Greece, collecting data from three university departments: two music departments (M1 and M2) and one primary education department (P) during the academic year 2006-2007. The project was based on data from 84 students (N = 84). Fieldwork in students' teaching practice comprised a…

  16. Practice of ultrasound-guided arthrocentesis and joint injection, including training and implementation, in Europe: results of a survey of experts and scientific societies

    DEFF Research Database (Denmark)

    Mandl, Peter; Naredo, Esperanza; Conaghan, Philip G

    2012-01-01

    Objectives. To document the practice and training opportunities of US-guided arthrocentesis and joint injection (UGAJ) among rheumatologists in the member countries of the European League Against Rheumatism (EULAR). Methods. An English-language questionnaire, containing questions on demographics......, clinical and practical aspects of UGAJ, training options in UGAJ for rheumatologists, UGAJ education in the rheumatology training curriculum and other structured education programmes in UGAJ was sent to three different groups: (i) all national rheumatology societies of EULAR; (ii) all national societies...... variations in practice and the lack of available structured training programmes for trainees in most countries indicates the need for standardization in areas including training guidelines....

  17. BEST PRACTICE IN INDIVIDUAL SUPERVISION OF PSYCHOLOGISTS WORKING IN THE FRENCH CAPEDP PREVENTIVE PERINATAL HOME-VISITING PROGRAM: RESULTS OF A DELPHI CONSENSUS PROCESS.

    Science.gov (United States)

    Greacen, Tim; Welniarz, Bertrand; Purper-Ouakil, Diane; Wendland, Jaqueline; Dugravier, Romain; Saïas, Thomas; Tereno, Susana; Tubach, Florence; Haddad, Alain; Guedeney, Antoine

    2017-03-01

    Individual supervision of home-visiting professionals has proved to be a key element for perinatal home-visiting programs. Although studies have been published concerning quality criteria for supervision in North American contexts, little is known about this subject in other national settings. In the context of the CAPEDP program (Compétences parentales et Attachement dans la Petite Enfance: Diminution des risques liés aux troubles de santé mentale et Promotion de la résilience; Parental Skills and Attachment in Early Childhood: Reducing Mental Health Risks and Promoting Resilience), the first randomized controlled perinatal mental health promotion research program to take place in France, this article describes the results of a study using the Delphi consensus method to identify the program supervisors' points of view concerning best practice for the individual supervision of home visitors involved in such programs. The final 18 recommendations could be grouped into four general themes: the organization and setting of supervision sessions; supervisor competencies; relationship between supervisor and supervisee; and supervisor intervention strategies within the supervision process. The quality criteria identified in this perinatal home-visiting program in the French cultural context underline the importance of clinical supervision and not just reflective supervision when working with families with multiple, highly complex needs.

  18. [German qualified doctors license to continue practice in south Jutland after the reunion. (Application of danish jus practicandi, process and result)].

    Science.gov (United States)

    Johannsen, Andreas

    2003-01-01

    At the reunion of the southern part of Jutland with Denmark 1920 danish legislation had to be introduced in the new incorporated region. According to a special law doctors educated in Germany could obtain danish medical authorization, if they were born or established in the region before 1.1.1918, under certain circumstances it was possible to dispense from this date. The law meant that all doctors, in the region had to ask for danish authorization. Matrimonial relationship and personal connections were strong arguments for a dispensation, but not always sufficient. In more cases a refusal was given because of a german attitude at the applicant in spite of matrimonial relationship, with the result that the applicant had to leave an established practice and Denmark. 53 doctors were given danish authorization immediately. 8 got an authorization by dispensation and 10 got a refusal. A survey of the applications and the corrected archives shows, that the cases mostly were handled without problems. But the cases, where dispensation and especially refusal were given, were often very complicated and followed by heavy local national reactions. This paper describes the background of the special law and the course of the cases with particular weight on the cases where dispensation or refusal were given.

  19. Gonorrhoea and Syphilis Epidemiology in Flemish General Practice 2009–2013: Results from a Registry-based Retrospective Cohort Study Compared with Mandatory Notification

    Directory of Open Access Journals (Sweden)

    Christoph Schweikardt

    2016-09-01

    Full Text Available Background: The number of newly diagnosed gonorrhoea and syphilis cases has increased in Flanders in recent years. Our aim was to investigate, to which extent these diagnoses were registered by general practitioners (GPs, and to examine opportunities and limits of the Intego database in this regard. Methods: Data from a retrospective cohort study based on the Flemish Intego general practice database was analyzed for the years 2009–2013. Case definitions were applied. Due to small case numbers obtained, cases were pooled and averaged over the observation period. Frequencies were compared with those calculated from figures of mandatory notification. Results: A total of 91 gonorrhoea and 23 syphilis cases were registered. The average Intego annual frequency of gonorrhoea cases obtained was 11.9 (95% Poisson confidence interval (CI 9.6; 14.7 per 100,000 population, and for syphilis 3.0 (CI 1.9; 4.5, respectively, while mandatory notification was calculated at 14.0 (CI: 13.6, 14.4 and 7.0 (CI: 6.7, 7.3, respectively. Conclusion: In spite of limitations such as small numbers and different case definitions, comparison with mandatory notification suggests that the GP was involved in the large majority of gonorrhoea cases, while the majority of new syphilis cases did not come to the knowledge of the GP.

  20. Personal breathing zone exposures among hot-mix asphalt paving workers; preliminary analysis for trends and analysis of work practices that resulted in the highest exposure concentrations.

    Science.gov (United States)

    Osborn, Linda V; Snawder, John E; Kriech, Anthony J; Cavallari, Jennifer M; McClean, Michael D; Herrick, Robert F; Blackburn, Gary R; Olsen, Larry D

    2013-01-01

    An exposure assessment of hot-mix asphalt (HMA) paving workers was conducted to determine which of four exposure scenarios impacted worker exposure and dose. Goals of this report are to present the personal-breathing zone (PBZ) data, discuss the impact of substituting the releasing/cleaning agent, and discuss work practices that resulted in the highest exposure concentration for each analyte. One-hundred-seven PBZ samples were collected from HMA paving workers on days when diesel oil was used as a releasing/cleaning agent. An additional 36 PBZ samples were collected on days when B-100 (100% biodiesel, containing no petroleum-derived products) was used as a substitute releasing/cleaning agent. Twenty-four PBZ samples were collected from a reference group of concrete workers, who also worked in outdoor construction but had no exposure to asphalt emissions. Background and field blank samples were also collected daily. Total particulates and the benzene soluble fraction were determined gravimetrically. Total organic matter was determined using gas chromatography (GC) with flame ionization detection and provided qualitative information about other exposure sources contributing to worker exposure besides asphalt emissions. Thirty-three individual polycyclic aromatic compounds (PACs) were determined using GC with time-of-flight mass spectrometry; results were presented as either the concentration of an individual PAC or a summation of the individual PACs containing either 2- to 3-rings or 4- to 6-rings. Samples were also screened for PACs containing 4- to 6-rings using fluorescence spectroscopy. Arithmetic means, medians, and box plots of the PBZ data were used to evaluate trends in the data. Box plots illustrating the diesel oil results were more variable than the B-100. Also, the highest diesel oil results were much higher in concentration than the highest B-100 results. An analysis of the highest exposure results and field notes revealed a probable association between

  1. Are joint and soft tissue injections painful? Results of a national French cross-sectional study of procedural pain in rheumatological practice

    Directory of Open Access Journals (Sweden)

    Poncet Coralie

    2010-01-01

    Full Text Available Abstract Background Joint, spinal and soft tissue injections are commonly performed by rheumatologists in their daily practice. Contrary to other procedures, e.g. performed in pediatric care, little is known about the frequency, the intensity and the management of procedural pain observed in osteo-articular injections in daily practice. Methods This observational, prospective, national study was carried out among a French national representative database of primary rheumatologists to evaluate the prevalence and intensity of pain caused by intra-and peri-articular injections, synovial fluid aspirations, soft tissue injections, and spinal injections. For each physician, data were collected over 1 month, for up to 40 consecutive patients (>18-years-old for whom a synovial fluid aspiration, an intra or peri-articular injection or a spinal injection were carried out during consultations. Statistical analysis was carried out in order to compare patients who had suffered from pain whilst undergoing the procedure to those who had not. Explanatory analyses were conducted by stepwise logistic regression with the characteristics of the patients to explain the existence of pain. Results Data were analysed for 8446 patients (64% female, mean age 62 ± 14 years recruited by 240 physicians. The predominant sites injected were the knee (45.5% and spine (19.1%. Over 80% of patients experienced procedural pain which was most common in the small joints (42% and spine (32% Pain was severe in 5.3% of patients, moderate in 26.6%, mild in 49.8%, and absent in 18.3%. Pain was significantly more intense in patients with severe pain linked to their underlying pathology and for procedures performed in small joints. Preventative or post-procedure analgesia was rarely given, only to 5.7% and 36.3% of patients, respectively. Preventative analgesia was more frequently prescribed in patients with more severe procedural pain. Conclusion Most patients undergoing intra-or peri

  2. Low Back Pain in Primary Care

    DEFF Research Database (Denmark)

    Hestbæk, Lise; Munck, Anders; Hartvigsen, Lisbeth;

    2014-01-01

    Study Design. Baseline description of a multicenter cohort study. Objective. To describe patients with low back pain (LBP) in both chiropractic and general practice in Denmark. Background. To optimize standards of care in the primary healthcare sector, detailed knowledge of the patient populations...... in different settings is needed. In Denmark, most LBP-patients access primary healthcare through chiropractic or general practice. Methods. Chiropractors and general practitioners recruited adult patients seeking care for LBP. Extensive baseline questionnaires were obtained and descriptive analyses presented...... separately for general and chiropractic practice patients, Mann-Whitney rank sum test and Pearson's chi-square test, were used to test for differences between the two populations. Results. Questionnaires were returned from 934 patients in chiropractic practice and 319 patients from general practice. Four out...

  3. An international effort towards developing standards for best practices in analysis, interpretation and reporting of clinical genome sequencing results in the CLARITY Challenge

    DEFF Research Database (Denmark)

    Brownstein, Catherine A; Beggs, Alan H; Homer, Nils

    2014-01-01

    Background : There is tremendous potential for genome sequencing to improve clinical diagnosis and care once it becomes routinely accessible, but this will require formalizing research methods into clinical best practices in the areas of sequence data generation, analysis, interpretation...

  4. Practice of ultrasound-guided arthrocentesis and joint injection, including training and implementation, in Europe: results of a survey of experts and scientific societies.

    LENUS (Irish Health Repository)

    Mandl, Peter

    2012-01-01

    To document the practice and training opportunities of US-guided arthrocentesis and joint injection (UGAJ) among rheumatologists in the member countries of the European League Against Rheumatism (EULAR).

  5. Trends in the knowledge, attitudes and practices of travel risk groups towards prevention of malaria: Results from the Dutch Schiphol airport survey 2002 to 2009

    NARCIS (Netherlands)

    P.J.J. van Genderen (Perry); P.P.A.M. van Thiel (Pieter P. A.); P.G.H. Mulder (Paul); D. Overbosch (David)

    2012-01-01

    textabstractBackground: Previous studies investigating the travellers knowledge, attitudes and practices (KAP) profile indicated an important educational need among those travelling to risk destinations. Initiatives to improve such education should target all groups of travellers, including business

  6. Imaging Guidance Improves the Results of Viscosupplementation with HANOX-M-XL in Patients with Ankle Osteoarthritis: Results of a Clinical Survey in 50 Patients Treated in Daily Practice

    Science.gov (United States)

    Bossert, Marie; Boublil, Daniel; Parisaux, Jean-Marc; Bozgan, Ana-Maria; Richelme, Emmanuel; Conrozier, Thierry

    2016-01-01

    BACKGROUND The objective of this survey was to assess retrospectively the interest of performing viscosupplementation using imaging guidance in patients suffering from ankle osteoarthritis (OA). PATIENTS AND METHODS This is a multicenter retrospective survey using a standardized questionnaire. Fifty patients suffering from ankle OA and treated, in daily clinical practice, with a single intra-articular injection of a novel viscosupplement made of a combination of a non-animal cross-linked hyaluronan and mannitol, HANOX M-XL, were included in the survey. The injection procedure (imaging or landmark guidance), demographic data, patient’s self-evaluation of pain, satisfaction, treatment efficacy, and tolerability were collected. Predictive factors of both efficacy and patient’s satisfaction were investigated. RESULTS The percentages of patients very satisfied/satisfied and not really satisfied/dissatisfied with the treatment were 68% and 32%, respectively. Efficacy was rated as very good, good, moderate, and poor by 38%, 30%, 12%, and 20% of the cases, respectively. Efficacy was unrelated to gender and age and was highly correlated with pain score (P steroidal anti-inflammatory drugs was >75% in 64% of the cases. Efficacy was significantly different with regard to imaging guidance. There was a statistically significant difference in efficacy and satisfaction between landmark-guided and imaging-guided injections (P = 0.02). The success rate was 2.3 times higher in the imaging-guided group than in the landmark-guided group. No significant difference was found between patients injected under fluoroscopy or ultrasound guidance, despite a trend favoring ultrasound (P = 0.09). Tolerability was rated as very good/good in 47 patients, moderate in two, and poor in one and was unrelated to the type of guidance. CONCLUSION This preliminary study suggests that the use of imaging guidance significantly optimizes the success rate of ankle viscosupplementation. No safety concern

  7. Food use in middle and high school fundraising: does policy support healthful practice? Results from a survey of Minnesota school principals.

