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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...... 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

    . Infantile colic was the most common presenting complaint in this age group. For the older children, musculoskeletal problems were the most dominant complaint, ranging from 33% among the preschool children to 75% among the teenagers. These complaints were often chronic and about a third of the children older....... 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. 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...

  4. 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

  5. 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...... by the chiropractic practitioner....

  6. 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.

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

    DEFF Research Database (Denmark)

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

    2016-01-01

    are subject to consumer trends and behaviors. The purpose of this investigation was to explore and describe consumer touch points relevant to perceived value through healthcare journeys in chiropractic practices. METHOD: We designed a convergent parallel, mixed methods study. Our purposive sampling framework...... identified 11 chiropractic clinics from which we collected observational field notes, video recordings and face-to-face interviews. RESULTS: Data was collected between April 14(th) and June 26(th) 2014. We described the exteriors and interiors of all participant clinics, interviewed 32 staff members, 12 new...... patients value consultations with clinicians who demonstrate professional competence by effective communication diagnosis/management and facilitating satisfactory treatment outcomes. CONCLUSION: At least six consumer touch points add/detract from value-related experiences in chiropractic practices...

  8. American Chiropractic Association

    Science.gov (United States)

    ... Fact Sheets Public Health Resources Practice Resource Center Public Relations Portal National Chiropractic Health Month 2016 Advocacy & Reimbursement ... Chiropractic in the Media ACA Radio Chiropractic Cares Social Media Facebook Twitter YouTube Instagram LinkedIn Advocacy Regulatory Policy ...

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

    OpenAIRE

    Shreeve, Michael W.

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Amorin-Woods Lyndon G

    2012-03-01

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

  11. 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...... are subject to consumer trends and behaviors. The purpose of this investigation was to explore and describe consumer touch points relevant to perceived value through healthcare journeys in chiropractic practices. METHOD: We designed a convergent parallel, mixed methods study. Our purposive sampling framework...... 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...

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

    Science.gov (United States)

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

    2016-04-01

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

  13. 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.

  14. 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…

  15. CHIROPRACTIC AND OSTEOPATHIC EDUCATION AT ROYAL MELBOURNE INSTITUTE TECHNOLOGY

    OpenAIRE

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

    1999-01-01

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

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

    OpenAIRE

    N. Naidoo; Bühler, L.

    2009-01-01

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

  17. Legislative approaches to the regulation of the chiropractic profession

    OpenAIRE

    Chapman-Smith, David A

    1996-01-01

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

  18. 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

  19. What Is Chiropractic?

    Science.gov (United States)

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

  20. History of Chiropractic Care

    Science.gov (United States)

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

  1. 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.

  2. 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.

  3. 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.

  4. Burnout among chiropractic practitioners: real or imagined an exploratory study protocol.

    Science.gov (United States)

    Williams, Shawn; Innes, Stanley

    2012-01-01

    Burnout is a psychological syndrome of emotional exhaustion, depersonalization and reduced personal accomplishment that has been found to exist in a significant number of healthcare and helping professionals. It imposes a significant societal burden by shortened practitioner lifespan, decreased efficiency, negative health outcomes and poorer levels of patient care. Theoretical models suggest that it appears to be the result of a complex interaction between job resources and job demands. It may be reasonable to conclude that Chiropractic professionals experience similar vocational demands and thus experience significant levels of occupational stress and subsequent burnout. However the data on burnout within the chiropractic profession is limited. It is possible that this results in significant negative outcomes on chiropractors and their patients. Therefore, the objective of this paper is to demonstrate the need to explore burnout in chiropractic practice and offer a research protocol for a potential study. PMID:22369737

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

    OpenAIRE

    Johnson, Claire

    2011-01-01

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

  6. The new chiropractic

    OpenAIRE

    Walker, Bruce F.

    2016-01-01

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

  7. Frequently Asked Questions about Chiropractic

    Science.gov (United States)

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

  8. Chiropractic care and public health

    DEFF Research Database (Denmark)

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

    2012-01-01

    The purpose of this collaborative summary is to document current chiropractic involvement in the public health movement, reflect on social ecological levels of influence as a profession, and summarize the relationship of chiropractic to the current public health topics of: safety, health issues...... 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...

  9. 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.

  10. 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...

  11. 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.

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

    Science.gov (United States)

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

    2015-01-01

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

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

    OpenAIRE

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

    2016-01-01

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

  14. 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.

  15. Chiropractic & Osteopathy. A new journal

    OpenAIRE

    Walker Bruce F; French Simon D; Cameron Melainie

    2005-01-01

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

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

    Science.gov (United States)

    Estrin Dashe, Alejandra A.

    2012-01-01

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

  17. 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.

  18. 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

  19. 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.

  20. 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.

  1. 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

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

    Directory of Open Access Journals (Sweden)

    Strasser Sheryl M

    2006-10-01

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

  3. Robotic Measurement and Control for Chiropractic Research

    Directory of Open Access Journals (Sweden)

    P. Goldsmith

    2006-01-01

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

  4. Chiropractic and geriatrics: a review of the training, role, and scope of chiropractic in caring for aging patients.

    Science.gov (United States)

    Killinger, Lisa Zaynab

    2004-05-01

    Chiropractors may be well-positioned to play an important role in health promotion, injury and disease prevention, and on geriatric care teams, due to their practice style and holistic philosophy. The bottom line in aging care is that someone in the health-care world must provide health promotion and preventive services to older patients before the wave of aged patients profoundly overwhelms our health-care system. Chiropractic services are safe and relatively low-cost, and patient satisfaction with them is very high. In the managed-care environment, time pressures on allopathic providers may preclude them from spending sufficient time discussing health promotion and illness prevention with their patients. Chiropractic, when paid for out-of-pocket, is not as affected by these extreme pressures. With the hands-on nature of chiropractic care, a strong doctor-patient relationship is forged in which health and lifestyle recommendations may be comfortably and effectively discussed. Relative to musculoskeletal care in elderly patients, chiropractic adjustments (spinal manipulative therapy) are recommended by the Agency for Health Care Policy and Research for the care of acute low back pain, and the American Geriatric Society Panel Guidelines for the Management of Chronic Pain state that non-pharmaceutical interventions such as chiropractic may be appropriate. Most geriatric health-care providers have a limited number of options to offer patients with these complaints. Various lower-force chiropractic techniques are available as safe alternatives to drugs and surgery for musculoskeletal complaints in the older patient. Due to the prevalence of these conditions in older patients, and the success of chiropractic in caring for these patients, interdisciplinary geriatric health care teams should include the doctor of chiropractic. Chiropractors, well trained in health assessment, diagnosis, radiographic studies, health promotion, and illness prevention, are well-positioned to

  5. 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...

  6. Quantitative corpus-based analysis of the chiropractic literature - a pilot study.

    Science.gov (United States)

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

    2011-03-01

    In this pilot study, a collection of peer-reviewed articles from the Journal of the Canadian Chiropractic Association was analyzed by computer to identify the more commonly occurring words and phrases. The results were compared to a reference collection of general English in order to identify the vocabulary which is distinctive of chiropractic. From texts with a combined word count in excess of 280,000, it was possible to identify almost 2,500 words which were over-represented in the chiropractic literature and therefore likely to hold special importance within this domain. Additionally, readability statistics were calculated and suggest that the peer-reviewed chiropractic literature is approximately as challenging to read as that of nursing, public health and midwifery. Certain words widely considered to be of importance to the profession, for example "subluxation and adjustment," were not particularly prevalent in the literature surveyed. PMID:21403783

  7. 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.

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

    DEFF Research Database (Denmark)

    Myburgh, Corrie; Mouton, Johan

    2007-01-01

    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...... health care practices as part of the education process and the concomitant perceived lack of exposure especially to black South Africans emerged as interesting and pertinent developmental themes in the local context. CONCLUSIONS: The international discourse related to issues in the domains of philosophy...

  10. 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...

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

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    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.

  12. Back problems. Chiropractic evaluation and management.

    Science.gov (United States)

    Haussler, K K

    1999-04-01

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

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

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    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.

  14. 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....

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

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    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

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

    OpenAIRE

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

    2011-01-01

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

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

    Science.gov (United States)

    Byun, Sunghak; Han, Dongwook

    2016-01-01

    [Purpose] The purpose of this study was to examine whether chiropractic techniques would reduce the curvature of idiopathic scoliosis, which commonly occurs in elementary school children. [Subjects] The subjects of this study were 5 healthy elementary students who listened to an explanation of the study methods and purpose of the study and agreed to participate in the experiment. [Methods] The Cobb angle was measured by taking an X-ray (FCT-1, Dongmun, Goyangsi, Republic of Korea) taken from the rear, using X-ray film. The method of intervention this study used was application of chiropractic techniques. Spinal correction was carried out for 30 minutes per session, which included soft tissue massage, 3 times a week for 8 weeks. [Results] It was established that the Cobb angle was noticeably decreased after 4 weeks of the intervention. Post Hoc analysis revealed that the Cobb angle noticeably decreased after 4 weeks compared with the Cobb angle before the chiropractic techniques were applied. However, no significant difference in Cobb angle was evident after the fourth week. [Conclusion] This study demonstrated that chiropractic techniques can effectively reduce the Cobb angle within as little as 4 weeks. So, we can confirm that the chiropractic techniques were effective for reducing the curvature of idiopathic scoliosis. PMID:27190435

  18. 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 ...

  19. Chiropractic

    Science.gov (United States)

    ... ice Electrical stimulation Relaxation techniques Rehabilitative and general exercise Counseling about diet, weight loss, and other lifestyle factors Dietary supplements Many people visit chiropractors for treatment of low back pain, neck pain, and headaches. NIH: National Center for ...

  20. 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

  1. The forgotten cousins : dental and chiropractic radiography

    International Nuclear Information System (INIS)

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

  2. 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.

  3. Plantar fasciitis: corticosteroid injection versus chiropractic therapy

    Directory of Open Access Journals (Sweden)

    Siddharth Raveendran

    2014-04-01

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

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

    Directory of Open Access Journals (Sweden)

    Pekkarinen Harri

    2008-11-01

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

  5. 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).

  6. 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.

  7. 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.

  8. 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.

  9. 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.

  10. 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

  11. 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...

  12. 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

  13. 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.

  14. 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

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

    OpenAIRE

    Russell, Eric G.

    2010-01-01

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

  16. 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

  17. 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

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

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    Wenban Adrian B

    2006-08-01

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

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

    DEFF Research Database (Denmark)

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

    2014-01-01

    about patient filed compensation claims related to the chiropractic consultation process. The aim of this study was to describe claims reported to the Danish Patient Compensation Association and the Norwegian System of Compensation to Patients related to chiropractic from 2004 to 2012. METHODS: All...... finalized compensation claims involving chiropractors reported to one of the two associations between 2004 and 2012 were assessed for age, gender, type of complaint, decisions and appeals. Descriptive statistics were used to describe the study population. RESULTS: 338 claims were registered in Denmark...... and Norway between 2004 and 2012 of which 300 were included in the analysis. 41 (13.7%) were approved for financial compensation. The most frequent complaints were worsening of symptoms following treatment (n = 91, 30.3%), alleged disk herniations (n = 57, 19%) and cases with delayed referral (n = 46, 15...

  20. The role of chiropractic care in older adults

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    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.

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

    Science.gov (United States)

    Hester, Hilary; Cunliffe, Christina; Hunnisett, Adrian

    2013-01-01

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

  2. 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 ...... for the chiropractic profession in Europe. Future discussion and study is necessary to determine whether the themes identified in this survey should be broadly implemented....

  3. 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

  4. Effects of Biofreeze and chiropractic adjustments on acute low back pain: a pilot study☆

    Science.gov (United States)

    Zhang, John; Enix, Dennis; Snyder, Brian; Giggey, Kristan; Tepe, Rodger

    2008-01-01

    Abstract Objective This randomized controlled study was designed to determine the pain-relieving effect of Biofreeze (Performance Health Inc., Export, PA) body surface application and chiropractic adjustments on subjects with acute low back pain (LBP). Methods The data were collected at the baseline, 2 weeks after treatment, and 4 weeks after treatment for final analyses. Diversified manual adjustments were provided by licensed chiropractors twice a week for 4 weeks to both control and experimental groups. Biofreeze was applied to the lower back area 3 times a day for 4 weeks in the experimental group. Outcome assessments included visual analog scale, Roland Morris Disability Questionnaire, heart rate variability for stress, and electromyography for low back muscle activity. Results A total of 36 subjects were recruited in the study (25 male). The average age was 34 years. Significant pain reduction was found after each week of treatment in the experimental group (P .05) in the experimental group after 4 weeks of Biofreeze and chiropractic adjustments. There were no statistically significant changes in the electromyography readings between the 2 groups. Conclusion Biofreeze combined with chiropractic adjustment showed significant reduction in LBP. PMID:19674721

  5. Plastination: a modern approach to chiropractic teaching

    Science.gov (United States)

    Grondin, Gilles

    1998-01-01

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

  6. 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

    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...

  7. 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.

  8. 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.

  9. 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

  10. 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.

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. 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-ol...

  16. 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.

  17. 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

  18. 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。

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

    Directory of Open Access Journals (Sweden)

    Dragasevic George

    2007-09-01

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

  20. 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.

  1. An exploratory mixed-method study to determine factors that may affect satisfaction levels of athletes receiving chiropractic care in a nonclinic setting☆

    Science.gov (United States)

    Talmage, Grant; Korporaal, Charmaine; Brantingham, James W.

    2009-01-01

    Abstract Objectives The objectives of this study were to determine factors that may affect satisfaction levels of participants in a nonclinic (sport) setting through participant observation and participation. Factors associated with general satisfaction (observed) were determined along with a participant demographic profile, participant knowledge about chiropractic, and satisfaction with treatment received from a chiropractic student. Thereafter, the relationships between the demographic factors, participant knowledge, and participant general satisfaction were determined. Lastly, factors affecting satisfaction levels were compared between the participants and the observers. Methods An exploratory mixed-method observational study that compared results reported by 30 participants and 2 observers, regarding the treatment process, by completion of a self-administered questionnaire. Statistical significance was set at P less than or equal to .05. Results Of the 30 participants, 83.3% were South African, 90% were white, and 63.3% were male, with a mean age of 35.6 years, who reported they were very satisfied with chiropractic care (P = .229). The only factor to produce a significant difference between participants and observers was communication (P = .082 with Spearman = .332). Conclusion In this study, communication had the greatest impact; therefore, it is suggested that positive verbal and nonverbal communication be emphasized in the training of future chiropractic professionals. PMID:19646388

  2. 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。

  3. 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

    Directory of Open Access Journals (Sweden)

    Pollard Henry

    2010-04-01

    Full Text Available 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 randomly allocated to an intervention (n = 29 or control group (n = 30, being matched for age and hamstring injury history. Twenty-eight intervention and 29 control group participants completed the trial. Both groups received the current best practice medical and sports science management, which acted as the control. Additionally, the intervention group received a sports chiropractic intervention. Treatment for the intervention group was individually determined and could involve manipulation/mobilization and/or soft tissue therapies to the spine and extremity. Minimum scheduling was: 1 treatment per week for 6 weeks, 1 treatment per fortnight for 3 months, 1 treatment per month for the remainder of the season (3 months. The main outcome measure was an injury surveillance with a missed match injury definition. Results After 24 matches there was no statistical significant difference between the groups for the incidence of hamstring injury (OR:0.116, 95% CI:0.013-1.019, p = 0.051 and primary non-contact knee injury (OR:0.116, 95% CI:0.013-1.019, p = 0.051. The difference for primary lower-limb muscle strains was significant (OR:0.097, 95%CI:0.011-0.839, p = 0.025. There was no significant difference for weeks missed due to hamstring injury (4 v14, χ2:1.12, p = 0.29 and lower-limb muscle strains (4 v 21, χ2:2.66, p = 0.10. A significant difference in weeks missed due to non-contact knee injury was noted (1 v 24, χ2:6.70, p = 0.01. Conclusions This study

  4. 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.

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

    OpenAIRE

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

    1980-01-01

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

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

    OpenAIRE

    Walker, Bruce F.

    1998-01-01

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

  7. Improvements in The Journal of Chiropractic Education for 2013

    OpenAIRE

    Green, Bart N.

    2013-01-01

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

  8. Potential unique causes of burnout for chiropractic professionals

    OpenAIRE

    Williams, Shawn

    2011-01-01

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

  9. 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.

  10. Some aspects of practical application of studies results

    International Nuclear Information System (INIS)

    Present article is devoted to aspects of practical application of studies results. Thus, the application of petroleum fractions of Kichik-Bel deposit for impregnation of asphalt-concrete cover for recovery of initial properties of asphalt-concrete cover is considered. The modification of lacquer coatings by corrosion inhibitors is considered as well.

  11. Academic Advising Assessment Practices: Results of a National Study

    Science.gov (United States)

    Powers, Keith L.; Carlstrom, Aaron H.

    2014-01-01

    Best practices of academic advising assessment involve identification of student learning outcomes, the development and use of multiple measures of student learning, and sound professional judgment to understand the information gathered and to improve student learning. However, the assessment results often come from minimal, narrow, and…

  12. The use of diagnostic coding in chiropractic practice

    DEFF Research Database (Denmark)

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

    2015-01-01

    BACKGROUND: Diagnostic coding has several potential benefits, including improving the feasibility of data collection for research and clinical audits and providing a common language to improve interdisciplinary collaboration. The primary aim of this study was to determine the views and perspectives......-2 PLUS) provided the 14 chiropractors with some experience in diagnostic coding, followed by an interview on the topic. The interviews were analysed thematically. The participating chiropractors and an independent coder applied ICPC-2 PLUS terms to the diagnoses of 10 patients. Then the level...

  13. Practical Results of Forecasting for the Natural Gas Market

    OpenAIRE

    Potocnik, Primoz; Govekar, Edvard

    2010-01-01

    Natural gas consumption forecasting is required to balance the supply and consumption of natural gas. Companies and natural gas distributors are motivated to forecast their consumption by the economic incentive model that dictates the cash flow rules corresponding to the forecasting accuracy. The rules are quite challenging but enable the company to gain positive cash flow by forecasting accurately their short-term natural gas consumption. In this chapter, some practical forecasting results f...

  14. Environmental scan of anal cancer screening practices: worldwide survey results

    International Nuclear Information System (INIS)

    Anal squamous cell carcinoma is rare in the general population but certain populations, such as persons with HIV, are at increased risk. High-risk populations can be screened for anal cancer using strategies similar to those used for cervical cancer. However, little is known about the use of such screening practices across jurisdictions. Data were collected using an online survey. Health care professionals currently providing anal cancer screening services were invited to complete the survey via email and/or fax. Information was collected on populations screened, services and treatments offered, and personnel. Over 300 invitations were sent; 82 providers from 80 clinics around the world completed the survey. Fourteen clinics have each examined more than 1000 patients. Over a third of clinics do not restrict access to screening; in the rest, eligibility is most commonly based on HIV status and abnormal anal cytology results. Fifty-three percent of clinics require abnormal anal cytology prior to performing high-resolution anoscopy (HRA) in asymptomatic patients. Almost all clinics offer both anal cytology and HRA. Internal high-grade anal intraepithelial neoplasia (AIN) is most often treated with infrared coagulation (61%), whereas external high-grade AIN is most commonly treated with imiquimod (49%). Most procedures are performed by physicians, followed by nurse practitioners. Our study is the first description of global anal cancer screening practices. Our findings may be used to inform practice and health policy in jurisdictions considering anal cancer screening

  15. Environmental scan of anal cancer screening practices: worldwide survey results.

    Science.gov (United States)

    Patel, Jigisha; Salit, Irving E; Berry, Michael J; de Pokomandy, Alexandra; Nathan, Mayura; Fishman, Fred; Palefsky, Joel; Tinmouth, Jill

    2014-08-01

    Anal squamous cell carcinoma is rare in the general population but certain populations, such as persons with HIV, are at increased risk. High-risk populations can be screened for anal cancer using strategies similar to those used for cervical cancer. However, little is known about the use of such screening practices across jurisdictions. Data were collected using an online survey. Health care professionals currently providing anal cancer screening services were invited to complete the survey via email and/or fax. Information was collected on populations screened, services and treatments offered, and personnel. Over 300 invitations were sent; 82 providers from 80 clinics around the world completed the survey. Fourteen clinics have each examined more than 1000 patients. Over a third of clinics do not restrict access to screening; in the rest, eligibility is most commonly based on HIV status and abnormal anal cytology results. Fifty-three percent of clinics require abnormal anal cytology prior to performing high-resolution anoscopy (HRA) in asymptomatic patients. Almost all clinics offer both anal cytology and HRA. Internal high-grade anal intraepithelial neoplasia (AIN) is most often treated with infrared coagulation (61%), whereas external high-grade AIN is most commonly treated with imiquimod (49%). Most procedures are performed by physicians, followed by nurse practitioners. Our study is the first description of global anal cancer screening practices. Our findings may be used to inform practice and health policy in jurisdictions considering anal cancer screening. PMID:24740973

  16. The chiropractic profession in Norway 2011

    DEFF Research Database (Denmark)

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

    2014-01-01

    : 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...... techniques on most patients, with soft tissue techniques and exercise modalities being almost as common. More than 3/4 of the profession reported that their clinical practice was in accordance with available clinical guidelines and about one third were positive about participating in future clinical research...... seems to follow the modern trends in evidence-based practice by using X-rays more sparingly than previously, adhering to guidelines and being positive about research....

