WorldWideScience

Sample records for standard chiropractic management

  1. Training chiropractic students in weight management counseling using standardized patients.

    Science.gov (United States)

    Hawk, Cheryl; Ramcharan, Michael; Kruger, Carla LeRiche

    2017-03-01

    The aim of this study was to describe and assess an activity that trained chiropractic students to counsel patients on weight management through the use of standardized patients. This was a descriptive study using mixed methods. Students were trained to apply health behavior theory and the transtheoretical model. Standardized patients were given a case to portray with the students. Students had 15 minutes for the encounter. The encounters were assessed in 2 ways: (1) standardized patients answered a brief questionnaire about the students' performance, and (2) students answered a questionnaire about the utility of the intervention. Numerical data were extracted from the audiovisual management platform, and statistics were computed for each question. Comments made by students and patients were transferred verbatim for content analysis. A total of 102 students took part in the activity. Students' performance in the encounter was uniformly high, with over 90% "yes" responses to all questions except "gave me printed information material" and "discussed the printed material with me." The key issue identified in the comments by standardized patients was that students tended not to connect weight management with their chief complaint (low back pain). Nearly all students (97%) thought the activity would be useful to their future practice, and 97% felt it had increased their confidence in providing weight management counseling. This experiential activity was assessed to be useful to students' future practice and appeared to provide them with skills to successfully communicate with patients on weight management.

  2. Educational Standards for Chiropractic Colleges.

    Science.gov (United States)

    Council on Chiropractic Education, Des Moines, IA.

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

  3. A case study of chiropractic management of pregnancy-related heartburn with postulated fetal epigenome implications.

    Science.gov (United States)

    Peterson, Caroline

    2012-01-01

    This case study reports on chiropractic care for pregnancy-related heartburn. The purpose of this article is to relate the benefit of chiropractic treatment for one individual, to contrast chiropractic management with the biomedical standard of care for pregnancy-related heartburn, and to point to potential epigenetic implications of the standard of care. A 32-year-old woman who was 24 weeks pregnant presented with persistent heartburn that she was treating with ranitidine (Zantac®) and calcium carbonate (Tums®) daily at the initiation of chiropractic care. Findings of the initial examination were thoracic intersegmental dysfunction and pain upon palpation of the diaphragm, with hypertonicity noted. Therapy localization was positive for reflexes associated with the esophagus and lower esophageal sphincter, suggesting spasms. Emotional components also were identified in association with the symptoms by the use of a mind-body therapy called NeuroEmotional Technique. The patient was treated by adjusting the thoracic spine, manually releasing the diaphragm spasms, and releasing the esophageal spasm with an activator (a small hand-held instrument that creates a percussive force). The patient was symptom-free and did not use medication after the fifth treatment. She was followed throughout the remainder of her pregnancy and was asymptomatic and required no further treatment. A larger study should investigate the effectiveness of chiropractic care for the treatment of pregnancy-related heartburn. Copyright © 2012 Elsevier Inc. All rights reserved.

  4. 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....

  5. Jurisprudence and business management course content taught at accredited chiropractic colleges: A comparative audit.

    Science.gov (United States)

    Gleberzon, Brian J

    2010-03-01

    the purpose of this study was to conduct a comparative audit of the jurisprudence and business management courses offered at a number of different accredited chiropractic colleges. Faculty members responsible for teaching students jurisprudence and/or business management courses at a number of accredited colleges were contacted and asked to electronically submit their course outlines for review. Of the 62 different topics delivered at the 11 chiropractic colleges surveyed, not one topic was taught at all of them. The following topics were taught at 10 of the 11 respondent chiropractic colleges: business plan development; ethics and codes of conduct and; office staff/employees. Several topics were only taught at one accredited chiropractic college. While most chiropractic colleges provide some education in the areas of jurisprudence and business management, it would appear that there is no consensus opinion or 'model curriculum' on these topics towards which chiropractic programs may align themselves. Based on a literature search, this study is the first of its kind. A more extensive study is required, as well as a Delphi process to determine what should be taught to chiropractic students with respect to jurisprudence and business management in order to protect the public interest.

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

    DEFF Research Database (Denmark)

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

    2013-01-01

    Study Design. Randomized controlled trial.Objective. To assess changes in pain levels and physical functioning in response to standard medical care (SMC) versus SMC plus chiropractic manipulative therapy (CMT) for the treatment of low back pain (LBP) among 18 to 35-year-old active-duty military...

  7. Acute respiratory distress syndrome: clinical recognition and preventive management in chiropractic acute care practice.

    Science.gov (United States)

    Mirtz, T A

    2001-09-01

    To present clinical information relevant to acute respiratory distress syndrome (ARDS) and its appearance in chiropractic acute care practice. The National Library of Medicine MEDLINE database was used, along with the bibliographies of selected articles and textbooks commonly found in chiropractic college libraries and bookstores. Clinical studies from the English literature were selected if they pertained to incidence, clinical relevancy, or the association of ARDS with commonly-seen diagnoses in chiropractic neuromusculoskeletal or orthopedic practice. All relevant studies identified by the search were evaluated based on information pertinent to chiropractic management of acute care patients. ARDS is a pulmonary distress syndrome with a high mortality rate. Recognizable indications for the possible development of ARDS include chest pain, head injury, and thoracic spine pain with or without trauma. Clinical evaluation, radiographic findings, and laboratory findings are presented to assist practitioners in identifying this disease process of multiple etiology. A study of the basic pathophysiologic processes that occur in the formation of ARDS is presented to help practitioners gain clinical appreciation. Strategies for preventing respiratory distress in chiropractic patients are also presented and include use of the postural position and the clinical maxim of "slow, deep breathing despite pain" to lessen incident rates of subjects at risk. Although ARDS may not be prevalent in chiropractic practice, it is important for physicians to be aware of the clinical basics (including its pathophysiology), its medical significance, and the preventive strategies that may be used to minimize its occurrence. This basic understanding will further advance knowledge of this disease complex.

  8. 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...

  9. Cost minimization analysis of low back pain claims data for chiropractic vs medicine in a managed care organization.

    Science.gov (United States)

    Grieves, Brian; Menke, J Michael; Pursel, Kevin J

    2009-01-01

    A managed care organization (MCO) examined differences in allowed cost for managing low back pain by medical providers vs chiropractors in an integrated care environment. The purpose of this study is to provide a retrospective cost analysis of administrative data of chiropractic vs medical management of low back pain in a managed care setting. All patients with a low back pain-related diagnosis presenting for health care from January 2004 to June 2004 who were insured by an MCO in northeast Wisconsin were tracked. The cumulative health care costs incurred by this MCO during the 2-year period from January 2004 to December 2005 related to these back pain diagnoses were collected. Allowed costs of chiropractic treatment were 12% greater than medical primary care and 60% less per case than other types of medical care combined, on a per-case basis: median cost of medical primary care was $365.00, chiropractic care was $417.00, and medical nonprimary care was $669.00. This study of an MCO's low back pain allowed costs may be better redirected to primary care or chiropractic, given equivalent levels of case complexity. This study suggests chiropractic management as less expensive compared with medical management of back pain when care extends beyond primary care. Primary care management alone is virtually indistinguishable from chiropractic management in terms of costs.

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

    DEFF Research Database (Denmark)

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

    2009-01-01

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

  11. Chiropractic management of a patient with symptoms of attention-deficit/hyperactivity disorder.

    Science.gov (United States)

    Muir, Jeffrey M

    2012-09-01

    The purpose of this study is to report a case of a child with attention-deficit/hyperactivity disorder (ADHD) who was treated with chiropractic care. Parents of a 5-year-old boy with diagnosed ADHD brought him for chiropractic care to address his subjective signs (acting out, ability to follow instructions, and poor home and school performance), which also included waking at night due to asthmatic symptoms and low self-esteem. Palpation revealed hypertonicity and trigger points in the paraspinal muscles at the thoracolumbar region with local pain. A preliminary diagnosis included cervical and thoracolumbar facet joint irritation with concurrent muscle hypertonicity. Treatment including spinal manipulative therapy, soft tissue therapy, and stretching was provided. Treatment began on a thrice-weekly basis and declined to twice weekly over the course of approximately 12 weeks. After 1 year of treatment, subjective improvements were noted in episodes of acting out, ability to follow instructions, and general home and school performance. The patient improved over 1 year in which he received chiropractic care, including manual treatments such as spinal manipulative therapy and soft tissue therapies. This suggests that there may be a role for doctors of chiropractic in the management of patients with ADHD.

  12. 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

    -dimension questionnaire (EQ-5D) and Short Form 36-item Health Survey (SF-36)) were compared in cost-effectiveness analyses over 12 months from baseline. Mean costs were €2183 lower for the group with chiropractic care, but not statistically significant (95% CI -4410.5 to 43.0). The incremental cost-effectiveness ratio......AIMS: To assess whether primary sector healthcare in the form of chiropractic care is cost-effective compared with self-management in patients with musculoskeletal chest pain, that is, a subgroup of patients with non-specific chest pain. METHODS AND RESULTS: 115 adults aged 18-75 years with acute...... information session aimed at encouraging self-management as complementary to usual care (n=56). Data on resource use were obtained from Danish national registries and valued from a societal perspective. Patient cost and health-related quality-adjusted life years (QALYs; based on EuroQol five...

  13. Feasibility of using a standardized patient encounter for training chiropractic students in tobacco cessation counseling.

    Science.gov (United States)

    Hawk, Cheryl; Kaeser, Martha A; Beavers, David V

    2013-01-01

    Objective : Although tobacco cessation training is included in many health profession programs, it is not yet routinely incorporated into chiropractic education. The purpose of this study was to assess the feasibility of incorporating a problem-based learning tobacco cessation activity into a lecture course for chiropractic students. Methods : Seventy-two students were assigned to participate in two 1-hour lectures on health promotion counseling and tobacco cessation followed by an experiential student-driven lab session using standardized patients at various stages of dependency and willingness to quit. The intervention was based on the transtheoretic model and the "5 A's" of counseling (ask, advise, assess, assist, arrange). Outcomes were assessed via (1) questionnaires completed by the standardized patients regarding the students' use of the 5A's, and (2) questionnaires completed by the students using a 5-point Likert scale of "strongly disagree" to "strongly agree" on the acceptability of this method of learning. Descriptive statistics were computed. Results : Sixty-eight students (94%) completed the activity, spending a median of 2.5 minutes with patients. Over 90% addressed 4 of the 5A's: 99% asked patients if they were smokers; 97% advised them to quit; 90% assessed if they were willing to quit; and 99% offered assistance in quitting. Only 79% arranged a follow-up visit. Overall, students expressed a positive response to the experience; 81% said it increased their confidence in being able to advise patients, and 77% felt it would be valuable for use in their future practice. Conclusion : This active learning exercise appeared to be a feasible way to introduce tobacco counseling into the curriculum.