    Science.gov (United States)

    Kubik, Martha Y; Lytle, Leslie A; Farbakhsh, Kian; Moe, Stacey; Samuelson, Anne

    2009-07-01

    This descriptive, cross-sectional study aimed to examine classroom, school-wide, and club/sports teams fundraising policies and practices of middle and high schools; concordance between policy and practice; and associations between healthful policy/practice scores and selected school characteristics. In 2006, principals/designees of middle (n=45) and high (n=71) schools in the St Paul/Minneapolis, MN, metropolitan area completed a self-administered mailed survey. Schools were attended by a convenience sample of students (n=349) participating in a longitudinal measurement study of children and their environments to assess obesity-related factors. Descriptive statistics, chi(2) tests, and multivariate linear regression were used to examine variables and associations of interest. Across schools, 50% had policies addressing the nutrient quality of food and drink items used in fundraising or disallowed food use for fundraising. About one third used chocolate, candy, and high-fat baked goods for classroom and school-wide fundraising; 60% sold these items for club/sports teams fundraising. More middle than high schools reported healthful fundraising policies or practices, as well as greater concordance between policies and practices. For all fundraising activities, high schools had significantly lower healthful policy/practice scores than middle schools (P<0.01). For school-wide fundraising, scores were significantly lower for public than private schools (P=0.02). Policies to regulate food used for fundraising were common and most supported healthful practice, particularly in middle schools. However, use of foods high in fat and added sugars remains a prevalent fundraising practice, especially in high schools and for club/sports teams, and requires additional attention.

  8. 玉屏风散结合捏脊治疗对小儿支气管肺炎临床治愈后干预效果的临床观察%Clinical observation the effect on treating children bronchial pneumonia by Yupingfeng powder combined with chiropractics

    Institute of Scientific and Technical Information of China (English)

    马晓薇; 邓丽娟; 欧宛新; 曹玉梅

    2014-01-01

    目的:观察玉屏风散结合捏脊治疗对小儿支气管肺炎临床治愈后的临床干预效果,为临床治疗提供科学依据。方法:随机选取80例2012年1月-2013年8月于我院儿内科诊断为肺炎并经过综合治疗后符合出院标准的患儿,根据年龄、病情将受试对象随机为两组:A组(中药组)40例;B组(空白对照组)40例。给予A组口服玉屏风散,配合捏脊治疗,连续3个月;给予B组观察治疗3个月并随访半年,记录儿童体质状况,外感咳嗽等有关的各项指标发生情况。结果:对治疗后两组咳嗽次数比较,A组疗效优于B组,P<0.05,差异具有统计学意义。两组临床疗效比较,A组疗效优于B组,P<0.05,差异具有统计学意义。结论:小儿支气管肺炎临床治愈后,采用玉屏风散结合捏脊治疗临床疗效显著,具有治愈率高,安全性优异,不良反应少,可操作性强的优点,值得临床的广泛使用和推广。%Objection:To observation the effects on treating children bronchial pneumonia by Yuping Feng powder combined with chiropractics. Methods:From January 2012 to August 2013, 80 cases in our hospital, were randomly into two groups:A group (Chinese medicine group) 40 cases;group B (control group) 40 cases. A group was treated by Yuping Feng powder combined with chiropractics, for the three consecutive months;B group was observed for 3 months and followed up for half a year, records of children’s physical condition, exogenous cough occurrence related indicators. Results: The A group is better than the B group, P<0.05, the difference was statistically significant. To compare the clinical curative effect of the two groups, A group is better than the B group, P<0.05, the difference was statistically significant. Conclusion:Treating children bronchial pneumonia by Yuping Feng powder combined with chiropractics with high cure rate, excellent safety, it is worthy of clinical

  9. Observation of Clinical Efficacy of the Combination Treatment of Tuyao Chiropractic Manipulative Therapy and Ironing Therapy for Gastroesophageal Reflux Disease%土瑶整脊疗法联合烫熨疗法对胃食管反流病的临床疗效观察

    Institute of Scientific and Technical Information of China (English)

    李海强; 贝光明; 李彤; 张冬琼; 韦刚; 罗昭芳; 王萍

    2012-01-01

    Objective: To observe the clinical efficacy of the treatment of gastroesophageal reflux disease, with the combination of Hezhou Tuyao chiropractic manipulative therapy and ironing therapy. Methods: 60 cases with GERD( gastroesophageal reflux disease) were randomly divided into two groups. 30 cases of the control group conventionally took the domperidone and lansoprazole, whereas the Hezhou Tuyao chiropractic manipulative therapy combined with the ironing therapy were added to the other 30 cases of the treatment group who were received routine treatment. The two courses of treatment were 4 weeks, clinical symptoms and endoscopic mucosal manifestations of the cases with GERD were compared before and after the treatment. Results:The total efficiency of the treatment group of the clinical symptoms was 86. 7% and 76.7% of the control group. For the comparison of efficacy between the two groups,the difference was significant(P < 0.05 ) . The total efficiency of endoscopic esophageal inflammation of the treatment group was 83. 3% and that of the control group was 73.3%. Between the two groups, the difference was significant ( P < 0. 05 ). Conclusion: Adding Hezhou Tuyao chiropractic manipulative therapy combined with the ironing therapy on the basis of conventional therapy to the treatment of GERD (gastroesophageal reflux disease) can significantly improve the clinical symptoms and the endoscopic performance and then enhance the efficacy of integrated treatment.%目的:观察贺州土瑶整脊疗法联合烫熨疗法治疗胃食管反流病的临床疗效.方法:将60例胃食管反流病患者随机分为两组,对照组30例常规服用多潘立酮及兰索拉唑,治疗组30例在常规治疗基础上加用贺州土瑶整脊疗法联合烫熨疗法,两组疗程均为4周,比较两组患者治疗前后临床症状、胃镜下黏膜表现.结果:临床症状总有效率治疗组为86.7%,对照组为76.7%,两组间疗效比较,差异有显著性意义(P<0.05);胃

  10. Clinical study of magnetic suction needle combined with chiropractic manipulative therapy in the treatment of cervicogenic facial nerve paralysis%磁吸针配合整脊手法治疗颈源性面神经麻痹的临床研究

    Institute of Scientific and Technical Information of China (English)

    钟建兵; 邓龙刚; 魏运芳; 宋宗仁; 田野

    2012-01-01

    目的 通过磁吸针配合整脊手法治疗颈源性面神经麻痹达到标本兼治的目的,找到一种治疗颈源性面神经麻痹安全、有效的新方法.方法 将我院91例颈源性面神经麻痹患者随机分成两组,治疗组48例采用磁吸针配合整脊手法治疗,对照组43例采用磁吸针治疗,20次为1个疗程,疗程间休息3~5 d;1个疗程后对照组未愈患者转入治疗组治疗;参照Bell面瘫疗效标准,观察患者临床疗效.结果 第1个疗程治疗组治愈率(89.6%)、总有效率(100.0%)明显高于对照组(69.8%、86.0%),两组比较差异有统计学意义(P<0.05);第1个疗程后治疗组总治愈率为100.0%.结论 磁吸针配合整脊手法治疗颈源性面神经麻痹效果显著.%Objective To find a safe and effective new method to treat cervicogenic facial nerve paralysis through magnetic suction needle combined with chiropractic manipulative therapy, in order to get goal treating both principal and secondary aspect of disease. Methods 91 patients with cervicogenic facial paralysis in our hospital were randomly divided into two groups, 48 cases in the treatment group were given magnetic suction needle combined with chiropractic manipulative therapy, and 43 cases in the control group were given magnetic suction needle treatment. Both groups took 20 times as a course of treatment, each course rested 3-5 days; After one course of treatment, the unhealed patients from the control group was transferred to the treatment group. Clinical efficacy was observed referenced with Bell facial paralysis curative effect standard from Shenzhen City Disease Clinic Guide. Results After the first course of treatment, the cure rate (89.6%) and the total efficiency rate (100.0%) of the treatment group were significantly higher than those of the control group (69.8%, 86.0%), there were significant differences between two groups (P < 0.05). After the first course of treatment, the total cure rate of treatment group was 100

  11. Resource use associated with type 2 diabetes in Africa, the Middle East, South Asia, Eurasia and Turkey: results from the International Diabetes Management Practice Study (IDMPS)

    Science.gov (United States)

    Gagliardino, Juan J; Atanasov, Petar K; Chan, Juliana C N; Mbanya, Jean C; Shestakova, Marina V; Leguet-Dinville, Prisca; Annemans, Lieven

    2017-01-01

    Objective Type 2 diabetes (T2D) and its complications form a global healthcare burden but the exact impact in some geographical regions is still not well documented. We describe the healthcare resource usage (HRU) associated with T2D in Africa, the Middle East, South Asia, Eurasia and Turkey. Research design and methods In the fifth wave of the International Diabetes Management Practices Study (IDMPS; 2011–2012), we collected self-reported and physician-reported cross-sectional data from 8156 patients from 18 countries across 5 regions, including different types of HRU in the previous 3–6 months. Negative binomial regression was used to identify parameters associated with HRU, using incidence rate ratios (IRRs) to express associations. Results Patients in Africa (n=2220), the Middle East (n=2065), Eurasia (n=1843), South Asia (n=1195) and Turkey (n=842) experienced an annual hospitalization rate (mean±SD) of 0.6±1.9, 0.3±1.2, 1.7±4.1, 0.4±1.5 and 1.3±2.7, respectively. The annual number of diabetes-related inpatient days (mean±SD) was 4.7±22.7, 1.1±6.1, 16.0±30.0, 1.5±6.8 and 10.8±34.3, respectively. Despite some inter-regional heterogeneity, macrovascular complications (IRRs varying between 1.4 and 8.9), microvascular complications (IRRs varying between 3.4 and 4.3) and, to a large extent, inadequate glycemic control (IRRs varying between 1.89 and 10.1), were independent parameters associated with hospitalization in these respective regions. Conclusions In non-Western countries, macrovascular/microvascular complications and inadequate glycemic control were common and important parameters associated with increased HRU. PMID:28123754

  12. Nuclear cardiology practice and associated radiation doses in Europe: results of the IAEA Nuclear Cardiology Protocols Study (INCAPS) for the 27 European countries

    Energy Technology Data Exchange (ETDEWEB)