  17. 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。

  18. 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.

  19. 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.

  20. The chiropractic profession in Denmark 2010-2014

    DEFF Research Database (Denmark)

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

    2015-01-01

    facilities, and 1 out of 4 employed a physiotherapist. Three out of 4 clinics employed a secretary, too. The average duration of a consultation was 40 min for a new patient and 13 min for a follow-up consultation. Virtually all Danish chiropractors working in the primary sector made use of manipulation...... as one of their treatment modalities. CONCLUSION: This is the first study to describe the state and latest development of the chiropractic profession in Denmark using repeated surveys. Displaying various characteristics of both clinics and individual chiropractors, the image emerging is one of a stable...

  1. 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....... The primary outcome measures were changes in back-related pain on the numerical rating scale and physical functioning at 4 weeks on the Roland-Morris Disability Questionnaire and back pain functional scale (BPFS).Results. Mean Roland-Morris Disability Questionnaire scores decreased in both groups during...... personnel.Summary of Background Data. LBP is common, costly, and a significant cause of long-term sick leave and work loss. Many different interventions are available, but there exists no consensus on the best approach. One intervention often used is manipulative therapy. Current evidence from randomized...

  2. 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

  3. 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.

  4. [Eslicarbazepine acetate in clinical practice. Efficacy and safety results].

    Science.gov (United States)

    Serrano-Castro, Pedro J; Payán-Ortiz, Manuel; Cimadevilla, José M; Quiroga-Subirana, Pablo; Fernández-Pérez, Javier

    2013-03-16

    INTRODUCTION. Eslicarbazepine acetate (ESL) is a new antiepileptic drug (AED) licensed in Spain in February 2011 as an adjunctive therapy in adults with partial seizures with or without secondary generalization. Clinical trials with ESL have demonstrated acceptable efficacy and safety. AIM. To evaluate the results of ESL in our epilepsy unit during its first year of clinical experience with this AED. PATIENTS AND METHODS. We included all patients who started treatment with ESL at our epilepsy unit from March 2011 to May 2012. We collected the following variables: gender, aetiology of epilepsy, epileptogenic area, reason for switch to ESL, clinical response after initiation of ESL, adverse effects of ESL, refractoriness criteria and treatment discontinuation. A bivariate factor-to-factor correlation study was carried out to establish associations between the independent variables and the clinical response. RESULTS. We recruited 105 patients (51.4% male). 20,7% of patients remained seizure-free and 58.4% showed > 50% improvement after introduction of ESL. At 6 months, 18.1% had experienced some type of side effect, with cognitive disorders being the most common, and 11.5% had discontinued treatment. Combination with lacosamide proved to be significantly less effective in the control of seizures. Combination of ESL with the rest of sodium channel inhibitors was similar in efficacy to others combinations. CONCLUSIONS. ESL is a well-tolerated and effective AED when is used as adjunctive treatment with most of other AED in clinical practice. PMID:23483464

  5. 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....

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

    OpenAIRE

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

    2015-01-01

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

  7. 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.

  8. 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

  9. Deforestation as a result of unsustainable agricultural practices

    OpenAIRE

    Travis, A.J.

    2005-01-01

    Deforestation is rampant in this region. The soil is depleted by current farming practices, particularly for cotton and tobacco. This leads to more deforestation as farming plots become useless within just a few years. LTRA-2 (An Agricultural Markets Model for Biodiversity Conservation)

  10. Dentists’ practice patterns regarding caries prevention: results from a dental practice-based research network

    OpenAIRE

    Yokoyama, Yoko; Kakudate, Naoki; Sumida, Futoshi; Matsumoto, Yuki; Gilbert, Gregg H.; Gordan, Valeria V.

    2013-01-01

    Objective The purposes of this study were to (1) quantify dentists' practice patterns regarding caries prevention and (2) test the hypothesis that certain dentists' characteristics are associated with these practice patterns. Design The study used a cross-sectional study design consisting of a questionnaire survey. Participants The study queried dentists who worked in outpatient dental practices who were affiliated with the Dental Practice-Based Research Network Japan, which seeks to engage d...

  11. 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.

  12. 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

  13. Environmental scan of anal cancer screening practices: worldwide survey results

    OpenAIRE

    Patel, Jigisha; Salit, Irving E.; Berry, Michael J.; de Pokomandy, Alexandra; Nathan, Mayura; Fishman, Fred; Palefsky, Joel; Tinmouth, Jill

    2014-01-01

    Anal squamous cell carcinoma is rare in the general population but certain populations, such as persons with HIV, are at increased risk. High-risk populations can be screened for anal cancer using strategies similar to those used for cervical cancer. However, little is known about the use of such screening practices across jurisdictions. Data were collected using an online survey. Health care professionals currently providing anal cancer screening services were invited to complete the survey ...

  14. 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。

  15. 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

  16. Practical Results of a Five-level Flying Capacitor Inverter

    Directory of Open Access Journals (Sweden)

    O. Sivkov

    2010-01-01

    Full Text Available This paper investigates the realization of a five-level Flying Capacitor Inverter. After a brief description of general Power Electronic Converters and an introduction to the advantages of Multilevel Inverters over conventional two-level Inverters the main focus is on the five-level Flying Capacitor Inverter. The Flying Capacitor Multilevel Inverter (FCMI is a Multilevel Inverter (MI where the capacitor voltage can be balanced using only a control strategy for any number of levels. After a general description of five-level FCMI topology, the simulation and experimental results are presented. The capacitor voltage is stabilized here with various output voltage amplitude values. The simulation and experimental results of five-level FCMI show that the voltage is stabilized on capacitors using the control strategy. A single-phase five-level FCMI model is currently being developed and constructed in the laboratory. Some of the experimental results are available.

  17. 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.

  18. 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。

  19. 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.

  20. 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

    participants randomly into one of the following four groups, all of which included a comprehensive self-care program: reversible interocclusal splint therapy (RIST), Activator Method Chiropractic Technique (AMCT) (Activator Methods International, Phoenix), sham AMCT and self-care only. They made assessments...

  1. 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

    , 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...

  2. 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.

  3. 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…

  4. 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

  5. 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.

  6. 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

  7. 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.

  8. 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.

  9. 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.

  10. 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.

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

    DEFF Research Database (Denmark)

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

    2014-01-01

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

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

    OpenAIRE

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

    2008-01-01

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

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

    OpenAIRE

    Morton Adam

    2012-01-01

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

  15. 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

  16. 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.

  17. Audit of a system for dealing with a practice's laboratory test results.

    OpenAIRE

    Stephenson, P.

    1993-01-01

    In order to improve efficiency in a non-computerized practice of 4700 patients the system for dealing with laboratory test results and communicating them to patients was audited over a two-week period. The audit involved a questionnaire for the practice team, a postal questionnaire to 36 patients, and an analysis of doctors' and receptionists' workload when dealing with laboratory test results. A new system was introduced, with two receptionists logging investigation details into a newly desi...

  18. 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.

  19. Frequency of yoga practice predicts health: results of a national survey of yoga practitioners.

    Science.gov (United States)

    Ross, Alyson; Friedmann, Erika; Bevans, Margaret; Thomas, Sue

    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; 1045 (24.3%) surveys completed. Results. Mean age 51.7 (± 11.7) years; 84.2% female. Frequency of home practice favorably predicted (P yoga practice (different categories of physical poses, breath work, meditation, philosophy study) predicted at least 1 health outcome (P yoga predicted health better than years of practice or class frequency. Different physical poses and yoga techniques may have unique health benefits. PMID:22927885

  20. Transfer Paths of Research Results to the Practice: Observations From the Receiving End

    Science.gov (United States)

    Findikakis, A. N.

    2005-12-01

    A non-scientific poll of fellow practicing professionals suggests that there is a range of opinions regarding the effectiveness of different ways of becoming acquainted with and using the results of academic research in their practice. Journal articles remain the dominant path for transferring research results to the profession, even though accessing them is becoming more difficult with time. Driven primarily by cost considerations personal and corporate subscriptions seem to be on the decline. Libraries are one of the first victims of cost cutting measures in the industry. Even though the availability of journal articles in electronic form facilitates their availability, their prices are prohibitive. This is especially true during when a professional is searching for a solution to a problem and may have to review several papers on the subject. One colleague suggested that the professional organizations and other publishers of research articles could learn from the experience of the music industry, by lowering the cost of downloading individual papers to something like a dollar per article, recovering thus their production costs through the increase in the volume of purchased articles. The posting on the internet of special reports and dissertations by research institutions is viewed as very useful by those working in practice. The distribution through the internet of reports by federal organizations conducting or sponsoring research, such as the U.S. Geological Survey and the U.S. Environmental Protection Agency is greatly appreciated by the practicing professionals. The use of leading researchers as consultants provides a direct path for bringing research results to the practice, but it is limited to a small number of cases where bringing in a consultant can be justified. Short courses are viewed as an effective way of familiarizing professionals with the latest research findings on specific subjects. The notes distributed in such courses are considered

  1. 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.

  2. 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.

  3. 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

  4. 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

  5. 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 .

  6. 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

  7. 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。

  8. 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.

  9. 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

  10. 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

  11. 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

  12. 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....

  13. 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

  14. Wildlife and habitat inventory for a results-based Forest Practices Code

    OpenAIRE

    Pendergast, B.

    2002-01-01

    Two significant changes are occurring within the forest industry in British Columbia, both of which will necessitate a greater reliance on species and habitat monitoring and inventories. First, as British Columbia moves towards adopting the "New Era" principles of the provincial government, the Forest Practices Code will change from regulatory-based to "results-based". This means that forest companies will have to be monitored to ensure they meet the desired results outlined by the provincial...

  15. 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.

  16. Access to complementary medicine via general practice.

    OpenAIRE

    Thomas, K.J.; Nicholl, J P; Fall, M.

    2001-01-01

    BACKGROUND: The popularity of complementary medicine continues to be asserted by the professional associations and umbrella organisations of these therapies. Within conventional medicine there are also signs that attitudes towards some of the complementary therapies are changing. AIM: To describe the scale and scope of access to complementary therapies (acupuncture, chiropractic, homoeopathy, hypnotherapy, medical herbalism, and osteopathy) via general practice in England. DESIGN OF STUDY: A ...

  17. The Impact of Knowledge Management Practices on NPP Organizational Performance - Results of a Global Survey

    International Nuclear Information System (INIS)

    The IAEA has been asked by Member States in the 2012 General Conference Resolutions to ''further increase the level of awareness of efforts in managing nuclear knowledge'' and to continue ''to further develop and disseminate guidance and methodologies for planning, designing, and implementing nuclear knowledge management programs''. The present report summarizes the results of empirical research on the relationship between KM practices in nuclear power plants, their impact on the quality of organizational knowledge processes and the resulting effects on the organizational effectiveness of nuclear power plants. It presents the basic findings of the ''IAEA Global Nuclear Power Plant Survey: Investigating the Link Between Knowledge Management Practices and Organizational Performance'', which was conducted in 2010. This benchmark survey of KM practices in nuclear power plants was developed using a standard research methodology. The survey was made available on a global basis to all nuclear power plant sites. Senior operations managers were asked to complete the survey with input, as required, from their plant management team. Data from individual survey responses were treated as confidential, and only aggregate findings were reported. A total of 124 station ''site organizations'' participated in the survey, representing a response rate of approximately 60%. The findings provide empirical evidence of the importance of KM practices in improving the organizational effectiveness of nuclear power plants. They provide information about the current state of the industry with respect to KM practices, illustrating the direct and tangible benefits of implementing such practices and justifying continued or further efforts to ensure that KM programmes and systems are strategically planned and implemented in operating nuclear power plants. The research provides insights into the mechanisms by which KM practices have an impact on organizational effectiveness and provides a basis for

  18. 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. PMID:22139638

  19. 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.)

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

    DEFF Research Database (Denmark)

    Hestbæk, Lise; Stochkendahl, Mette Jensen

    2010-01-01

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

  1. Ethanol Marketing and Input Procurement Practices of U.S. Ethanol Producers: 2008 Survey Results

    OpenAIRE

    Schmidgall, Timothy J.; Tudor, Kerry W.; Spaulding, Aslihan D.; Winter, J. Randy

    2010-01-01

    A mail survey was used to collect information about input procurement and ethanol and co-product marketing practices from 60 U.S. ethanol production facilities. Data were used to answer questions about the conduct or behavior of ethanol producers. It was anticipated that firm conduct or behavior would be fairly homogeneous because the ethanol industry was in Stage II of the industry life-cycle, and societal support for ethanol production resulted in large volumes of publicly available informa...

  2. 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.

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. 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.

  9. 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.

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

    Science.gov (United States)

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

    2015-01-01

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

  11. Research Priorities in Correctional Nursing Practice: Results of a Three-Round Delphi Study.

    Science.gov (United States)

    Schoenly, Lorry

    2015-10-01

    Correctional nursing has been recognized as a specialty since 1985, but research to describe and support nursing practice in the criminal justice system has been sparse. The development of a research agenda can stimulate the research necessary to provide an evidence base for specialty practice development. A three-round Delphi study was undertaken to elicit a prioritized list of research topics to guide future research efforts for meaningful results. Six predominant themes emerged from an analysis of top research questions generated by a panel of 18 correctional nursing experts. Research priorities include critical thinking and clinical judgment, competency and educational level, assessment, nursing protocols, effect on patient outcomes, and the environment of care. PMID:26285595

  12. How similar are the changes in neural activity resulting from mindfulness practice in contrast to spiritual practice?

    Science.gov (United States)

    Barnby, Joseph M; Bailey, Neil W; Chambers, Richard; Fitzgerald, Paul B

    2015-11-01

    Meditation and spiritual practices are conceptually similar, eliciting similar subjective experiences, and both appear to provide similar benefits to the practicing individuals. However, no research has examined whether the mechanism of action leading to the beneficial effects is similar in both practices. This review examines the neuroimaging research that has focused on groups of meditating individuals, groups who engage in religious/spiritual practices, and research that has examined groups who perform both practices together, in an attempt to assess whether this may be the case. Differences in the balance of activity between the parietal and prefrontal cortical activation were found between the three groups. A relative prefrontal increase was reflective of mindfulness, which related to decreased anxiety and improved well-being. A relative decrease in activation of the parietal cortex, specifically the inferior parietal cortex, appears to be reflective of spiritual belief, whether within the context of meditation or not. Because mindful and spiritual practices differ in focus regarding the 'self' or 'other' (higher being), these observations about neurological components that reflect spirituality may continue work towards understanding how the definition of 'self' and 'other' is represented in the brain, and how this may be reflected in behaviour. Future research can begin to use cohorts of participants in mindfulness studies which are controlled for using the variable of spirituality to explicitly examine how functional and structural similarities and differences may arise. PMID:26172520

  13. 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.

  14. 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.

  15. 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.

  16. 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.

  17. [Selective screening for hypercholesterolemia. Results from a screening model in general practice].

    Science.gov (United States)

    Agner, E; Christensen, T E; Mahnfeldt, M S; Baastrup, A; Jacobsen, K; Jensen, S E

    1990-11-01

    At present, it appears to be probable that both dietary changes and medicinal treatment can reduce the risk of development of coronary disease in middle-aged men with moderately to severely raised blood cholesterol values. Internationally, the limits for cholesterol intervention are considerably lower than in Denmark. Extensive cholesterol screening is, however, very expensive and the identified persons with high cholesterol values will frequently be found in sex and age groups where the beneficial effect of intervention is probably limited. A model for selective cholesterol screening in high risk groups in general practice is described here. In 20 general practices, all of the men aged 45-59 years belonging to the practice were invited to examination of cholesterol and blood pressure. Plasma cholesterol was measured by means of a Reflotron (results are available within three minutes) and the blood pressure and tobacco consumption were registered. After this, the patient's own general practitioner calculated with each of the persons the risk for development of myocardial infarction within the next ten years and intervention could be commenced immediately. 41% of those invited came for examination. Out of these, 29% had cholesterol values greater than or equal to 7.0 mmol/l (Danish limiting value), 44% greater than or equal to 6.5 mmol/l (limiting value in the remainder of Western Europe), and 5% greater than or equal to 9.0 mmol/l (severe hypercholesterolaemia) while only 18% had completely normal cholesterol less than 5.2 mmol/l. In every practice, two patients on an average were found with severe hypercholesterolaemia greater than or equal to 9.0 mmol/l. 28% of the participants had at least two of the three risk factors investigated. (ABSTRACT TRUNCATED AT 250 WORDS) PMID:2238223

  18. 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

  19. 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。

  20. Comprehensive Geriatric Assessment (CGA in general practice: Results from a pilot study in Vorarlberg, Austria

    Directory of Open Access Journals (Sweden)

    Mann Eva

    2004-05-01

    Full Text Available Abstract Background Most comprehensive geriatric assessment (CGA programs refer to hospital-based settings. However the body of geriatric healthcare is provided by general practitioners in their office. Structured geriatric problem detection by means of assessment instruments is crucial for efficient geriatric care giving in the community. Methods We developed and pilot tested a German language geriatric assessment instrument adapted for general practice. Nine general practices in a rural region of Austria participated in this cross-sectional study and consecutively enrolled 115 persons aged over 75 years. The prevalence of specific geriatric problems was assessed, as well as the frequency of initiated procedures following positive and negative tests. Whether findings were new to the physician was studied exemplarily for the items visual and hearing impairment and depression. The acceptability was recorded by means of self-administered questionnaires. Results On average, each patient reported 6.4 of 14 possible geriatric problems and further consequences resulted in 43.7% (27.5% to 59.8% of each problem. The items with either the highest prevalence and/or the highest number of initiated actions by the GPs were osteoporosis risk, urinary incontinence, decreased hearing acuity, missing pneumococcal vaccination and fall risk. Visual impairment was newly detected in only 18% whereas hearing impairment and depression was new to the physician in 74.1% and 76.5%, respectively. A substantial number of interventions were initiated not only following positive tests (43.7% per item; 95% CI 27.5% to 59.8%, but also as a consequence of negative test results (11.3% per item; 95% CI 1.7% to 20.9%. The mean time expenditure to accomplish the assessment was 31 minutes (SD 10 min. Patients (89% and all physicians confirmed the CGA to provide new information in general on the patient's health status. All physicians judged the CGA to be feasible in everyday

  1. 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...

  2. 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

  3. Intermediate results of the observational program on the Eligard (45 mg administration in the clinical practice

    Directory of Open Access Journals (Sweden)

    V. B. Matveev

    2016-01-01

    Full Text Available This article deals with the intermediate results of the multicentral observational program on the 6-month prodrug leuprorelin acetate (Eligard 45 mg administration. The study objective is to confirm the efficiency and safety of the Eligard 45 mg administration in patients with the prostate cancer in the clinical practice of the oncourology specialists in Russia. In 12 months of the hormone therapy with the Eligard 45 mg there was the clinically relevant decrease of the prostatic specific antigen (PSA levels secondary to the appropriate suppression of the testosterone level lower than the castration one < 20 ng / dl. The PSA level decreased, at an average, on 82 % (from 41.4 to 7.65 ng / ml. In 89 % of patients, treated with Eligard 45 mg, the testosterone level was < 20 ng / dl. The patients», treated with Eligard 45 mg, quality of life analysis showed the improvement of this criteria in the course of the treatment. Thus, intermediate results of the multicentral observational program, proved the favorable tolerability and efficiency of the 6-month prodrug Eligard 45 mg towards the PSA and testosterone serum levels suppression in the routine clinical practice in prostate cancer patients.

  4. 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.

  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. [Implementation of Study Results in Guidelines and Adherence to Guidelines in Clinical Practice].

    Science.gov (United States)

    Waldfahrer, F

    2016-04-01

    Guidelines were introduced in hospital and practice-based otorhinolaryngology in the 1990s, and have been undergoing further development ever since. There are currently 20 guidelines on file at the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. The Society has cooperated in a further 34 guidelines. The quality of the guidelines has been continually improved by concrete specifications put forward by the Association of the Scientific Medical Societies in Germany [Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften e.V.]. Since increasing digitalisation has made access to scientific publications quicker and more simple, relevant study results can be incorporated in guidelines more easily today than in the analogue world. S2e and S3 guidelines must be based on a formal literature search with subsequent evaluation of the evidence. The consensus procedure for S2k guidelines is also regulated. However, the implementation of guidelines in routine medical practice must still be considered inadequate, and there is still a considerable need for improvement in adherence to these guidelines. PMID:27128403

  7. 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.