  14. Chiropractic and concussion in sport: a narrative review of the literature.

    Science.gov (United States)

    Johnson, Claire D; Green, Bart N; Nelson, Robert C; Moreau, Bill; Nabhan, Dustin

    2013-12-01

    Concussion is a common sporting injury that may be seen by doctors of chiropractic and should be managed following current practice guidelines. The purpose of this abstract is to present a literature review on chiropractic management of concussion in sport and to discuss current guidelines. A review of the literature was performed using the PubMed search engine. MeSH terms included chiropractic and concussion. Search dates were the beginning of the record through July 30, 2013. All languages and article types were included in the search. Articles found were retrieved and evaluated for the relevance of chiropractic management of concussion in sport. Five articles were found (1 prospective study, 1 survey, 3 literature reviews) ranging in publication years from 1993 to 2012. No articles reported a position statement, and none provided a review of current concussion management practices related to chiropractic practice. No articles reported adverse outcomes of chiropractic management of an athlete with concussion. Research related to the chiropractic management of concussion in sport is a nascent area of investigation. Although there are few published articles, the articles in this review showed that doctors of chiropractic encounter concussed athletes at events and in clinical practice. It is essential for doctors of chiropractic to understand the importance of using standardized concussion assessment tools and current concussion guidelines.

  15. Conservative chiropractic management of urinary incontinence using applied kinesiology: a retrospective case-series report.

    Science.gov (United States)

    Cuthbert, Scott C; Rosner, Anthony L

    2012-03-01

    The purpose of this case series is to describe the chiropractic management of 21 patients with daily stress and occasional total urinary incontinence (UI). Twenty-one case files of patients 13 to 90 years of age with UI from a chiropractic clinic were reviewed. The patients had a 4-month to 49-year history of UI and associated muscle dysfunction and low back and/or pelvic pain. Eighteen wore an incontinence pad throughout the day and night at the time of their appointments because of unpredictable UI. Patients were evaluated for muscle impairments in the lumbar spine, pelvis, and pelvic floor and low back and/or hip pain. Positive manual muscle test results of the pelvis, lumbar spine muscles, and pelvic floor muscles were the most common findings. Lumbosacral dysfunction was found in 13 of the cases with pain provocation tests (applied kinesiology sensorimotor challenge); in 8 cases, this sensorimotor challenge was absent. Chiropractic manipulative therapy and soft tissue treatment addressed the soft tissue and articular dysfunctions. Chiropractic manipulative therapy involved high-velocity, low-amplitude manipulation; Cox flexion distraction manipulation; and/or use of a percussion instrument for the treatment of myofascial trigger points. Urinary incontinence symptoms resolved in 10 patients, considerably improved in 7 cases, and slightly improved in 4 cases. Periodic follow-up examinations for the past 6 years, and no less than 2 years, indicate that for each participant in this case-series report, the improvements of UI remained stable. The patients reported in this retrospective case series showed improvement in UI symptoms that persisted over time.

  16. Chiropractic Adjustment

    Science.gov (United States)

    ... How you prepare No special preparation is required before a chiropractic adjustment. Chiropractic treatment may require a series of visits to your chiropractor. Ask your care provider about the frequency of visits and be ...

  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. Chiropractic management of patients with bilateral congenital hip dislocation with chronic low back and leg pain.

    Science.gov (United States)

    Diez, Francisco

    2004-05-01

    To discuss conservative methods for treating patients with chronic low back and leg pain associated with the biomechanical and postural alterations related to bilateral congenital hip dislocation. This report describes the cases of 2 adult female subjects with bilateral congenital hip dislocation without acetabula formation who suffered from chronic low back and leg pain managed conservatively by chiropractic methods. The first subject is a 45-year-old woman with a 9-month history of right buttock pain and radiating right leg pain and paresthesia down to the first 2 toes, with a diagnosis of a herniated L4 intervertebral disk. The second subject is a 53-year-old woman who complained of chronic intermittent low back pain and constant unremitting pain on her right leg for the last 3 years. Chiropractic manipulation utilizing Logan Basic apex and double notch contacts, as well as sacroiliac manipulation on a drop table with a sacrum contact and with a posterior to anterior and superior to inferior (PA-SI) rocking thrust, together with a spinal stabilization exercise program, were used on these 2 patients. Both patients had significant clinical improvement, with reduction on the Visual Analogue Scale (VAS) of 67% and 84%, Oswestry Disability Index improvement of 73% and 81%, and an improvement on the Harris hip score of 71% and 44%, respectively. A conservative management approach, including specific chiropractic manipulation and a spinal stabilization exercise program, can help manage the treatment of adult patients with chronic low back and leg pain related to bilateral congenital dislocation of the hips.

  19. Similarities and differences of a selection of key accreditation standards between chiropractic councils on education: a systematic review.

    Science.gov (United States)

    Innes, Stanley I; Leboeuf-Yde, Charlotte; Walker, Bruce F

    2016-01-01

    Councils of Chiropractic Education (CCE) indirectly influence patient care and safety through their role of ensuring the standards of training delivered by chiropractic educational institutions. This is achieved by a process of accreditation where CCEs define and assess graduate competencies and educational standards. A previous study comparing CCE graduate competencies found variations between the CCE jurisdictions. It was proffered that variations in standards may potentially compromise patient care and safety and also inter-jurisdictional mutual recognition. This study continues the examination of CCEs by looking for similarities and differences in CCE accreditation standards. There were two purposes of this review. The first was to compare the accreditation standards, domains of accreditation standards, and components of the domains of accreditation standards as represented by the domains of "Mission, goals, vision, objectives", "Resources", "Faculty/Academic staff", "Educational program/curriculum". In addition, we compared the accreditation standards between CCEs and those of the widely accepted medical accreditation standards of the World Federation of Medical Education (WFME), in order to search for deficiencies and opportunities for improvements in these standards. The second purpose was to make recommendations, if significant deficiencies or variations were found. We undertook a systematic review of the similarities and differences between five CCEs' definitions of an accreditation standard and the descriptive lists of accreditation standards they have adopted. CCE selection criteria and data selection method were undertaken in a systematic manner. This information was tabulated for a comparative analysis and took place in April 2016. Only two CCEs had a definition of the term "accreditation / educational standard". At the domain level there was considerably more similarities than differences. The differences became more apparent when the comparisons were

  20. 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.

  1. Beyond spinal manipulation: should Medicare expand coverage for chiropractic services? A review and commentary on the challenges for policy makers.

    Science.gov (United States)

    Whedon, James M; Goertz, Christine M; Lurie, Jon D; Stason, William B

    2013-12-01

    documentation practices; and additional rigorous efficacy/effectiveness research and clinical studies for chiropractic services need to be performed. Research of chiropractic services should target the triple aim of high-quality care, affordability, and improved health. The barriers that were identified in this study can be addressed. To overcome these barriers, the chiropractic profession and individual physicians must assume responsibility for correcting deficiencies in compliance and documentation; further research needs to be done to evaluate chiropractic services; and effectiveness of extended episodes of preventive chiropractic care should be rigorously evaluated. Centers for Medicare and Medicaid Services policies related to chiropractic reimbursement should be reexamined using the same standards applicable to other health care providers. The integration of chiropractic physicians as fully engaged Medicare providers has the potential to enhance the capacity of the Medicare workforce to care for the growing population. We recommend that Medicare policy makers consider limited expansion of Medicare coverage to include, at a minimum, reimbursement for evaluation and management services by chiropractic physicians.

  2. Beyond spinal manipulation: should Medicare expand coverage for chiropractic services? A review and commentary on the challenges for policy makers

    Science.gov (United States)

    Whedon, James M.; Goertz, Christine M.; Lurie, Jon D.; Stason, William B.

    2013-01-01

    efforts to improve claims and documentation practices; and additional rigorous efficacy/effectiveness research and clinical studies for chiropractic services need to be performed. Research of chiropractic services should target the triple aim of high-quality care, affordability, and improved health. Conclusions The barriers that were identified in this study can be addressed. To overcome these barriers, the chiropractic profession and individual physicians must assume responsibility for correcting deficiencies in compliance and documentation; further research needs to be done to evaluate chiropractic services; and effectiveness of extended episodes of preventive chiropractic care should be rigorously evaluated. Centers for Medicare and Medicaid Services policies related to chiropractic reimbursement should be reexamined using the same standards applicable to other health care providers. The integration of chiropractic physicians as fully engaged Medicare providers has the potential to enhance the capacity of the Medicare workforce to care for the growing population. We recommend that Medicare policy makers consider limited expansion of Medicare coverage to include, at a minimum, reimbursement for evaluation and management services by chiropractic physicians. PMID:25067927

  3. Chiropractic. State of the Art.

    Science.gov (United States)

    Schafer, R. C., Ed.

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

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

    DEFF Research Database (Denmark)

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

    2013-01-01

    BACKGROUND: Temporomandibular pain has multiple etiologies and a range of therapeutic options. In this pilot study, the authors assessed the feasibility of conducting a larger trial to evaluate chiropractic treatment of temporomandibular disorders (TMDs). METHODS: The authors assigned 80...... at baseline and at month 2 and month 6, including use of the Research Diagnostic Criteria for Temporomandibular Disorders. RESULTS: The authors screened 721 potential participants and enrolled 80 people; 52 participants completed the six-month assessment. The adjusted mean change in current pain over six...... the study design and methodology to be manageable. They gained substantial knowledge to aid in conducting a larger study. AMCT, RIST and self-care should be evaluated in a future comparative effectiveness study. PRACTICAL IMPLICATIONS: This pilot study was a necessary step to prepare for a larger study...

  5. Chiropractic Adjustment

    Science.gov (United States)

    ... Results Chiropractic adjustment can be effective in treating low back pain, although much of the research done shows only a modest benefit — similar to the results of more conventional treatments. Some studies suggest that spinal manipulation also may ...

  6. Chiropractic Integrated Care Pathway for Low Back Pain in Veterans: Results of a Delphi Consensus Process.

    Science.gov (United States)

    Lisi, Anthony J; Salsbury, Stacie A; Hawk, Cheryl; Vining, Robert D; Wallace, Robert B; Branson, Richard; Long, Cynthia R; Burgo-Black, A Lucille; Goertz, Christine M

    2018-02-01

    The purpose of this study was to develop an integrated care pathway for doctors of chiropractic, primary care providers, and mental health professionals who manage veterans with low back pain, with or without mental health comorbidity, within Department of Veterans Affairs health care facilities. The research method used was a consensus process. A multidisciplinary investigative team reviewed clinical guidelines and Veterans Affairs pain and mental health initiatives to develop seed statements and care algorithms to guide chiropractic management and collaborative care of veterans with low back pain. A 5-member advisory committee approved initial recommendations. Veterans Affairs-based panelists (n = 58) evaluated the pathway via e-mail using a modified RAND/UCLA methodology. Consensus was defined as agreement by 80% of panelists. The modified Delphi process was conducted in July to December 2016. Most (93%) seed statements achieved consensus during the first round, with all statements reaching consensus after 2 rounds. The final care pathway addressed the topics of informed consent, clinical evaluation including history and examination, screening for red flags, documentation, diagnostic imaging, patient-reported outcomes, adverse event reporting, chiropractic treatment frequency and duration standards, tailored approaches to chiropractic care in veteran populations, and clinical presentation of common mental health conditions. Care algorithms outlined chiropractic case management and interprofessional collaboration and referrals between doctors of chiropractic and primary care and mental health providers. This study offers an integrative care pathway that includes chiropractic care for veterans with low back pain. Copyright © 2018. Published by Elsevier Inc.