    Lindner, Oliver; Burchert, Wolfgang [University Hospital of the Ruhr University, Institute of Radiology, Nuclear Medicine and Molecular Imaging, Heart and Diabetes Center North Rhine-Westphalia Bochum, Bad Oeynhausen (Germany); Pascual, Thomas N.B.; Kashyap, Ravi; Dondi, Maurizio; Paez, Diana [International Atomic Energy Agency, Section of Nuclear Medicine and Diagnostic Imaging, Division of Human Health, Vienna (Austria); Mercuri, Mathew [Columbia University Medical Center and New York-Presbyterian Hospital, Division of Cardiology, Department of Medicine, New York, NY (United States); Acampa, Wanda [National Council of Research, Institute of Biostructures and Bioimaging, Naples (Italy); Flotats, Albert [Universitat Autonoma de Barcelona, Nuclear Medicine Department, Hospital de la Santa Creu i Sant Pau, Barcelona (Spain); Kaufmann, Philipp A. [University Hospital Zurich, Department of Nuclear Medicine and Cardiac Imaging, Zurich (Switzerland); Kitsiou, Anastasia [Sismanoglio Hospital, Department of Cardiology, Athens (Greece); Knuuti, Juhani [University of Turku, and Turku University Hospital, Turku PET Centre, Turku (Finland); Underwood, S.R. [Imperial College London, National Heart and Lung Institute, London (United Kingdom); Royal Brompton and Harefield Hospitals, Department of Nuclear Medicine, London (United Kingdom); Vitola, Joao V. [Quanta Diagnostico and Terapia, Curitiba (Brazil); Mahmarian, John J. [Houston Methodist DeBakey Heart and Vascular Center, Department of Cardiology, Houston, TX (United States); Karthikeyan, Ganesan [All India Institute of Medical Sciences, Department of Cardiology, New Delhi (India); Better, Nathan [Royal Melbourne Hospital and University of Melbourne, Department of Nuclear Medicine, Melbourne (Australia); Rehani, Madan M. [International Atomic Energy Agency, Radiation Protection of Patients Unit, Vienna (Austria); Massachusetts General Hospital and Harvard Medical School, Department of Radiology, Boston, MA (United States); Einstein, Andrew J. [Columbia University Medical Center and New York-Presbyterian Hospital, Division of Cardiology, Department of Medicine, New York, NY (United States); Columbia University Medical Center and New York-Presbyterian Hospital, Department of Radiology, New York, NY (United States); Collaboration: for the INCAPS Investigators Group

    2016-04-15

    Nuclear cardiology is widely used to diagnose coronary artery disease and to guide patient management, but data on current practices, radiation dose-related best practices, and radiation doses are scarce. To address these issues, the IAEA conducted a worldwide study of nuclear cardiology practice. We present the European subanalysis. In March 2013, the IAEA invited laboratories across the world to document all SPECT and PET studies performed in one week. The data included age, gender, weight, radiopharmaceuticals, injected activities, camera type, positioning, hardware and software. Radiation effective dose was calculated for each patient. A quality score was defined for each laboratory as the number followed of eight predefined best practices with a bearing on radiation exposure (range of quality score 0 - 8). The participating European countries were assigned to regions (North, East, South, and West). Comparisons were performed between the four European regions and between Europe and the rest-of-the-world (RoW). Data on 2,381 European patients undergoing nuclear cardiology procedures in 102 laboratories in 27 countries were collected. A cardiac SPECT study was performed in 97.9 % of the patients, and a PET study in 2.1 %. The average effective dose of SPECT was 8.0 ± 3.4 mSv (RoW 11.4 ± 4.3 mSv; P < 0.001) and of PET was 2.6 ± 1.5 mSv (RoW 3.8 ± 2.5 mSv; P < 0.001). The mean effective doses of SPECT and PET differed between European regions (P < 0.001 and P = 0.002, respectively). The mean quality score was 6.2 ± 1.2, which was higher than the RoW score (5.0 ± 1.1; P < 0.001). Adherence to best practices did not differ significantly among the European regions (range 6 to 6.4; P = 0.73). Of the best practices, stress-only imaging and weight-adjusted dosing were the least commonly used. In Europe, the mean effective dose from nuclear cardiology is lower and the average quality score is higher than in the RoW. There is regional variation in effective dose in

  13. Efficacy and safety of leflunomide in patients with rheumatoid arthritis in real-life clinical practice (results of the Russian multicenter surveillance study

    Directory of Open Access Journals (Sweden)

    R.M. Balabanova

    2014-01-01

    Full Text Available Methotrexate or leflunomide is recommended to be used as the first synthetic disease-modifying anti-rheumatic drug to treat rheumatoid arthri- tis (RA. In 2011, ELAFRA (leflunomide, Haupt Pharma Munster GmbH, Germany; license LP-000804 registered October 3, 2011 was cer- tified and approved in Russia. This surveillance study was aimed at assessing the effectiveness and tolerability of ELAFRA in RA patients in real-life clinical practice. Material and Methods. The study involved patients corresponding to the 1987 RA classification criteria, with varying disease duration. The patients were monitored at 33 Russian medical institutions in March–December 2013. According to the drug label, ELAFRA was prescribed at a dose of 10 mg/day during the first 3 days and subsequently at a dose of 20 mg/day. In case of adverse effects (AEs, the daily dose was recommended to be reduced to 10 mg. The patients were examined before the drug was prescribed; as well as 1, 3, 6 months after therapy was started. The number of painful swollen joints and pain intensity according to the Visual Analog Scale (VAS were assessed. The patients were subjected to laboratory exam- ination (blood test; ESR test; C-reactive protein (CRP test. RA activity was determined using the DAS28 index. AEs were identified. The data on 99 patients (87 females and 12 males; mean age: 51.1±11.1 years; mean disease duration 74.9±65.7 months were used for sta- tistical analysis. Disease activity was moderate in 9 patients and high in 90 patients.Results. Six-month therapy with ELAFRA reduced the mean number of swollen joints from 13.7 to 5.1 and the number of painful joints, from 14.9 to 9.5. VAS pain intensity decreased from 62.7 to 29.6 mm; ESR decreased from 38.8 to 22.18 mm/h; SRP, from 24.9 to 13.0. Low and moderate RA activity according to DAS28 and CDAI indices after treatment was observed in 63 and 46 patients, respectively. No serious AEs have been revealed; non-serious AEs were

  14. 美式整脊手法结合脊柱脉冲诊疗仪治疗小儿寰枢椎旋转半脱位%Treatment of atlantoaxial rotatory subluxation with chiropractic manipulation and spinal adjusting instrument in children

    Institute of Scientific and Technical Information of China (English)

    于红; 吴闻文; 侯树勋; 周中华; 何建军; 王强; Shawn He; Christopher Colloca

    2016-01-01

    治疗有指导意义。%Objective To investigate the effectiveness of chiropractic manipulation with spinal adjusting instrument in treating children with atlantoaxial rotary subluxation.Methods This was a retrospective analysis for the cases from July 2004 to August 2014 in our hospital. There were 37 cases ( 27 males and 10 females ), and the age ranged from 3.5 to 12 years ( mean 7.9 years ). Clear history of upper respiratory tract infection before the onset was found in 8 children ( 21.6% ); while a clear history of head and neck trauma accounted for 13 ( 35.1% ). Treatment time was ranging from the day of the onset to 3 months after the onset. All patients underwent neck examination for the range of motion, and visual analog scale ( VAS ) was performed on some elder children. All patients received cervical spinal X ray, including PA lateral and open mouth position; some of the children also received an atlantoaxial spiral CT scanning and 3 D reconstruction. Three-dimensional CT examination focused on measuring atlantoaxial rotation angle in both vertical and sagittal axes of deformities. All patients underwent chiropractic manipulation. The treatment protocol included the children receiving continuous treatment for 2 to 3 days, 1 time / day, followed by 2 to 3 times /week, 2 weeks with a cervical collar. Each patient received spiral CT after the treatment for reviewing. VAS scores prior and post to the treatment were statistically analyzed.Results After the treatment, most children had signiifcant improvement in pain symptoms. Eleven patients received VAS evaluation before ( 7.2 - 10 points, mean 8.68 points ) and after the treatment ( 0 - 3 points, mean 1.75 points ), showing signiifcant improvement with statistical signiifcance (P < 0.01 ). Thirteen patients had imaging review and most of them improved significantly, but with different intervals ( 1.5 hours -7 years ). Only 2 cases showed slightly worsening in the review of X-ray, and further treatment and observation were needed

  15. Incidence rates and management of urinary tract infections among children in Dutch general practice: results from a nation-wide registration study.

    NARCIS (Netherlands)

    W.Y. Kwok (Wing-Yee); M.C. Kwaadsteniet (Marjolein); M. Harmsen (Mirjam); L.W.A. van Suijlekom-Smit (Lisette); F.G. Schellevis (François); J.C. van der Wouden (Hans)

    2006-01-01

    textabstractBACKGROUND: We aimed to investigate incidence rates of urinary tract infections in Dutch general practice and their association with gender, season and urbanisation level, and to analyse prescription and referral in case of urinary tract infections. METHOD: During one calendar year, 195

  16. Is the incidence of diabetes increasing in all age-groups in The Netherlands?: Results of the second study in the Dutch Sentinel Practice Network

    NARCIS (Netherlands)

    Ruwaard, D.; Gijsen, R.; Bartelds, A.I.M.; Hirasing, R.A.; Verkleij, H.; Kromhout, D.

    1996-01-01

    OBJECTIVE - To assess possible changes in the incidence of diabetes in all age-groups in The Netherlands during a 10-year period (1980-1983/1990-1992). RESEARCH DESIGN AND METHODS - Since 1970, a network of sentinel stations (the Dutch Sentinel Practice Network) consisting of ∼1% of the Dutch popula

  17. How are women with SUI-symptoms treated with duloxetine in real life practice? Preliminary results from a large observational study in Germany

    NARCIS (Netherlands)

    M. Manning; U. Gotsch; A. Minarzyk; D. Quail; A. Gross; I. Pages; H.D. Methfessel; M.C. Michel

    2009-01-01

    Background: Duloxetine was found safe and effective in the treatment of moderate to severe female stress urinary incontinence (SUI) in controlled clinical trials; complementary data from routine clinical practice are still wanted. Objectives: To explore the use of various initial duloxetine doses by

  18. Incidence rates and management of urinary tract infections among children in Dutch general practice: results from a nation-wide registration study.

    NARCIS (Netherlands)

    Kwok, W.Y.; Kwaadsteniet, M.C. de; Harmsen, M.; Suijlekom-Smit, L.W. van; Schellevis, F.G.; Wouden, J.C. van der

    2006-01-01

    BACKGROUND: We aimed to investigate incidence rates of urinary tract infections in Dutch general practice and their association with gender, season and urbanisation level, and to analyse prescription and referral in case of urinary tract infections. METHOD: During one calendar year, 195 general prac

  19. Incidence rates and management of urinary tract infections among children in Dutch general practice: results from a nation-wide registration study.

    NARCIS (Netherlands)

    Kwok, W.Y.; Kwaadsteniet, M.C.E. de; Harmsen, M.; Suijlekom-Smit, L.W.A. van; Schellevis, F.G.; Wouden, J.C. van der

    2006-01-01

    Background: We aimed to investigate incidence rates of urinary tract infections in Dutch general practice and their association with gender, season and urbanisation level, and to analyse prescription and referral in case of urinary tract infections. Method: During one calendar year, 195 general prac

  20. Interim report of a study on gastroenteritis in sentinel practices in the Netherlands (NIVEL) 1996-1999. Results of the first two years

    NARCIS (Netherlands)

    Wit MAS de; Koopmans MPG; Kortbeek LM; Leeuwen WJ van; Vinje J; Duijnhoven YTPH van; CIE

    1999-01-01

    In 1996, a study was started on gastroenteritis in collaboration with the Netherlands Institute of Primary Health Care (NIVEL) among gastroentritis patients in care of a general practitioner. This study was aimed at estimating the incidence of gastroenteritis in general practices, evaluating the eff

  1. [Nursing observation chart: between the objectives targeted by this model and actual practice, where should we place the reflective process of the nurse? Results of the study. Future prospects of teaching tools].

    Science.gov (United States)

    Ripoche, Sébastien

    2012-09-01

    The research presented below examines the focus charting model in French nursing practice. Between the objectives targeted by this model and actual practice, where to place the reflective process of the nurse? To answer this question, the methodology used is the comprehensive approach. It is characterized by the production of semi-structured interviews of nurses using the model studied, but also by the in situ observation of practices. The results show that nurses engaged a reflexive process in the use of the focus charting model. This reflexive process is "in" the action rather than "on" or "for" the action. Nurse's position vis a vis at their disposal is investigated.

  2. [Family practice diagnosis of patients with venous diseases in relation to severity, diagnosis and practice facilities. Results of the ASAM study "Physician status and factor evaluation study of ambulatory patient management"].