  8. Parent education after separation: results from a multi-site study on best practices.

    Science.gov (United States)

    McKenzie, Brad; Bacon, Brenda

    2002-01-01

    Although parent education after separation in Canada is relatively new, most provinces and territories now have some type of program that provides separating parents with information on their children's needs, co-parenting options, and strategies for improving communication. A 1999-2000 survey of parents in 10 such program sites throughout Canada: (a) demonstrates a high level of parent satisfaction with the programs, (b) chronicles benefits related to reduced conflict and improved child well-being 3 to 4 months following program attendance, and (c) identifies several implications for best practices. Results of this study suggest that parent education is but one program within a network of services needed to support both parents and children after separation. PMID:14664107

  9. 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.

  10. The effect of acupuncture combined with the observation of 34 cases of chiropractic treatment of cervical vertigo%针灸配合整脊治疗颈性眩晕34例效果观察

    Institute of Scientific and Technical Information of China (English)

    俞文江

    2015-01-01

    Objective:to investigate the clinical feasibility of the implementation of acupuncture and chiropractic therapy on patients with cervical vertigo. Methods: from 2012 august to 2014 august in our hospital for the treatment of cervical vertigo patients with a total of 68 patients, and randomly divided into two groups, the control group to implement simple chiropractic therapy, the observation group with acupuncture treatment, the therapeutic effect of two groups. Results:after the treatment, the total clinical efifcacy observation group is 94.11%, compared to a control group of 79.41%higher, with statistical signiifcance (P0.05), after treatment all appear to improve, and the observation group than in the control group improved more signiifcantly (P0.05),经治疗后均出现改善,且观察组相比对照组改善更显著(P<0.05)。结论对颈性眩晕患者实施针灸配合整脊施治,疗效更显著,对解除眩晕症状更有效,值得加强普及应用。

  11. 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.

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

    DEFF Research Database (Denmark)

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

    2013-01-01

    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...

  13. 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.

  14. 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.

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

    Directory of Open Access Journals (Sweden)

    Schulz Craig A

    2011-03-01

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

  16. Scoliosis short-term rehabilitation (SSTR according to 'Best Practice' standards - are the results repeatable?

    Directory of Open Access Journals (Sweden)

    Borysov Maksym

    2012-01-01

    Full Text Available Abstract Claims have been made in a pilot study that a new form of short-term rehabilitation according to 'Best Practice' standards would change signs and symptoms of patients with scoliosis in the short-term. Aim of this study is to repeat the study published 2010 with a larger sample of patients using the same protocol. Both authors have undergone training in this special approach to scoliosis rehabilitation in 2010. Materials and methods 34 patients with Adolescent Idiopathic Scoliosis (AIS, 32 girls and 2 boys, average age 13.7 years and an average Cobb angle of 28.7 degrees (21-43 degrees underwent Scoliosis Short-Term Rehabilitation (SSTR of seven days. Two days with an intensity of 3 × 90 min sessions/day, and five days with an intensity of 2 × 60 min sessions/day. Angle of trunk rotation (ATR was measured before and after the time of treatment as well as the active correctability of the ATR after the programme as it has been done in the pilot investigation. Additionally to that, we also recorded the changes in Vital Capacity (VC before and after the programme. Results ATR was reduced significantly from 11,5 degrees to 8,4 degrees, the active correctability as measured with the Scoliometer (TM was also reduced significantly from the ATR after treatment 8,9 degrees to 6,5 degrees in the patients with thoracic curves. VC improved significantly (P Discussion The results achieved in the pilot investigation published previously are repeatable. The deformity of the trunk can be reduced significantly after SSTR. During the pilot study VC was not investigated. In our study VC improved significantly. Therefore, also shorter rehabilitation times with an appropriate programme seem to be able to change signs and symptoms of a patient with scoliosis. Like the out-patient Schroth programme as described in a study from Turkey, the SSTR provides benefits leading to an improvement of the condition. Conclusion Out-patient rehabilitation following the

  17. Daylighting practices of the architectural industry (baseline results of a national survey)

    Energy Technology Data Exchange (ETDEWEB)

    Hattrup, M.P.

    1990-05-01

    A national survey of over 300 commercial design architects was conducted to develop baseline information on their knowledge, perceptions, and use of daylighting in commercial building designs. Pacific Northwest Laboratory conducted the survey for the US Department of Energy's (DOE) Office of Building and Community Systems (BCS). In the survey daylighting was defined as the intentional use of natural light as a partial substitute for artificially generated light. The results suggested that architects need to be educated about the true benefits of daylighting and the impacts it can have on a building's energy performance. Educational programs that will increase the architects' understanding and awareness of modern daylighting technologies and practices should be developed by utilities, stage agencies, and the federal government. If more architects can be made aware of the true effectiveness and positive attributes of daylighting systems and technologies, daylighting may be used in more commercial buildings. The results of the survey show that the more familiar architects feel they are with daylighting, the more they use daylighting. 3 refs., 19 tabs.

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

    International Nuclear Information System (INIS)

    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. 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. 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. 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

  19. 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…

  20. 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. PMID:27235563

  1. Design and Practice on Metadata Service System of Surveying and Mapping Results Based on Geonetwork

    Science.gov (United States)

    Zha, Z.; Zhou, X.

    2011-08-01

    Based on the analysis and research on the current geographic information sharing and metadata service,we design, develop and deploy a distributed metadata service system based on GeoNetwork covering more than 30 nodes in provincial units of China.. By identifying the advantages of GeoNetwork, we design a distributed metadata service system of national surveying and mapping results. It consists of 31 network nodes, a central node and a portal. Network nodes are the direct system metadata source, and are distributed arround the country. Each network node maintains a metadata service system, responsible for metadata uploading and management. The central node harvests metadata from network nodes using OGC CSW 2.0.2 standard interface. The portal shows all metadata in the central node, provides users with a variety of methods and interface for metadata search or querying. It also provides management capabilities on connecting the central node and the network nodes together. There are defects with GeoNetwork too. Accordingly, we made improvement and optimization on big-amount metadata uploading, synchronization and concurrent access. For metadata uploading and synchronization, by carefully analysis the database and index operation logs, we successfully avoid the performance bottlenecks. And with a batch operation and dynamic memory management solution, data throughput and system performance are significantly improved; For concurrent access, , through a request coding and results cache solution, query performance is greatly improved. To smoothly respond to huge concurrent requests, a web cluster solution is deployed. This paper also gives an experiment analysis and compares the system performance before and after improvement and optimization. Design and practical results have been applied in national metadata service system of surveying and mapping results. It proved that the improved GeoNetwork service architecture can effectively adaptive for distributed deployment

  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. 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

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. [Formalized dietary advice in hypercholesterolemia. Results in 110 men diagnosed by selective screening in general practice].

    Science.gov (United States)

    Agner, E; Christensen, T E; Jacobsen, K; Baastrup, A; Mahnfeldt, M S; Jensen, S E

    1990-11-01

    In connection with a screening investigation for high blood cholesterol in middle-aged men in general practice in the Municipality of Copenhagen, all participants with cholesterol values greater than or equal to 7.5 mmol/l were given brief advice by their own general practitioner and were invited to come for fasting blood lipid tests approximately ten days later. In cases with continued cholesterol greater than or equal to 6.8 mmol/l, the participants together with wives or partners were invited to formalized dietary advice in small groups. Already before the formalized dietary advice, an average decrease in serum cholesterol of 10% was observed. This was attributed to biological variation, absence of fasting, the degree of error between the measuring methods and also a genuine decrease on the basis of the brief dietary advice by the general practitioner. On control after dietary advice, a further decrease in cholesterol of 15% was observed while low density lipoprotein cholesterol fell by 20% and triglycerides by 23%. These decreases must be considered to result mainly from the dietary advice. It is concluded that a single but professional session of dietary advice in small groups and with involvement of the wives or partners is an effective method of treatment in hypercholesterolaemia. If the decrease in cholesterol obtained can be maintained, the literature suggests that the risk of development of ischaemic heart disease during the subsequent 5-7 years is reduced by 20-30%. PMID:2238224

  9. 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

  10. 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...

  11. Standard practice for presentation of constant amplitude fatigue test results for metallic materials

    CERN Document Server

    American Society for Testing and Materials. Philadelphia

    1990-01-01

    1.1 This practice covers the desirable and minimum information to be communicated between the originator and the user of data derived from constant-force amplitude axial, bending, or torsion fatigue tests of metallic materials tested in air and at room temperature. Note 1—Practice E 466, although not directly referenced in the text, is considered important enough to be listed in this standard.

  12. 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.

  13. Practice.

    Science.gov (United States)

    Chambers, David W

    2008-01-01

    Practice refers to a characteristic way professionals use common standards to customize solutions to a range of problems. Practice includes (a) standards for outcomes and processes that are shared with one's colleagues, (b) a rich repertoire of skills grounded in diagnostic acumen, (c) an ability to see the actual and the ideal and work back and forth between them, (d) functional artistry, and (e) learning by doing that transcends scientific rationality. Communities of practice, such as dental offices, are small groups that work together in interlocking roles to achieve these ends. PMID:19413050

  14. 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. PMID:25138154

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

    DEFF Research Database (Denmark)

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

    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...

  16. 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.…

  17. Female Sexual Abuse Evaluation in the Urological Practice : Results of a Dutch Survey

    NARCIS (Netherlands)

    Beck, Jack; Bekker, Milou; Van Driel, Mels; Putter, Hein; Pelger, Rob; Nijeholt, A. A. B. Lycklama A.; Elzevier, Henk Willem

    2010-01-01

    Introduction. There is a strong association between urological complaints and a history of sexual abuse, especially in females. It is not known whether urologists integrate these facts in their daily practice. Aim. To evaluate whether Dutch urologists address the issues of sexual abuse in their fema

  18. 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…

  19. 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

  20. 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…

  1. 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.

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

    OpenAIRE

    GROSU MARIA

    2011-01-01

    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 politi...

  4. Japanese haemodialysis anaemia management practices and outcomes (1999–2006): results from the DOPPS

    OpenAIRE

    Akizawa, Tadao; Ronald L Pisoni; Akiba, Takashi; Saito, Akira; Fukuhara, Shunichi; Asano, Yasushi; Hasegawa, Takeshi; Port, Friedrich K; Kurokawa, Kiyoshi

    2008-01-01

    Background. Japanese haemodialysis (HD) patients not only have a very low mortality and hospitalization risk but also low haemoglobin (Hb) levels. Internationally, anaemia is associated with mortality, hospitalization and health-related quality of life (QoL) measures of HD patients. Methods. Longitudinal data collected from 1999 to 2006 from 60 to 64 representative Japanese dialysis units participating in the Dialysis Outcomes and Practice Patterns Study (DOPPS) were used to describe anaemia ...

  5. Health practice correlates in three adult age groups: results from two community surveys.

    OpenAIRE

    Rakowski, W; Lefebvre, R C; Assaf, A R; Lasater, T M; Carleton, R A

    1990-01-01

    Independently done surveys of a target population can make an important contribution to knowledge about the determinants of personal health behavior by highlighting variables that consistently emerge as significant predictors. This investigation examined the correlates of four health practice and knowledge indices related to cardiovascular disease (CVD) in two baseline community surveys of the Pawtucket Heart Health Program (N = 2,413; N = 2,808). An additional dimension was the use of three ...

  6. Distribution of episodes of mental illness in general practice: results from the Second National Morbidity Survey.

    OpenAIRE

    Smeeton, N C

    1986-01-01

    The Second National Morbidity Survey, conducted in England and Wales between 1970 and 1976, contains a unique body of information on episodes of mental illness experienced by individuals registered in a representative sample of general practices around the country. This information is used to construct the episode distribution among the individuals surveyed. The Poisson and negative binomial distributions are then used to model the episodes. The Poisson model gives a very poor fit but the neg...

  7. [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 leveltext 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). PMID:26831812

  8. 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。

  9. 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。

  10. 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.

  11. 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。

  12. Clinical observation on treatment of cervicalspondylotic radiculopathy by lancet combined with chiropractic treatment%刃针配合整脊治疗神经根型颈椎病临床观察

    Institute of Scientific and Technical Information of China (English)

    陈文艺; 蔡少娜; 邓柳兰

    2016-01-01

    目的:探析神经根型颈椎病患者进行刃针配合整脊疗法的临床效果观察。方法:入选我院2014年4月—2015年3月收治的神经根型颈椎病患者60例,根据随机数字表法分为研究组和对照组,研究组进行刃针配合整脊疗法,对照组进行常规针灸联合推拿手法治疗,两组均治疗1个月;比较两组的临床效果。结果:研究组的临床有效率为86.7%,对照组的临床有效率为60.0%,两组比较差异有统计学意义(P<0.05)。结论:神经根型颈椎病进行刃针配合整脊疗法临床效果确切,可显著改善患者的临床症状,值得临床推广。%Objective: To investigate the curative effect of lancet combined with chiropractic treatment on patients with cervicalspondylotic radiculopathy. Methods: 60 cases with ervicalspondylotic radiculopathy admitted in our hospital from April, 2014 to March, 2015 were divided into a research group and a control group according to the random number table method. The research group was treated with lancet combined with chiropractic treatment, while the control group was treated with conventional acupuncture combined with Tuina for one month as a curse. The clinical effects of the two groups were compared. Results: The effective rate of the research group was 86.7%, while that of the control group was 60.0% and the difference between the two groups was significant(P<0.05). Conclusion: Lancet combined with chiropractic treatment has accurate effect on cervicalspondylotic radiculopathy and improve the clinical syndrome, which is worthy of promotion.

  13. 微型针刀松解结合王氏整脊手法治疗面肌痉挛的临床疗效观察%Clinical observation on facial spasm with micro acupotomy and chiropractic

    Institute of Scientific and Technical Information of China (English)

    张静; 王燮荣; 贾杰海; 孙军; 向东东; 乔晋琳

    2016-01-01

    目的:观察微型针刀松解结合王氏整脊手法治疗面肌痉挛的临床疗效。方法:采用随机抽样法将所选研究病例分为两组,治疗组采取针刀结合手法治疗;对照组采用传统电针治疗。观察两组治疗前后疗效情况。结果:两组病例治疗后总有效率比较差异有统计学意义,经治疗后两组痉挛强度评分均较治疗前有所降低,但治疗组较对照组下降更明显(P<0.05)。结论:微型针刀松解结合王氏整脊手法治疗面肌痉挛具有临床疗效确切,操作简单,安全可靠且无毒副作用等优点,值得临床推广及运用。%Objective:To observe the clinical effect on facial spasm with micro acupotomy and chiropractic. Methods:70 patients with hemifacial spasm were randomized into control group(n=36)and treatment group(n=34). The treatment group was intervened with acupotomy and chiropractic therapy and the control group was treated with electroacupuncture. The curative effect of the two groups before and after treatment were observed. Result:The difference of the total effective rate after treatment had statistical significance. After treatment,The spastic intensity scores of the two groups were lower than before,the treatment group decreased more significantly,the differences were statistically significant compared to control group (P<0.05). Conclusion:The micro acupotomy and chiropractic therapy has exact clinical curative effect on facial spasm and it is worth clinical promotion and application.

  14. 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.

  15. 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.

  16. 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.

  17. Efficacy of chiropractic treatment plus Xiao’er Jianweile on infantile anorexia%小儿健胃乐配合捏脊治疗小儿厌食症的疗效观察

    Institute of Scientific and Technical Information of China (English)

    王云蝶; 蔡建文; 林冬雁

    2015-01-01

    目的:观察小儿健胃乐配合捏脊治疗小儿厌食症的临床疗效。方法:将100例小儿厌食症患儿随机分为对照组和治疗组,对照组口服吗丁啉混悬液和双歧三联活菌胶囊;治疗组口服小儿健胃乐,配合捏脊疗法,2周后统计疗效。结果:对照组显效14例,有效23例,无效13例,总有效率为74%;治疗组显效32例,有效14例,无效4例,总有效率为92%;两组比较,差异有统计学意义(P<0.05)。结论:小儿健胃乐配合捏脊治疗小儿厌食症,疗效显著,值得临床推广应用。%Objective: To investigate clinical efficacy of chiropractic treatment plus Xiao’er Jianweile on infantile anorexia. Methods:100 cases of children anorexia were randomly divided into the control group and the treatment group; the control group was treated with domperidone suspension, probiotics capsules; the treatment group was given chiropractic treatment plus Xiao’er Jianweile, for 2 weeks. Results:In the control group, 14 cases were markedly effective; 23 cases were effective; 13 cases were invalid; the total efficiency was 74%; in the treatment group, 32 cases were markedly effective; 14 cases were effective; 4 cases were invalid; the total efficiency was 92% (P<0.05). Conclusion: Chiropractic treatment plus Xiao’er Jianweile for children with anorexia make a significant effect, is worthy of clinical promotion.

  18. 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.

  19. 捏脊疗法在婴幼儿喘息性疾病中的应用研究%Application research of chiropractic therapy on treating infantile gasping diseases

    Institute of Scientific and Technical Information of China (English)

    袁锦权; 卢金海; 黄碧梅; 锐光; 刘志伟

    2013-01-01

      目的:观察捏脊疗法在婴幼儿喘息性疾病中的临床疗效。方法:治疗组选择75例在首次喘息发作缓解后的婴幼儿给予捏脊疗法治疗3个月;观察组选75例口服玉屏风颗粒进行预防,3月后观察疗效。结果:治疗组显效60例,有效8例,无效3例,总有效率94.2%;对照组显效55例,有效6例,无效10例,总有效率85.2%。结论:通过捏脊疗法对婴幼儿喘息性疾病首次发作进行早期干预,可增强患儿免疫功能,提高机体抗病能力,减少喘息再次发作次数,再发症状减轻,从而达到减少反复呼吸道感染发作几率。%Objective:To investigate the clinical effect of chiropractic therapy on infantile gasping diseases. Methods:75 patients were selected as the treated group and given chiropractic therapy for 3 months since the remittance of first pursiness, other 75 patients were selected as the control group and orally given Yupingfeng powder for prevention. Results:In the treated group, 60 cases were significantly effective, 8 cases were effective, 3 cases were invalid, with the total effective rate 94.2%. In the control group, 55 cases were significantly effective, 6 cases were effective, 10 cases were invalid, with the total effective rate 85.2%. Conclusion: Chiropractic therapy was significantly effective on infantile gasping diseases.

  20. 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.)

  1. 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.

  2. 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. PMID:24761922

  3. Improvement in fresh frozen plasma transfusion practice: results of an outcome audit.

    Science.gov (United States)

    Kakkar, N; Kaur, R; Dhanoa, J

    2004-06-01

    Blood components have been in use in clinical practice for many decades now. In spite of fairly clear guidelines regarding their use, inappropriate prescriptions for components are still rampant. We undertook this work to assess the appropriateness of fresh frozen plasma (FFP) transfusions in our hospital. A prospective audit of 504 transfusion orders for 1761 FFP units was conducted over a 6-month period which was followed by a re-audit of 294 FFP prescriptions for 961 units. In the initial audit, we identified 304 (60.3%) prescriptions which were inappropriate according to the British Committee for Standardization in Hematology (BCSH) guidelines. The re-audit performed after an educational campaign among clinicians showed a reduction in inappropriate requests by 26.6%. The specific areas of misuse were FFP transfusions in patients with hypoproteinaemic states (40.5%), anaemia (36.5%), bleeding without coagulation factor deficiency (10.2%) and volume depletion (9.2%). A significant 50.3% of requests in the initial audit and 38.4% in the re-audit were for single- or two-unit transfusions, which were subtherapeutic. FFP transfusions carry the same risks to the patients as any other blood component. Prescribers of these transfusions need to be aware of the clinical setting where their use is appropriate. Local hospital transfusion committees can play a vital role in overseeing transfusion practices to ensure optimal use of blood/component therapy. PMID:15180815

  4. 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.

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

    International Nuclear Information System (INIS)

    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. (authors)

  6. 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.

  7. 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.

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

    OpenAIRE

    Wagner N; Beckett W; Steinberg R

    2006-01-01

    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 medic...

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

    Science.gov (United States)

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

    2016-05-01

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

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

    Science.gov (United States)

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

    2016-05-01

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

  11. Four Years of Practical Arrangements between IAEA and Moscow SIA 'Radon': Preliminary Results - 13061

    International Nuclear Information System (INIS)

    The International Education Training Centre (IETC) at Moscow State Unitary Enterprise Scientific and Industrial Association 'Radon' (SIA 'Radon'), in co-operation with the International Atomic Energy Agency (IAEA), has developed expertise and provided training to waste management personnel for the last 15 years. Since 1997, the educational system of the enterprise with the support of the IAEA has acquired an international character: more than 470 experts from 35 countries- IAEA Member States completed the professional development. Training is conducted at various thematic courses or fellowships for individual programs and seminars on IAEA technical projects. In June 2008 a direct agreement (Practical Arrangements) was signed between SIA 'Radon' and the IAEA on cooperation in the field of development of new technologies, expert's advice to IAEA Member States, and, in particular, the training of personnel in the field of radioactive waste management (RWM), which opens up new perspectives for fruitful cooperation of industry professionals. The paper summarizes the current experience of the SIA 'Radon' in the organization and implementation of the IAEA sponsored training and others events and outlines some of strategic educational elements, which IETC will continue to pursue in the coming years. (authors)

  12. 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...

  13. 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

    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 D...