  7. Chiropractic Handbook.

    Science.gov (United States)

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

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

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

    Science.gov (United States)

    Waigandt, Alex; And Others

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

  9. 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

  10. Should the chiropractic profession embrace the doctrine of informed consent?

    Science.gov (United States)

    Lehman, James J.; Conwell, Timothy D.; Sherman, Paul R.

    2008-01-01

    Abstract This commentary provides a narrative review of the literature focusing on the use of a health care informed consent process in the United States. This article reviews the current positions of the World Medical Association, American Medical Association, American Chiropractic Association, Wisconsin and New Jersey State Courts, US Federal Government Office of Health Policy and Clinical Outcomes, and 1 college of chiropractic regarding the doctrine of informed consent. The authors recommend that the chiropractic profession embrace the doctrine of informed consent and promulgate it as a standard of care. The implementation of this doctrine by chiropractic physicians promotes and improves the safety of chiropractic interventions. PMID:19646372

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

    Science.gov (United States)

    Nelson, Craig F; Lawrence, Dana J; Triano, John J; Bronfort, Gert; Perle, Stephen M; Metz, R Douglas; Hegetschweiler, Kurt; LaBrot, Thomas

    2005-01-01

    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. PMID:16000175

  12. What Is Chiropractic?

    Science.gov (United States)

    ... NCLC 2018 Schedule at a Glance Educational Program Hotel & Travel Exhibitors & Sponsors Conference Policies FAQs 2018 Advocacy ... and Chiropractic Neck Pain and Chiropractic Posture Backpack Safety Spinal Health Winter Activities Kids and Sports Exercising ...

  13. 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

  14. 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

  15. Essential literature for the chiropractic profession: Results and implementation challenges from a survey of international chiropractic faculty

    Science.gov (United States)

    Mansholt, Barbara A.; Salsbury, Stacie A.; Corber, Lance G.; Stites, John S.

    2017-01-01

    Objective: Scientific literature applicable to chiropractic practice proliferates in quantity, quality, and source. Chiropractic is a worldwide profession and varies in scope between states or provinces and from country to country. It is logical to consider that the focus and emphasis of chiropractic education varies between programs as well. This original research study endeavored to determine “essential literature” recommended by chiropractic faculty. The purpose of this article is (1) to share our results and (2) to promote discussion and explore means for future collaboration of chiropractic faculty through a worldwide platform. Methods: A 2-phase recruitment occurred initially at the institutional level and subsequently at the faculty level. A Web-based survey used qualitative data collection methods to gather bibliographic citations. Descriptive statistics were calculated for demographics, and citation responses were ranked per number of recommendations, grouped into categories, and tabulated per journal source and publication date. Results: Forty-one chiropractic programs were contacted, resulting in 30 participating chiropractic programs (16 US and 14 international). Forty-five faculty members completed the entire survey, submitting 126 peer-reviewed publications and 25 additional citations. Readings emphasized clinical management of spine pain, the science of spinal manipulation, effectiveness of manual therapies, teaching of chiropractic techniques, outcomes assessments, and professional issues. Conclusion: A systematic approach to surveying educators in international chiropractic institutions was accomplished. The results of the survey provide a list of essential literature for the chiropractic profession. We recommend establishing a chiropractic faculty registry for improved communication and collaboration. PMID:28768114

  16. What is chiropractic?

    DEFF Research Database (Denmark)

    Hartvigsen, Jan; French, Simon

    2017-01-01

    While in some jurisdictions chiropractic is fully integrated in public and insurance funded health care systems, in others it is outside and considered as complementary or alternative health care. There is a paucity of data and rigorous scientific studies regarding most aspects of chiropractic...... practice although research activity has been increasing in recent years. We call for papers for a thematic series inChiropractic and Manual Therapiesthat can help define chiropractic better to stakeholders inside and outside the profession under the themeWhat is Chiropractic?...

  17. Best practices recommendations for chiropractic care for infants, children, and adolescents: results of a consensus process.

    Science.gov (United States)

    Hawk, Cheryl; Schneider, Michael; Ferrance, Randy J; Hewitt, Elise; Van Loon, Meghan; Tanis, Lora

    2009-10-01

    There has been much discussion about the role of chiropractic care in the evaluation, management, and treatment of pediatric patients. To date, no specific guidelines have been adopted that address this issue from an evidence based perspective. Previous systematic reviews of the chiropractic literature concluded that there is not yet a substantial body of high quality evidence from which to develop standard clinical guidelines. The purpose of this project was to develop recommendations on "best practices" related primarily to the evaluation and spinal manipulation aspects of pediatric chiropractic care; nonmanipulative therapies were not addressed in detail. Based on both clinical experience and the results of an extensive literature search, a set of seed documents was compiled to inform development of the seed statements. These were circulated electronically to the Delphi panel until consensus was reached, which was considered to be present when there was agreement by at least 80% of the panelists. A multidisciplinary panel of 37 was made up primarily of doctors of chiropractic with a mean of 18 years in practice, many with post-graduate training in pediatrics. The panel represented 5 countries and 17 states; there were members of the American Chiropractic Association, the International Chiropractors Association, and the International Chiropractic Pediatric Association. The panel reached a minimum of 80% consensus on the 51 seed statements after 4 rounds. A broad-based panel of experienced chiropractors was able to reach a high level (80%) of consensus regarding specific aspects of the chiropractic approach to clinical evaluation, management, and manual treatment for pediatric patients, based on both scientific evidence and clinical experience.

  18. 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.

  19. Chiropractic and CAM utilization: a descriptive review.

    Science.gov (United States)

    Lawrence, Dana J; Meeker, William C

    2007-01-22

    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 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. A total of 137 papers were selected, based upon including information about chiropractic utilization, CAM utilization and low back pain and other conditions. Information was extracted from each paper addressing use of chiropractic and CAM, and is summarized in tabular form. 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. Studies looking at chiropractic utilization demonstrate that the rates vary, but generally fall into a range from around 6% to 12% of the population, most of whom seek chiropractic care for low back pain and not for organic disease or visceral dysfunction. CAM is itself used by people suffering from a variety of conditions, though it is often used not as a primary intervention, but rather as an additional form of care. CAM and chiropractic often offer lower costs for comparable results compared to conventional medicine.

  20. Chiropractic care for back pain

    Science.gov (United States)

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

  1. New standard environmental management

    International Nuclear Information System (INIS)

    Andriola, Luca; Luciani, Roberto

    2006-01-01

    The ISO 14001:2004 standard, like ISO 9001:2000 on quality management, transcends the preventive approach (based on a rigid and more or less adequate process-management model still mainly inspired by traditional production methods) and introduces in its stead a highly flexible approach applicable to any socio-economic activity. It is structured by processes rather than system elements, and is based on the quest for efficacy and ongoing improvement [it

  2. Concussion knowledge among Sport Chiropractic Fellows from the Royal College of Chiropractic Sports Sciences (Canada).

    Science.gov (United States)

    Kazemi, Mohsen; Bogumil, Mary Emma; Vora, Khushboo

    2017-12-01

    The objective of this study was to investigate the degree of knowledge that sports chiropractors have in regard to concussion diagnosis and management. A concussion knowledge survey was administered to Sport Chiropractic Fellows of the Royal College of Chiropractic Sports Sciences - Canada (RCCSS(C)) (n=44) via SurveyMonkey.com. Sports chiropractors scored statistically higher on the survey when compared to chiropractic residents (mean =5.57 vs. 5.25; t=2.12; p=0.04) and to fourth year chiropractic interns (mean = 5.57 vs 5.2; t=2.45; p=0.02). Additionally, with our modified scoring, the sports chiropractors scored 85.3%. A few knowledge gaps were identified in the sample population. Sports chiropractors demonstrated the skills and knowledge to diagnose concussion and excel at identifying the definition and mechanism of concussion, but knowledge gaps regarding diagnosis and management of concussion were found in the sample population.

  3. A Survey of the Public Perception of Chiropractic After Exposure to Chiropractic Public Place Marketing Events in New Zealand.

    Science.gov (United States)

    Russell, David G; Glucina, Tanja T; Sherson, Matthew W; Bredin, Melinda

    2017-12-01

    The purpose of this study was to assess public perception of chiropractic public place marketing events. A chiropractic public place marketing program was held at 3 events (a community sports event, an exposition, and a university campus market day) over a 5-month period in Auckland, New Zealand, between 2008 and 2009. Participants were interviewed by chiropractic students. Interview questions were standardized and sought to find out participants' perception of chiropractic and whether it was influenced in a positive or negative manner after their exposure to the marketing program. Three hundred forty-five interviews were completed during 3 events. The minority of participants (15.9%) had a negative view of chiropractic, 29.2% were neutral, and 54.9% had a positive view of chiropractic. Of the responses of those surveyed, 54% did not change their opinion of chiropractic, 44.3% were more positive, and 1.7% were more negative. This study found that direct or indirect exposure to chiropractic public place marketing events may possibly influence the public perception of chiropractic. Because of the limited sample, these findings cannot be extrapolated to other regions or populations. Further studies are needed to test these findings in other world regions and in more controlled environments.

  4. 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.

  5. 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

    rating scale) and self-perceived change in pain (7-point ordinal scale). RESULTS: Both groups experienced decreases in pain, self-perceived positive changes, and increases in Medical Outcomes Study Short Form 36-Item Health Survey scores. Observed between-group significant differences were in favor...... minimal intervention in patients without acute coronary syndrome but with musculoskeletal chest pain. Results suggest that chiropractic treatment might be useful; but further research in relation to patient selection, standardization of interventions, and identification of potentially active ingredients...

  6. Perspectives of older adults on co-management of low back pain by doctors of chiropractic and family medicine physicians: a focus group study.

    Science.gov (United States)

    Lyons, Kevin J; Salsbury, Stacie A; Hondras, Maria A; Jones, Mark E; Andresen, Andrew A; Goertz, Christine M

    2013-09-16

    While older adults may seek care for low back pain (LBP) from both medical doctors (MDs) and doctors of chiropractic (DCs), co-management between these providers is uncommon. The purposes of this study were to describe the preferences of older adults for LBP co-management by MDs and DCs and to identify their concerns for receiving care under such a treatment model. We conducted 10 focus groups with 48 older adults who received LBP care in the past year. Interviews explored participants' care seeking experiences, co-management preferences, and perceived challenges to successful implementation of a MD-DC co-management model. We analyzed the qualitative data using thematic content analysis. Older adults considered LBP co-management by MDs and DCs a positive approach as the professions have complementary strengths. Participants wanted providers who worked in a co-management model to talk openly and honestly about LBP, offer clear and consistent recommendations about treatment, and provide individualized care. Facilitators of MD-DC co-management included collegial relationships between providers, arrangements between doctors to support interdisciplinary referral, computer systems that allowed exchange of health information between clinics, and practice settings where providers worked in one location. Perceived barriers to the co-management of LBP included the financial costs associated with receiving care from multiple providers concurrently, duplication of tests or imaging, scheduling and transportation problems, and potential side effects of medication and chiropractic care. A few participants expressed concern that some providers would not support a patient-preferred co-managed care model. Older adults are interested in receiving LBP treatment co-managed by MDs and DCs. Older adults considered patient-centered communication, collegial interdisciplinary interactions between these providers, and administrative supports such as scheduling systems and health record

  7. The use of nutritional guidance within chiropractic patient management: a survey of 333 chiropractors from the ACORN practice-based research network.