    Science.gov (United States)

    Hoopmann, M; Klein-Lange, M; Busse, R; Schwartz, F W; Weber, J

    1996-01-01

    Although venous diseases are very common and represent frequent reasons for consultations in general practices, little is known about the actual ambulatory care for these patients. In a sentinel network consisting of general practitioners, 385 contacts with patients suffering from venous diseases (64% with varicose veins, 24% with phlebitis and 11% with ulcers) were documented. In 9% of the cases, the functional disability was "severe". The diagnostic procedures included laboratory tests in 23%, ECG in 11%, Doppler sonography in 8% and X-ray or angiography in 5%. The frequency of these diagnostic procedures correlated significantly with the degree of severity. The probability of a Doppler sonography in practices with ultrasound equipment compared to practices without it, was-stratified for the degree of severity, the unequal distribution of diseases and the level of acquaintance with the patient-between 2.2 and 2.6 (p always < 0.05), the probability of laboratory tests between 2.4 and 2.6 (p always < 0.001). This significant dependence of diagnostic procedures from the available equipment calls for the introduction of diagnostic standards as measures of quality assurance even for so-called trivial diseases.

  3. 美式脊椎矫正学的发展史与现状%History and current situation of American Chiropractic

    Institute of Scientific and Technical Information of China (English)

    董安立; 闫国华; 郭义

    2002-01-01

    @@ 美式脊椎矫正学(Chiropractic)又称整脊疗法或按脊疗法,源于欧洲的传统医学,是目前在美国广泛流行的一种自然疗法;是一门以脊椎解剖学、生物力学、X线影像学为基础,有着规范、科学矫正手法的独立学科.Chiropractic一词来自两个希腊文Chairo和Practikos,字面的含义是手的实践,它是一门哲学、科学与艺术相结合的学科.美式脊椎矫正学注重人体的整体研究,强调人体内部各器官、组织的相互关系,寻求一种维护、修复自然生理平衡与物理平衡的脊柱矫正方法.在这种思想指导下,脊椎矫正学从人体的整体平衡出发,来认识人体内部的奥秘,以达到使人体恢复健康的目的.

  4. Efficacy of various chiropractic treatments, age distribution and incidence of accident- and nonaccident-caused low back pain in male and female patients.

    Science.gov (United States)

    Sheladia, V L; Johnston, D A

    1986-12-01

    From a total pool of 1189 male and female patients with accident- (AC) and nonaccident- (NA) caused low back pain, 465 cases with completed therapy were studied for effectiveness of various chiropractic treatments. For those who completed therapy, the age distribution and incidence of this disorder were also studied. At the completion of the therapy, the response was evaluated as very good (pain-free, cured), better (very small degree of discomfort), relief (some reduction in pain) or no response to the treatment. The females with NA responded better than AC cases (p less than .001). However, male NA cases showed an increase in "no relief," but it was not significant (p = 0.052). The response of male AC cases was better than that of female AC cases (p less than 0.001). The cervical, thoracic, lumbar and ilium adjustment levels in female and male NA did not show any differences in response (p = 0.15, female; p = 0.46, male). The incidence of NA back pain disorders in both male and female was higher as compared to AC-caused back problems (p less than 0.001). The lower back pain problems did not show any age-specific association in either sex. Manipulative approaches in addition to nonmanipulative methods are superior to nonmanipulative measures alone, and females responded better to nonmanipulative care than did males.

  5. The Grit in the Oyster – does an appreciation of threshold concepts in an adult literacies teaching qualification result in pearls of practice

    Directory of Open Access Journals (Sweden)

    David Wallace

    2010-08-01

    Full Text Available This paper draws from the experiences of a new adult literacies teaching qualification in Scotland that has been designed for experienced but unqualified adult literacies tutors.  Created to respond to an approach to adult literacies as social practices (Scottish Executive 2001, 2005, Tett et al 2006, the course team employs a sociocultural pedagogy that explicitly rejects transmission and seeks to build critical reflection through learning from experience, collaborative activities and the creation of an on-line community (Ackland and Wallace 2006.  Recognising that ‘moments of conflict and disjuncture may form the spaces in which learning occurs’ (Lewis, Enciso and Moje 2007:5 the paper explores whether ideas about liminality and threshold concepts (Cousin 2006:1, Land, Meyer and Smith 2008 illuminate the learning process.  It concludes that engagement with these concepts may assist adult literacies tutors to develop transformed practice (Cope and Kalantzis 2003:35.

  6. Clinical practice of analysis of anti-drug antibodies against interferon beta and natalizumab in multiple sclerosis patients in Europe: A descriptive study of test results.

    Science.gov (United States)

    Link, Jenny; Ramanujam, Ryan; Auer, Michael; Ryner, Malin; Hässler, Signe; Bachelet, Delphine; Mbogning, Cyprien; Warnke, Clemens; Buck, Dorothea; Hyldgaard Jensen, Poul Erik; Sievers, Claudia; Ingenhoven, Kathleen; Fissolo, Nicolas; Lindberg, Raija; Grummel, Verena; Donnellan, Naoimh; Comabella, Manuel; Montalban, Xavier; Kieseier, Bernd; Soelberg Sørensen, Per; Hartung, Hans-Peter; Derfuss, Tobias; Lawton, Andy; Sikkema, Dan; Pallardy, Marc; Hemmer, Bernhard; Deisenhammer, Florian; Broët, Philippe; Dönnes, Pierre; Davidson, Julie; Fogdell-Hahn, Anna

    2017-01-01

    Antibodies against biopharmaceuticals (anti-drug antibodies, ADA) have been a well-integrated part of the clinical care of multiple sclerosis (MS) in several European countries. ADA data generated in Europe during the more than 10 years of ADA monitoring in MS patients treated with interferon beta (IFNβ) and natalizumab have been pooled and characterized through collaboration within a European consortium. The aim of this study was to report on the clinical practice of ADA testing in Europe, considering the number of ADA tests performed and type of ADA assays used, and to determine the frequency of ADA testing against the different drug preparations in different countries. A common database platform (tranSMART) for querying, analyzing and storing retrospective data of MS cohorts was set up to harmonize the data and compare results of ADA tests between different countries. Retrospective data from six countries (Sweden, Austria, Spain, Switzerland, Germany and Denmark) on 20,695 patients and on 42,555 samples were loaded into tranSMART including data points of age, gender, treatment, samples, and ADA results. The previously observed immunogenic difference among the four IFNβ preparations was confirmed in this large dataset. Decreased usage of the more immunogenic preparations IFNβ-1a subcutaneous (s.c.) and IFNβ-1b s.c. in favor of the least immunogenic preparation IFNβ-1a intramuscular (i.m.) was observed. The median time from treatment start to first ADA test correlated with time to first positive test. Shorter times were observed for IFNβ-1b-Extavia s.c. (0.99 and 0.94 years) and natalizumab (0.25 and 0.23 years), which were introduced on the market when ADA testing was already available, as compared to IFNβ-1a i.m. (1.41 and 2.27 years), IFNβ-1b-Betaferon s.c. (2.51 and 1.96 years) and IFNβ-1a s.c. (2.11 and 2.09 years) which were available years before routine testing began. A higher rate of anti-IFNβ ADA was observed in test samples taken from older

  7. Clinical practice of analysis of anti-drug antibodies against interferon beta and natalizumab in multiple sclerosis patients in Europe: A descriptive study of test results

    Science.gov (United States)

    Auer, Michael; Ryner, Malin; Hässler, Signe; Bachelet, Delphine; Mbogning, Cyprien; Warnke, Clemens; Buck, Dorothea; Hyldgaard Jensen, Poul Erik; Sievers, Claudia; Ingenhoven, Kathleen; Fissolo, Nicolas; Lindberg, Raija; Grummel, Verena; Donnellan, Naoimh; Comabella, Manuel; Montalban, Xavier; Kieseier, Bernd; Soelberg Sørensen, Per; Hartung, Hans-Peter; Derfuss, Tobias; Lawton, Andy; Sikkema, Dan; Pallardy, Marc; Hemmer, Bernhard; Deisenhammer, Florian; Broët, Philippe; Dönnes, Pierre; Davidson, Julie; Fogdell-Hahn, Anna

    2017-01-01

    Antibodies against biopharmaceuticals (anti-drug antibodies, ADA) have been a well-integrated part of the clinical care of multiple sclerosis (MS) in several European countries. ADA data generated in Europe during the more than 10 years of ADA monitoring in MS patients treated with interferon beta (IFNβ) and natalizumab have been pooled and characterized through collaboration within a European consortium. The aim of this study was to report on the clinical practice of ADA testing in Europe, considering the number of ADA tests performed and type of ADA assays used, and to determine the frequency of ADA testing against the different drug preparations in different countries. A common database platform (tranSMART) for querying, analyzing and storing retrospective data of MS cohorts was set up to harmonize the data and compare results of ADA tests between different countries. Retrospective data from six countries (Sweden, Austria, Spain, Switzerland, Germany and Denmark) on 20,695 patients and on 42,555 samples were loaded into tranSMART including data points of age, gender, treatment, samples, and ADA results. The previously observed immunogenic difference among the four IFNβ preparations was confirmed in this large dataset. Decreased usage of the more immunogenic preparations IFNβ-1a subcutaneous (s.c.) and IFNβ-1b s.c. in favor of the least immunogenic preparation IFNβ-1a intramuscular (i.m.) was observed. The median time from treatment start to first ADA test correlated with time to first positive test. Shorter times were observed for IFNβ-1b-Extavia s.c. (0.99 and 0.94 years) and natalizumab (0.25 and 0.23 years), which were introduced on the market when ADA testing was already available, as compared to IFNβ-1a i.m. (1.41 and 2.27 years), IFNβ-1b-Betaferon s.c. (2.51 and 1.96 years) and IFNβ-1a s.c. (2.11 and 2.09 years) which were available years before routine testing began. A higher rate of anti-IFNβ ADA was observed in test samples taken from older

  8. Quality Markers in Cardiology. Main Markers to Measure Quality of Results (Outcomes) and Quality Measures Related to Better Results in Clinical Practice (Performance Metrics). INCARDIO (Indicadores de Calidad en Unidades Asistenciales del Área del Corazón): A SEC/SECTCV Consensus Position Paper.

    Science.gov (United States)

    López-Sendón, José; González-Juanatey, José Ramón; Pinto, Fausto; Cuenca Castillo, José; Badimón, Lina; Dalmau, Regina; González Torrecilla, Esteban; López-Mínguez, José Ramón; Maceira, Alicia M; Pascual-Figal, Domingo; Pomar Moya-Prats, José Luis; Sionis, Alessandro; Zamorano, José Luis

    2015-11-01

    Cardiology practice requires complex organization that impacts overall outcomes and may differ substantially among hospitals and communities. The aim of this consensus document is to define quality markers in cardiology, including markers to measure the quality of results (outcomes metrics) and quality measures related to better results in clinical practice (performance metrics). The document is mainly intended for the Spanish health care system and may serve as a basis for similar documents in other countries.

  9. Practice changing practices

    DEFF Research Database (Denmark)

    Thomsen, Rikke; Buch, Anders

    2016-01-01

    Based on a concrete practice-based study we discuss how such studies can be an important integrated part of critical participatory action research that spur change from inside a professional practice. We also discuss our roles as researchers (and union activists). We see and explore the potential...... makes work intelligible. This provides possibilities for action and change. We claim that the practice-based studies can become an integrated part of doing critical action research, and we investigate and reflect upon our stewardship of the practices we engaged in....... in initiating changes within a practice tradition. To make local changes in the practices is to change the world. The majority of practice-based studies are analyzing different kinds of practices, but only few studies have engaged in doing action research in a practice tradition. Our paper explores how practice...... study about the practices of a study administration unit in a university college in Denmark. The study includes ten weeks of participation observation study and five qualitative interviews, both in the central part and in three local study administrations. Managerial initiated organizational change...

  10. Evidence-based practice recommendations for nutrition-related management of children and adults with cystic fibrosis and pancreatic insufficiency: results of a systematic review.

    Science.gov (United States)

    Stallings, Virginia A; Stark, Lori J; Robinson, Karen A; Feranchak, Andrew P; Quinton, Hebe

    2008-05-01

    The Cystic Fibrosis Foundation established a process of systematic review of evidence to inform the development of clinical care guidelines and encourage evidence-based practice. The Subcommittee on Growth and Nutrition reviewed the evidence in two areas: energy intake and dosing for pancreatic enzyme replacement therapy. Evidence-based recommendations are presented here. Also, an ad hoc working group conducted a review of the literature and performed new analyses using the Cystic Fibrosis Foundation Patient Registry to update the recommendations for growth and weight-status monitoring. These Registry data-based recommendations are presented.