  14. 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.

  15. 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。

  16. 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...

  17. Application and practice of EU FP5. Research results in the area key action water - pollution prevention: are results fit for use?

    Energy Technology Data Exchange (ETDEWEB)

    Bittens, M. [Univ. Tuebingen (Germany). Center for Applied Geoscience; Prokop, G. [Umweltbundesamt, Wien (Austria)

    2003-07-01

    Embedded in the EU-funded project 'Innovative Management of Groundwater Resources in Europe - Training and RTD Co-ordination (IMAGE-TRAIN)' a two-phase (identification and testing) evaluation process was performed on basis of delivered research results from scientific projects running in the FP5 Key Action 'Management and Quality of Water - Pollution Prevention'. The 'Application and Practice Report', APR, documents available methods, concepts, and applications, which are qualified for supporting and enhancing the implementation processes of European policies and regulations with regard to the management and quality of water. Additionally, the APR determines boundary conditions for the application of available deliverable as result of the testing phase and facilitates the selection of the best available techniques for accompanying European implementation processes in accordance with the sustainable solutions strategy of European Union's 6{sup th} Environmental Action Programme 'Our Future, or choice'. IMAGE-TRAIN has the ambition to improve cooperation and interaction between ongoing research projects in the field of soil and groundwater contamination and to communicate new technology achievements to young scientists by means of training courses. IMAGE-TRAIn is a three year project which started in September 2001 and operates at two levels. (1) Senior level: At this level cluster meetings for researchers of ongoing research projects are being organised with the objective to establish topic links between RTD projects, dealing with contaminated land and groundwater and to promote their practical application. Furthermore practical case studies with selected experts are being organised to perform short feasibility studies related to current groundwater or mine water problems. (2) Junior level: At this level Advanced Study Courses are organised with theobjective to quickly transfer existing and emerging knowledge to young

  18. A best practice method to maximize pigging results in high velocity pipelines

    Energy Technology Data Exchange (ETDEWEB)

    Freeman, Eric; Strong, Robert; Drysdale, Colin [T.D. Williamson Inc. (United States)

    2009-07-01

    Many pipelines run at high product velocities which inhibits the results of maintenance pigging. In order to compensate for this, some operators temporarily slow flow rates or run pigs at the higher velocities. Each of these approaches yields different costs and effectiveness. T.D. Williamson (TDW) has developed a patent-pending speed reducing venturi pig (or SR-21 Raptor{sup TM}-Pig), which utilizes high bypass flow through the pig body designed to reduce pig travel speed, while incorporating an inertia/flow actuated valve to minimize stalling and surging. The aim of this paper is to summarize performance characteristics and field testing results for this patent-pending venturi pig, and how it may deliver better results in high-velocity pipeline conditions. (author)

  19. Use of hyperlinks in electronic test result communication: a survey study in general practice

    Directory of Open Access Journals (Sweden)

    Mukai Thomas

    2012-10-01

    Full Text Available Abstract Background Information is essential in healthcare. Recording, handling and sharing healthcare information is important in order to ensure high quality of delivered healthcare. Information and communication technology (ICT may be a valuable tool for handling these challenges. One way of enhancing the exchange of information could be to establish a link between patient-specific and general information sent to the general practitioner (GP. The aim of the present paper is to study GPs' use of a hyperlink inserted into electronic test result communication. Methods We inserted a hyperlink into the electronic test result communication sent to the patients’ GPs who participated in a regional, systematic breast cancer screening program. The hyperlink target was a web-site with information on the breast cancer screening program and breast cancer in general. Different strategies were used to increase the GPs’ use of this hyperlink. The outcome measure was the GPs’ self-reported use of the link. Data were collected by means of a one-page paper-based questionnaire. Results The response rate was 73% (n=242. In total, 108 (45% of the GPs reported to have used the link. In all, 22% (n=53 of the GPs used the web-address from a paper letter and 37% (n=89 used the hyperlink in the electronic test result communication (Δ = 15%[95%confidence  int erval(CI = 8 − 22%P  Conclusions The results suggest that hyperlinks in electronic test result communication could be a feasible strategy for combining and sharing different types of healthcare information.

  20. 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.

  1. 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...

  2. 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

  3. 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.

  4. 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.

  5. Libraries and Inter-Generational Communication Good Practices and Their Educational Results

    OpenAIRE

    Petrova - Vasileva, Rositsa

    2014-01-01

    The process of changes today, on the border between traditional and digital culture, is a clear sign for a change of the communication characteristics and habits of man. As a result of the expansion of new information technologies people who have different communication skills are born and brought up, and rapid technological changes create communication gap between generations living together in a common period of time. Availability and / or lack of information literacy nowaday...

  6. Policy impacts on pedagogical practice and ICT use: An exploration of the results from SITES 2006

    OpenAIRE

    Law, N.; Lee, MW; Chan, A.

    2010-01-01

    The Second Information Technology in Education Study (SITES) 2006 results reveal that principals' perceived presence of lifelong learning-related pedagogical activities in their schools had changed markedly since the same data was collected in 1998 in SITES-M1. More intriguing was the fact that the directions of the changes were quite different depending on the education systems concerned - many of the Asian countries reported very high increases while some of the European countries reported ...

  7. Assessment of soil-structure interaction practice based on synthesized results from Lotung experiment - earthquake response

    International Nuclear Information System (INIS)

    On the assumption that the foundation can be appropriately modeled, it would be difficult to distinguish between the computational capabilities of the SASSI, CLASSI and SUPERALUSH/CLASSI methods of SSI analysis. Given the appropriate model, all three methodologies would produce very similar valid results. However, both CLASSI (Bechtel) and Soil-Spring methods should be used cautiously within their known limitations. The use of FLUSH should be limited to essentially 2D problems. More than the computational methods, the differences in the seismic response results obtained are due to the modeling of the soil-structure system and the characterization of the input motions. A number of insights have been obtained with respect to the validity of SSI analysis methodologies for earthquake response. Among these are the following: vertical wave propagation assumption in performing SSI is adequate to describe the wave field; equivalent linear analysis of soil response for SSI analysis, such as performed by the SHAKE code, provides acceptable results; a significant but non-permanent degradation of soil modulus occurs during earthquakes; the development of soil stiffness degradation and damping curves as a function of strain, based on geophysical and laboratory tests, requires improvement to reduce variability and uncertainty; backfill stiffness plays an important role in determining impedance functions and possibly input motions; scattering of ground motion due to embedment is an important element in performing SSI analysis. (author)

  8. 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

  9. [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.

  10. [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. PMID:25523849

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

    OpenAIRE

    Truyers Carla; Buntinx Frank; De Lepeleire Jan; De Hert Marc; Van Winkel Ruud; Aertgeerts Bert; Bartholomeeusen Stefaan; Lesaffre Emmanuel

    2011-01-01

    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 with...

  12. Audit of radiotherapy dosimetry in New Zealand: Practical considerations and results

    International Nuclear Information System (INIS)

    In order to verify regulatory compliance, every two years staff of the National Radiation Laboratory (NRL) of New Zealand visit each of the radiotherapy departments in New Zealand to carry out an independent audit of the dosimetry of their external radiation beams. The audit is carried out under Technical Reports Series No. 277 reference conditions using dosimetry equipment belonging to the NRL to maximize the independence of the measurements. Audits have been carried out regularly since 1991 and the results show that discrepancies of up to 2% for linac beams are within normal output variability. However, much greater discrepancies are observed in kilovoltage X ray beams.This is due to the use of different dosimetry protocols rather than error. Experience to date suggests that the dosimetry audit is of continuing benefit to radiotherapy departments, but should be supplemented with dosimetry of planned treatments in an anthropomorphic phantom. (author)

  13. Secondary water chemistry control practices and results of the Japanese PWR plants

    International Nuclear Information System (INIS)

    the concept of the Japanese water chemistry specification, the status and the results of the chemical treatment of all the Japanese PWR plants, and examples of the water chemistry improvement program and the results at the representative plants. (authors)

  14. The New Zealand audit of radiotherapy dosimetry: Practical considerations and results

    International Nuclear Information System (INIS)

    The New Zealand Radiation Protection Regulations 1982 state that the dose delivered to a radiotherapy patient must be within ±5% of the prescribed dose. Following the overdose of 153 patients because of an error in dosimetry at Royal Devon and Exeter Hospital, UK, in 1988 it was decided to audit compliance with this routinely. Since 1991 every high-energy beam in NZ used for teletherapy has been independently measured every two years by staff from NRL. Since 1997 all kV x-ray beams have been measured as well. The measurements follow the dosimetry protocol TRS-277. A Sr-90 check is taken at each site to verify stability of the measurement system. Agreement within 0.5% is accepted. The SSD on a linear accelerator is set using the optical distance indicator after checking it against a mechanical front pointer. Recombination corrections are measured on each linear accelerator beam and polarity corrections as well in the case of electron beams. The results for high-energy beams have been reassuring both to the regulators and to the physicists who appreciate the independent check. The only disagreements significantly greater than 2% have caused by the use of a cylindrical chamber on a 4MV electron beam by a hospital, and confusion between SSD and isocentric set-up. When we repeated the measurement using the same set-up as the hospital the difference was resolved

  15. Patterns of Care outcome Studies: results of the national practice in adenocarcinoma of the prostate

    International Nuclear Information System (INIS)

    The Patterns of Care Study reviewed the processes and outcome of 682 patients with carcinoma of the prostate treated with radiation therapy from 1973-1976. The study and patient sampling were designed to reflect a valid representation of how prostate cancer is treated by radiation oncologists in the United States. The outcome results represent national benchmarks. The three year actuarial survival was 91% for Stage A, 88% for Stage B, and 76% for Stage C. Stage, grade, elevated serum acid phosphatase, Karnofsky performance status, previous hormonal therapy, age, and prior transurethral resection were identified by multivariate regression analysis to be important independent prognostic variables. Local control was related to the dose of the primary site, paraprostatic region, and pelvic sidewall. Major complications occurred in 9% of patients with Stage A, 2% of Stage B, and 6% with Stage C disease. Complications were related to dose and treatment technique. The Patterns of Care Process Survey identified that only 60% of patients surveyed had the necessary pretreatment evaluation studies required for best current management of adenocarcinoma of the prostate

  16. 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.

  17. Practice patterns of naturopathic physicians: results from a random survey of licensed practitioners in two US States

    Directory of Open Access Journals (Sweden)

    Smith Michael J

    2004-10-01

    Full Text Available Abstract Background Despite the growing use of complementary and alternative medicine (CAM by consumers in the U.S., little is known about the practice of CAM providers. The objective of this study was to describe and compare the practice patterns of naturopathic physicians in Washington State and Connecticut. Methods Telephone interviews were conducted with state-wide random samples of licensed naturopathic physicians and data were collected on consecutive patient visits in 1998 and 1999. The main outcome measures were: Sociodemographic, training and practice characteristics of naturopathic physicians; and demographics, reasons for visit, types of treatments, payment source and visit duration for patients. Result One hundred and seventy practitioners were interviewed and 99 recorded data on a total of 1817 patient visits. Naturopathic physicians in Washington and Connecticut had similar demographic and practice characteristics. Both the practitioners and their patients were primarily White and female. Almost 75% of all naturopathic visits were for chronic complaints, most frequently fatigue, headache, and back symptoms. Complete blood counts, serum chemistries, lipids panels and stool analyses were ordered for 4% to 10% of visits. All other diagnostic tests were ordered less frequently. The most commonly prescribed naturopathic therapeutics were: botanical medicines (51% of visits in Connecticut, 43% in Washington, vitamins (41% and 43%, minerals (35% and 39%, homeopathy (29% and 19% and allergy treatments (11% and 13%. The mean visit length was about 40 minutes. Approximately half the visits were paid directly by the patient. Conclusion This study provides information that will help other health care providers, patients and policy makers better understand the nature of naturopathic care.

  18. 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.

  19. A case study in technology utilization: Industrial products and practices. [summary of benefits to national economy resulting from space programs

    Science.gov (United States)

    1973-01-01

    In pursuit of such missions as Apollo, the National Aeronautics and Space Administration has called into being unique equipment that obviously has little direct application beyond the achievement of mission objectives. Yet, to assume that further direct application of space program hardware is somehow a measure of the industrial benefits accruing to the nation is to misunderstand how the creation of new technology affects modern industrial capability. This document presents a profile of the significant ways in which technological developments in response to aerospace mission requirements have been coupled into industrial practice, with the result being that improved products and processes are now being utilized to benefit the nation.

  20. 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.

  1. 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.

  2. 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

  3. 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…

  4. Current practice for diagnosis and management of silent atrial fibrillation: results of the European Heart Rhythm Association survey.

    Science.gov (United States)

    Dobreanu, Dan; Svendsen, Jesper Hastrup; Lewalter, Thorsten; Hernández-Madrid, Antonio; Lip, Gregory Y H; Blomström-Lundqvist, Carina

    2013-08-01

    Although it is well known that silent atrial fibrillation (AF) is associated with morbidity and mortality rates similar to those of symptomatic AF, no specific strategy for screening and management of this form of AF has been advocated. The purpose of this survey was to identify current practices for the diagnosis and management of silent AF. This survey is based on an electronic questionnaire sent to the European Heart Rhythm Association Research Network partners. Responses were received from 33 centres in 16 countries. The preferred screening methods for silent AF in patients with rhythm control by pharmacological therapy was 12-lead electrocardiogram (ECG) at outpatient visits (31.3%) and periodical 24 h Holter ECG recordings (34.4%), while after pulmonary vein isolation the corresponding figures were 6.3 and 65.6%, respectively. No consensus has been reached concerning the therapeutic approach for such patients. Most responders preferred rate control over rhythm control in patients with silent AF, although some favoured pulmonary vein isolation in young patients. However, oral anticoagulant therapy in patients at high thromboembolic risk was considered mandatory by most, provided that at least one episode of silent AF was documented, without recommending further investigations. The results of this survey have confirmed that there is currently no consensus regarding the screening and management of patients with silent AF and that clinical practice is not always consistent with the few existing evidence-based recommendations. PMID:23878150

  5. Patterns of radiotherapy practice for biliary tract cancer in Japan: results of the Japanese radiation oncology study group (JROSG) survey

    International Nuclear Information System (INIS)

    The patterns of radiotherapy (RT) practice for biliary tract cancer (BTC) in Japan are not clearly established. A questionnaire-based national survey of RT used for BTC treatment between 2000 and 2011 was conducted by the Japanese Radiation Oncology Study Group. Detailed information was collected for 555 patients from 31 radiation oncology institutions. The median age of the patients was 69 years old (range, 33–90) and 81% had a good performance status (0–1). Regarding RT treatment, 78% of the patients were treated with external beam RT (EBRT) alone, 17% received intraluminal brachytherapy, and 5% were treated with intraoperative RT. There was no significant difference in the choice of treatment modality among the BTC subsites. Many patients with EBRT were treated with a total dose of 50 or 50.4 Gy (~40%) and only 13% received a total dose ≥60 Gy, even though most institutions (90%) were using CT-based treatment planning. The treatment field consisted of the primary tumor (bed) only in 75% of the patients. Chemotherapy was used for 260 patients (47%) and was most often administered during RT (64%, 167/260), followed by after RT (63%, 163/260). Gemcitabine was the most frequently used drug for chemotherapy. This study established the general patterns of RT practice for BTC in Japan. Further surveys and comparisons with results from other countries are needed for development and optimization of RT for patients with BTC in Japan

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

    DEFF Research Database (Denmark)

    Eirikstoft, Heidi; Kongsted, Alice

    2014-01-01

    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...... 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...

  7. 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.

  8. 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

  9. Knowledge, attitudes, and practices concerning malaria in pregnancy: results from a qualitative study in Madang, Papua New Guinea.

    Directory of Open Access Journals (Sweden)

    Erin V W Andrew

    Full Text Available Malaria is the leading cause of illness and death in Papua New Guinea (PNG. Infection during pregnancy with falciparum or vivax malaria, as occurs in PNG, has health implications for mother and child, causing complications such as maternal anemia, low birth weight and miscarriage. This article explores knowledge, attitudes and practices concerning malaria during pregnancy and it's prevention in Madang, PNG, a high prevalence area.As part of a qualitative study in Madang, exploring MiP, participatory techniques (free-listing and sorting were conducted along with focus group discussions, in-depth interviews (with pregnant women, health staff and other community members and observations in the local community and health facilities.The main themes explored were attitudes towards and knowledge of MiP, its risks, and prevention. Although there was a general awareness of the term "malaria", it was often conflated with general sickness or with pregnancy-related symptoms. Moreover, many preventive methods for MiP were related to practices of general healthy living. Indeed, varied messages from health staff about the risks of MiP were observed. In addition to ideas about the seriousness and risk of MiP, other factors influenced the uptake of interventions: availability and perceived comfort of sleeping under insecticide-treated mosquito nets were important determinants of usage, and women's heavy workload influenced Chloroquine adherence.The non-specific symptoms of MiP and its resultant conflation with symptoms of pregnancy that are perceived as normal have implications for MiP prevention and control. However, in Madang, PNG, this was compounded by the inadequacy of health staff's message about MiP.

  10. Evidence-Based Practice Knowledge, Use, and Factors that Influence Decisions: Results from an Evidence-Based Practice Survey of Providers in American Indian/Alaska Native Communities

    Science.gov (United States)

    Sheehan, Angela; Walrath-Greene, Christine; Fisher, Sylvia; Crossbear, Shannon; Walker, Joseph

    2007-01-01

    Data from the Evidence-based Treatment Survey were used to compare providers serving families in American Indian and Alaska Native communities to their counterparts in non-American Indian/Alaska Native communities on provider characteristics and factors that influence their decision to use evidence-based practices (N = 467). The findings suggest…

  11. Adherence to clinical practice guidelines among three primary contact professions: a best evidence synthesis of the literature for the management of acute and subacute low back pain

    Science.gov (United States)

    Amorin-Woods, Lyndon G.; Beck, Randy W.; Parkin-Smith, Gregory F.; Lougheed, James; Bremner, Alexandra P.

    2014-01-01

    Aim: To determine adherence to clinical practice guidelines in the medical, physiotherapy and chiropractic professions for acute and subacute mechanical low back pain through best-evidence synthesis of the healthcare literature. Methods: A structured best-evidence synthesis of the relevant literature through a literature search of relevant databases for peer-reviewed papers on adherence to clinical practice guidelines from 1995 to 2013. Inclusion of papers was based on selection criteria and appraisal by two reviewers who independently applied a modified Downs & Black appraisal tool. The appraised papers were summarized in tabular form and analysed by the authors. Results: The literature search retrieved 23 potentially relevant papers that were evaluated for methodological quality, of which 11 studies met the inclusion criteria. The main finding was that no profession in the study consistently attained an overall high concordance rating. Of the three professions examined, 73% of chiropractors adhered to current clinical practice guidelines, followed by physiotherapists (62%) and then medical practitioners (52%). Conclusions: This review showed that quality papers in this area of research are very limited. Notwithstanding, chiropractors appear to adhere to clinical practice guidelines more so than physiotherapists and medical practitioners, although there is scope for improvement across all three professions. PMID:25202150

  12. 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

  13. 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

  14. 赖氨葡锌联合捏脊疗法治疗儿童厌食症临床观察%The Researches on Lysine Hydrochloride and Zinc Gluconate and Chiropractic Therapy Method for Child Anorexia

    Institute of Scientific and Technical Information of China (English)

    何胜尧; 李秀兰; 吴仙娜; 曹美珠

    2015-01-01

    Objective: Research on the Lysine Hydrochloride and Zinc Gluconate Tablets and Chiropractic Therapy Metrod for Child Anorexia. Method: 106 cases with Child Anorexia was selected from September 2011 to September 2013. They were divided into two groups in random. 53 cases in the test group, the other 53 cases in the control group. Cases in the control group were treated with conventional method. The test group used Lysine Hydrochloride and Zinc Gluconate Tablets and Chiropractic Therapy. After one month , compare the treatment effect and the record difference of serum protein and trace elements of two groups. Results: The cure rate of the test group was 90.57%, and the control group was 73.58%, with significant difference (P<0.05). The test group has better record of protein, albumin, globulin, elements zinc, and calcium after treatment than the control group, with significant difference(P<0.01). Both two groups do not have adverse reaction during treatment.Conclusion:Lysine Hydrochloride and Zinc Gluconate and Chiropractic Therapy Method for Child Anorexia have satisfied effects , can be used in clinical treatment.%目的:观察应用赖氨葡锌联合小儿捏脊疗法治疗小儿厌食症的效果。方法:选择2011年9月~2013年9月我科住院及门诊的厌食症患儿106例,随机分成对照组和观察组,对照组、观察组各53例。对照组患儿进行常规治疗,观察组患儿加用赖氨葡锌联合小儿捏脊疗法治疗。两组患儿治疗周期均为1月,比较两组患儿治疗效果、血清蛋白及微量元素变化。结果:观察组总有效率为90.57%,对照组总有效率为73.58%,差异显著(P<0.05)。观察组总蛋白、白蛋白、球蛋白、元素锌、元素钙治疗前、后变化差较对照组差异显著(P<0.01)。治疗过程中两组患儿均未出现不良反应。结论:应用赖氨葡锌联合捏脊疗法治疗儿童厌食症,效果满意,值得临床推广。

  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. Assistant practitioners (APs) perceptions of their developing role and practice in radiography: Results from a national survey

    International Nuclear Information System (INIS)

    Introduction: In 2000, the NHS Plan set out the government's plans for investment and reform across the NHS. Through the introduction of a new workforce at assistant practitioner (AP) level the Department of Health intended to implement new ways in which to deliver a more efficient service. At the time, little published information existed on the integration of these assistants into the contemporary radiography workforce. Publications were limited to experiences gained by various individual departments ranging in their perception of the role and education of APs. Further research was suggested to track the continuing implementation of the 4-tier structure, establish the precise nature and scope of the roles across Trusts and determine their impact on workload and patient care. Aim: To establish the number and employment locality of APs in radiography professions in England, and to explore their scope of applied practice. Method and materials: The study was conducted over three phases and employed a mixed methods design to address the aims and objectives. Phase I was a scoping exercise performed prior to data collection in which n = 226 radiography sites were identified for contact across England. Phase II utilized a questionnaire as data collection tool to investigate the role of APs in radiography and explore how their roles were integrated into the radiography workforce in England. Results from phase III of the study which utilized semi-structured qualitative interviews are not included in this paper. Conclusion and discussion: Key findings depict the nature and variety of roles and responsibilities undertaken by APs in radiography. This study was the first of its kind to identify the integration of APs in radiography across a sizable geographical region. There were mixed responses to the question asking APs if they were required to perform duties outside their scope of practice. Questionnaire data revealed that a high numbers of APs were working in areas under

  19. 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.