    Science.gov (United States)

    Lee, Mi Kyung; Amorin-Woods, Lyndon; Cascioli, Vincenzo; Adams, Jon

    2018-01-01

    Food consumption and nutritional status affect an individual's health throughout their life-course and an unhealthy diet is a major risk factor for the current global burden of chronic disease. The promotion of health and good nutrition through healthy eating requires the active involvement of all health professionals including chiropractors. This paper reports findings from the first nationally representative examination of the use of nutritional guidance within chiropractic patient management in Australia. A sample of 1000 practising chiropractors was randomly selected from the Australian Chiropractic Research Network (ACORN) practice-based research network database for a cross-sectional study and 33% participated in the online survey in November 2016. The questionnaire, based on previous designs used in similar surveys and nutrition resources developed by the National Health and Medical Research Council, was pretested prior to the survey. Pearson's Chi square and bivariate logistic regression were undertaken to explore relationships with variables of interest. The demographic details of the respondents are similar to those of the chiropractic workforce registered in Australia. Most chiropractors provided nutritional advice as part of their patient care and around a quarter provided specific dietary advice to their patients, including the use of nutrition supplements. Nutrition-related conditions most commonly encountered by the chiropractors were musculoskeletal, usually inflammatory in origin. Common nutritional assessment methods used included questioning patients to assess their nutritional and health status and physical appearance. Most of the participants provided nutritional resources to their patients in their clinics. However, the Australian Dietary Guidelines and the accompanying Australian Guide to Healthy Eating were not well utilised by the respondents. Australian chiropractors often referred patients with nutrition issues to qualified dietitians and

  8. Best Practices for Chiropractic Care of Children: A Consensus Update.

    Science.gov (United States)

    Hawk, Cheryl; Schneider, Michael J; Vallone, Sharon; Hewitt, Elise G

    2016-01-01

    Chiropractic care is the most common complementary and integrative medicine practice used by children in the United States, and it is used frequently by children internationally as well. The purpose of this project was to update the 2009 recommendations on best practices for chiropractic care of children. A formal consensus process was completed based on the existing recommendations and informed by the results of a systematic review of relevant literature from January 2009 through March 2015. The primary search question for the systematic review was, "What is the effectiveness of chiropractic care, including spinal manipulation, for conditions experienced by children (chiropractic care including spinal manipulation among children (chiropractic management of infants, children, and adolescents. Copyright © 2016 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.

  9. ISO 50001 Energy Management Standard

    Energy Technology Data Exchange (ETDEWEB)

    None

    2013-08-12

    This powerful standard from the International Organization for Standardization (ISO) provides an internationally recognized framework for organizations to voluntarily implement an energy management system.

  10. Chiropractic: An Introduction

    Science.gov (United States)

    ... the many different types of adjustments and other manual therapies used in chiropractic care. Given mainly to the ... restoring health. Joint mobilization is another type of manual therapy that may be used. Chiropractors may combine the ...

  11. The ABC's of health promotion and disease prevention in chiropractic practice.

    Science.gov (United States)

    Evans, Marion W

    2003-01-01

    To describe the importance of health promotion techniques and use of active disease prevention techniques as part of chiropractic practice through a selective review of literature using a mnemonic device. There is evidence that doctors of chiropractic use some health promotion techniques in practice such as instruction on exercise, dietary advice, smoking cessation recommendations and the encouraging of preventive chiropractic visits. Healthy People goals for the nation suggest that providers encourage preventive services, work toward better access to care and stress disease prevention. However, information on how this can be routinely done in chiropractic practice is fragmented. This article suggests ways to implement health promotion into the everyday management of the chiropractic patient. Health promotion and disease prevention can be easily performed in chiropractic practice. The nature of the chiropractic supportive or maintenance visit gives doctors a unique platform on which they can launch full-scale health promotion efforts on their patients.

  12. Emergency Management Standards and Schools

    Science.gov (United States)

    National Clearinghouse for Educational Facilities, 2009

    2009-01-01

    This publication discusses emergency management standards for school use and lists standards recommended by FEMA's National Incident Management System (NIMS). Schools are encouraged to review these standards carefully and to adopt, where applicable, those that meet their needs. The lists of standards, resources, and references contained herein…

  13. Frequently Asked Questions about Chiropractic

    Science.gov (United States)

    ... NCLC 2018 Schedule at a Glance Educational Program Hotel & Travel Exhibitors & Sponsors Conference Policies FAQs 2018 Advocacy ... and Chiropractic Neck Pain and Chiropractic Posture Backpack Safety Spinal Health Winter Activities Kids and Sports Exercising ...

  14. Chiropractic management using a brain-based model of care for a 15-year-old adolescent boy with migraine headaches and behavioral and learning difficulties: a case report.

    Science.gov (United States)

    Kuhn, Kurt W; Cambron, Jerrilyn

    2013-12-01

    The purpose of this report is to describe chiropractic management, using a brain-based model of care, of a teen who had migraine headaches and several social and learning difficulties. A 15-year-old adolescent boy with a chronic history of migraines and more than 10 years of learning and behavioral difficulties, including attention-deficit/hyperactivity disorder, obsessive compulsive disorder, and Tourette syndrome, presented for chiropractic care. The patient received spinal manipulation and was given home physical coordination activities that were contralateral to the side of the involved basal ganglia and ipsilateral to the involved cerebellum, along with interactive metronome training. Quantitative changes were noted in neurological soft signs, tests of variables of attention Conners' Parent Rating Scale, the California Achievement Test, grade point, and reduction of medications. The patient reported qualitative improvements in tics, attention, reading, vision, health, relationships with his peers and his family, and self-esteem. The patient with migraine headaches and learning difficulties responded well to the course of chiropractic care. This study suggests that there may be value in a brain-based model of care in the chiropractic management of conditions that are beyond musculoskeletal in nature.

  15. Chiropractic and rehabilitation management of a patient with extraforaminal entrapment of L4 nerve with balance problem.

    Science.gov (United States)

    Alagha, Babak

    2015-01-01

    Disc herniation is one of the most common causes of low back pain with radicular pain. Among various types of disc herniation, the extraforaminal disc herniation is a rare cause of lumbar radiculopathy. The aim of presenting this case study is to demonstrate the benefits of Chiropractic care including spine and extremity manipulation and rehabilitation in the treatment of a rare case of extraforaminal L4 nerve entrapment causing severe L4 radiculopathy and chronic mild low back pain (LBP). The aim of presenting this case study is to demonstrate the benefits of Chiropractic care including spine and extremity manipulation and rehabilitation in treatment of rare case of extraforaminal L4 nerve entrapment which caused severe L4 radiculopathy and chronic mild low back pain (LBP). A 45-year old female patient arrived at the clinic with chronic mild low back pain and right buttock pain, all of which had presented for two years' duration. During the preceding month, the radicular pain initiated in medium to high intensity, radiating to her right leg following the L4 dermatomal pattern with a periodic tingling sensation in her right foot. A neuro exam demonstrated a proprioception deficit in her right leg. A Romberg test was positive. The patient was treated by low amplitude high velocity spinal and extremity manipulation for 10 consecutive sessions (2 weeks), followed by rehabilitation and exercise therapy including advanced myofascial release therapy for an additional 12 sessions (4 weeks). After treatment, the patient reported a significant improvement in her low back pain and radiculopathy. In addition, she achieved some improvement in balance. It seems that Chiropractic care and rehabilitation therapy may be a safe and effective modality in treatment of an L4 radiculopathy in a patient with an extraforaminal L4 nerve entrapment. Although it is rare, an L4 extraforaminal disc herniation should be considered as a possible cause of symptoms in patients with chronic mild

  16. The standard for portfolio management

    CERN Document Server

    2017-01-01

    The Standard for Portfolio Management – Fourth Edition has been updated to best reflect the current state of portfolio management. It describe the principles that drive accepted good portfolio management practices in today’s organizations. It also expands the description of portfolio management to reflect its relation to organizational project management and the organization.

  17. Chiropractic care and public health

    DEFF Research Database (Denmark)

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

    2012-01-01

    to public health? What public health roles can chiropractic interns perform for underserved communities in a collaborative environment? Can the chiropractic profession contribute to community health? What opportunities do doctors of chiropractic have to be involved in health care reform in the areas...... of prevention and public health? What role do citizen-doctors of chiropractic have in organizing community action on health-related matters? How can our future chiropractic graduates become socially responsible agents of change?......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...

  18. IMPLEMENTING A RISK MANAGEMENT STANDARD

    Directory of Open Access Journals (Sweden)

    Constantin PREDA

    2013-01-01

    Full Text Available After risk management “conquered” more and more project managers’ minds and showed its benefits for business and programs, the need to have a global risk management standard has become a crucial issue in the world of risk management. But having a global risk management standard has been a big challenge, starting from the decision of developing the standard (March-June 2005, to the moment of publishing it, November 2009. So, developing the ISO 31000:2009 standard has been more or less like a bumpy ride. Apparently, the people involved in developing the global risk management standard understood from the very beginning that no challenges are too big, nor any tasks too small and that the task of having a new, comprehensive global risk management standard should be completed with excellence: defining the principles and the framework guiding the risk management process applicable for all type of organizations and for a wide range of activities. Coming up with a global standard should always be based on the real organizations’ needs and should fulfill real risk management requirements. The article is trying to present the pros and cons of risk management standard implementation, challenging the implementation process itself and the added value of implementing the standard due to the lack of implementation enablers, like risk culture, a real problem especially in an international environment.

  19. Chiropractors' characteristics associated with physician referrals: results from a survey of Canadian doctors of chiropractic.