  11. Characteristics of the home health practice setting that attract and retain physical therapists: results of a survey and implications for home health.

    Science.gov (United States)

    Collins, Tracey L

    2011-03-01

    An electronic survey of the home health (HH) section members of the American Physical Therapy Association (APTA) found that physical therapists (PTs) are attracted to HH for flexible work hours, the ability to work one on one with a patient, the functional setting, and salary, in that order. They continue to practice in HH because they take pride in their work, the relationships they have with their patients/caregivers, their ability to make autonomous work decisions, their control over their schedule, the relationships they have within the home health agency (HHA), salary, the relationships they have with peers, their benefits, and their ability to handle documentation demands, in that order.

  12. Do changes in prescription practice in patients with rheumatoid arthritis treated with biological agents affect treatment response and adherence to therapy? Results from the nationwide Danish DANBIO Registry

    DEFF Research Database (Denmark)

    Hetland, M L; Lindegaard, H M; Hansen, A;

    2008-01-01

    BACKGROUND: Prescription practice for tumour necrosis factor alpha (TNFalpha) inhibitors has changed towards treating patients with lower disease activity. OBJECTIVE: To determine the trend in treatment response in cohorts of patients with rheumatoid arthritis who started TNFalpha inhibitor...... treatment between 2000 and 2005. METHODS: 1813 patients with RA starting treatment with biological agents in 2000-5 were registered prospectively in the nationwide DANBIO Registry. Baseline disease activity and 12 months' treatment responses were determined in cohorts based on start year (2000/1; 2002; 2003...

  13. Effectiveness of trivalent and pandemic influenza vaccines in England and Wales 2008-2010: results from a cohort study in general practice.

    Science.gov (United States)

    Hardelid, Pia; Fleming, Douglas M; Andrews, Nick; Barley, Michele; Durnall, Hayley; Mangtani, Punam; Pebody, Richard

    2012-02-08

    Estimation of influenza vaccine effectiveness (VE) is complicated by various degrees of mismatch between circulating and vaccine strains each season. We carried out a cohort study to estimate VE of trivalent (TIV) and pandemic influenza vaccines (PIV) in preventing various respiratory outcomes among general practice (GP) patients in England and Wales between 2008 and 2010. Dates of consultations for influenza-like illness (ILI), acute respiratory tract infection (ARTI), lower respiratory tract infection (LRTI) and nasopharyngeal swabs were obtained from the patient-level electronic records of the 100 practices enrolled in a national GP network. Dates of vaccination with TIV and PIV were also extracted. Confounders including age, time period and consultation frequency were adjusted for through Poisson regression models. In the winter of 2008/9, adjusted VE of TIV in preventing ILI was 22.3% (95% CI 13.5%, 30.2%). During the 2009/10 winter VE for PIV in preventing ILI was 21.0% (5.3%, 34.0%). The VE for PIV in preventing PCR-confirmed influenza A/H1N1 (2009) was 63.7% (-6.1%, 87.6%). TIV during the period of influenza circulation of 2008/9 and PIV in the winter of 2009/10 were effective in preventing GP consultations for ILI. The cohort study design could be used each season to estimate VE; however, residual confounding by indication could still present issues, despite adjustment for propensity to consult.

  14. General Introduction to the Recent 15 Years of Chiropractic Therapy on Infantile Enuresis%捏脊治疗小儿遗尿近15年治疗概况

    Institute of Scientific and Technical Information of China (English)

    肖显俊; 王子岳; 胡伟峰; 卢群文; 彭德忠

    2015-01-01

    应用CNKI、维普等医学数据库检索近15年来捏脊为主治疗小儿遗尿的研究报道及相关资料,对其治疗方法及疗效进行综述。%Used medical databases such as CNKI and VIP to search the research reports and related data about treating infantile enuresis based on chiropractic therapy in recent 15 years, and reviewed its therapeutic methods and efficacy.

  15. Zoonotic disease risk and prevention practices among biologists and other wildlife workers--results from a national survey, US National Park Service, 2009.

    Science.gov (United States)

    Bosch, Stacey A; Musgrave, Karl; Wong, David

    2013-07-01

    In 2007, a National Park Service (NPS) biologist died from pneumonic plague after unprotected exposure to an infected mountain lion. This incident increased awareness of occupational zoonotic disease transmission and prompted an assessment of employees who handle wildlife. During April-June 2009, we conducted a national online survey of NPS biologists and other wildlife workers to assess in the preceding 12 mo: 1) potential work-related zoonotic disease exposures; 2) protective practices, including use of personal protective equipment (PPE); and 3) barriers and facilitators to PPE use. Summary protective measure scores were calculated and compared with sociodemographic and work-related factors. Surveys were completed by 238 employees from 131 parks in all NPS regions. Seventy-one percent were biologists or technicians, 16% natural resource specialists or managers, and 13% had other job titles. Among a majority of respondents, interactions with animals were infrequent and occurred approximately several times per year as follows: handling live (39%), sick (43%), or dead animals (46%), and drawing blood from animals (42%). The most frequently reported protective measures used were hand hygiene and gloves. Commonly agreed-upon measures that would facilitate PPE use included having PPE stocked and readily available (92%) and having specific PPE kits for use during necropsies (91%) and in remote field settings (91%). Significantly higher summary protective measure scores were found if respondents had either read or reviewed "NPS safe work practices for employees handling wildlife" with their supervisor, had zoonotic disease safety or PPE use included in their employee performance appraisal plans, or had conducted a job-hazard analysis for handling wildlife. Ninety (38%) respondents reported receiving zoonotic disease training. Our findings support the development and implementation of workplace interventions to increase zoonotic disease awareness and promote a culture of

  16. Treatment of pelvic obliquity by chiropractic manipulation%西方整脊手法治疗骨盆偏斜导致的腰痛

    Institute of Scientific and Technical Information of China (English)

    于红

    2010-01-01

    目的:观察西方整脊手法(Chiropractic)对骨盆倾斜性腰痛及纠正骨盆偏斜的治疗效果.方法:在详细了解病史、阅读X线片及临床检查基础上,对患者先行侧卧位的整脊手法治疗,动作以高速度,低振幅为原则;每次手法治疗后即刻对腰骶部及骶髂关节周围给予脊柱诊断仪治疗.结果:在本研究所治疗的13个病例中,治疗前两侧髂嵴高度差为(1.73±0.61)cm,治疗后两侧髂嵴高度为(0.28±0.10)cm,治疗前后二者差异有统计学意义;病例治疗后患者疼痛症状显著缓解或消除.结论:双侧髂嵴不等高是骨盆旋转与位移的一种特殊方式,用两侧髂嵴高度差表示病变程度和疗效评价标准方便实用.西方整脊手法配合仪器治疗此类腰痛效果显著.

  17. The 1000-roofs programme. World`s biggest practical performance test of grid-connected photovoltaic systems. Evaluation of the Berlin results; Das 1000-Daecher-Programm. Weltweit groesster Breitentest fuer netzgekoppelte Photovoltaik-Anlagen - Auswertung der Berliner Ergebnisse

    Energy Technology Data Exchange (ETDEWEB)

    Hartmann, U. [Deutsche Gesellschaft fuer Sonnenenergie, Landesverband, Berlin-Brandenburg e.V. (Germany); Wuest, R.; Hielscher, T.

    1994-12-31

    The world`s biggest practical performance test of grid-connected photovoltaic systems is discussed on the basis of the Berlin results. (orig.) [Deutsch] Der weltweit groesste Breitentest fuer netzgekoppelte Photovoltaik-Anlagen wird anhand der Berliner Ergebnisse vorgestellt. (orig.)

  18. A practice-based clinical evaluation of the survival and success of metal-ceramic and zirconia molar crowns: 5-year results.

    Science.gov (United States)

    Rinke, S; Kramer, K; Bürgers, R; Roediger, M

    2016-02-01

    This practice-based study evaluates the survival and success of conventionally luted metal-ceramic and zirconia molar crowns fabricated by using a prolonged cooling period for the veneering porcelain. Fifty-three patients were treated from 07/2008 to 07/2009 with either metal-ceramic crowns (MCC) or zirconia crowns (ZC). Forty-five patients (26 female) with 91 restorations (obser-vational period: 64.0 ± 4.8 months) participated in a clinical follow-up examination and were included in the study. Estimated cumulative survival (ECSv), success (ECSc) and veneering ceramic success (ECVCSc) were calculated (Kaplan-Meier) and analysed by the crown fabrication technique and the position of the restoration (Cox regression model) (P crowns placed on tooth-neighboured abutments (n = 47), (5-year VCF-rate: 4.3%). In the present study, zirconia molar crowns demonstrated a 5-year ECSv, ECSc and ECVCSc comparable to MCCs. Irrespective of the fabrication technique, crowns on terminal abutments bear a significantly increased risk for VCFs. Clinical investigations with an increased number of restorations are needed.

  19. NASA/DOD Aerospace Knowledge Diffusion Research Project. Report 27: The technical communication practices of engineering and science students: Results of the phase 3 academic surveys

    Science.gov (United States)

    Pinelli, Thomas E.; Barclay, Rebecca O.; Hecht, Laura M.; Kennedy, John M.

    1994-01-01

    This report describes similarities and differences between undergraduate and graduate engineering science students in the context of two general aspects of the educational experience. First, we explore the extent to which students differ regarding the factors that lead to the choice of becoming an engineer or a scientist, current satisfaction with that choice, and career-related goals and objectives. Second, we look at the technical communication practices, habits, and training of engineers and science (Physics) students. The reported data were obtained from a survey of students enrolled in the College of Engineering at the University of Illinois at Urbana-Champaign, Bowling Green State University, and Texas A&M University. The survey was undertaken as part of the NASA/DOD Aerospace Knowledge Diffusion Research Project. Data are reported for the following categories: student demographics; skill importance, skill training, and skill helpfulness; collaborative writing; computer and information technology use and importance, use of electronic networks; use and importance of libraries and library services; use and importance of information sources and products; use of foreign technical reports; and foreign language (reading and speaking) skills.

  20. Impact of eLearning course on nurses' professional competence in seclusion and restraint practices: 9-month follow-up results of a randomized controlled study (ISRCTN32869544).

    Science.gov (United States)

    Kontio, R; Hätönen, H; Joffe, G; Pitkänen, A; Lahti, M; Välimäki, M

    2013-04-01

    eLearning may facilitate continuing vocational education, but data on the long-term effects of an eLearning course are lacking. The aim of this study was to explore the long-term impact of an eLearning course entitled ePsychNurse.Net on psychiatric nurses' professional competence in practicing seclusion and restraint and on their job satisfaction and general self-efficacy at 9-month follow-up. In a randomized controlled study, 12 wards were randomly assigned to the ePsychNurse.Net (intervention) or training as usual (control). Baseline and 9-month follow-up data on nurses' knowledge of coercion-related legislation, physical restraint and seclusion, their attitudes towards physical restraint and seclusion, job satisfaction and general self-efficacy were analysed for 137 completers (those who participated in the 9-month follow-up assessment). No between-group differences were found on any variable, with the exception of a change in attitude to seclusion in favour of the control group. The findings of the long-term effects did not differ from the immediate outcomes (3-month follow-up) and the improved level of knowledge acquired and further consolidation of that knowledge did not take place in the 6-month period after the 3-month ePsychNurse.Net course. The ePsychNurse.Net should be further developed and its future modifications will require additional studies, probably with some new outcome measures.

  1. An outpatient program in behavioral medicine for chronic pain patients based on the practice of mindfulness meditation: theoretical considerations and preliminary results.