  20. 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 (R.); 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

  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. 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.

  3. Translating Evidence-Based Falls Prevention into Clinical Practice in Nursing Facilities: Results and Lessons from a Quality Improvement Collaborative

    Science.gov (United States)

    Colón-Emeric, Cathleen; Schenck, Anna; Gorospe, Joel; McArdle, Jill; Dobson, Lee; DePorter, Cindy; McConnell, Eleanor

    2007-01-01

    OBJECTIVES To describe the changes in process of care before and after an evidence-based fall reduction quality improvement collaborative in nursing facilities. DESIGN Natural experiment with nonparticipating facilities serving as controls. SETTING Community nursing homes. PARTICIPANTS Thirty-six participating and 353 non-participating nursing facilities in North Carolina. INTERVENTION Two in-person learning sessions, monthly teleconferences, and an e-mail discussion list over 9 months. The change package emphasized screening, labeling, and risk-factor reduction. MEASUREMENTS Compliance was measured using facility self-report and chart abstraction (n = 832) before and after the intervention. Fall rates as measured using the Minimum Data Set (MDS) were compared with those of nonparticipating facilities as an exploratory outcome. RESULTS Self-reported compliance with screening, labeling, and risk-factor reduction approached 100%. Chart abstraction revealed only modest improvements in screening (51% to 68%, P<.05), risk-factor reduction (4% to 7%, P = .30), and medication assessment (2% to 6%, P = .34). There was a significant increase in vitamin D prescriptions (40% to 48%, P = .03) and decrease in sedative-hypnotics (19% to 12%, P = .04) but no change in benzodiazepine, neuroleptic, or calcium use. No significant changes in proportions of fallers or fall rates were observed according to chart abstraction (28.6% to 37.5%, P = .17), MDS (18.2% to 15.4%, P = .56), or self-report (6.1–5.6 falls/1,000 bed days, P = .31). CONCLUSON Multiple-risk-factor reduction tasks are infrequently implemented, whereas screening tasks appear more easily modifiable in a real-world setting. Substantial differences between self-reported practice and medical record documentation require that additional data sources be used to assess the change-in-care processes resulting from quality improvement programs. Interventions to improve interdisciplinary collaboration need to be developed. PMID

  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. Practice patterns of naturopathic physicians: results from a random survey of licensed practitioners in two US States

    OpenAIRE

    Smith Michael J; Cramer Elaine H; Booker Jennifer; Milliman Bruce; Sherman Karen J; Erro Janet; Cherkin Daniel C; Boon Heather S; Deyo Richard A; Eisenberg David M

    2004-01-01

    Abstract Background Despite the growing use of complementary and alternative medicine (CAM) by consumers in the U.S., little is known about the practice of CAM providers. The objective of this study was to describe and compare the practice patterns of naturopathic physicians in Washington State and Connecticut. Methods Telephone interviews were conducted with state-wide random samples of licensed naturopathic physicians and data were collected on consecutive patient visits in 1998 and 1999. T...

  6. [Reaching Target Groups--Shaping Accessibility. Results of a Survey Among Experts on Recommendations for Science and Practice].

    Science.gov (United States)

    Jahn, I; Gansefort, D; Lehmann, F; Walter, U; Brand, T

    2015-09-01

    In an online survey, in which 18 experts participated, recommendations for research and practice to improve access to target groups were discussed. The recommendations were developed within the context of the KNP project. For the implementation of the recommendations, not only is an increased cooperation between science and practice particularly important, but also materials and training as well as standardization of methods. Furthermore, financial resources, especially for conducting evaluation studies are needed. PMID:26406533

  7. Real-world treatment practice in patients with advanced melanoma in the era before ipilimumab: results from the IMAGE study.

    Science.gov (United States)

    Middleton, Mark R; Dalle, Stéphane; Claveau, Joel; Mut, Pilar; Hallmeyer, Sigrun; Plantin, Patrice; Highley, Martin; Kotapati, Srividya; Le, Trong Kim; Brokaw, Jane; Abernethy, Amy P

    2016-07-01

    The therapeutic landscape for advanced melanoma has recently been transformed by several novel agents (immune checkpoint inhibitors and molecular-targeted agents). The prospective, multi-site, observational study IMAGE (ipilimumab: management of advanced melanoma in real practice) included a retrospective cohort to describe real-world treatment prior to approval of the immune checkpoint inhibitor ipilimumab. This retrospective cohort of patients, who started second-line/subsequent treatment (index therapy) for advanced melanoma within 3 years before ipilimumab approval, was selected randomly by chart review. Collected data included treatment history, patient outcomes, and healthcare resource utilization. All patients had ≥1 year of follow-up data. This analysis included 177 patients from Europe (69%) and North America (31%). The most common index therapies (used alone or in combination) were fotemustine (23%), dacarbazine (21%), temozolomide (14%), and platinum-based chemotherapy (14%). Most patients (89%) discontinued index treatment during the study period; the most common reason was disease progression (59%). Among patients with tumor assessment (153/177; 86%), 2% had complete response, 5% had partial response, and 12% had stable disease on last tumor assessment. At 1-year study follow-up, median progression-free survival was 2.6 months (95% confidence interval [CI], 2.1-2.9) and median overall survival was 8.8 months (95% CI, 6.5-9.7). During follow-up, 95% of the patients had healthcare visits for advanced melanoma, 74% of whom were hospitalized or admitted to a hospice facility. These results provide insights into patient care with advanced melanoma in the era before ipilimumab and may serve as a benchmark for new agents in future real-world studies. PMID:27118102

  8. Real-world treatment practice in patients with advanced melanoma in the era before ipilimumab: results from the IMAGE study.

    Science.gov (United States)

    Middleton, Mark R; Dalle, Stéphane; Claveau, Joel; Mut, Pilar; Hallmeyer, Sigrun; Plantin, Patrice; Highley, Martin; Kotapati, Srividya; Le, Trong Kim; Brokaw, Jane; Abernethy, Amy P

    2016-07-01

    The therapeutic landscape for advanced melanoma has recently been transformed by several novel agents (immune checkpoint inhibitors and molecular-targeted agents). The prospective, multi-site, observational study IMAGE (ipilimumab: management of advanced melanoma in real practice) included a retrospective cohort to describe real-world treatment prior to approval of the immune checkpoint inhibitor ipilimumab. This retrospective cohort of patients, who started second-line/subsequent treatment (index therapy) for advanced melanoma within 3 years before ipilimumab approval, was selected randomly by chart review. Collected data included treatment history, patient outcomes, and healthcare resource utilization. All patients had ≥1 year of follow-up data. This analysis included 177 patients from Europe (69%) and North America (31%). The most common index therapies (used alone or in combination) were fotemustine (23%), dacarbazine (21%), temozolomide (14%), and platinum-based chemotherapy (14%). Most patients (89%) discontinued index treatment during the study period; the most common reason was disease progression (59%). Among patients with tumor assessment (153/177; 86%), 2% had complete response, 5% had partial response, and 12% had stable disease on last tumor assessment. At 1-year study follow-up, median progression-free survival was 2.6 months (95% confidence interval [CI], 2.1-2.9) and median overall survival was 8.8 months (95% CI, 6.5-9.7). During follow-up, 95% of the patients had healthcare visits for advanced melanoma, 74% of whom were hospitalized or admitted to a hospice facility. These results provide insights into patient care with advanced melanoma in the era before ipilimumab and may serve as a benchmark for new agents in future real-world studies.

  9. 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.

  10. 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。

  11. 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.

  12. 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.

  13. 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.

  14. 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。

  15. 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.

  16. Forecasting the Effect of the Change in Timing of the ABR Diagnostic Radiology Examinations: Results of the ACR Survey of Practice Leaders.

    Science.gov (United States)

    Bluth, Edward I; Muroff, Lawrence R; Cernigliaro, Joseph G; Moore, Arl V; Smith, Geoffrey G; Flug, Jonathan; DeStigter, Kristen K; Allen, Bibb; Thorwarth, William T; Roberts, Anne C

    2015-05-01

    The results of a survey sent to practice leaders in the ACR Practice of Radiology Environment Database show that the majority of responding groups will continue to hire recently trained residents and fellows even though they have been unable to take the final ABR diagnostic radiology certifying examination. However, a significant minority of private practice groups will not hire these individuals. The majority of private practices expect the timing change for the ABR certifying examinations to affect their groups' function. In contrast, the majority of academic medical school practices expect little or no impact. Residents and fellows should not expect work time off or protected time to study for the certifying examination or for their maintenance of certification examinations in the future. PMID:25737379

  17. 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…

  18. 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

  19. Teaching Practice of Life Study Lesson of Classroom Teacher Candidates Analysis of the Results of Peer Assessment

    Science.gov (United States)

    Bektas, Mustafa

    2013-01-01

    The purpose of this study is to examine peer assessments that the classroom candidates applied at teaching practice on life study lesson. The cross sectional survey method which is one of the survey methods has been used in the research. In this study the sampling criteria, one of the purposive sampling methods, is used. Thus, in the fall semester…

  20. 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

  1. 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。

  2. [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.

  3. [New oral anticoagulants for prophylaxis of stroke. Results of an expert conference on practical use in geriatric patients].

    Science.gov (United States)

    Bahrmann, Philipp; Harms, Fred; Schambeck, Christian Martin; Wehling, Martin; Flohr, Jürgen

    2016-04-01

    Geriatric patients with non-valvular atrial fibrillation (AF) are increasingly being treated with novel oral anticoagulants (NOAC) to prevent ischemic stroke. This article highlights the outcome of an expert meeting on the practical use of NOAC in elderly patients. An interdisciplinary group of experts discussed the current situation of stroke prevention in geriatric patients and its practical management in daily clinical practice. The topic was examined through focused impulse presentations and critical analyses as the basis for the expert consensus. The key issues are summarized in this paper. The European Society of Cardiology (ESC) guidelines from 2012 for the management of patients with non-valvular AF recommend NOAC as the preferred treatment and vitamin K antagonists (VKA) only as an alternative option. Currently, the NOAC factor Xa inhibitors apixaban and rivaroxaban and the thrombin inhibitor dabigatran are more commonly used in clinical practice for patients with AF. Although these drugs have many similarities and are often grouped together it is important to recognize that the pharmacology and dose regimes differ between compounds. Especially n elderly patients NOAC drugs have some advantages compared to VKA, e.g. less drug-drug interactions with concomitant medication and a more favorable risk-benefit ratio mostly driven by the reduction of bleeding. Treatment of anticoagulation in geriatric patients requires weighing the serious risk of stroke against an equally high risk of major bleeding and pharmacoeconomic considerations. Geriatric patients in particular have the greatest benefit from NOAC, which can also be administered in cases of reduced renal function. Regular control of the indications is indispensable, as also for all other medications of the patient. The use of NOAC should certainly not be withheld from geriatric patients who have a clear need for oral anticoagulation. PMID:26861870

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

    OpenAIRE

    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 the use of ERP implementation methods, ERP phase models, critical success factors (CSF’s), and critical failure factors (CFF’s). A central question was to investigate the consultants’ use of scient...

  5. 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.

  6. 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.

  7. 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.

  8. 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.

  9. Reanalysis of two studies with contrasting results on the association between statin use and fracture risk : the General Practice Research Database

    NARCIS (Netherlands)

    de Vries, Frank; de Vries, Corinne; Cooper, Cyrus; Leufkens, Bert; van Staa, Tjeerd-Pieter

    2006-01-01

    BACKGROUND: Two recent case-control studies by Meier et al. and van Staa et al. used the UK General Practice Research Database (GPRD) to examine the association between the use of statins and the risk of fractures, with different results. The objective of the present study was to examine methodologi

  10. 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.

  11. 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.

  12. Improving Library Service Quality to Graduate Students: LibQual+[TM] Survey Results in a Practical Setting

    Science.gov (United States)

    Jankowska, Maria Anna; Hertel, Karen; Young, Nancy J.

    2006-01-01

    The LibQUAL+[TM] survey was conducted to determine user satisfaction and expectations concerning library service quality. The results of the "22 items and a box" constituted a rich source of information for the University of Idaho (UI) Library's strategic planning process. Focusing on graduate students, this study used three methodologies to…

  13. Proceedings of the joint CEC OECD IAEA specialists meeting on non-destructive examination - Practice and results

    International Nuclear Information System (INIS)

    This meeting was organized to be an international forum for discussion of recent application results and of utility experience with non-destructive methods used for the inspection of steel components and weldments; it was also the closing meeting of the Round Robin Tests phase of PISC III (Programme for the Inspection of Steel Components). Lessons learned, data base available and first results were presented and discussed in view of further detailed analysis of all the information generated by that programme. The meeting addressed, in terms of the state of art, the capability and reliability of NDT procedures applied to the major nuclear reactor components. Special emphasis was placed on NDE techniques to detect and size flaws in order to assure structural integrity during plant design life or beyond. Related topics included qualification with emphasis on performance demonstration and application of NDT in plant life management

  14. 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.

  15. 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.

  16. INTENSIFICATION OF THE MODERN POLITICAL PROCESS AS AN OBJECT OF SOCIAL COGNITION AND A RESULT OF POLICY-MANAGEMENT PRACTICES

    Directory of Open Access Journals (Sweden)

    Narikova S. P.

    2014-11-01

    Full Text Available In the article we consider the features of an intensification of modern political processes at various stages of civilization development in the countries with various types of board and a state system. Two main measurements of this intensification – an intensification of political processes as a result of change of internal tendencies in society, and influence on dynamics of the political power of a foreign policy situation are defined

  17. 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

  18. Risk-Based Immunization Policies and Tuberculosis Screening Practices for Animal Care and Research Workers in the United States: Survey Results and Recommendations

    OpenAIRE

    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...

  19. 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...

  20. 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.

  1. 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. PMID:20067999

  2. Assessing Rates of Inadequate Feeding Practices Among Children 12-24 months: Results from a Cross-Sectional Survey in Myanmar.

    Science.gov (United States)

    Thet, May Me; Richards, Leah-Mari; Sudhinaraset, May; Paw, Naw Eh Thi; Diamond-Smith, Nadia

    2016-08-01

    Objectives To ensure proper nutrition and optimal health outcomes, it is critical that infants are exclusively breastfed (0-6 months) and then receive adequate feeding from 6-23 months (breastfeeding and frequent feedings of complementary foods). Despite policies and guidelines on adequate feeding in Myanmar, past research has found low rates of adequately fed infants 0-11 months and little is known about the adequacy of feeding practices for children 12-23 months. The aim of this study is to understand the feeding practices of children aged 0-24 months in Myanmar and maternal characteristics associated with adequate feeding practices. Methods This study examines the rates of adequately fed infants and young children (0-23 months) in hard-to-reach townships in Myanmar from a cross-sectional, multistage cluster survey. Survey data on nutritional practices were collected from 489 mothers. Data were analyzed using multivariate regressions. Results We found that 41.8 % of infants under 6 months were exclusively breastfed, 63.2 % of those aged 6-11 months were adequately fed, and 10.3 % of 12-23 month-olds were adequately fed. In multivariate regressions we found that antenatal care visits [1-4 visits, AOR = 6.59 (p 4 visits, AOR = 6.63 (p breastfeeding for under 6 month old infants. Having >4 antenatal care visits [AOR = 9.97 (p < 0.05)] was associated with adequate feeding for 6-11 months old infants. Conclusions Future nutritional interventions and policies should focus on improving messaging about adequate feeding practices, especially for 12-23 months olds. PMID:27003151

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

    Directory of Open Access Journals (Sweden)

    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.

  4. 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

    Directory of Open Access Journals (Sweden)

    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

  5. 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

    Directory of Open Access Journals (Sweden)

    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

  6. 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.

    Directory of Open Access Journals (Sweden)

    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.

  7. 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

  8. 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.

  9. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  11. Chiropractic: An Introduction

    Science.gov (United States)

    ... Events Multimedia (Video, Images, and Audio) NCCIH Clinical Digest A monthly newsletter with evidence-based information on ... require a viewer such as the free Adobe Reader . NCCIH Pub No.: D403 Date Created: November 2007 ...

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

    Science.gov (United States)

    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

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

    Science.gov (United States)

    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.

  14. 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)

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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    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

  17. 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).

  18. 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...

  19. 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

  20. 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

  1. 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

  2. Logistic feasibility of health related quality of life measurement in clinical practice: results of a prospective study in a large population of chronic liver patients

    Directory of Open Access Journals (Sweden)

    de Man Robert A

    2008-11-01

    Full Text Available Abstract Background The objective of the present study was to provide a complete and detailed report of technical and logistical feasibility problems with the implementation of routine computerized HRQoL measurement at a busy outpatient department of Hepatology that can serve as a tool for future researchers interested in the procedure. Methods Practical feasibility was assessed by observing problems encountered during the development of the computer program, observing patients' ability to complete the HRQoL questionnaires, monitoring the number of times that patients completed the HRQoL questionnaires and observing logistics at the outpatient department. Patients' reasons for not completing the HRQoL questionnaires were assessed retrospectively by means of a mailed questionnaire. Physicians' attitudes towards the availability of computerized HRQoL information about their patients were assessed by means semi-structured interviews and by means of checklists administered after each consultation with s study participant. Results All physicians (n = 11 and 587 patients agreed to participate in the study. Practical feasibility problems concerned complicated technical aspects of developing a user-friendly computer program and safe data transmission over the Internet, patients' lack of basic computer skills and patients' lack of compliance (completion of questionnaires on only 43% of the occasions. The main reason given for non-compliance was simply forgetting, which seemed to be related to reception employees' passive attitude towards sending patients to the computer. Physicians were generally positive about the instant computerized availability of HRQoL information. They requested the information in 92% of the consultations and found the information useful in 45% of the consultations, especially when it provided them with new information. Conclusion This study was among the first to implement the complete procedure of routine computerized HRQo

  3. 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.

  4. Combining Real-Time fMRI Neurofeedback Training of the DLPFC with N-Back Practice Results in Neuroplastic Effects Confined to the Neurofeedback Target Region.