    Science.gov (United States)

    Blanchette, Marc-André; Rivard, Michèle; Dionne, Clermont E; Cassidy, J David

    2015-01-01

    The purpose of this study was to identify characteristics of Canadian doctors of chiropractic (DCs) associated with the number of patients referred by medical doctors (MDs). Secondary data analyses were performed on the 2011 cross-sectional survey of the Canadian Chiropractic Resources Databank. The Canadian Chiropractic Resources Databank survey included 81 questions about the practice of DCs. Of the 6533 mailed questionnaires, 2529 (38.7%) were returned and 489 did not meet our inclusion criteria. Our analyzed sample included 2040 respondents. Bivariate analyses were conducted between predetermined potential predictors and the annual number of patients referred by MDs, and negative binomial multivariate regression was performed. On average, DCs reported receiving 15.6 (standard deviation, 31.3) patient referrals from MDs per year and nearly one-third did not receive any. The type of clinic (multidisciplinary with MD), the province of practice (Atlantic provinces), the number of treatments provided per week, the number of practicing hours, rehabilitation and sports injuries as the main sector of activity, prescription of exercises, use of heat packs and ultrasound, and the percentage of patients referred to other health care providers were associated with a higher number of MD referrals to DCs. The percentage of patients with somatovisceral conditions, using a particular chiropractic technique (hole in one and Thompson), taking his/her own radiographs, being the client of a chiropractic management service, and considering maintenance/wellness care as a main sector of activity were associated with fewer MD referrals. Canadian DCs who interacted with other health care workers and who focus their practice on musculoskeletal conditions reported more referrals from MDs. Copyright © 2015 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.

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

    OpenAIRE

    Wangler, Martin; Fujikawa, Ricardo; Hestbæk, Lise; Michielsen, Tom; Raven, Timothy J; Thiel, Haymo W; Zaugg, Beatrice

    2011-01-01

    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 ...

  1. 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

  2. The Early Years of Organized Chiropractic Orthopedics, 1954–1973: A Social History

    Science.gov (United States)

    Green, Bart N.; Johnson, Claire D.

    2009-01-01

    Objective: This paper presents the origins and development of the organized chiropractic orthopedics movement in the United States from 1954–1973. Methods: Hand searches of early periodicals were performed and information was organized chronologically to create a timeline. Context for the timeline was provided by extracting pertinent information from audio recordings of interviews. Relevant background information was located using the cumulative index of the journal Chiropractic History and searching the MANTIS database. Historical Features: After World War I, The advent of third party reimbursement for health care created a new environment for health care practitioners. For doctors of chiropractic, this event provided the impetus to begin the postgraduate chiropractic orthopedics program over 50 years ago. In 1954, Alvin A. Hancock, DC and F. Maynard Lipe, DC successfully launched an active orthopedics movement after several earlier attempts failed during the 1940s and early 1950s. The movement generated from the desire to train and certify chiropractors to manage personal injury and workers’ compensation low back injuries. In addition to developing interdisciplinary educational programs, the chiropractic orthopedics group was responsible for producing a research agenda, some of the profession’s early orthopedic-focused research, and for starting the National Council on Chiropractic Orthopedics of the National Chiropractic Association, which later became the American Chiropractic Association Council on Orthopedics. These organizations produced thousands of specialists in chiropractic orthopedics, later known as Diplomates of the American Board of Chiropractic Orthopedists. Conclusion: Several orthopedics interest groups were formed and credentialing processes were created to qualify doctors as recognized chiropractic orthopedics specialists. The popularity of this movement resulted in the inclusion of orthopedics into core chiropractic college curricula and

  3. Chiropractic and children

    DEFF Research Database (Denmark)

    Leboeuf-Yde, Charlotte; Hestbæk, Lise

    2010-01-01

    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...

  4. Chiropractic. New York State.

    Science.gov (United States)

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

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

  5. 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

  6. The role of chiropractic care in older adults

    Directory of Open Access Journals (Sweden)

    Dougherty Paul E

    2012-02-01

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

  7. The role of chiropractic care in older adults.

    Science.gov (United States)

    Dougherty, Paul E; Hawk, Cheryl; Weiner, Debra K; Gleberzon, Brian; Andrew, Kari; Killinger, Lisa

    2012-02-21

    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.

  8. The role of chiropractic care in older adults

    Science.gov (United States)

    2012-01-01

    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. PMID:22348431

  9. The standard for program management

    CERN Document Server

    2017-01-01

    The Standard for Program Management – Fourth Edition differs from prior editions by focusing on the principles of good program management. Program activities have been realigned to program lifecycle phases rather than topics, and the first section was expanded to address the key roles of program manager, program sponsor and program management office. It has also been updated to better align with PMI’s Governance of Portfolios, Programs, and Projects: A Practice Guide.

  10. Department of Defense Chiropractic Internships

    Science.gov (United States)

    Dunn, Andrew S.

    2006-01-01

    Objective: Department of Defense (DoD) chiropractic internships first began in July of 2001. At the time of this study, 30 New York Chiropractic College student interns had completed part of their clinical education within chiropractic clinics at either the National Naval Medical Center or Naval Hospital Camp Lejeune. The purpose of this study was to evaluate and compare the careers of DoD chiropractic internship participants with comparable nonparticipants in terms of demographics, professional activities, income, and satisfaction. Methods: Survey research was employed to gather data from DoD chiropractic internship participants and comparable nonparticipants. Statistical analysis was carried out to determine significant differences with a nominal significance level set as.05. Results: There were no statistically significant differences in demographics, professional activities, income, or career satisfaction between the 21 DoD chiropractic internship participants (70% response rate) and 35 internship nonparticipants (35% response rate). Conclusions: This study utilized practice parameters as a form of feedback for a comparative analysis of DoD chiropractic internship participants and nonparticipants and found no significant differences between these groups. Limitations of the study may have influenced the results. Opportunities for chiropractic students to train within these settings remains limited and should be further explored, as should additional research into this component of chiropractic clinical education. PMID:18483629

  11. Chiropractic professionalization and accreditation: an exploration of the history of conflict between worldviews through the lens of developmental structuralism.

    Science.gov (United States)

    Senzon, Simon A

    2014-12-01

    The purpose of this commentary is to describe the conflicts in the history of chiropractic's professionalization and conflict through the path of increasing educational standards and accreditation using the lens of developmental structuralism. Within the story of chiropractic's professionalization and accreditation lie the battles between competing worldviews. Gibbons proposed 4 periods of chiropractic's educational history; this article proposes a fifth period along with a new methodological approach to explore the complexity of chiropractic's history. The methodology draws upon constructive developmental psychology and proposes 5 levels of thinking common to the individuals from chiropractic's history. By using a psychological framework to analyze historical events, it appears that the battle within chiropractic education continues at present. Several important issues are explored: the Council on Chiropractic Education's origins in the medical paradigm and rational thinking, the pre-rational, rational, and post-rational critics of the Council on Chiropractic Education, the schools of thought that were reified or emerged from the history, as well as the more recent legal, economic, and social pressures, which helped to shape chiropractic's accreditation and professionalization. A transrational approach, one that includes the partial truths of all perspectives, is a first step to allow for a richer understanding of how the interior worldviews, individual actions, and the exterior forces (legal, economic, political, and educational) brought forth the chiropractic clashes together. Viewing the conflicts within chiropractic from this approach may foster new educational structures to evolve.

  12. The origins and early history of the National Chiropractic Association

    Science.gov (United States)

    Keating, Joseph C; Rehm, William S

    1993-01-01

    Early organization in chiropractic was prompted by the profession’s need to promote itself and to defend against the onslaught of political medicine and organized osteopathy. The first priorities were legal defense against prosecution for unlicensed practice and malpractice insurance. The Universal Chiropractors’ Association (UCA), organized at the Palmer School of Chiropractic (PSC) in 1906, sought to meet these needs by insuring its members and by developing a legal department under the supervision of attorney Tom Morris, one time lieutenant governor of Wisconsin. The public relations and marketing needs of chiropractors were largely served by the PSC and its legendary leader. However, as chiropractors increasingly sought to avoid prosecution by passage of chiropractic laws, Palmer’s efforts to direct this legislation so as to limit chiropractors’ scope of practice increasingly alienated many in the profession. The American Chiropractic Association (ACA) was founded in 1922 to provide a broadscope alternative to BJ’s UCA. With Palmer’s departure from the UCA following the neurocalometer debacle, ACA and UCA sought amalgamation. Simultaneously, organized medicine renewed its attack on the profession by introducing basic science legislation, which prompted chiropractors to try to upgrade and standardize chiropractic education. Early efforts to bring about the needed consensus were centered in the International Chiropractic Congress (ICC), particularly its division of state examining boards. In 1930 the ACA and UCA combined to form the National Chiropractic Association (NCA), and by 1934 the ICC had merged with the NCA to form part of its council structure. With this modicum of solidarity the NCA began the process of educational boot-strapping at its 1935 convention in Los Angeles, when its Committee on Education, a forerunner of today’s Council on Chiropractic Education, was proposed by C.O. Watkins of Montana. ImagesFigure 2Figure 3Figure 4Figure 5

  13. Danish Chiropractic Practice

    DEFF Research Database (Denmark)

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

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

  14. Sport Concussion Knowledge and Clinical Practices: A Survey of Doctors of Chiropractic With Sports Certification.

    Science.gov (United States)

    Moreau, William J; Nabhan, Dustin C; Walden, Taylor

    2015-09-01

    The purpose of this study is to describe the knowledge base and clinical practices regarding concussion by sports-certified doctors of chiropractic. A 21-item survey was distributed to the 312 attendees of the 2014 American Chiropractic Board of Sports Physicians Sports Sciences Symposium. Results were measured by frequency analysis and descriptive statistics for all surveys completed by sports-certified chiropractors. Seventy-six surveys were returned by sports-certified doctors of chiropractic. All (N = 76) 100% of respondents believe that the evaluation of concussion should be performed by a health care provider with training in concussion. The respondents actively assess and manage concussion in adults (96%), adolescents (95%), and children (75%). A majority (79%) of respondents believe that the Sideline Concussion Assessment Tool-3 represents a current standard of care for the sideline evaluation of the athlete who possibly has sustained a sport concussion. Most respondents agreed or strongly agreed that manual therapies may be appropriate in certain circumstances in adults (80%) and minors (80%). This cross section of certified sports chiropractors strongly believes that the evaluation of concussion should be performed by a health care provider with specific training in concussion. A high percentage of the sports-certified chiropractors who responded assess and manage sport concussion in their practice, and many of them endorse the use of the Sideline Concussion Assessment Tool-3 as a sideline assessment tool.

  15. Chiropractic & Osteopathy. A new journal

    Directory of Open Access Journals (Sweden)

    Walker Bruce F

    2005-04-01

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

  16. 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...... in a determined effort to bring forward evidence-based strategies for prevention of spinal pain and other musculoskeletal problems. Chiropractors may play a significant role in finding and implementing evidence-based prevention and treatment strategies aimed at infants, children, and adolescents....

  17. Epidemiology of musculoskeletal injuries among students entering a chiropractic college.

    Science.gov (United States)

    Ndetan, Harrison T; Rupert, Ronald L; Bae, Sejong; Singh, Karan P

    2009-02-01

    The purpose of this study was to report the prevalence, distribution, and severity of injuries to students before entering chiropractic college and to explore the possible demographic risk factors to these injuries. A cross-sectional survey was administered to first-year chiropractic students (n = 255) of one chiropractic college. Survey questions were adopted from the Standardized Nordic and Outcome Assessment Health Status Questionnaires. Data were collected on severity and period of last perception of low back, hand/wrist (HW), and neck/shoulder (NS) injuries of the students before attending chiropractic college. The response rate was 98.8% (N = 252), among which 66.7% were males. Injury prevalence to low back, HW, and NS before attending chiropractic college was 50.4%, 40.1%, and 53.2%, respectively. Of the respondents, 48.8% were overweight/obese and they were more likely to report injuries to HW (odds ratio, 2.10; 95% confidence interval, 1.25-3.51) and NS (odds ratio, 1.70; 95% confidence interval, 1.04-2.73) compared with those with normal weight. Among those with injuries, the mean body mass index for the females was significantly greater than for the males. This study identified a high prevalence of musculoskeletal injuries among students before attending this particular chiropractic college. Only a small percentage of those injuries were severe enough to impede normal daily work. From this study sample, it seems that males entering this chiropractic college tend to report more injuries than females. However, females with high BMI seemed to report more previous injuries.