    Science.gov (United States)

    Kabat-Zinn, J

    1982-04-01

    The practice of mindfulness meditation was used in a 10-week Stress Reduction and Relaxation Program to train chronic pain patients in self-regulation. The meditation facilitates an attentional stance towards proprioception known as detached observation. This appears to cause an "uncoupling " of the sensory dimension of the pain experience from the affective/evaluative alarm reaction and reduce the experience of suffering via cognitive reappraisal. Data are presented on 51 chronic pain patients who had not improved with traditional medical care. The dominant pain categories were low back, neck and shoulder, and headache. Facial pain, angina pectoris, noncoronary chest pain, and GI pain were also represented. At 10 weeks, 65% of the patients showed a reduction of greater than or equal to 33% in the mean total Pain Rating Index (Melzack) and 50% showed a reduction of greater than or equal to 50%. Similar decreases were recorded on other pain indices and in the number of medical symptoms reported. Large and significant reductions in mood disturbance and psychiatric symptomatology accompanied these changes and were relatively stable on follow-up. These improvements were independent of the pain category. We conclude that this form of meditation can be used as the basis for an effective behavioral program in self-regulation for chronic pain patients. Key features of the program structure, and the limitations of the present uncontrolled study are discussed.

  2. NASA/DOD Aerospace Knowledge Diffusion Research Project. Report 26: The technical communication practices of aerospace engineering students: Results of the phase 3 AIAA National Student Survey

    Science.gov (United States)

    Pinelli, Thomas E.; Hecht, Laura M.; Barclay, Rebecca O.; Kennedy, John M.

    1994-01-01

    This report describes similarities and differences between undergraduate and graduate engineering students in the context of two general aspects of the educational experience. First, we explore the extent to which students differ regarding the factors that lead to the choice of becoming an engineer, current satisfaction with that choice, and career-related goals and objectives. Second, we look at the technical communication practices, habits, and training of aerospace engineering students. The reported data were obtained from a survey of student members of the American Institute of Aeronautics and Astronautics (AIAA). The survey was undertaken as a phase 3 activity of the NASA/DoD Aerospace Knowledge Diffusion Research Project. Data are reported for the following categories: student demographics; skill importance, skill training, and skill helpfulness; collaborative writing; computer and information technology use and importance; use of electronic networks; use and importance of libraries and library services; use and importance of information sources and products; use of foreign language technical reports; and foreign language (reading and speaking) skills.

  3. Perceptions of interprofessional education and practice within a complementary and alternative medicine institution.

    Science.gov (United States)

    Kadar, Gena E; Vosko, Andrew; Sackett, Michael; Thompson, H Garrett Rush

    2015-01-01

    A survey of the constituents of a complementary and alternative medicine (CAM) institution was conducted to identify perceptions of interprofessional education (IPE) and practice (IPP). A 22 question survey was developed and administered to: chiropractic students, acupuncture and oriental medicine students, faculty and alumni of both professions, staff and administrators. The majority of the 321 respondents demonstrated positive perceptions of IPE and IPP, however many reported a lack of understanding of the distinct roles of select healthcare professions. The study also suggested that the campus community is not homogenous in its understanding of CAM or allopathic professions, or is it homogenous in its understanding of IPE and IPP. While the overall positive attitudes toward IPE and IPP imply a willingness to improve collaboration between these groups, the lack of understanding of profession-specific roles must be addressed to support effective implementation of IPE.

  4. The Effectiveness of Visual Short-Time Neurofeedback on Brain Activity and Clinical Characteristics in Alcohol Use Disorders: Practical Issues and Results.

    Science.gov (United States)

    Lackner, Nina; Unterrainer, Human F; Skliris, Dimitris; Wood, Guilherme; Wallner-Liebmann, Sandra J; Neuper, Christa; Gruzelier, John H

    2016-07-01

    The present study was carried out to examine the efficacy of alpha/theta neurofeedback (NF) with a new visual paradigm in a cohort of alcohol use disordered (AUD) patients (n = 25) treated in an Austrian therapeutic community center. The experimental study design focused on changes in absolute and relative resting EEG band power as well as in clinical variables, including depression (Beck Depresion Inventory [BDI-V]), psychiatric symptoms (Brief Symptom Inventory [BSI], coping (Freiburg Questionnaire on Coping with Illness [FKV-lis]), psychotherapy motivation (Therapy Motivation Questionnaire [FPTM-23]), sense of coherence (Sense of Coherence Scale [SOC-13]), posttraumatic growth (Posttraumatic Growth Inventory [PPR]), and alcohol cravings (Alcohol Craving Questionnaire [ACQ]). For measuring training effects, participants were randomly allocated to 2 groups: an experimental group (EG, n = 13) and a control group (CG, n = 12). Patients in EG received 12 sessions of visual NF training over a period of 6 weeks to enhance alpha (8-12 Hz) and theta (4-7 Hz) frequency band power in addition to the standard treatment program of the rehabilitation center. Participants in CG received no additional NF intervention. The multivariate analysis of covariance (MANCOVA) showed a change by trend in absolute alpha and theta power in the EG. Even though no MANCOVA effects were found in the clinical scales, AUD patients reported increasing control of their brain activity during the course of NF. However, changes in several clinical scales (BDI-V, BSI, FKV-lis, PPR) from pre- to posttest were observed only in the EG contrary to the CG. The findings of this pilot study provide first evidence for the practicality and effectiveness of visual short-term NF as an additive intervention in the therapeutic community.

  5. Burden of herpes zoster and postherpetic neuralgia in Japanese adults 60 years of age or older: Results from an observational, prospective, physician practice-based cohort study.

    Science.gov (United States)

    Sato, Keiko; Adachi, Koichi; Nakamura, Hiroyuki; Asano, Kazuhiro; Watanabe, Akihiro; Adachi, Riri; Kiuchi, Mariko; Kobayashi, Keiju; Matsuki, Taizo; Kaise, Toshihiko; Gopala, Kusuma; Holl, Katsiaryna

    2016-12-05

    Approximately one in three persons will develop herpes zoster during their lifetime, and it can lead to serious complications such as postherpetic neuralgia. However, evidence on burden of herpes zoster and postherpetic neuralgia in Japan is limited. This prospective, observational, multicenter, physician practice-based cohort study was conducted in Kushiro, Hokkaido, Japan (Clinicaltrials.gov identifier NCT01873365) to assess the incidence and hospitalization rates of herpes zoster, and the proportion, clinical burden and risk factors for postherpetic neuralgia in adults aged 60 years or more. Within the study area, 800 subjects developed herpes zoster and 412 were eligible for the study. Herpes zoster incidence was 10.2/1000 person-years and higher among women and older subjects. Subjects with herpes zoster required on average 5.7 outpatient consultations. Herpes zoster-associated hospitalization rate was 3.4% (27/800). The proportion of postherpetic neuralgia and other complications was 9.2% (38/412) and 26.5% (109/412), respectively. Statistically significant association with the development of postherpetic neuralgia was male sex (odds ratio [OR], 2.51; 95% confidence interval [CI], 1.17-5.38), age of 70-74 years (OR, 3.51; 95% CI, 1.09-11.3), immunosuppressive therapy (OR, 6.44; 95% CI, 1.26-32.9), severe herpes zoster pain at first consultation (OR, 3.08; 95% CI, 1.10-8.62) and rash on upper arms (vs no rash on upper arms; OR, 3.46; 95% CI, 1.10-10.9). Considerable herpes zoster and postherpetic neuralgia burden exists among elderly in Japan, and there may be predictive factors at the first visit which could be indicative of the risk of developing postherpetic neuralgia.

  6. A Cultural Thinking on Local Knowledge——Taking Chinese Chiropractic as an Example%作为地方性知识的文化思考——以中国整脊学为例

    Institute of Scientific and Technical Information of China (English)

    叶延勋

    2015-01-01

    Compared with science and technology, local knowledge has always been regarded as pseudoscience by academia. That led to a misunderstanding to local culture and a lack of it. Taking China chiropractic as an example, this paper analyzes local culture knowledge from four aspects-misunderstanding to local knowledge, beliefs value, scientific rationality and ethical connotations. By comparing the local knowledge and the"axiom", exploring the real value of local knowledgeˊs existence not only can enhance the national culture's self-confidence, but also can promote the development of China chiropractic.%相对于科学技术而言,地方性知识一直被学术界认为是伪科学的,从而导致人们对地方性文化的误解和地方性知识的缺失. 我们以中国整脊学为例,从对地方性知识认识的误区、信仰价值、科学合理性和伦理内涵四个方面进行分析,通过地方性知识与"公理"对比来探讨地方性知识存在的真正价值,不仅可以提升民族文化自信,同时对中国整脊学的发展也可以起到一定的推动作用.

  7. ISI Proceedings分析工具Results Analysis的功能分析及检索实践%Function Analysis and Retrieval Practice about Result Analysis of ISI Proceedings

    Institute of Scientific and Technical Information of China (English)

    王园春

    2008-01-01

    本文以ISI Proceedings的科技版ISTP具体检索为倒,探讨了ISI Proceedings个性化服务的分析工具Results Analysis的功能和使用技巧,以及检索结果的信息分析和挖掘对用户的指导意义.

  8. Nearshoring Practices

    DEFF Research Database (Denmark)

    Slepniov, Dmitrij; Brazinskas, Sigitas; Wæhrens, Brian Vejrum

    2013-01-01

    Purpose: The principal objective of this paper is to unravel and assess current nearshoring practices and their outlook in the Baltic region. Design/methodology/approach: We draw on the offshoring and outsourcing literature and use mixed methods of enquiry, including case studies, survey techniques...... affected them. The survey results reveal the perspective of Lithuanian vendors regarding their relationships with Scandinavian partners. These findings are used in assessing the future prospects of nearshoring in the Baltic region. Practical implications: The study relates the key attributes...

  9. Evaluating Curricular Influence on Preparation for Practice, Career Outcomes, and Job Satisfaction: Results from an Alumni Survey of a 40-Year Rehabilitation and Mental Health Counseling Program

    Science.gov (United States)

    Smith, Tammy Jorgensen; Reid, Joan A.; Henry, Ryan G.; Dixon, Charlotte G.; Wright, Tennyson J.

    2013-01-01

    Alumni of a Council on Rehabilitation Education (CORE)-accredited graduate rehabilitation counselor education (RCE) program were surveyed to evaluate career outcomes, job satisfaction, licensure and certification rates, client populations served, and RCE program satisfaction and effectiveness. Results indicate a high level of satisfaction with the…

  10. Clinical results obtained with a combination of an anti-inflammatory steroid, an antibacterial agent and an antifungal in dermatological outpatient practice.

    Science.gov (United States)

    Pazzaglia, A

    1985-07-01

    Forty outpatients with skin diseases were treated with an extempore combination of three creams, the respective bases of which were beclomethasone dipropionate, sodium fusidate and ketoconazole. Positive results were obtained in 97.5% of the cases with good relief of symptoms and excellent local tolerance in all cases treated.

  11. COBACORE Community Based Comprehensive Recovery : D6.8: Guidelines for Practical Introduction of COBACORE Project Results - WP6: Dissemination, Exploitation and Education

    NARCIS (Netherlands)

    Rijken, M.; Streefkerk, J.W.; Huis in 't Veld, M.A.A.; Pieneman, R.B.J.; Buul-Besseling, K. van; Neef, R.M.

    2016-01-01

    This document describes a method to support local implementations of COBACORE project results and similar innovations for civilian-professional collaboration. The method highlights critical factors of concern and facilitates the development of a bespoke implementation in co-creation with local stake

  12. Legislation and Litigation Resulting from the Canadian Commission of Inquiry into the Use of Drugs and Banned Practices Intended To Increase Athletic Performance.

    Science.gov (United States)

    Moriarty, Dick; And Others

    This paper presents the results from the Dubin Inquiry Report (1990) into drug abuse for athletic purposes. The inquiry involved testimonies from 48 steroid users, and from coaches, sport administrators, medical doctors, sport scientists, and International Olympic Committee representatives. Recommendations from the Dubin Report include: (1)…

  13. Delivery of care to diabetic patients with foot ulcers in daily practice: results of the Eurodiale Study, a prospective cohort study

    DEFF Research Database (Denmark)

    Prompers, L.; Huijberts, M.; Apelqvist, J.

    2008-01-01

    Aims To determine current management and to identify patient-related factors and barriers that influence management strategies in diabetic foot disease. Methods The Eurodiale Study is a prospective cohort study of 1232 consecutive individuals presenting with a new diabetic foot ulcer in 14 centres...... suggest that current guidelines are too general and that healthcare organizational barriers and personal beliefs result in underuse of recommended therapies. Action should be undertaken to overcome these barriers and to guarantee the delivery of optimal care for the many individuals with diabetic foot...... across Europe. We determined the use of management strategies: referral, use of offloading, vascular imaging and revascularization. Results Twenty-seven percent of the patients had been treated for > 3 months before referral to a foot clinic. This varied considerably between countries (6-55%). At study...