    Science.gov (United States)

    Sherwood, Matthew S; Weisend, Michael P; Kane, Jessica H; Parker, Jason G

    2016-01-01

    In traditional fMRI, individuals respond to exogenous stimuli and are naïve to the effects of the stimuli on their neural activity patterns. Changes arising in the fMRI signal are analyzed post-hoc to elucidate the spatial and temporal activation of brain regions associated with the tasks performed. The advent of real-time fMRI has enabled a new method to systematically alter brain activity across space and time using neurofeedback training (NFT), providing a new tool to study internally-driven processes such as neuroplasticity. In this work, we combined n-back practice with fMRI-NFT of the left dorsolateral prefrontal cortex (DLPFC) to better understand the relationship between open- and closed-loop neuromodulation. FMRI data were acquired during both traditional n-back and NFT across five imaging sessions. Region-of-interest (ROI) and voxel-wise 2 × 2 within subjects ANOVAs were carried out to determine the effects of, and interaction between, training session and neuromodulation type. A main effect of training session was identified for only a single, highly focused cluster that shared spatial properties with the fMRI-NFT target region (left DLPFC). This finding indicates that combined open- and closed-loop neuroplastic enhancement techniques result in focal changes that are confined to the target area of NFT, and do not affect up- or down-stream network components that are normally engaged during working memory. Additionally, we identified a main effect of neuromodulation type for 15 clusters with significantly different activation between open- and closed-loop neuromodulation during training, 12 of which demonstrated higher activity during the open-loop neuromodulation. Our results, taken together with previous reports, indicate that fMRI-NFT combined with n-back practice leads to a highly focal volume exhibiting neuroplasticity without additional network effects. PMID:27445733

  5. External audit of clinical practice and medical decision making in a new Asian oncology center: Results and implications for both developing and developed nations

    International Nuclear Information System (INIS)

    Purpose: The external audit of oncologist clinical practice is increasingly important because of the incorporation of audits into national maintenance of certification (MOC) programs. However, there are few reports of external audits of oncology practice or decision making. Our institution (The Cancer Institute, Singapore) was asked to externally audit an oncology department in a developing Asian nation, providing a unique opportunity to explore the feasibility of such a process. Methods and Materials: We audited 100 randomly selected patients simulated for radiotherapy in 2003, using a previously reported audit instrument assessing clinical documentation/quality assurance and medical decision making. Results: Clinical documentation/quality assurance, decision making, and overall performance criteria were adequate 74.4%, 88.3%, and 80.2% of the time, respectively. Overall 52.0% of cases received suboptimal management. Multivariate analysis revealed palliative intent was associated with improved documentation/clinical quality assurance (p = 0.07), decision making (p 0.007), overall performance (p = 0.003), and optimal treatment rates (p 0.07); non-small-cell lung cancer or central nervous system primary sites were associated with better decision making (p = 0.001), overall performance (p = 0.03), and optimal treatment rates (p = 0.002). Conclusions: Despite the poor results, the external audit had several benefits. It identified learning needs for future targeting, and the auditor provided facilitating feedback to address systematic errors identified. Our experience was also helpful in refining our national revalidation audit instrument. The feasibility of the external audit supports the consideration of including audit in national MOC programs

  6. 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).

  7. 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).

  8. Food use in middle and high school fundraising: Does policy support healthy practice? Results from a survey of Minnesota school principals

    OpenAIRE

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

    2009-01-01

    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 healthy 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, Minnesota metropolitan area completed a self-administered mailed survey. Schools were attended by ...

  9. 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

  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. PMID:20825274

  11. 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.

  12. [Physician Counseling about Physical and Sports Activity in Neurological Practices in Germany: Results of a Survey Among Members of the German Neurological Society].

    Science.gov (United States)

    Reimers, C D; Reuter, I; Straube, A; Tettenborn, B; Braumann, K M; Reimers, A K

    2016-01-01

    Physical inactivity is a major but modifiable risk factor for morbidity and mortality. Regular physical activity has preventive and therapeutic effects on numerous diseases including neurological disorders. Therefore, it is desirable that physicians motivate their patients to increase their physical and sports activities and that they help them to overcome barriers to exercising. The present study is a survey of neurologists who are members of the German Neurological Society with their own practices; they were asked whether they advised their patients on the benefits of physical activity. Details on physician counseling on physical activity were obtained, such as the frequency of counseling, the neurological disorders considered by the practitioners to be worth the effort of counseling, and the barriers to exercise on the part of patients. More than 80 % of the participants who responded to the survey stated that they frequently provide their patients with advice on the preventive and therapeutic aspects of physical activity. Almost all of them recommended endurance sports; this was followed by Far Eastern types of sport such as tai chi or yoga (70 % of all physicians who advice sports activities). The frequency of counseling about physical activity significantly correlated to the physician's own sports activity. Frequency of counseling was reduced if the physician assessed the patients to be incapable of adopting and maintaining a lifestyle of habitual physical activity. Lack of time as well as an insufficient reimbursement of the counseling, however, did not significantly influence the frequency of counseling. The physician's own sports activity matched that of individuals with similar social status. Thus, a selection bias does not seem to be of importance regarding the results of the survey. However, since only 169 of the 784 invited neurologists (21.6 %) responded to the questionnaire, the representativeness of the survey may be limited. Counseling about

  13. 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.

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

    International Nuclear Information System (INIS)

    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

  15. 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.

  16. 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

  17. 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…

  18. How often do GPs use rapid computer access to laboratory results? A description of 18 months’ use by 72 practices in Tayside

    Directory of Open Access Journals (Sweden)

    Deborah Clark

    2004-02-01

    This pattern conforms to that describing the introduction of new technologies in other settings. Continued use in practice and the concordance of usage between practices confirms that rapid and reliable access to laboratory reports from primary care is both useful and used.

  19. [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.

  20. 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

  1. 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.

  2. 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...

  3. 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).

  4. 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

  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

    Directory of Open Access Journals (Sweden)

    van Genderen Perry JJ

    2012-05-01

    Full Text Available Abstract Background 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 travellers, those visiting friends and relatives (VFRs, and elderly travellers. Methods In the years 2002 to 2009, a questionnaire-based survey was conducted at the Dutch Schiphol Airport with the aim to study trends in KAP of travel risk groups towards prevention of malaria. The risk groups last-minute travellers, solo-travellers, business travellers, VFRs and elderly travellers were specifically studied. Results A total of 3,045 respondents were included in the survey. Travellers to destinations with a high risk for malaria had significantly more accurate risk perceptions (knowledge than travellers to low-risk destinations. The relative risk for malaria in travellers to high-risk destinations was probably mitigated by higher protection rates against malaria as compared with travellers to low risk destinations. There were no significant differences in intended risk-taking behaviour. Trend analyses showed a significant change over time in attitude towards more risk-avoiding behaviour and towards higher protection rates against malaria in travellers to high-risk destinations. The KAP profile of last-minute travellers substantially increased their relative risk for malaria, which contrasts to the slight increase in relative risk of solo travellers, business travellers and VFRs for malaria. Conclusions The results of this sequential cohort survey in Dutch travellers suggest an annual 1.8% increase in protection rates against malaria coinciding with an annual 2.5% decrease in intended risk-seeking behaviour. This improvement may reflect the continuous efforts of travel health advice providers to create awareness and to propagate safe and healthy travel

  6. Results of concurrent radio-chemotherapy for the treatment of head and neck squamous cell carcinoma in everyday clinical practice with special reference to early mortality

    International Nuclear Information System (INIS)

    Randomized controlled trials have established concurrent chemo-radiotherapy as the preferred treatment option for inoperable local-regionally advanced head and neck squamous cell carcinomas (HNSCCs). Because many patients have multiple co-morbidities and would not fulfill the eligibility criteria of clinical trials, the results need to be re-evaluated in daily clinical practice with special reference to early mortality. 167 consecutive patients with HNSCC who received concurrent chemo-radiotherapy at the Basel University Hospital between 1988 and 2006 were analyzed retrospectively with a special focus on early deaths and risk factors for an unfavorable outcome. In our cohort, the 3- and 5-year overall survival rates were 54% and 47%, respectively. The therapy was associated with relevant toxicity and an early mortality rate of 5.4%. Patients dying early were analyzed individually for the cause of death. Patients with elevated white blood cell counts (HR: 2.66 p = 0,016) and vascular co-morbidities (HR: 5.3, p = 0,047) showed significantly worse survival rates. The same factors were associated with a trend toward increased treatment-related mortality. The 3-year survival rate improved from approximately 43% for patients treated before the year 2000 to 65% for patients treated after the year 2000 (Fisher’s exact test p = 0.01). Although many patients who received concurrent chemo-radiotherapy would not have qualified for clinical trials, the outcome was favorable and has significantly improved in recent years. However the early mortality was slightly worse than what is described in the literature

  7. 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.

  8. 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

  9. 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

  10. 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

  11. 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

  12. 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

  13. 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

  14. 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

  15. 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

  16. The Identification and Description of Critical Thinking Behaviors in the Practice of Clinical Laboratory Science, Part 1: Design, Implementation, Evaluation, and Results of a National Survey.

    Science.gov (United States)

    Kenimer, Elizabeth A.

    2002-01-01

    A survey of 1,562 clinical laboratory scientists ranked critical thinking behaviors used in practice. Important behaviors were cognitive, behavioral, affective, and situated/contextual. Findings support a view of critical thinking as a metaprocess that spans learning domains. (Contains 17 references.) (SK)

  17. 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.

  18. RESULTS OF AN OBSERVATIONAL PROSPECTIVE STUDY OF THE EFFICACY AND SAFETY OF BELIMUMAB (BENLYSTA® IN SYSTEMIC LUPUS ERYTHEMATOSUS IN REAL CLINICAL PRACTICE

    Directory of Open Access Journals (Sweden)

    E. A. Aseeva

    2016-01-01

    Full Text Available Therapy for systemic lupus erythematosus (SLE remains challenging. The long-term use of glucocorticoids (GC and cytostatics considerably improves life expectancy, but at the same time favors the development of irreversible organ damages. To evaluate the efficacy of belimumab (BLM, a biological agent, that blocks B-lymphocyte-stimulating factor registered for the treatment of active SLE, is an important task of the practice of rheumatology.Objective: to evaluate the efficacy and safety of BLM in patients with high and moderate SLE activity.Subjects and methods. The investigation enrolled 16 patients with a Systemic Lupus Erythematosus Disease Activity Index (SLEDAI-2K score of 6 to 19, who were positive for antinuclear factor (100% and had low complement levels and high anti-native DNA antibodies (81%. BLM was used as monthly intravenous infusions at a dose of 10 mg/kg. The efficiency and safety of the therapy were evaluated monthly and 1 year after the initiation of treatment with BLM; SLE activity was estimated using SLEDAI-2K; a physician’s global assessment of disease activity on a visual analogue scale (VAS; anti-DNA antibody level changes, complement levels, a GC dose, damage index, and adverse events were determined.Results and discussion. BLM therapy proved to be effective in 62% of cases at 1 year after therapy initiation. At 1 month, SLE activity significantly decreased with SLEDAI-2K score diminishment from 9.31±3.21 to 6.25±2.80 in the entire group (p < 0.04. Over a month, the physician’s global assessment of disease activity significantly reduced from 19.25±6.60 to 13.68±3.97 mm (р<0.01 and reached minimum (8.28±6.87 mm by 10 months of therapy. There was a significant decrease in anti-DNA antibodies and an increase in complement C4 level at 5 and 3 months of therapy, respectively. Six of the 10 patients who had received a complete cycle of BLM therapy achieved remission at 12 months. The dose of GC was significantly reduced

  19. Effect of savings-led economic empowerment on HIV preventive practices among orphaned adolescents in rural Uganda: results from the Suubi-Maka randomized experiment.

    Science.gov (United States)

    Jennings, Larissa; Ssewamala, Fred M; Nabunya, Proscovia

    2016-01-01

    Improving economic resources of impoverished youth may alter intentions to engage in sexual risk behaviors by motivating positive future planning to avoid HIV risk and by altering economic contexts contributing to HIV risk. Yet, few studies have examined the effect of economic-strengthening on economic and sexual behaviors of orphaned youth, despite high poverty and high HIV infection in this population. Hierarchal longitudinal regressions were used to examine the effect of a savings-led economic empowerment intervention, the Suubi-Maka Project, on changes in orphaned adolescents' cash savings and attitudes toward savings and HIV-preventive practices over time. We randomized 346 Ugandan adolescents, aged 10-17 years, to either the control group receiving usual orphan care plus mentoring (n = 167) or the intervention group receiving usual orphan care plus mentoring, financial education, and matched savings accounts (n = 179). Assessments were conducted at baseline, 12, and 24 months. Results indicated that intervention adolescents significantly increased their cash savings over time (b = $US12.32, ±1.12, p < .001) compared to adolescents in the control group. At 24 months post-baseline, 92% of intervention adolescents had accumulated savings compared to 43% in the control group (p < .001). The largest changes in savings goals were the proportion of intervention adolescents valuing saving for money to buy a home (ΔT1-T0 = +14.9, p < .001), pursue vocational training (ΔT1-T0 = +8.8, p < .01), and start a business (T1-T0 = +6.7, p < .01). Intervention adolescents also had a significant relative increase over time in HIV-preventive attitudinal scores (b = +0.19, ±0.09, p < .05), most commonly toward perceived risk of HIV (95.8%, n = 159), sexual abstinence or postponement (91.6%, n = 152), and consistent condom use (93.4%, n = 144). In addition, intervention adolescents had 2.017 significantly greater

  20. 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.

  1. Evaluating the psychological impact of practice dispatch-assisted cardiopulmonary instructions using the ALERT protocol: preliminary results in Liege dispatching centre.

    OpenAIRE

    Hirtz, Elodie; Ghuysen, Alexandre; STIPULANTE, Samuel; EL-FASSI, Mehdi; Etienne, Anne-Marie

    2013-01-01

    ABSTRACT Background. The ALERT algorithm, an effective compression-only phone cardiopulmonary resuscitation (CPR) protocol has the potential to help bystanders initiate CPR. This study evaluates the psychological impact of the CPR’s practice on untrained persons (UP). Methods. This is a quasi experimental longitudinal study (n = 153). We used: demographics data, CPR’ emotional characteristics; the Peritraumatic Dissociative Experiences Questionnaire ; the Way of Coping Check List and th...

  2. 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

    OpenAIRE

    van Genderen Perry JJ; van Thiel Pieter PAM; Mulder Paul GH; Overbosch David

    2012-01-01

    Abstract Background 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 travellers, those visiting friends and relatives (VFRs), and elderly travellers. Methods In the years 2002 to 2009, a questionnaire-based survey was conducted at the Dutch Schiphol Airport with the a...

  3. 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.

  4. 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.

  5. 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...

  6. 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

    2012-02-01

    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. PMID:22178524

  7. 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.

  8. 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. PMID:22672441

  9. 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 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.

  10. Patterns of delivery of dietetic care in private practice for patients referred under Medicare Chronic Disease Management: results of a national survey.

    Science.gov (United States)

    Cant, Robyn P

    2010-05-01

    A national survey was used to examine patterns of delivery of dietetic care for patients referred to private practitioners under Medicare Chronic Disease Management (CDM). This asked dietitians about referrals from general practitioners, patient management, fees charged and patient billing. There were 356 (47%) Australian private practice dietitians who responded to the questionnaire; 330 (94%) were Medicare providers. They described a counselling-type service and inability to complete initial patient education within funded consultation time. Many provided a longer consultation than was reported as being funded by Medicare. Fees for initial appointments were generally higher than the scheduled Medical Benefit Scheme fee of AU$56.25 (median $80), requiring patients to pay a fee gap. For review appointments, two of every five dietitians bulk-billed or charged an identical fee ($47.85). Providers communicated by written reports (as required under Medicare policy). There was little evidence of team-based chronic care management. The dietetics Medicare CDM process should mirror other counselling-type Medicare services which provide for both longer and more frequent consultations and higher payment. System integration between dietitians and general practitioners is required to achieve true collaboration and team care of chronic disease patients. PMID:20497733

  11. 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.

  12. 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.

  13. Enhancing the Quality of Prescribing Practices for Older Veterans Discharged from the Emergency Department (EQUiPPED): Preliminary Results from Enhancing Quality of Prescribing Practices for Older Veterans Discharged from the Emergency Department, a Novel Multicomponent Interdisciplinary Quality Improvement Initiative.

    Science.gov (United States)

    Stevens, Melissa B; Hastings, Susan Nicole; Powers, James; Vandenberg, Ann E; Echt, Katharina V; Bryan, William E; Peggs, Kiffany; Markland, Alayne D; Hwang, Ula; Hung, William W; Schmidt, Anita J; McGwin, Gerald; Ikpe-Ekpo, Edidiong; Clevenger, Carolyn; Johnson, Theodore M; Vaughan, Camille P

    2015-05-01

    Suboptimal medication prescribing for older adults has been described in a number of emergency department (ED) studies. Despite this, few studies have examined ED-targeted interventions aimed at reducing the use of potentially inappropriate medications (PIMs). Enhancing Quality of Prescribing Practices for Older Veterans Discharged from the ED (EQUiPPED) is an ongoing multicomponent, interdisciplinary quality improvement initiative in eight Department of Veterans Affairs EDs. The project aims to decrease the use of PIMs, as identified by the Beers criteria, prescribed to veterans aged 65 and older at the time of ED discharge. Interventions include provider education; informatics-based clinical decision support with electronic medical record-embedded geriatric pharmacy order sets and links to online geriatric content; and individual provider education including academic detailing, audit and feedback, and peer benchmarking. Poisson regression was used to compare the number of PIMs that staff providers prescribed to veterans aged 65 and older discharged from the ED before and after the initiation of the EQUiPPED intervention. Initial data from the first implementation site show that the average monthly proportion of PIMs that staff providers prescribed was 9.4±1.5% before the intervention and 4.6±1.0% after the initiation of EQUiPPED (relative risk=0.48, 95% confidence interval=0.40-0.59, P<.001). Preliminary evaluation demonstrated a significant and sustained reduction of ED-prescribed PIMs in older veterans after implementation of EQUiPPED. Longer follow-up and replication at collaborating sites would allow for an assessment of the effect on health outcomes and costs. PMID:25945692

  14. 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. PMID:26415612

  15. Practical wisdom

    DEFF Research Database (Denmark)

    Sørensen, Dorthe; Frederiksen, Kirsten; Groefte, Thorbjoern;

    2013-01-01

    . A secondary analysis on data of qualitative participant observations during non-invasive ventilation treatment and additional 6 interviews with experi-enced ICU nurses was carried out in 2012. Results: The experienced nurses exhibited ‘practical wisdom’. Each nurse could stay alert to the patient’s condition...

  16. 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.

  17. 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.

  18. 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…

  19. Preparing for aging: development, feasibility and preliminary results of an educational program for midlife and older based on practice coping theory.

    NARCIS (Netherlands)

    Bode, C.; Ridder, D.T.D. de; Bensing, J.M.

    2006-01-01

    OBJECTIVES: This article describes the development, content, feasibility and first results of a short educational program for preparing for aging, based on the process model of proactive coping [Aspinwall LG, Taylor SE. A stitch in time: self regulation and proactive coping. Psychol Bull 1997; 121:

  20. 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)…

  1. Practical Results from the Application of Model Checking and Test Generation from UML/SysML Models of On-Board Space Applications

    Science.gov (United States)

    Faria, J. M.; Mahomad, S.; Silva, N.

    2009-05-01

    The deployment of complex safety-critical applications requires rigorous techniques and powerful tools both for the development and V&V stages. Model-based technologies are increasingly being used to develop safety-critical software, and arguably, turning to them can bring significant benefits to such processes, however, along with new challenges. This paper presents the results of a research project where we tried to extend current V&V methodologies to be applied on UML/SysML models and aiming at answering the demands related to validation issues. Two quite different but complementary approaches were investigated: (i) model checking and the (ii) extraction of robustness test-cases from the same models. These two approaches don't overlap and when combined provide a wider reaching model/design validation ability than each one alone thus offering improved safety assurance. Results are very encouraging, even though they either fell short of the desired outcome as shown for model checking, or still appear as not fully matured as shown for robustness test case extraction. In the case of model checking, it was verified that the automatic model validation process can become fully operational and even expanded in scope once tool vendors help (inevitably) to improve the XMI standard interoperability situation. For the robustness test case extraction methodology, the early approach produced interesting results but need further systematisation and consolidation effort in order to produce results in a more predictable fashion and reduce reliance on expert's heuristics. Finally, further improvements and innovation research projects were immediately apparent for both investigated approaches, which point to either circumventing current limitations in XMI interoperability on one hand and bringing test case specification onto the same graphical level as the models themselves and then attempting to automate the generation of executable test cases from its standard UML notation.

  2. Preparing for aging: development, feasibility and preliminary results of an educational program for midlife and older based on practice coping theory.

    OpenAIRE

    Bode, C; Ridder, D.T.D. de; Bensing, J.M.

    2006-01-01

    OBJECTIVES: This article describes the development, content, feasibility and first results of a short educational program for preparing for aging, based on the process model of proactive coping [Aspinwall LG, Taylor SE. A stitch in time: self regulation and proactive coping. Psychol Bull 1997; 121: 417-36]. The aim of the program is to increase proactive competencies and improve proactive orientations and behaviour. The program consists of four-weekly meetings with 8-10 participants and is gi...

  3. 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...

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. 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.

  9. Results from a National Central Auditory Processing Disorder Service: A Real-World Assessment of Diagnostic Practices and Remediation for Central Auditory Processing Disorder.

    Science.gov (United States)

    Cameron, Sharon; Glyde, Helen; Dillon, Harvey; King, Alison; Gillies, Karin

    2015-11-01

    This article describes the development and evaluation of a national service to diagnose and remediate central auditory processing disorder (CAPD). Data were gathered from 38 participating Australian Hearing centers over an 18-month period from 666 individuals age 6, 0 (years, months) to 24, 8 (median 9, 0). A total of 408 clients were diagnosed with either a spatial processing disorder (n = 130), a verbal memory deficit (n = 174), or a binaural integration deficit (n = 104). A hierarchical test protocol was used so not all children were assessed on all tests in the battery. One hundred fifty clients decided to proceed with deficit-specific training (LiSN & Learn or Memory Booster) and/or be fitted with a frequency modulation system. Families were provided with communication strategies targeted to a child's specific listening difficulties and goals. Outcomes were measured using repeat assessment of the relevant diagnostic test, as well as the Client Oriented Scale of Improvement measure and Listening Inventories for Education teacher questionnaire. Group analyses revealed significant improvements postremediation for all training/management options. Individual posttraining performance and results of outcome measures also are discussed. PMID:27587910

  10. 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

  11. 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

  12. 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.