  18. Medication prescription: a pilot survey of Bernese doctors of chiropractic practicing in Switzerland.

    Science.gov (United States)

    Wangler, Martin; Zaugg, Beatrice; Faigaux, Eric

    2010-01-01

    The purpose of this survey was to assess the use of and the attitude toward prescribing medication among doctors of chiropractic in 1 of 26 Swiss cantons. A Likert scale electronic questionnaire was sent to licensed doctors of chiropractic of the canton of Berne (n = 47). Percentages, mean values, and standard deviations were calculated. A follow-up survey was used to assess comments from the main survey. A probability value of P chiropractic treatment. Although 92% actively prescribe medication at least once a week, this is significantly less than asked for by their patients (P chiropractic rated the present privilege to prescribe nonprescription medications as an advantage for chiropractic care. Fifty-eight percent thought that chiropractic should aim at expanding the options of nonsteroidal anti-inflammatory drugs, analgesics, and muscle relaxants that can be prescribed. Ninety-one percent agreed on continuing education in pharmacology. Despite prescribing medication at least once a week, less than half of Bernese doctors of chiropractic perceived medications as a necessary component of their treatment, mainly using them to help patients who cannot sleep because of pain and to speed up recovery. When asked if they would be allowed to prescribe medications of the "B-list," the majority would want structured continuing education. Limited medication prescription was judged as an advantage for the chiropractic profession by this group of survey participants. Copyright 2010 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.

  19. The chiropractic care of children.

    Science.gov (United States)

    Alcantara, Joel; Ohm, Jeanne; Kunz, Derek

    2010-06-01

    The objective of this study was to characterize the practice of pediatric chiropractic. The study design was a cross-sectional descriptive survey. The settings were private practices throughout the United States, Canada, and Europe. The participants were 548 chiropractors, the majority of whom are practicing in the United States, Canada, and Europe. Practitioner demographics (i.e., gender, years in practice, and chiropractic alma mater), practice characteristics (i.e., patient visits per week, practice income reimbursement), and chiropractic technique were surveyed. The practitioners were also asked to indicate common indicators for pediatric presentation, their practice activities (i.e., use of herbal remedies, exercise and rehabilitation, prayer healing, etc.), and referral patterns. A majority of the responders were female with an average practice experience of 8 years. They attended an average of 133 patient visits per week, with 21% devoted to the care of children (chiropractic care. Fifty-eight percent (58%) indicated an established relationship with an osteopathic or medical physician. Eighty percent (80%) of the responders indicated referring patients to medical practitioners while only 29% indicated receiving a referral from a medical/osteopathic physician. The chiropractic care of children is a significant aspect of the practice of chiropractic. Further research is warranted to examine the safety and effectiveness of this popular nonallopathic approach to children's health.

  20. Conflict of interest policies among institutions and organizations offering chiropractic continuing education.

    Science.gov (United States)

    Funk, Matthew F; Lisi, Anthony J

    2009-05-01

    The purpose of this study is to document and describe the policies governing conflict of interest (COI) among select organizations and institutions offering chiropractic continuing education. Surveys were sent to the following: all North American chiropractic colleges; major national chiropractic organizations; and state chiropractic organizations in states with more than 3500 licensed Doctors of Chiropractic. Each organization or institution was surveyed regarding written and verbal COI policies. Half of the respondents in this survey indicated that they had written policies for management of COI, whereas half did not. None included most of the common elements typically outlined in continuing medical education COI policies. Content varied among the policies available for review. Relevant financial interest is the issue most often defined, and respondents generally prohibit presenters from selling products or services directly during presentations. Overall, these results suggest that processes for managing COI in chiropractic CE are less robust than those previously described for continuing medical education. This study provides preliminary insight into the status of COI management in chiropractic CE.

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

    Science.gov (United States)

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

    2015-03-18

    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 among adult patients with non-specific LBP. Two systematic reviews will be conducted to identify 1) randomized controlled trials and 2) full economic evaluations of chiropractic care for low back pain compared to standard care provided by other healthcare providers. We will conduct searches in specialized electronic databases for randomized controlled trials and full economic evaluations published between 1990 and 2014 using a combination of keywords and MeSH terms. This will be supplemented by a search of the gray literature. Citations, abstracts, and relevant papers will be screened for eligibility by two reviewers independently. Studies will be critically appraised using 1) the Cochrane risk of bias tool and 2) the Drummond (BMJ) checklist. Results will be summarized using Slavin's qualitative best-evidence synthesis approach. Data relating to the primary outcomes of the effectiveness study will be evaluated for inclusion in meta-analyses. The costs will be standardized to the same currency (USD) and adjusted to the same year for inflation. The incremental cost-effectiveness, incremental net benefit, and relevant confidant intervals will be recalculated in order to facilitate comparison between studies. Our review will evaluate both the clinical effectiveness and the cost-effectiveness associated with chiropractic care for LBP. A more precise estimate of the cost-effectiveness of chiropractic care for LBP relative to other forms of conservative care is needed for decision-makers and

  2. Clinical Practice Guideline: Chiropractic Care for Low Back Pain.

    Science.gov (United States)

    Globe, Gary; Farabaugh, Ronald J; Hawk, Cheryl; Morris, Craig E; Baker, Greg; Whalen, Wayne M; Walters, Sheryl; Kaeser, Martha; Dehen, Mark; Augat, Thomas

    2016-01-01

    The purpose of this article is to provide an update of a previously published evidence-based practice guideline on chiropractic management of low back pain. This project updated and combined 3 previous guidelines. A systematic review of articles published between October 2009 through February 2014 was conducted to update the literature published since the previous Council on Chiropractic Guidelines and Practice Parameters (CCGPP) guideline was developed. Articles with new relevant information were summarized and provided to the Delphi panel as background information along with the previous CCGPP guidelines. Delphi panelists who served on previous consensus projects and represented a broad sampling of jurisdictions and practice experience related to low back pain management were invited to participate. Thirty-seven panelists participated; 33 were doctors of chiropractic (DCs). In addition, public comment was sought by posting the consensus statements on the CCGPP Web site. The RAND-UCLA methodology was used to reach formal consensus. Consensus was reached after 1 round of revisions, with an additional round conducted to reach consensus on the changes that resulted from the public comment period. Most recommendations made in the original guidelines were unchanged after going through the consensus process. The evidence supports that doctors of chiropractic are well suited to diagnose, treat, co-manage, and manage the treatment of patients with low back pain disorders. Copyright © 2016 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.

  3. Chiropractic Identity: A Neurological, Professional, and Political Assessment.

    Science.gov (United States)

    Rosner, Anthony L

    2016-12-01

    The purpose of this article is to propose a focused assessment of the identity of chiropractic and its profession, triangulating multiple viewpoints converging upon various aspects and definitions of neurology, manual medicine, and alternative or mainstream medicine. Over 120 years since its inception, chiropractic has struggled to achieve an identity for which its foundations could provide optimal health care. Despite recognition of the benefits of spinal manipulation in various government guidelines, advances in US military and Veterans Administration, and persistently high levels of patient satisfaction, the chiropractic profession remains underrepresented in most discussions of health care delivery. Distinguishing characteristics of doctors of chiropractic include the following: (1) they embrace a model of holistic, preventive medicine (wellness); (2) they embrace a concept of neurological imbalance in which form follows function, disease follows disturbed biochemistry, and phenomenology follows physiology; (3) they diagnose, and their institutions of training are accredited by a body recognized by the US Department of Education; (4) they manage patients on a first-contact basis, often as primary care providers in geographical areas that are underserved; (5) the spine is their primary-but not exclusive-area of interaction; (6) they deliver high-velocity, low-amplitude adjustments with a superior safety record compared with other professions; and (7) they use a network of institutions worldwide that have shown increasing commitments to research. This article provides an overview of chiropractic identity from 6 points of view: (1) concepts of manual medicine; (2) areas of interest beyond the spine; (3) concepts of the chiropractic subluxation; (4) concepts of neurology; (5) concepts of mainstream or alternative health care; and (6) concepts of primary care, first-contact provider, or specialist.

  4. Optimization and standardization of pavement management processes.

    Science.gov (United States)

    2004-08-01

    This report addresses issues related to optimization and standardization of current pavement management processes in Kentucky. Historical pavement management records were analyzed, which indicates that standardization is necessary in future pavement ...

  5. Use of post-isometric relaxation in the chiropractic management of a 55-year-old man with cervical radiculopathy

    OpenAIRE

    Emary, Peter

    2012-01-01

    This case report chronicles the successful management of a 55-year-old patient diagnosed with cervical radiculopathy using spinal manipulative therapy and cervical paraspinal post-isometric relaxation stretches.

  6. 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.

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

    Science.gov (United States)

    Evans, Marion W; Hawk, Cheryl; Strasser, Sheryl M

    2006-10-12

    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. To test a campaign regarding initial impact aimed at increasing chiropractic interns advising on cessation and delivery of information to smokers on cessation. 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. 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.

  8. Cost-effectiveness of medical and chiropractic care for acute and chronic low back pain.

    Science.gov (United States)

    Haas, Mitchell; Sharma, Rajiv; Stano, Miron

    2005-10-01

    To identify relative provider costs, clinical outcomes, and patient satisfaction for the treatment of low back pain (LBP). This was a practice-based, nonrandomized, comparative study of patients self-referring to 60 doctors of chiropractic and 111 medical doctors in 51 chiropractic and 14 general practice community clinics over a 2-year period. Patients were included if they were at least 18 years old, ambulatory, and had low back pain of mechanical origin (n = 2780). Outcomes were (standardized) office costs, office costs plus referral costs for office-based care and advanced imaging, pain, functional disability, patient satisfaction, physical health, and mental health evaluated at 3 and 12 months after the start of care. Multiple regression analysis was used to correct for baseline differences between provider types. Chiropractic office costs were higher for both acute and chronic patients (P .20). Acute and chronic chiropractic patients experienced better outcomes in pain, functional disability, and patient satisfaction (P pain and disability improvement were found for chronic patients only. Chiropractic care appeared relatively cost-effective for the treatment of chronic LBP. Chiropractic and medical care performed comparably for acute patients. Practice-based clinical outcomes were consistent with systematic reviews of spinal manipulation efficacy: manipulation-based therapy is at least as good as and, in some cases, better than other therapeusis. This evidence can guide physicians, payers, and policy makers in evaluating chiropractic as a treatment option for low back pain.