  14. NASA/DOD Aerospace Knowledge Diffusion Research Project. Report 23: The communications practices of US aerospace engineering faculty and students: Results of the phase 3 survey

    Science.gov (United States)

    Pinelli, Thomas E.; Barclay, Rebecca O.; Kennedy, John M.

    1994-01-01

    The U.S. government technical report is a primary means by which the results of federally funded research and development (R&D) are transferred to the U.S. aerospace industry. However, little is known about this information product in terms of its actual use, importance, and value in the transfer of federally funded R&D. To help establish a body of knowledge, the U.S. government technical report is being investigated as part of the NASA/DOD Aerospace Knowledge Diffusion Research Project. In this report, we summarize the literature on technical reports and provide a model that depicts the transfer of federally funded aerospace R&D via the U.S. government technical report. We present results from our investigation of aerospace knowledge diffusion vis-a-vis the U.S. government technical report, and present the results of research that investigated aerospace knowledge diffusion vis-a-vis U.S. aerospace engineering faculty and students.

  15. Healthcare Costs Reduced After Incorporating the Results of the American College of Surgeons Oncology Group Z0011 Trial into Clinical Practice.

    Science.gov (United States)

    Fillion, Michelle M; Glass, Katherine E; Hayek, Joe; Wehr, Allison; Phillips, Gary; Terando, Alicia; Agnese, Doreen M

    2016-11-30

    The purpose of our study was to quantitate the changes in axillary lymph node dissection (ALND), frozen section (FS), and the impact on costs after the publication of the American College of Surgeons Oncology Group (ACOSOG) Z0011 trial. We compared axillary nodal management and cost data in breast cancer patients who met Z0011 criteria and were treated with lumpectomy and sentinel lymph nodes (SLN) biopsy from 2007 to July 2013. Of 800 patients, 67 (13.5%) and 34 (12.5%) patients in the pre- and post-Z0011 era had 1-2 positive SLN. ALND decreased from 78% to 21% (p < 0.001) after publication of Z0011. The mean overall cost of SLN biopsy was $41,059 per patient, while SLN biopsy with completion ALND was $50,999 (p < 0.001). Intraoperative FS use decreased from 95% to 66% (p = 0.015). Omitting the FS decreased mean costs from $4,319 to $2,036. The application of Z0011 resulted in an overall mean cost savings of $571,653 from 2011 to July 2013. ACOSOG Z0011 significantly impacted axillary management resulting in a 20% reduction in the mean overall cost per patient by omitting ALND. In these patients, intraoperative FS analysis had poor sensitivity (56%) and doubled the cost of pathologic examination. Fewer ALND and intraoperative FS were performed after the publication of ACOSOG Z0011. Eliminating FS and ALND in patients who met Z0011 criteria, results in significant cost savings.

  16. Practice and Result Analysis of Therapeutic Drug Monitoring%治疗药物监测实践及结果分析

    Institute of Scientific and Technical Information of China (English)

    林宇涵; 许双临; 陈子春

    2012-01-01

      目的分析治疗药物监测结果,评价其临床效果和意义.方法采用 HPLC 法测定5种药物的血药浓度,对监测结果进行分析、统计.结果治疗药物监测结果在有效治疗窗内的仅占56.7%.监测值在低、中、高血药浓度范围内出现临床症状、症状控制、中毒症状的比例分别为90.5%、94.1%、100%.结论治疗药物监测对临床个体化给药具有重要意义.%  Objective To analyze and evaluate the results of therapeutic drug nonitoring (TDM) data. Methods The blood concentrations of 5 drugs were measured by HPLC, analysis and statistics of TDM data were carried out. Results Among all the TDM concentration, only 56.7% was within the therapeutic window. The monitoring value at low, medium and high blood drug level respectively within the scope of clinical symptoms appear, symptom under control, toxic symptom ratio was 90.5%, 94.1% and 100%. Conclusion Therapeutic drug monitoring is significant for individual administration in clinical.

  17. APPROACH AND TREATMENT OF SUICIDAL BEHAVIOR IN THE CLINICAL PRACTICE OF DIFFERENT GROUPS OF HEALTH PROFESSIONALS IN SPAIN: RESULTS OF THE PROJECT EUREGENA.

    Directory of Open Access Journals (Sweden)

    Juan Luis Muñoz

    2014-12-01

    Full Text Available According to the WHO (World Health Organization and the European Union, suicide is considered to be a health problem of prime importance and to be one of the principal causes of unnatural death. In Spain, the number of suicides has increased 12% since 2005 . The Research Project “European Regions Enforcing Actions against Suicide (EUREGENAS, funded by the Health Program 2008-2013, has as main objective the description of an integrated model of Mental Health orientated to the prevention of suicide. The differences that allow distinguishing the meaning of prevention in suicide behavior are described and explained through a qualitative methodological strategy and through the creation of discussion groups formed by different groups of health professionals. The results highlight the existing differences between the diverse health professionals who come more in contact with this problem and it shows as well the coincidence of meaning that suicide has to be considered as a priority in the field of health.

  18. Exposure of the limbs during practice nuclear medicine diagnostics and therapy. Project result Oramed; Exposicion de las extremidades durante practicas de medicina nuclear de diagnostico y terapia. Resultados del proyecto oramed

    Energy Technology Data Exchange (ETDEWEB)

    Carnicer, A.; Ginjaume, M.; Ortega, X.; Babchler, S.; Donadille, L.; Donadille, L.; Ferrari, P.; Fulop, M.; Gualdrini, G.; Krim, S.; Mariotti, F.; Rimples, A.; Ruiz, N.; Sans Merce, M.; Vanhavers, F.

    2011-07-01

    This paper presents the main results of the project ORAMED (Optimization of Radiation Protection of medical staff) . One of the working groups (WP4) was devoted to the study and improvement of the doses received in the hand for the implementation of operating procedures in nuclear medicine departments. The objectives of the working group responded to the need to expand the knowledge and improvements in this field, since in previous work had identified practices that could potentially high doses exceed the dose limits.

  19. A follow-up study of the in-practice results of pulsed electromagnetic field therapy in the management of nonunion fractures

    Directory of Open Access Journals (Sweden)

    Murray HB

    2016-12-01

    Full Text Available Hallie B Murray,1 Brian A Pethica1,2 1EBI, LLC (a Zimmer Biomet company, Parsippany, NJ, USA; 2Department of Chemical and Biological Engineering, Princeton University, Princeton, NJ, USA Abstract: During normal fracture repair, healing occurs within a few months. However, for a minority of patients, the processes of bone repair are compromised or interrupted leading to the development of delayed union and nonunion fractures. Noninvasive bone growth stimulators using pulsed electromagnetic field (PEMF technology are currently in widespread use by patients with impaired fracture healing. This article reports the results of a follow-up study of 1,382 patients treated with PEMF stimulation to evaluate success rates and the relationship between average daily use and the clinical outcomes of therapy as reported by their prescribing physicians. The reported overall success rate for the 1,382 patients was 89.6%. The results were analyzed in audited subsets comparing days of treatment time and average daily use of the electrical bone growth stimulator, using several statistical methods. Linear regression analysis indicated a 6-day reduction in time to heal with each additional hour of average daily use. Survival analysis concluded that the median heal time was reduced by 35%–60%, depending on the different fracture characteristics of patients who complied with the recommended daily use of 10 hours per day. A third statistical analysis indicated that patients treated with the PEMF device for 9 hours or more per day had a significant reduction in time to heal, achieving successful fracture repair an average of 76 days earlier than patients treated with the PEMF device for an average of 3 hours or less per day. Overall, these different methods of statistical analysis indicate that PEMF therapy correlates with an acceleration in the healing of nonunion fractures. Keywords: PEMF, pulsed electromagnetic field, dose–response, nonunion, time to heal

  20. Risk Factors Associated with Unsafe Injection Practices at the First Injection Episode among Intravenous Drug Users in France: Results from PrimInject, an Internet Survey

    Directory of Open Access Journals (Sweden)

    Anne Guichard

    2015-01-01

    Full Text Available Background. New drug use patterns may increase the risk of human immunodeficiency virus and hepatitis infections. In France, new injection patterns among youths with diverse social backgrounds have emerged, which may explain the persistently high rates of hepatitis C virus infection. This study explores factors associated with injection risk behaviours at first injection among users who began injecting in the post-2000 era. Methods. A cross-sectional study was conducted on the Internet from October 2010 to March 2011, through an online questionnaire. Multivariate logistic regression identified the independent correlates of needle sharing and equipment (cooker/cotton filter sharing. Results. Among the 262 respondents (mean age 25 years, 65% were male. Both risk behaviours were positively associated with initiation before 18 years of age (aOR 3.7 CI 95% 1.3–10.6 and aOR 3.0 CI 95% 1.3–7.0 and being injected by another person (aOR 3.1 CI 95% 1.0–9.9 and aOR 3.0 CI 95% 1.3–7.1. Initiation at a party was an independent correlate of equipment sharing (aOR 2.6 95% CI 1.0–6.8. Conclusions. Results suggest a need for innovative harm reduction programmes targeting a variety of settings and populations, including youths and diverse party scenes. Education of current injectors to protect both themselves and those they might initiate into injection is critically important.

  1. First-in-man clinical results with good manufacturing practice (GMP)-compliant polypeptide-expanded adenovirus-specific T cells after haploidentical hematopoietic stem cell transplantation.

    Science.gov (United States)

    Geyeregger, René; Freimüller, Christine; Stemberger, Julia; Artwohl, Michaela; Witt, Volker; Lion, Thomas; Fischer, Gottfried; Lawitschka, Anita; Ritter, Julia; Hummel, Michael; Holter, Wolfgang; Fritsch, Gerhard; Matthes-Martin, Susanne

    2014-05-01

    Adoptive immunotherapy against viral infections is a promising treatment option for patients after hematopoietic stem cell transplantation. However, the generation of virus-specific T cells is either cost-intensive or time-consuming. We developed the first GMP-compliant protocol to generate donor-derived adenovirus (HAdV), cytomegalovirus, and Epstein-Barr virus-specific T-cell lines (TCLs) within 12 days by the use of overlapping polypeptides derived from different viruses in combination with IL-15. Two patients after undergoing haploidentical hematopoietic stem cell transplantation with HAdV viremia displaying rising viral loads despite treatment with cidofovir received 1×10 donor-derived short-term expanded HAdV-specific TCLs per kg body weight. In both patients, HAdV-specific T cells could be detected by IFN-γ-ELISpot 30 and 22 days postinfusion, and resulted in complete clearance or >1.5 log reduction of viral load within 15 and 18 days, respectively. This protocol facilitates rapid and cost-effective generation of virus-specific TCLs, which appear to provide an effective treatment option.

  2. Measurement of ocean water optical properties and seafloor reflectance with scanning hydrographic operational airborne lidar survey (SHOALS): II. Practical results and comparison with independent data

    Science.gov (United States)

    Tuell, Grady H.; Feygels, Viktor; Kopilevich, Yuri; Weidemann, Alan D.; Cunningham, A. Grant; Mani, Reza; Podoba, Vladimir; Ramnath, Vinod; Park, J. Y.; Aitken, Jen

    2005-08-01

    Estimation of water column optical properties and seafloor reflectance (532 nm) is demonstrated using recent SHOALS data collected at Fort Lauderdale, Florida (November, 2003). To facilitate this work, the first radiometric calibrations of SHOALS were performed. These calibrations permit a direct normalization of recorded data by converting digitized counts at the output of the SHOALS receivers to input optical power. For estimation of environmental parameters, this normalization is required to compensate for the logarithmic compression of the signals and the finite frequency of the bandpass of the detector/amplifier. After normalization, the SHOALS data are used to estimate the backscattering coefficient, the beam attenuation coefficient, the single-scattering albedo, the VSF asymmetry, and seafloor reflectance by fitting simulated waveforms to actual waveforms measured by the SHOALS APD and PMT receivers. The resulting estimates of these water column optical properties are compared to in-situ measurements acquired at the time of the airborne data collections. Images of green laser bottom reflectance are also presented and compared to reflectance estimated from simultaneously acquired passive spectral data.