  13. 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.

  14. 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.)

  15. 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.

  16. Management practices for improving sustainable crop production in tropical acid soils. Results of a coordinated research project organized by the Joint FAO/IAEA Programme of Nuclear Techniques in Food and Agriculture

    International Nuclear Information System (INIS)

    As a result of the burgeoning world population, there is an urgent need to increase food crop production. This can be achieved through intensification, diversification and specialization of agricultural production systems in existing cultivated land or by expansion of the land under cultivation. According to FAO estimates, only 11% of the earth's surface is currently cultivated (1406 Mha) and about 24% (3900 Mha) is potentially arable, most of which, 2500 Mha, is composed of acid soils with 1700 Mha located in the humid tropics. Thus, the greatest potential for expanding agricultural land lies in the tropical forest and savannah regions dominated by highly weathered, acid, infertile soils, mostly Oxisols and Ultisols. Soil acidification problems are also likely to increase, with rising CO2 levels in the atmosphere, continuous use of ammonium-based nitrogenous fertilizers, removal of nutrients in farm products without replenishment and nitrate leaching. The savannahs are mainly located in humid and subhumid tropical areas and suitable for rainfed cropping conditions. They comprise a sizeable amount of the agricultural land in many countries of Africa and Latin America and include also the largely anthropic savannahs of tropical Asia. The acid savannah soils are mostly considered marginal because of their inherent low fertility and high susceptibility to rapid degradation. The cultivation of these soils without proper soil management and conservation practices has resulted in an accelerated rate of degradation of the natural resource base. Therefore, management practices must be developed/improved to avoid further degradation of the resource base and to sustain cop productivity in tropical acid soils. This Coordinated Research Project (CRP) was conceived as a follow-up of the CRP on 'The use of nuclear and related techniques to evaluate the agronomic effectiveness of phosphatic fertilizers in particular rock phosphates' (1993-1998), where P fertilizer management

  17. Assuring the Quality of Test Results in the Field of Nuclear Techniques and Ionizing Radiation. The Practical Implementation of Section 5.9 of the EN ISO/IEC 17025 Standard

    Science.gov (United States)

    Cucu, Daniela; Woods, Mike

    2008-08-01

    The paper aims to present a practical approach for testing laboratories to ensure the quality of their test results. It is based on the experience gained in assessing a large number of testing laboratories, discussing with management and staff, reviewing results obtained in national and international PTs and ILCs and exchanging information in the EA laboratory committee. According to EN ISO/IEC 17025, an accredited laboratory has to implement a programme to ensure the quality of its test results for each measurand. Pre-analytical, analytical and post-analytical measures shall be applied in a systematic manner. They shall include both quality control and quality assurance measures. When designing the quality assurance programme a laboratory should consider pre-analytical activities (like personnel training, selection and validation of test methods, qualifying equipment), analytical activities ranging from sampling, sample preparation, instrumental analysis and post-analytical activities (like decoding, calculation, use of statistical tests or packages, management of results). Designed on different levels (analyst, quality manager and technical manager), including a variety of measures, the programme shall ensure the validity and accuracy of test results, the adequacy of the management system, prove the laboratory's competence in performing tests under accreditation and last but not least show the comparability of test results. Laboratory management should establish performance targets and review periodically QC/QA results against them, implementing appropriate measures in case of non-compliance.

  18. 重庆市强化实验室监(检)测结果技术依托的做法%Practice of Intensifying Test Results Technology Based Laboratory in Chongqing

    Institute of Scientific and Technical Information of China (English)

    曹芸; 曾政; 熊仲良; 范首君; 黄诚; 黄恒

    2015-01-01

    兽医实验室是动物防疫技术支撑体系的重要环节,在疫病防控中起着基础性作用。在长期的工作实践中,重庆市不断探索如何充分发挥兽医实验室的职能职责,推动兽医实验室建设和可持续发展,结合重庆市兽医工作“三项制度”的建设情况,探索建立以兽医实验室监(检)测结果为导向、推进兽医实验室建设与发展的工作模式。%Veterinary labs provide strong technical support to animal epidemic prevention system,and play basis role in animal disease prevention and control. Chongqing CADC,in the long term working practice,continued efforts to fulfill functions and duties of veterinary labs,promote veterinary labs construction and sustainable development. This article discussed a veterinary labs test result guiding brand-new working pattern,and combined with "three systems" in Chongqing veterinary work practice,to promote construction and development of veterinary labs.

  19. Pro NET Best Practices

    CERN Document Server

    Ritchie, Stephen D

    2011-01-01

    Pro .NET Best Practices is a practical reference to the best practices that you can apply to your .NET projects today. You will learn standards, techniques, and conventions that are sharply focused, realistic and helpful for achieving results, steering clear of unproven, idealistic, and impractical recommendations. Pro .NET Best Practices covers a broad range of practices and principles that development experts agree are the right ways to develop software, which includes continuous integration, automated testing, automated deployment, and code analysis. Whether the solution is from a free and

  20. Politician2.0 on Facebook: Information Behavior and Dissemination on Social Networking Sites – Gaps and Best-Practice. Evaluation Results of a novel eParticipation toolbox to let politicians engage with citizens online.

    Directory of Open Access Journals (Sweden)

    Timo Wandhoefer

    2012-01-01

    Full Text Available This article covers our findings on information behavior and dissemination of parliamentary decision-makers in terms of using Social Networking Sites like Facebook. The article investigates why politicians use those technologies and integrate them more and more in their everyday workflow. In addition to the purpose of social network usage, the focus of our paper is also on best practices and how to deal with challenges like authenticity of politicians’ online profiles. The results presented within the remit of this paper are the outcome of 16 semi-structured interviews that took place as part of an evaluation effort within the EU research project WeGov [1]. The overall aim of the project is to develop a toolbox that enriches the dialogue between citizens and politicians on the web.

  1. An Analysis of Media Ethics Anomie Resulting from Informal Media Relations Practice%论非正式媒体关系活动导致的媒体伦理失范现象

    Institute of Scientific and Technical Information of China (English)

    冯丙奇

    2011-01-01

    Informal media relations practices by public relations practitioners can result in media ethics anomie. Researchers in the field of media relations have analyzed related phenomena, focusing on the relationship between public relations practitioners and me%公关人员开展的非正式媒体关系活动会导致特定媒体伦理失范现象发生。媒体关系领域的研究者以公关人员与媒体人员之间的关系为出发点,对相关现象进行了关注。本文通过文献研究,试图对非正式媒体关系活动及其导致的媒体伦理失范现象进行解析。

  2. Practice wisdom.

    Science.gov (United States)

    Litchfield, M

    1999-12-01

    A participatory process approach in research and scholarship is proposed in the context of the postmodern movement and a disciplinary emphasis on practice. Two sequential studies are presented to illustrate praxis in nursing in which health is expanding consciousness. A framework of personal practice was developed from the first study and reconceptualized in the second as a process of modeling practice involving partnership, dialogue, pattern recognition, and health as dialectic. This praxis illustrates the merging of theory, practice and research as practice wisdom. Health and caring can be seen as the same process.

  3. NASA/DOD Aerospace Knowledge Diffusion Research Project. Report 45; The Technical Communications Practices of US Aerospace Engineers and Scientists: Results of the Phase 3 US Aerospace Engineering Educators Survey

    Science.gov (United States)

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

    1996-01-01

    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. Little is also known about the intermediary-based system that is used to transfer the results of federally funded R&D to the U.S. aerospace industry. 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, present a model that depicts the transfer of federally funded aerospace R&D via the U.S. government technical report, and present the results of research that investigated aerospace knowledge diffusion vis-a-vis the technical communication practices of U.S. aerospace engineers and scientists who were members of the American Institute of Aeronautics and Astronautics (AIAA) and identified themselves as educators.

  4. NASA/DoD Aerospace Knowledge Diffusion Research Project: Report 43: The Technical Communication Practices of U.S. Aerospace Engineers and Scientists: Results of the Phase 1 Mail Survey -- Manufacturing and Production Perspective

    Science.gov (United States)

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

    1996-01-01

    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 communication practices of U.S. aerospace engineers and scientists who were members of the Society of Manufacturing Engineers.

  5. NASA/DOD Aerospace Knowledge Diffusion Research Project. Report No. 36: The Technical Communications Practices of US Aerospace Engineers and Scientists: Results of the Phase 1 NASA Langley Research Center 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 were assigned to the Research and Technology Group (RTG) at the NASA Langley Research Center in September 1995.

  6. NASA/DOD Aerospace Knowledge Diffusion Research Project. Report 25: The technical communications practices of British aerospace engineers and scientists: Results of the phase 4 RAeS 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 British aerospace engineers and scientists.

  7. A formação médica e a clínica ampliada: resultados de uma experiência brasileira The medical education and the extended general practice: results of a Brazilian experiment

    Directory of Open Access Journals (Sweden)

    Maria de Lourdes Marmorato Botta Hafner

    2010-06-01

    Full Text Available Trata-se de um estudo qualitativo que faz parte de uma pesquisa de avaliação de um curso de medicina com o uso de metodologias ativas de ensino-aprendizagem, baseada na triangulação de métodos. O objetivo é avaliar resultados relacionados ao conceito de clínica ampliada. As fontes de informação utilizadas no estudo abrangem dezessete entrevistas semiestruturadas com egressos e uma situação que simulava a prática médica, da qual participaram sete egressos e uma paciente simulada. A análise das informações e a produção dos dados baseiam-se no método de interpretação de sentidos, segundo referencial da hermenêutica-dialética. Os resultados apontam aspectos que fundamentam a clínica ampliada, evidenciados em duas temáticas: a relação médico-paciente e abordagem do paciente. Em termos de conclusão, observa-se que o curso de medicina avaliado se aproxima da formação do médico generalista, humanista, crítico e reflexivo, que pode intervir tanto nos diferentes níveis de atenção de saúde quanto no enfoque individual e coletivo. Conclui-se, ainda, que há limites para a efetivação de uma clínica ampliada nos diversos cenários de saúde.This is a qualitative study that is part of an evaluation research of a medicine course with the use of active teaching-learning methodologies based on the triangulation of methods. The aim is to evaluate the results related to the extended general practice concept. The sources of information used in the study include 17 semi-structured interviews with ex-prisoners and a situation that simulated the medical practice, of which seven ex-prisoners and a simulated patient participated. The analysis of the information and the production of the data were based on the method of interpretation of senses, according to the referential hermeneutic-dialectic system. The results point to aspects that justify the extended general practice, evidenced in two themes: the doctor-patient relationship

  8. [Environmental Hazards Assessment Program annual report, June 1992--June 1993]. Results of the environmental health activities and needs assessment of the South Carolina statewide family practice system for the Environmental Hazards Assessment Program: EHAP Volume 1, No. 1

    Energy Technology Data Exchange (ETDEWEB)

    Musham, C.; Hainer, B.

    1993-05-01

    An activities and needs assessment was conducted to determine what each of the seven family practice residency programs in South Carolina is providing in environmental health education. In addition, this study was designed to determine: what are the barriers to greater emphasis on environmental health in family practice residency programs and, what the basic environmental health educational goals for family practice residency programs should be.

  9. Progress and goals for INMM ASC N15 consensus standard ""Administrative practices for the determination and reporting of results of non-destructive assay measurements of nuclear material in situ for safeguards nuclear criticality safety and other purposes

    Energy Technology Data Exchange (ETDEWEB)

    Bracken, David S [Los Alamos National Laboratory; Lamb, Frank W [UNWIN CORPORATION

    2009-01-01

    This paper will discuss the goals and progress to date on the development of INMM Accredited Standard Committee (ASC) N15 consensus standard Administrative Practices for the Determination and Reporting of Results of Non-Destructive Assay Measurements of Nuclear Material in situ for Safeguards, Nuclear Criticality Safety, and Other Purposes. This standard will define administrative practices in the areas of data generation and reporting of NDA assay of holdup deposits with consideration of the stakeholders of the reported results. These stakeholders may include nuclear material accounting and safeguards, nuclear criticality safety, waste management, health physics, facility characterization, authorization basis, radiation safety, and site licensing authorities. Stakeholder input will be solicited from interested parties and incorporated during the development of the document. Currently only one consensus standard exists that explicitly deals with NDA holdup measurements: ASTM C1455 Standard Test Method for Nondestructive Assay of Special Nuclear Material Holdup Using Gamma-Ray Spectroscopic Methods. The ASTM International standard emphasizes the activities involved in actually making measurements, and was developed by safeguards and NDA experts. This new INMM ASC N15 standard will complement the existing ASTM international standard. One of the largest driving factors for writing this new standard was the recent emphasis on in situ NDA measurements by the safeguards community due to the Defense Nuclear Facility Safety Board (DNFSB) recommendation 2007-1 on in situ NDA measurements. Specifically, DNFSB recommendation 2007-1 referenced the lack of programmatic requirements for accurate in situ measurements and the use of measurement results for compliance with safety based requirements. That being the case, this paper will also discuss the progress made on the Implementation Plan for Defense Nuclear Facilities Safety Board Recommendation 2007-1 Safety-Related In Situ

  10. Practicing Humanities

    DEFF Research Database (Denmark)

    Gimmler, Antje

    2016-01-01

    In contemporary societies, the humanities are under constant pressure and have to justify their existence. In the ongoing debates, Humboldt’s ideals of ‘Bildung’ and ‘pure science’ are often used to justify the unique function of the humanities of ensuring free research and contributing to a vital...... and self-reflective democracy. Contemporary humanities have adopted a new orientation towards practices, and it is not clear how this fits with the ideals of ‘Bildung’ and ‘pure science’. A possible theoretical framework for this orientation towards practices could be found in John Dewey’s pragmatic...... philosophy. Contrary to Humboldt’s idea that the non-practical is the most practical in the long run, philosophical pragmatism recommends to the humanities to situate knowledge in practices and apply knowledge to practices....

  11. Results of an experimental campaign of monitoring of agricultural practice of field combustion of rice straw; Risultati di una campagna sperimentale di monitoraggio della pratica di combustione all`aperto della paglia di riso

    Energy Technology Data Exchange (ETDEWEB)

    Spezzano, P.; Cerea, E.; Massironi, L.; Nocente, M.; Olivetta, A. [ENEA, Centro Ricerche Saluggia, Vercelli (Italy). Dipt. Ambiente; Castellani, C. M.; De Zaiacomo, T. [ENEA, centro Ricerche ``Ezio Clementel``, Bologna (Italy). Dipt. Ambiente

    1997-09-01

    For the evaluation of environmental impact of agricultural practice of field combustion of rice straw following harvest an experimental campaign was performed in a field situated near Rive Vercellese (Vercelli, Italy) by burning the amount of rice straw in a 1.2 hectare piece of ground. Four sampling positions were operated, each one composed of a miniaturized impactor and a battery-powered pump, and an optical monitor was also used to measure aerosuspended aerosol concentration continuously. Experimental results show that after field combustion, resulting ash is depleted in cadmium, copper, lead and zinc while manganese and silica remaining almost quantitatively in the ash. Manganese and silica were the only components attributable to field combustion of rice straw in the atmospheric aerosol collected during this monitoring survey. Aerosuspended mass concentration values obtained by means of both optical measurements and gravimetric determinations are presented. Aerosol granulometric distribution, measured in the vicinity of the experimental field and the parameter values of the log-normal distribution obtained with experimental data are also indicated. Finally, a comparison is made between aerosol granulometric data and respirable fraction as defined by international standards.

  12. Chiropractic e-Impulse therapy repairs osteoblasts and produces tensile and compressive stresses%脊椎矫正枪技术修复骨骼组织细胞产生拉应力及压应力的作用

    Institute of Scientific and Technical Information of China (English)

    杨杰华; 冼晓琪; 区大明; 孙静; 邓君

    2014-01-01

    BACKGROUND:American spinal corrective electric gun inteligent instrument hand, alternative to traditional massage, in treatment of nonspecific low back pain-induced waist motor dysfunction has good clinical effects. OBJECTIVE:To compare the efficacy and safety of chiropractic e-Impulse therapyversus traditional massage in treatment of nonspecific low back pain-induced waist motor dysfunction so as to provide basic evidence for clinical treatment on the nonspecific low back pain using spinal corrective electric gun. METHODS:A total of 78 patients with nonspecific low back pain were randomly divided into two groups: a treatment group (n=39) treated with chiropractic e-Impulse therapy, and a control group (n=39) treated with traditional massage. Both groups were given lumber functional exercises after 2 weeks of treatment. Before and after 4 weeks of treatment, the Visual Analogue Scale and Oswestry Disability Index were used to assess patients with nonspecific low back pain. The clinical cure rate and safety were compared. RESULTS AND CONCLUSION:At 4 weeks after treatment, the Visual Analogue Scale and Oswestry Disability Index were better in two groups when compared with those before the treatment (P   目的:比较脊椎矫正枪与传统推拿治疗非特异性腰痛所致腰部运动功能障碍的疗效和安全性,为脊椎矫正枪技术产生的拉应力和压应力作用应用于非特异性腰痛所致腰部运动功能障碍的康复提供依据。  方法:选取78例非特异性腰痛患者,用随机数字法将其随机分为治疗组(采用脊椎矫正枪治疗,n=39)与对照组(采用传统推拿治疗,n=39);两组治疗2周后均要求进行腰肌体操功能锻炼。所有患者治疗前、治疗4周后进行选用目测类比评分法和 Oswestry 功能障碍指数对非特异性腰痛患者疼痛和运动功能障碍进行客观评定;以及临床治愈率和安全性对比。  结果与结论:两组患者治疗4周

  13. Chiropractic with new theoretical system for vertebral disease rehabilitation%美式脊椎矫正学为脊椎疾病康复干预注入新的内容与活力

    Institute of Scientific and Technical Information of China (English)

    郭明; 董安立; 刘芳龄

    2007-01-01

    目的:阐述美式脊椎矫正学(Chiropractic)的发展史与现状,从人体健康的平衡观、整体观及脊椎、脊柱的力学结构方面介绍脊椎矫正学的理论体系.方法:查阅关于美式脊椎矫正学的国外3部著作,同时检索2002-10/2006-01中国期刊全文网关于美式脊椎矫正学的相关文献,检索词为"美式脊椎矫正".结果:脊椎矫正学的主要目标是针对人体脊椎功能异常和/或与神经系统的关系,找出并恢复位移异常的脊椎,去除对神经系统的影响,使身体回到健康自然的状态.其主要治疗特点是针对性强,无创伤,无痛苦,疗效显著,安全系数高,是绿色疗法、纯自然疗法.结论:脊椎矫正学从人体健康的平衡观、整体观出发,对脊椎、脊柱的力学结构进一步重新认识,从而对脊椎、脊柱常见病、多发病已经形成了自己独到的理论体系,以及相应的诊疗方法,这些理论和方法过去和现在已经被越来越多的临床实践所证实.

  14. Resultados percibidos obtenidos por las empresas asociados al uso de las prácticas de alta implicación (HIWP (perceived results obtained by companies associated to the use of high involvement work practices

    Directory of Open Access Journals (Sweden)

    Graziela Conci

    2012-06-01

    Full Text Available El objetivo principal de este artículo es investigar las relaciones entre las prácticas de alta implicación (HIWP y los resultados percibidos por los mandos de las empresas. En la investigación identificamos los metaanalisis y revisiones de literatura realizados en los últimos 25 años. Aportamos una revisión de literatura de los artículos publicados en los años no contenidos en las revisiones anteriores (del 2007 al 2011 y que analizan la asociación de los indicadores de productividad, satisfacción, calidad, competitividad o atención al cliente como resultados de la aplicación de las HIWP. Como principal conclusión podemos indicar que la adopción de las HIWP, en general, aporta resultados positivos a las organizaciones. (The main goal of this article is to investigate the relationships between high involvement work practices (HIWP and the results perceived by managers of the companies using them. In the research we identify both the meta-analyses and the literature reviews done in the last 25 years. We present a revision of the literature of the articles published in the years not included in the previous revisions (from 2007 to 2011 and that analyze the association of productivity, satisfaction, quality, competitiveness or customer care indicators, as a result of the use of HIWP. As a main conclusion we can show that the adoption of HIWP, in general, contribute with positive results to the organizations.

  15. Ophthalmic practice

    Directory of Open Access Journals (Sweden)

    Sue Stevens

    2005-03-01

    Full Text Available Eye health workers carry out many basic routine procedures. Sometimes bad practice develops and this, in turn, may lead to new members of staff learning unsafe methods. Community Eye Health Journal plans to run a series on practical procedures, when applicable, relating to the theme.

  16. Ophthalmic practice.

    OpenAIRE

    Sue Stevens

    2005-01-01

    Eye health workers carry out many basic routine procedures. Sometimes bad practice develops and this, in turn, may lead to new members of staff learning unsafe methods. Community Eye Health Journal plans to run a series on practical procedures, when applicable, relating to the theme.