  9. A retrospective study of chiropractic treatment of 276 danish infants with infantile colic.

    Science.gov (United States)

    Wiberg, Karin R; Wiberg, Jesper M M

    2010-09-01

    The aim of this study was to investigate if the outcome of excessively crying infants treated with chiropractic manipulation (1) was associated with age and/or (2), at least partially, can be explained by age according to the natural decline in crying. This was a retrospective evaluation of clinical records of 749 infants from a private Danish chiropractic practice. All of the infants were healthy, thriving infants born to term within the age of 0 to 3 months who fulfilled the diagnostic criteria for excessively crying infants (infantile colic), whose parents sought chiropractic treatment. The infants were treated using chiropractic management as decided by the treating doctor of chiropractic, and changes in crying based upon the parents' report were noted as improved, uncertain, or nonrecovered. Age predictor groups were cross-tabulated against the outcome variables, and difference between classification groups was tested with χ(2) tables and confidence intervals. Slightly older age was found to be linked to excessively crying infants who experienced clinical improvement. However, no apparent link between the clinical effect of chiropractic treatment and a natural decline in crying was found for this group of infants. The findings of this study do not support the assumption that effect of chiropractic treatment of infantile colic is a reflection of the normal cessation of this disorder. Copyright © 2010 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.

  10. A proposed protocol for hand and table sanitizing in chiropractic clinics and education institutions

    Science.gov (United States)

    Evans, Marion Willard; Ramcharan, Michael; Floyd, Rod; Globe, Gary; Ndetan, Harrison; Williams, Ronald; Ivie, Ronald

    2009-01-01

    Abstract Objective By nature, chiropractic is a hands-on profession using manipulation applied to the joints with direct skin-to-skin contacts. Chiropractic tables are designed with a face piece to accommodate the prone patient's head in a neutral position and hand rests to allow for relaxed shoulders and upper spine so treatment is facilitated. The purpose of this article is to present a proposed guideline for hand and treatment table surface sanitizing for the chiropractic profession that is evidence-based and can easily be adopted by teaching institutions and doctors in the field. Methods A review of the chiropractic literature demonstrated that pathogenic microbes are present on treatment tables in teaching clinics at multiple facilities, yet no standardized protocols exist in the United States regarding table sanitizing and hand hygiene in chiropractic clinics or education institutions. This article reviews the scientific literature on the subject by using several search engines, databases, and specific reviews of documents pertaining to the topic including existing general guidelines. Results The literature has several existing guidelines that the authors used to develop a proposed protocol for hand and table sanitizing specific to the chiropractic profession. Recommendations were developed and are presented on hand hygiene and table sanitizing procedures that could lower the risk of infection for both clinical personnel and patients in chiropractic facilities. Conclusion This article offers a protocol for hand and table sanitizing in chiropractic clinics and education institutions. The chiropractic profession should consider adoption of these or similar measures and disseminate them to teaching clinics, institutions, and private practitioners. PMID:19646384

  11. INTEGRATIVE AUGMENTATION OF STANDARDIZED MANAGEMENT SYSTEMS

    Directory of Open Access Journals (Sweden)

    Stanislav Karapetrovic

    2008-03-01

    Full Text Available The development, features and integrating abilities of different international standards related to management systems are discussed. A group of such standards that augment the performance of quality management systems in organizations is specifically focused on. The concept, characteristics and an illustrative example of one augmenting standard, namely ISO 10001, are addressed. Integration of standardized augmenting systems, both by themselves and within the overall management system, is examined. It is argued that, in research and practice alike, integrative augmentation represents the future of standardized quality and other management systems.

  12. Management plan for the Nuclear Standards Program

    International Nuclear Information System (INIS)

    1979-11-01

    This Management Plan was prepared to describe the manner in which Oak Ridge National Laboratory will provide technical management of the Nuclear Standards Program. The organizational structure that has been established within ORNL for this function is the Nuclear Standards Management Center, which includes the Nuclear Standards Office (NSO) already in existence at ORNL. This plan is intended to support the policies and practices for the development and application of technical standards in ETN projects, programs, and technology developments as set forth in a standards policy memorandum from the DOE Program Director for Nuclear Energy

  13. Management plan for the Nuclear Standards Program

    Energy Technology Data Exchange (ETDEWEB)

    1979-11-01

    This Management Plan was prepared to describe the manner in which Oak Ridge National Laboratory will provide technical management of the Nuclear Standards Program. The organizational structure that has been established within ORNL for this function is the Nuclear Standards Management Center, which includes the Nuclear Standards Office (NSO) already in existence at ORNL. This plan is intended to support the policies and practices for the development and application of technical standards in ETN projects, programs, and technology developments as set forth in a standards policy memorandum from the DOE Program Director for Nuclear Energy.

  14. The identity, role, setting, and future of chiropractic practice: a survey of Australian and New Zealand chiropractic students.

    Science.gov (United States)

    de Luca, Katie E; Gliedt, Jordan A; Fernandez, Matthew; Kawchuk, Greg; Swain, Michael S

    2018-03-06

    To evaluate Australian and New Zealand chiropractic students' opinions regarding the identity, role setting, and future of chiropractic practice. An online, cross-sectional survey was administered to chiropractic students in all chiropractic programs in Australia and New Zealand. The survey explored student viewpoints about the identity, role/scope, setting, and future of chiropractic practice as it relates to chiropractic education and health promotion. Associations between the number of years in the program, highest degree preceding chiropractic education, institution, and opinion summary scores were evaluated by multivariate analysis of variance tests. A total of 347 chiropractic students participated in the study. For identity, most students (51.3%) hold strongly to the traditional chiropractic theory but also agree (94.5%) it is important that chiropractors are educated in evidence-based practice. The main predictor of student viewpoints was a student's chiropractic institution (Pillai's trace =.638, F[16, 1368] = 16.237, p Chiropractic institution explained over 50% of the variance around student opinions about role/scope of practice and approximately 25% for identity and future practice. Chiropractic students in Australia and New Zealand seem to hold both traditional and mainstream viewpoints toward chiropractic practice. However, students from different chiropractic institutions have divergent opinions about the identity, role, setting, and future of chiropractic practice, which is most strongly predicted by the institution. Chiropractic education may be a potential determinant of chiropractic professional identity, raising concerns about heterogeneity between chiropractic schools.

  15. 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

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

    Directory of Open Access Journals (Sweden)

    Stoline Michael R

    2006-08-01

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

  17. Discussion on enterprise technical standard management work

    International Nuclear Information System (INIS)

    Li Xinyou

    2010-01-01

    The technical standard management is an important part of enterprise information work, also the basis of enterprise standardization work. Only by rational and orderly management, can it exert maximum effectiveness, provide reliable support for the production and business of enterprise. (author)

  18. Medicare part B claims for chiropractic spinal manipulation, 1998 to 2004.

    Science.gov (United States)

    Whedon, James M; Davis, Matthew A

    2010-10-01

    The objective of this study was to examine the volume and rate of Medicare Part B claims for chiropractic spinal manipulation longitudinally from 1998 to 2004. A descriptive retrospective analysis was performed on Medicare part B claims from 1998 to 2004 using the Medicare Part B Standard Analytical Variable Length File. Using a 5% random sample of Medicare part B claims, the total number of claims were determined for chiropractic spinal manipulation procedures, and the rate of chiropractic spinal manipulation procedures per 1000 beneficiaries. From 1998 through 2003, the number of chiropractic spinal manipulation claims increased by 38% (from 824,249 total claims in 1998 to 1,133,872 in 2003) followed by a 24% decline from 2003 to 2004. The rate of total chiropractic spinal manipulation claims rose 29% from 649 claims per 1000 beneficiaries per year in 1998 to a high of 839 claims per 1000 beneficiaries per year in 2003 and then declined by 25% to 632 claims per 1000 beneficiaries per year in 2004. Medicare Part B claims for chiropractic spinal manipulation increased significantly from 1998 to 2003 and then abruptly declined from 2003 to 2004. Estimates for 2004 are at variance with earlier published estimates. Copyright © 2010 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.

  19. Study of International Standards of Risk Management

    Directory of Open Access Journals (Sweden)

    Dykan Volodymyr L.

    2014-01-01

    Full Text Available The goal of the article lies in the study of existing international standards of risk management, an important factor of improvement of risk management in domestic corporations and enterprises and development of recommendations on application of international standards in Ukraine, in particular, within the framework of building corporate systems of risk management. The conducted study shows that approaches on organisation of the process of risk management, used in standards of risk management, are of general character and differ with the degree of detailing. Their undoubted value in development of risk management in Ukraine is identification of a general direction of building corporate systems of risk management in practice. The said approaches at the national and corporate levels of standardisation in Ukraine within the framework of building corporate systems of risk management would allow improvement of risk management in corporations and enterprises. The prospect of further studies of domestic specialists in the field of risk management is development of the domestic standard of risk management with consideration of modern domestic specific features of development of risk management in Ukraine and leading foreign experience.

  20. Essential literature for the chiropractic profession: a survey of chiropractic research leaders

    Science.gov (United States)

    2013-01-01

    Background Evidence-based clinical practice (EBCP) is an accepted practice for informed clinical decision making in mainstream health care professions. EBCP augments clinical experience and can have far reaching effects in education, policy, reimbursement and clinical management. The proliferation of published research can be overwhelming—finding a mechanism to identify literature that is essential for practitioners and students is desirable. The purpose of this study was to survey leaders in the chiropractic profession on their opinions of essential literature for doctors of chiropractic, faculty, and students to read or reference. Methods Deployment of an IRB exempted survey occurred with 68 academic and research leaders using SurveyMonkey®. Individuals were solicited via e-mail in August of 2011; the study closed in October of 2011. Collected data were checked for citation accuracy and compiled to determine multiple responses. A secondary analysis assessed the scholarly impact and Internet accessibility of the recommended literature. Results Forty-three (43) individuals consented to participate; seventeen (17) contributed at least one article of importance. A total of 41 unique articles were reported. Of the six articles contributed more than once, one article was reported 6 times, and 5 were reported twice. Conclusions A manageable list of relevant literature was created. Shortcomings of methods were identified, and improvements for continued implementation are suggested. A wide variety of articles were reported as “essential” knowledge; annual or bi-annual surveys would be helpful for the profession. PMID:24289298

  1. Illinois Occupational Skill Standards: Housekeeping Management Cluster.

    Science.gov (United States)

    Illinois Occupational Skill Standards and Credentialing Council, Carbondale.

    This document contains 44 occupational skill standards for the housekeeping management occupational cluster, as required for the state of Illinois. Skill standards, which were developed by committees that included educators and representatives from business, industry, and labor, are intended to promote education and training investment and ensure…

  2. Regional vegetation management standards for commercial pine ...

    African Journals Online (AJOL)

    Although the understanding gained from these trials allowed for the development of vegetation management standards, their operational and economic viability need to be tested on a commercial basis. Four pine trials were thus initiated to test the applicability of these standards when utilised on a commercial scale. Two of ...