  3. Best Practices for Interdisciplinary Care Management by Hospital Glycemic Teams: Results of a Society of Hospital Medicine Survey Among 19 U.S. Hospitals

    Science.gov (United States)

    Magee, Michelle; Ramos, Pedro; Seley, Jane Jeffrie; Nolan, Ann; Kulasa, Kristen; Caudell, Kathryn Ann; Lamb, Aimee; MacIndoe, John; Maynard, Greg

    2014-01-01

    Abstract Objective. The Society for Hospital Medicine (SHM) conducted a survey of U.S. hospital systems to determine how nonphysician providers (NPPs) are utilized in interdisciplinary glucose management teams. Methods. An online survey grouped 50 questions into broad categories related to team functions. Queries addressed strategies that had proven successful, as well as challenges encountered. Fifty surveys were electronically distributed with an invitation to respond. A subset of seven respondents identified as having active glycemic committees that met at least every other month also participated in an in-depth telephone interview conducted by an SHM Glycemic Advisory Panel physician and NPP to obtain further details. The survey and interviews were conducted from May to July 2012. Results. Nineteen hospital/hospital system teams completed the survey (38% response rate). Most of the teams (52%) had existed for 1–5 years and served 90–100% of noncritical care, medical critical care, and surgical units. All of the glycemic control teams were supported by the use of protocols for insulin infusion, basal-bolus subcutaneous insulin orders, and hypoglycemia management. However, > 20% did not have protocols for discontinuation of oral hypoglycemic agents on admission or for transition from intravenous to subcutaneous insulin infusion. About 30% lacked protocols assessing A1C during the admission or providing guidance for insulin pump management. One-third reported that glycemic triggers led to preauthorized consultation or assumption of care for hyperglycemia. Institutional knowledge assessment programs were common for nurses (85%); intermediate for pharmacists, nutritionists, residents, and students (40–45%); and uncommon for fellows (25%) and attending physicians (20%). Many institutions were not monitoring appropriate use of insulin, oral agents, or insulin protocol utilization. Although the majority of teams had a process in place for post-discharge referrals

  4. Best Practices for Interdisciplinary Care Management by Hospital Glycemic Teams: Results of a Society of Hospital Medicine Survey Among 19 U.S. Hospitals.

    Science.gov (United States)

    Rodriguez, Annabelle; Magee, Michelle; Ramos, Pedro; Seley, Jane Jeffrie; Nolan, Ann; Kulasa, Kristen; Caudell, Kathryn Ann; Lamb, Aimee; MacIndoe, John; Maynard, Greg

    2014-08-01

    Objective. The Society for Hospital Medicine (SHM) conducted a survey of U.S. hospital systems to determine how nonphysician providers (NPPs) are utilized in interdisciplinary glucose management teams. Methods. An online survey grouped 50 questions into broad categories related to team functions. Queries addressed strategies that had proven successful, as well as challenges encountered. Fifty surveys were electronically distributed with an invitation to respond. A subset of seven respondents identified as having active glycemic committees that met at least every other month also participated in an in-depth telephone interview conducted by an SHM Glycemic Advisory Panel physician and NPP to obtain further details. The survey and interviews were conducted from May to July 2012. Results. Nineteen hospital/hospital system teams completed the survey (38% response rate). Most of the teams (52%) had existed for 1-5 years and served 90-100% of noncritical care, medical critical care, and surgical units. All of the glycemic control teams were supported by the use of protocols for insulin infusion, basal-bolus subcutaneous insulin orders, and hypoglycemia management. However, > 20% did not have protocols for discontinuation of oral hypoglycemic agents on admission or for transition from intravenous to subcutaneous insulin infusion. About 30% lacked protocols assessing A1C during the admission or providing guidance for insulin pump management. One-third reported that glycemic triggers led to preauthorized consultation or assumption of care for hyperglycemia. Institutional knowledge assessment programs were common for nurses (85%); intermediate for pharmacists, nutritionists, residents, and students (40-45%); and uncommon for fellows (25%) and attending physicians (20%). Many institutions were not monitoring appropriate use of insulin, oral agents, or insulin protocol utilization. Although the majority of teams had a process in place for post-discharge referrals and specific

  5. Practice and results of clinic nursing performance resolution%临床护理人员绩效改革实施与成效

    Institute of Scientific and Technical Information of China (English)

    王燕; 谭启明

    2015-01-01

    目的:为了调动护理人员工作积极性,全面推动优质护理服务工作,探讨临床护理人员绩效改革实施方法与成效。方法对护理岗位进行调研与配置,在儿科进行试点,根据不同病区、不同岗位将护理绩效分成五大模块(特殊岗位、最低保障绩效、职务系数、岗位系数、工作绩效),体现多劳多得、优绩优酬,并且综合护士全年工作考评成绩,在评先评优中给予优先考虑。结果改革后绩效差距明显减小,低年资护士绩效明显提升,护士工作满意度明显提高,护理缺陷、投诉及意外事件减少,重点缺陷项明显减少。结论绩效分配倾向高风险、技术难度大岗位,降低护理风险,提高护士满意度;落实岗位责任制,按岗取酬,提高护理质量,提高护理服务满意度;绩效分配改革后,强化继续教育,提高了护理人员综合素质,积极推进了优质护理服务工作。%Objective To improve the enthusiasm of nursing in work and prompte nursing service by all means. Methods By investigating and allocating different nursing jobs, according to different sections and different jobs in pediatrics, we divided nursing performance into ifve modules,(special position bonus, minimum performance bonus, position index and job performance), which relfect excellent merit pay, equity and justice. We could do prefer the good ones by summarizing the total performance at the end of year.Results During the evolution progress, the differences of performance bonus became smaller, the bonus level of low-income nurses increased distinctly, the satisfactory of nurses improved signiifcantly, the responsibility enhanced and the adverse events decrease, severe defects decreased significantly.Conclusion The allocation of performance preferred to the high risk and high dififcult jobs, which could lower nursing risk and heighten nurses’ satisfaction; the revolution relfects the

  6. NASA/DOD Aerospace Knowledge Diffusion Research Project. Paper 54: The technical communications practices of engineering technology students: Results of the NASA/DOD Aerospace Knowledge Diffusion Research Project phase 3 student surveys

    Science.gov (United States)

    Pinelli, Thomas E.; England, Mark; Barclay, Rebecca O.; Kennedy, John M.

    1995-01-01

    Engineering technology programs are characterized by their focus on application and practice, and by their approximately 50/50 mix of theory and laboratory experience. Engineering technology graduates are employed across the technological spectrum and are often found in areas that deal with application, implementation, and production. Yet we know very little about the communications practices and information-use skills of engineering technology students. In this paper, we report selected results of an exploratory study of engineering technology students enrolled in three U.S. institutions of higher education. Data are presented for the following topics: career goals and aspirations; the importance of, receipt of, and helpfulness of communications and information-use skills instruction; collaborative writing; use of libraries; and the use of electronic (computer) networks.

  7. The Educational Results in Practice Teaching

    Science.gov (United States)

    Kurenkova, Iu. V.

    2013-01-01

    Education reforms in Russia are aimed at increasing goal-based instruction and at expanding the range of desired outcomes, but survey research data show that teachers are not well-prepared to implement these changes. (Contains 2 tables and 4 notes.)

  8. Practice-audit-publish: A practice reflection.

    Science.gov (United States)

    Ferrari, Robert

    2016-12-01

    Practice audits are useful opportunities to improve practice efficiency and effectiveness, reduce clinical errors, demonstrate quality care to stakeholders, promote high standards of practice, lower the risk of liability, and foster practice change. However, a benefit that is usually overlooked is the possibility of publication of the results of a practice audit. Publication (research) has a number of benefits for the clinician, including skill development as a scholar, communicator, professional, and collaborator. A practice audit is beneficial to an individual physician; furthermore, publication of the audit results could be beneficial for many others such as health care providers, patients, and other stakeholders in a health care system. The problem is that practice audits often begin without a clear plan. The important steps in planning and carrying out a practice audit can be captured by thinking about how a research publication evolves. Thus, a good researcher is a good practice auditor. This paper reviews the author's experience and provides examples and directions of the process of practice-audit-publish.

  9. 基于不同房树人测验特征分布的医学本科生实习成绩分析%Practice Results Analysis of Different Undergraduates HTP Characteristics

    Institute of Scientific and Technical Information of China (English)

    郭鹏军; 李立; 吴晨曦

    2015-01-01

    Objective Understand the relevance of Medical Students′ Personality Characteristics and practice scores to provide technical information to improve the level of medical education . Methods Make HTP test for 229 medical students of Lanzhou University ,and the different types of internship results were statistically analyzed .Results Personality traits of medical students′are an important fac‐tor affecting performance practice . Conclusion Teachers should pay attention to medical students′sound personality ,so as to improve the level of medical education .%目的:了解医学生人格特征与实习成绩的关联性,为医学教育水平提高提供技术参考。方法对兰州大学临床医学专业229名学生进行房树人绘画测验,并对不同人格类型对应的实习成绩进行统计学分析研究。结果人格特质是影响医学生实习成绩的重要因素。结论在医学生培养中,学生管理者应该重视医学生健全人格的培养,从而推动医学教育水平的良性提升。

  10. Exposures to patients in Australian radiological practice

    Energy Technology Data Exchange (ETDEWEB)

    Paix, D. (South Australian Inst. of Tech., Adelaide)

    1983-11-01

    The findings of a 1980 Australian Radiation Laboratory study of genetic and bone-marrow doses to the population from medical, dental and chiropractic uses of ionising radiation are discussed. Attention is drawn to the large variability in patient exposure: maximum values were from five to eleven times greater than the means.

  11. Access to complementary medicine in general practice: survey in one UK health authority.

    Science.gov (United States)

    Wearn, A M; Greenfield, S M

    1998-09-01

    Complementary therapy (CT) has become increasingly popular with the general public and interest from the health professions has been rising. There has been no study focusing on the pattern of availability of CT within urban and inner-city general practice. We aimed to describe the prevalence and pattern of access to complementary therapy in this setting, identifying the characteristics of practices offering CT and the perceived barriers to service provision. We sent a postal questionnaire to all 254 general practices on the Birmingham Family Health Services Authority list. Practices were asked whether they offered any access to CTs, how services were organized and which therapies were available and to identify any barriers to provision. 175 practices (68.9%) responded. Half of the practices offered access to CT. Of these, half offered an in-house service, usually provided by the doctor (81.8%). Of GPs practising therapies themselves, 58% began in or after 1990. Seventeen separate therapies were offered, most commonly acupuncture, osteopathy, chiropractic, hypnotherapy and homoeopathy. Practices significantly more likely to offer access to CT were of larger list size and training or teaching practices. They were equally likely to be fundholders or non-fundholders. Practices offering an in-house service tended to be fundholding, training and of larger list size. Finance was perceived as the major barrier. In the area studied, many patients now have some access to CT within primary care, often within their own practice. In the main, therapies offered are the 'medically acceptable face' of complementary medicine.

  12. Practical Stereochemistry.

    Science.gov (United States)

    Kellogg, Richard M

    2017-03-01

    The relationship between fundamental and applied is often uneasy, particularly in modern political climates. A familiar political view, aimed negatively at the scientific community, is that the former is a waste of money whereas the latter gives value for investment. The answer that fundamental is required as the basis for practical suffers from the fact that the timelines between fundamental and practical are often long and the routes contorted and unexpected. This has been my experience. In this Account, examples are given from the research in which I have been involved wherein quite fundamental considerations have led to various applications. The longer the time, the clearer and broader the relationship. Fundamental can and does lead to application. They need and depend on each other. I have seen this both from the side of academia and from small companies. In the course of the past 40 plus years, I have been involved in various aspects of stereochemistry and, in particular, chirality. It has been rewarding to see that several of the developments, most originally grounded in fundamental research considerations, have been used in the chemical community and given new dimensions and often practical applications by others. In this Account, a path-not planned deliberately by me-from orbital symmetry and Woodward-Hoffmann rules through crown ethers to conformational analysis to diastereomeric resolutions to deracemizations powered by Ostwald ripening and the Gibbs-Thomson effect to nucleation to helicenes is described. In order of discussion, the orbital symmetry aspects have via an unusual and unpredicted path has resulted in, among other things, a synthesis of hindered alkenes useful for t