  17. Revisión crítica sobre los modelos de práctica enfermera y sus resultados Critical review of literature about nursing practice models and their results

    Directory of Open Access Journals (Sweden)

    Sergio Romeo López Alonso

    2004-06-01

    Full Text Available Objetivos: Revisar y analizar críticamente aquellos estudios primarios que investiguen la relación entre los Modelos de Práctica Enfermera y sus resultados en términos del cliente interno, externo y de la institución. Material y método: Diseño: Revisión crítica de artículos de investigación de MPE. Bases de datos: Cinahl, Embase, Healthstar y Medline. Resultados: Se han encontrado 16 artículos. Ningún artículo cumple con el rigor metodológico exigido por la guía utilizada. Sólo un artículo emplea un diseño potente de investigación para establecer un nivel de evidencia aceptable. 14 artículos estudian resultados sobre el cliente interno. Predominan los resultados favorables para la satisfacción del cliente externo y la calidad de los cuidados para el cliente externo. Se encuentran resultados contradictorios para la satisfacción del cliente interno. Conclusión: Existe una pobreza de la calidad metodológica de los estudios revisados que atenta contra la validez interna y externa de sus resultados.Objectives: To review and analyze critically all primary articles which study Nursing Practice Models and results in terms of the external and internal client, and the institution. Methods: Design: Critical review of research articles of NPM. Databases: Cinahl, Embase, Healthstar and Medline. Results: 16 articles found. None of them complete the criteria established for the methodological validity of the studies by the checklist used. Only one research used a strong design. 14 articles study results in terms of internal client. Most positive results are found for external client satisfaction and quality of care for the external client. Contradictory results found for internal client satisfaction Conclusion: There is a poor methodological quality of the articles found which attempts against the internal and external validity of their results.

  18. Recovery of the external anticorrosion protection systems of onshore pipelines - evaluation methods and practical results; Recuperacao de sistemas de protecao anticorrosiva externa de dutos terrestres - metodos de avaliacao e resultados praticos

    Energy Technology Data Exchange (ETDEWEB)

    Castinheiras, Wilson; Koebsch, Andre; Silva, Flavio A. da [PETROBRAS S.A., Rio de Janeiro, RJ (Brazil)

    2003-07-01

    The rehabilitation of an old pipeline means to increase its lifetime, making it safety to operate in the necessaries conditions to transport the product. The pipe steel wall evaluation, related to it thickness reduction, due to, basically, internal and external corrosion, is fundamental to guide its rehabilitation. The techniques used to this evaluation are 'pig' and specials field survey. These last surveys are realized over the soil surface (digs is not necessary to access the pipeline or the pipeline operation is not necessary to stop) and objective to verify the pipeline coating and Cathodic Protection System conditions. Due to the actual authors experience, this paper will only treat of the Rehabilitation of the External Anti corrosive Protection System (coating and cathodic protection) of onshore pipelines. This paper present the techniques current attenuation, ON-OFF pipe-to-soil potential close interval survey and DCVG and same practical results obtained with the application of these techniques on the Sergipe/Bahia gas pipeline. (author)

  19. Analysis of disease patterns and cost of treatments for prevention of deep venous thrombosis after total knee or hip replacement: results from the Practice Analysis of THromboprophylaxis after Orthopaedic Surgery (PATHOS study

    Directory of Open Access Journals (Sweden)

    Degli Esposti L

    2012-12-01

    Full Text Available Luca Degli Esposti,1 Guido Didoni,2 Teresa Simon,3 Stefano Buda,1 Diego Sangiorgi,1 Ezio Degli Esposti11CliCon Health, Economics and Outcomes Research, Ravenna, Italy; 2BMS Italy, Rome, Italy; 3BMS Global, Princeton, NJ, USAIntroduction: Venous thromboembolism (VTE is a well-known complication of total hip replacement (THR and total knee replacement (TKR. Various drugs have been introduced in an attempt to reduce the mortality as well as the short-term and long-term morbidity associated with the development of VTE. The aim of this study was to analyze drug utilization for thromboprophylaxis and the cost of illness in real clinical practice in patients with THR or TKR.Materials and methods: A multicenter, retrospective, observational cohort study based on local health unit administrative databases was conducted. All patients (≥18 years old discharged for THR/TKR procedures between January 1, 2007 and December 31, 2008 were included in the study. The date of first hospital discharge was the index date; patients were followed up for a period of 12 months.Results: A total of 10,389 patients were included: 3516 males (33.8%, 69.4 ± 10.4 years and 6873 females (66.2%, 71.7 ± 9.0 years, of which 5483 (52.8% were discharged for THR and 4906 (47.2% for TKR. First antithrombotic treatments after discharge were enoxaparin (3937, 37.9%, heparin (3752, 36.1%, antiplatelet agents (658, 6.3%, vitamin K antagonists (276, 2.7%, fondaparinux (136, 1.3%, combinations (185, 1.8%, and no therapy (1445, 13.9%. Overall, we observed 2347 (22.6% treatment changes; median duration of antithrombotic treatment was 23 days (range 11–47 for THR and 22 days (range 11–46 for TKR. During the follow-up period, we observed 129 cases of VTE (120 per 10,000 patients, five post-thrombotic syndrome (4.8 per 10,000 patients, and three heparin-induced thrombocytopenia (2.9 per 10,000 patients. Median cost for both THR and TKR was €9052.00 (range €8063.00–€9084.96, with

  20. Analysis of Practice and Results of Quality Control Circle in Pharmacy Intravenous Admixture Services%品管圈在静脉用药调配中心的实践与结果分析

    Institute of Scientific and Technical Information of China (English)

    薛进; 罗建华; 张先明

    2013-01-01

    Objective:Through carrying out quality control circle (QCC) in pharmacy intravenous admixture services (PIVAS),to reduce medicine configuration errors,ensure patients' medication safety and improve the level of pharmaceutical affairs management in hospital.Methods:Introduce concept of quality management,use a variety of statistical methods,and solve problems in practice work by seven QC gimmick.Results:Configuration errors in the process of PIVAS fell by an average of 34.00 per month to an average of 17.17 per month after implementation of QCC.Conclusions:Operating QCC on the management of medicine configuration and quality in PIVAS,can greatly exert the team cooperation ability of whole department,reduce the medicine configuration errors,improve the quality of the medicine,and reduce the risk in the process of practice.%目的:通过在静脉用药调配中心(PIVAS)推行品管圈活动,减少药物调配差错,保障患者用药安全,提高医院药事管理水平.方法:引入品质管理概念,运用多种统计方法,按照品管七大手法来解决实际工作中的问题.结果:PIVAS药物调配过程的差错由改善前的平均每月34.00例降低至改善后的平均每月17.17例.结论:将品管圈的改善方法运用于PIVAS的药物调配质量管理中,可以极大发挥整个科室团队协作能力,减少药物调配差错,提高药物调配质量,降低工作过程中的风险.

  1. Best Practices in Project Management

    OpenAIRE

    Liviu ILIES; Emil CRISAN; Ioana Natalia MURESAN

    2010-01-01

    Project management has evolved over time, becoming the principal mean of dealing with change in modern organizations. Best practices have occurred as a result of business evolution and of practicing project management at a global level. Best practices in project management, if followed, increase the chances of success in achieving goals when dealing with projects. In this article we present the concept of best practice, the advantages of using best practices in project management, which are t...

  2. Industrial practices

    International Nuclear Information System (INIS)

    This document reports the industrial practices carried out by the author viewing the requirements fulfilled for obtention the academic degree in chemical engineering of the San Andres University - Bolivia

  3. Practicing induction:

    DEFF Research Database (Denmark)

    Sprogøe, Jonas; Rohde, Nicolas

    2009-01-01

    We claim that induction potentially triggers both individual and organizational learning and by drawing on practice-based theory we discuss how the interplay between individual and organization, what we call a generative dance, ignites both kinds of learning....

  4. Social Practices

    DEFF Research Database (Denmark)

    Schmidt, Kirsten

    2013-01-01

    The present understanding of LCM as a product management system supported by a number of tools and methods does not pay attention to the importance of social practices that the employees develop in relation to the systematic approach. A new conceptual model of LCM including the social practices...... is presented and discussed from theoretical and empirical perspectives. Theoretically, the analyses cover the formalized structures related to the division of labor and the coordination of the tasks on the one hand, and the social practices as meanings, values and priorities on the other hand. A larger Danish...... company serves as case for the empirical analyses of the formalized structures and their interaction with the social practices developed by the employees over time....

  5. 防范住院患者跌倒的管理策略研究及其实效观察%Management Strategy to Prevent Inpatients'Falls and Its Practical Results

    Institute of Scientific and Technical Information of China (English)

    邓菲菲; 甘秀妮; 唐玮

    2011-01-01

    Objective Through the implementation of management strategies to prevent falls for hospitalized patients, so as to improve the effectiveness in prevention of inpatients' falls. Methods The inpatient' falls risk assessment form, preventive measures table, fall event analysis table, education on and process of fall prevention were set up, at the same time focus was put on its specialization, and applying them to the patients of the clinical care unit, as to make fall prevention more effective. Results Through one and a half year's data collection and practical observation, comparison of the fall numbers and fall rates before and after the implementation of management strategies showed that he number of falls was reduced from 24 to 9 , falling rate from 1. 94‰ to 0. 63‰ ( P <0. 05 ); and serious injury rate from 20. 8% to 11. 1%. Conclusion The application of scientific management strategies on assessment, intervention, and evaluation can improve the effectiveness of fall prevention for inpatients. It is still necessary in subsequent clinical practice to constantly improve the overall system of the assessment, intervention, and e-valuation for raising the level of preventing falls.%目的 通过实施防范住院患者跌倒的管理策略,探讨其预防住院患者跌倒的实效.方法 建立住院患者跌倒风险评估表、预防措施表、跌倒事件分析表、防跌倒宣教单和预防跌倒流程,同时注重其专科化,对临床护理单元的患者予以应用,使预防跌倒更具有针对性,提高跌倒实效.结果 经过一年半的资料收集和实效观察,对实施跌倒管理策略前后的跌倒人数、跌倒率等情况进行比较,发生跌倒人数由24例降低到9例,跌倒率由1.94‰下降至0.63‰,差异有统计学意义(P<0.05);严重损伤率由20.8%下降到11.1%.结论 运用评估、干预、评价的科学管理策略能提高预防住院患者跌倒的实效.在今后的临床实践中,仍要从完善评估、

  6. Limited Health Knowledge as a Reason for Non-Use of Four Common Complementary Health Practices.

    Directory of Open Access Journals (Sweden)

    Adam Burke

    Full Text Available Complementary health practices are an important element of health/healthcare seeking behavior among adults in the United States. Reasons for use include medical need, prevention and wellness promotion, and cultural relevance. Survey studies published over the past several decades have provided important information on the use of complementary health practices, such as acupuncture and yoga. A review of the literature, however, reveals an absence of studies looking specifically at who does not use these approaches, and why not.To explore this issue two samples were created using data from the 2007 National Health Interview Survey Complementary and Alternative Medicine supplement. Of particular interest was the relationship between lack of health knowledge, as a reason for non-use, and key independent variables. The first sample was comprised of individuals who had never used any of four common complementary health practices -- acupuncture, chiropractic, natural products, and yoga. The second was a subset of those same non-users who had also reported low back pain, the most frequently cited health concern related to use of complementary therapies.A hypothesized association between lack of health knowledge, lower educational attainment, and other key socioeconomic indicators was supported in the findings. Although it was hypothesized that low back pain would be associated with greater information seeking, regardless of level of education, that hypothesis was not supported.Lack of knowledge was found to affect utilization of common complementary health practices, regardless of the potentially motivating presence of back pain. Disparities in the utilization of complementary medicine, related to educational attainment and other socioeconomic factors, may negatively affect quality of care for many Americans. Creative approaches are needed to help reduce inequities in understanding and improve access to care for underserved populations.

  7. Trends in the knowledge, attitudes and practices of travel risk groups toward prevention of hepatitis B: Results from the repeated cross-sectional Dutch Schiphol Airport Survey 2002-2009

    NARCIS (Netherlands)

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

    2014-01-01

    textabstractBackground Previous studies investigating the travellers' knowledge, attitudes and practices (KAP) profile indicated an important educational need among those travelling to risk destinations. Methods In the years 2002-2009 an annually repeated cross-sectional questionnaire-based survey w

  8. Results of the PAS Study: A Randomized Controlled Trial Evaluating the Effectiveness of a Web-Based Multiple Tailored Smoking Cessation Program Combined With Tailored Counseling by Practice Nurses.

    Science.gov (United States)

    Smit, E S; Candel, M J J M; Hoving, C; de Vries, H

    2016-09-01

    This study investigated the effects of Web-based multiple computer tailoring and counseling by a practice nurse (MTC) compared with computer tailoring without counseling (MT) and usual care (UC) on smoking cessation rates, via a randomized controlled trial with 414 Dutch adult smokers, recruited by 91 practice nurses from May 2009 to June 2010. Logistic multilevel regression analyses were conducted with 24-hour point prevalence, 7-day point prevalence, and prolonged abstinence after 6 and 12 months as dependent variables and experimental condition as the independent variable. After 6 and 12 months, 38% and 56% of respondents were followed up, respectively. At both follow-ups, no main effects of the interventions could be identified when comparing them with care as usual and with each other-neither in analyses using available data nor in analyses using a negative scenario in which respondents lost to follow-up were considered to still be smoking. A Web-based multiple computer-tailored smoking cessation program combined with a single face-to-face counseling session by a practice nurse may not be more effective than this computer-tailored program alone or than usual smoking cessation care in the general practice setting. Yet before concluding that the addition of counseling to Web-based computer tailoring cannot be successful, more research needs to be conducted to identify the optimal number of counseling sessions to be combined with the Web-based program and to how to best attune the two modalities. PMID:26934538

  9. Neglecting Results?

    DEFF Research Database (Denmark)

    Pedersen, Morten Jarlbæk

    2016-01-01

    Much research has been undertaken to cast light on to the role of interest groups in the European Union and elsewhere. However, only a few researchers have focused their energy on the practical effects of involvement – effects on the legal output of the political process. Thus, we have a good kno...... as this organisation is often said to be much dependent on the effective and efficient functioning of its rules – its output legitimacy....

  10. Practical leadership

    Science.gov (United States)

    Sato, Mistilina Dawn

    This study examines conceptions of leadership and leadership enactment by teachers to develop a conceptual foundation for teacher leadership. The research question driving this study was: How do elementary school teacher leaders within a curricular and instructional reform effort describe their conceptions and enactment of leadership within their school and district contexts? Two program sites for elementary school science reform were selected, and six teachers from each program were invited to participate in the study. First-hand reports of conceptions of leadership and stories of enactment, collected through individual and focus group interviews with the teachers, served as the primary data for the study. A case for each of the twelve teachers is presented and analyzed. The outcome of the study is a theory of practical leadership. This conception draws upon the intellectual tradition of practical reasoning, which emphasizes deliberation and action of the individual when faced with a decision or a problematic situation. Practical leadership draws primarily from three dimensions: the self of the leader; the contexts in which the leader is acting; and the purposes that drive the leader's actions. Examples of leadership enactment from the cases are presented with attention to how these enactment stories demonstrate the teachers' use of practical reasoning in the situations described. The final analysis looks more specifically at the idea of practical leadership using a dynamic model called "leadership space" to demonstrate interactions among self, contexts, and purposes over time. The dissertation highlights three conclusions: (1) practical reasoning as the theoretical foundation for analyzing leadership provides a useful and valid analytical framework since it locates the leadership enactment in the deliberation and actions of the leader rather than understanding leadership as the application of a generalized set of principles about how to lead; (2) conceptions of

  11. Practice makes…?

    OpenAIRE

    Simpson, Adam

    2010-01-01

    One vivid memory from my time as a student was a quirk of a lecturer of mine, who would let us know that our performance in presentations was inadequate by writing ‘5P’ on a piece of paper and handing it to us. The term 5P referred to ‘plenty of practice prevents poor performance.’ Receiving a 5P meant that your performance wasn’t up to scratch and that you should have practiced more. I’m happy to report that I was never the recipient of such a note. The five Ps can of course be applied to an...

  12. Eating practices

    DEFF Research Database (Denmark)

    Christensen, Bodil Just

    The objective of the thesis is to describe and discuss how hunger and fullness are practiced (Mol and Law 2004), and emerge as multiple objects (Mol 2002). Within a theoretical framework inspired by Actor Network Theory and material semiotics, this is accomplished through a critical discussion an...

  13. Practical Metallurgy

    DEFF Research Database (Denmark)

    Bissacco, Giuliano; Deganello, Davide

    2003-01-01

    This is the report regards the activities carried out during the practical metatllurgy course concerning material properties and structures and their testing & analysis methods. During the course several aspects of the materials have been considered and different techniques have been analyzed....

  14. COUNSELING PRACTICES.

    Science.gov (United States)

    WATERLOO, GLENN E.

    THE NEED FOR COUNSELING IS EMPHASIZED BY THE FACT THAT 875,000 CHILDREN IN THE UNITED STATES HAVE MENTAL AND PHYSICAL IMPEDIMENTS TO LEARNING. TYPICAL COUNSELING PRACTICES ARE PROBLEM-CENTERED COUNSELING, EXCLUSIVELY "VOCATIONAL" OR "EDUCATIONAL" COUNSELING WITH LITTLE CONCERN FOR THE WHOLE INDIVIDUAL, EXTREME DIRECTIVE OR NONDIRECTIVE COUNSELING,…

  15. Academic Practice

    DEFF Research Database (Denmark)

    Nielsen, Sandro; Heine, Carmen

    Vejledning i at undgå plagiering ved at følge de normer, der gælder for good academic practice. Dette indebærer at man angiver kilder korrekt, og når det er nødvendigt, og at man har en korrekt udformet fortegnelse over referencer. Vejledningen indeholder konkrete eksempler på korrekt kildeangive...

  16. Practical Latex

    CERN Document Server

    Grätzer, George

    2014-01-01

    Accessible at 200+ pages to all who want to learn the practical usages of LaTeX Avoids technical subjects like font usage Friendly and easy to read, with many examples included Extra source materials include sample LaTeX files and suggestions for further reading

  17. The Practice

    Science.gov (United States)

    Billy, Reverend

    2008-01-01

    Consulting for a moment such luminaries as Mahatma Gandhi, Dr. King, Cesar Chavez--I would say that personal revelation is not less necessary to radical change than public revolution. Amen? "Backing Away From The Product" really has to be both a spiritual practice and a public embarrassment so extreme that its witnesses won't stop talking about it…

  18. Differentiation in Classroom Practice

    DEFF Research Database (Denmark)

    Mottelson, Martha

    2015-01-01

    Differentiation in School Practice is an ongoing research project currently being carried out in UCC’s research department by myself and my coworker Christina Jørgensen. The project includes a field study of everyday life in a Danish 5th grade classroom with the aim to observe, describe and analyze...... those everyday practices in the classroom that ultimately result in offering students different positions, identities and opportunities for participation....

  19. Fatores geradores de competitividade na manufatura: uma relação entre práticas e resultados FACTORS THAT GENERATE COMPETITIVENESS IN MANUFACTURING: A RELATIONSHIP BETWEEN PRACTICES AND RESULTS

    Directory of Open Access Journals (Sweden)

    Rolf Hermann Erdmann

    2011-04-01

    Full Text Available The current context and rapid change a lot of possibilities of decisions organizational environment becomes more complex. The global dimension of competition requires that companies will be administeredunder a new perspective that relations between the different areas of the organization. To this end, it is necessary to observe which are competitive surrounding priorities on the areas and leading the Organization to achieve higher levels of competitiveness. This work, through a vast documentary research in books, journals and Annals, installed a waiver in respect of the main priorities competitive. The consolidated results in 100 (one hundred and thirteen items generators of competitiveness. These were classified into 14 (fourteen groups: Lean Production, Benchmarking, Customer Relations, Technology, Integration, Eco Responsibility, Information, Flexibility, Cost, Quality, Innovation, Reliability, Training and Speed. Still, examined the interrelation between them through a vision of practices and outcomes. From this conclusion future objective studies for the use of these items or factors in the development of an organizational diagnostic tool that takes into account the complex relations of a production system. Normal 0 21 false false false PT-BR X-NONE X-NONE MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Tabela normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso

  20. Modelling Practice

    DEFF Research Database (Denmark)

    Cameron, Ian; Gani, Rafiqul

    2011-01-01

    This chapter deals with the practicalities of building, testing, deploying and maintaining models. It gives specific advice for each phase of the modelling cycle. To do this, a modelling framework is introduced which covers: problem and model definition; model conceptualization; model data...... requirements; model construction; model solution; model verification; model validation and finally model deployment and maintenance. Within the adopted methodology, each step is discussedthrough the consideration of key issues and questions relevant to the modelling activity. Practical advice, based on many...... years of experience is providing in directing the reader in their activities.Traps and pitfalls are discussed and strategies also given to improve model development towards “fit-for-purpose” models. The emphasis in this chapter is the adoption and exercise of a modelling methodology that has proven very...