  3. Business School's Performance Management System Standards Design

    Science.gov (United States)

    Azis, Anton Mulyono; Simatupang, Togar M.; Wibisono, Dermawan; Basri, Mursyid Hasan

    2014-01-01

    This paper aims to compare various Performance Management Systems (PMS) for business school in order to find the strengths of each standard as inputs to design new model of PMS. There are many critical aspects and gaps notified for new model to improve performance and even recognized that self evaluation performance management is not well…

  4. 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.

  5. 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.

  6. Chiropractic intervention in the treatment of postmenopausal climacteric symptoms and insomnia: A review.

    Science.gov (United States)

    Goto, Viviane; Frange, Cristina; Andersen, Monica L; Júnior, José M S; Tufik, Sergio; Hachul, Helena

    2014-05-01

    Insomnia is a frequent postmenopausal symptom and may be due to hormonal changes, depressive states related to this period of life, hot flashes or nocturia. Chiropractic care has been demonstrated to be effective in the treatment of these symptoms. The aim of this study was to review chiropractic interventions in postmenopausal women as a possible management approach to menopausal symptoms and insomnia. A PubMed search was conducted by cross-referencing the key words insomnia, sleep, and menopause with chiropractic. The search used an end date of January 2014 and retrieved 17 articles. Three articles were eligible for the study. All epidemiological data from large surveys demonstrated a lack of evidence for chiropractic intervention as a complementary and alternative therapeutic method in the management of menopausal symptoms and insomnia. There is no evidence for the effectiveness of chiropractic intervention as a complementary and alternative therapy for menopausal symptoms and insomnia. Further studies with proper methodological designs are warranted. Copyright © 2014. Published by Elsevier Ireland Ltd.

  7. Performance standards of road safety management

    Directory of Open Access Journals (Sweden)

    Čabarkapa Milenko R.

    2016-01-01

    Full Text Available Road safety management controlling means the process of finding out the information whether the road safety is improving in a measure to achieve the objectives. The process of control consists of three basic elements: definition of performances and standards, measurement of current performances and comparison with the set standards, and improvement of current performances, if they deviate from the set standards. The performance standards of road safety management system are focused on a performances measurement, in terms of their design and characteristics, in order to support the performances improvement of road safety system and thus, ultimately, improve the road safety. Defining the performance standards of road safety management system, except that determines the design of the system for performances measurement, directly sets requirements whose fulfillment will produce a road safety improvement. The road safety management system, based on the performance standards of road safety, with a focus on results, will produce the continuous improvement of road safety, achieving the long-term 'vision zero', the philosophy of road safety, that human life and health take priority over mobility and other traffic objectives of the road traffic.

  8. Safety standards for radioactive waste management

    International Nuclear Information System (INIS)

    Warnecke, E.

    1993-01-01

    The International Atomic Energy Agency (IAEA) has established the Radioactive Waste Safety Standards (RADWASS) programme upon request by its Member States to provide evidence that radioactive waste can be managed safely. The RADWASS programme consists of a series of fifty-five international consensus documents covering all parts of radioactive waste management, i.e. the subject areas: planning; pre-disposal; near surface disposal; geological disposal; U/Th mining and milling; and decommissioning. A single Safety Fundamentals document will set out the basic safety principles for radioactive waste management. Each subject area is headed by a Safety Standard. Twenty-eight Safety Guides and twenty Safety Practices will provide further details for the implementation of safety requirements stated in the Safety Standards. The programme was started in 1991 and is being carried out in three phases (Phase I: 1991-1994; Phase II: 1995-1998; Phase III: post 1998). (author)

  9. Safety standards of IAEA for management systems

    International Nuclear Information System (INIS)

    Vincze, P.

    2005-01-01

    IAEA has developed a new series of safety standards which are assigned for constitution of the conditions and which give the instruction for setting up the management systems that integrate the aims of safety, health, life environment and quality. The new standard shall replace IAEA 50-C-Q - Requirements for security of the quality for safety in nuclear power plants and other nuclear facilities as well as 14 related safety instructions mentioned in the Safety series No. 50-C/SG-Q (1996). When developing of this complex, integrated set of requirements for management systems, the IAEA requirements 50-C-Q (1996) were taken into consideration as well as the publications developed within the International organisation for standardization (ISO) ISO 9001:2000 and ISO14001: 1996. The experience of European Union member states during the development, implementation and improvement of the management systems were also taken into consideration

  10. A Qualitative Study of Doctors of Chiropractic in a Nova Scotian Practice-based Research Network: Barriers and Facilitators to the Screening and Management of Psychosocial Factors for Patients With Low Back Pain.

    Science.gov (United States)

    Stilwell, Peter; Hayden, Jill A; Des Rosiers, Piaf; Harman, Katherine; French, Simon D; Curran, Janet A; Hefford, Warren

    2018-01-01

    This study aimed to assess chiropractors' awareness of clinical practice guidelines for low back pain and to identify barriers and facilitators to the screening and management of psychosocial factors in patients with low back pain. This qualitative study used semi-structured interviews informed by the Theoretical Domains Framework with 10 Nova Scotian chiropractors who were members of a practice-based research network. The participants correctly identified what the guidelines generally recommend and described the value of psychosocial factors; however, none of the participants could name specific clinical practice guidelines for low back pain. We identified 6 themes related to barriers and facilitators for chiropractors screening and managing psychosocial factors. The themes revolved around the participants' desire to fulfill patients' anatomy-focused treatment expectations and a perceived lack of training for managing psychosocial factors. Participants had concerns about going beyond the chiropractic scope of practice, and they perceived a lack of practical psychosocial screening and management resources. Social factors, such as the influence of other health care practitioners, were reported as both barriers and facilitators to screening and managing psychosocial factors. The participants in this study reported that they mostly treated with an anatomical and biomechanical focus and that they did not always address psychosocial factors identified in their patients with low back pain. Although these findings are limited to Nova Scotian chiropractors, the barriers identified appeared to be potentially modifiable and could be considered in other groups. Low-cost interventions, such as continuing education using evidence-informed behavior change techniques, could be considered to address these barriers. Copyright © 2017. Published by Elsevier Inc.

  11. Standardization Versus Innovation In Management Consultancy

    Directory of Open Access Journals (Sweden)

    Ciumara Tudor

    2011-12-01

    Full Text Available This paper is supported by the Sectoral Operational Programme Human Resources Development (SOP HRD, financed from the European Social Fund and by the Romanian Government under the contract number SOP HRD/89/1.5/S/62988. In this paper we propose some perspectives on the relationship between standardization and innovation in the management consulting business. Most of the consulting services are situated somewhere between absolute standardization and absolute innovation. Approaching any of these poles brings some advantages and disadvantages, both to the service providers and to their customers. It is important to find a balance between innovation and standardization to maximize the results of all agents involved.

  12. Management and Internal Standardization of Chemistry Terminology ...

    African Journals Online (AJOL)

    This article describes the terminological processing of a technical source text prior to translation, which formed part of the compilation of a Quadrilingual Explanatory Dictionary of Chemistry. It reports on the model of terminology management that was utilized and explores strategies for the internal standardization of terms in ...

  13. The integration of environmental management standards in ...

    African Journals Online (AJOL)

    environmental management standards but use different structures, which lead to different impacts on the actual hotel rating and thus present varying .... increasing percentage needs to be obtained based on the length of ones' membership, .... area in the hotel based on condition and quality, cleanliness, and facilities and.

  14. Chiropractic in the Netherlands : A survey of Dutch chiropractors

    NARCIS (Netherlands)

    Assendelft, W. J.J.; Pfeifle, C. E.; Bouter, L. M.

    1995-01-01

    Background: In the Netherlands, there is increasing public and political interest in chiropractic treatment. There is, however, very little descriptive information available in the Netherlands on the chiropractic profession. Therefore, a survey was conducted among all Dutch chiropractors. Methods: A

  15. Chiropractic practice in the Danish public health care sector

    DEFF Research Database (Denmark)

    Myburgh, Corrie

    2009-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  17. Chiropractic and public health: current state and future vision.

    Science.gov (United States)

    Johnson, Claire; Baird, Rand; Dougherty, Paul E; Globe, Gary; Green, Bart N; Haneline, Michael; Hawk, Cheryl; Injeyan, H Stephen; Killinger, Lisa; Kopansky-Giles, Deborah; Lisi, Anthony J; Mior, Silvano A; Smith, Monica

    2008-01-01

    This article provides an overview of primary chiropractic issues as they relate to public health. This collaborative summary documents the chiropractic profession's current involvement in public health, reflects on past barriers that may have prevented full participation within the public health movement, and summarizes the relationship of current chiropractic and public health topics. Topics discussed include how the chiropractic profession participates in preventive health services, health promotion, immunization, geriatrics, health care in a military environment, and interdisciplinary care.

  18. Applying ‘science’ in chiropractic clinical practice

    OpenAIRE

    Jamison, Jennifer R

    1990-01-01

    The chiropractic profession is increasingly expressing the sentiment that chiropractic clinical intervention should rest upon a scientific foundation. Before ‘scientific research’ can become meaningful in chiropractic clinical practice, it is necessary that field practitioners be conversant with research terminology. If chiropractic clinical practice is to achieve credibility as a scientific mode of health care and if the benefits of a ‘scientific’ practice model are to enhance patient care, ...

  19. 7 CFR 3015.61 - Financial management standards.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 15 2010-01-01 2010-01-01 false Financial management standards. 3015.61 Section 3015... Management Systems § 3015.61 Financial management standards. The following standards shall be met by recipients and subrecipients in managing their financial management system. (a) Financial reporting. Complete...

  20. Data standardization. The key to effective management

    Science.gov (United States)

    Wagner, C. Russell

    1991-01-01

    Effective management of the nation's water resources is dependent upon accurate and consistent hydrologic information. Before the emergence of environmental concerns in the 1960's, most hydrologic information was collected by the U.S. Geological Survey and other Federal agencies that used fairly consistent methods and equipment. In the past quarter century, however, increased environmental awareness has resulted in an expansion of hydrologic data collection not only by Federal agencies, but also by state and municipal governments, university investigators, and private consulting firms. The acceptance and use of standard methods of collecting and processing hydrologic data would contribute to cost savings and to greater credibility of flow information vital to responsible assessment and management of the nation's water resources. This paper traces the evolution of the requirements and uses of open-channel flow information in the U.S., and the sequence of efforts to standardize the methods used to obtain this information in the future. The variable nature of naturally flowing rivers results in continually changing hydraulic properties of their channels. Those persons responsible for measurement of water flowing in open channels (streamflow) must use a large amount of judgement in the selection of appropriate equipment and technique to obtain accurate flow information. Standardization of the methods used in the measurement of streamflow is essential to assure consistency of data, but must also allow considerable latitude for individual judgement to meet constantly changing field conditions.

  1. 48 CFR 970.3270 - Standard financial management clauses.

    Science.gov (United States)

    2010-10-01

    ... Standard financial management clauses. (a) The following DEAR and FAR clauses are standard financial... Accounting Standards. (b) The following DEAR clauses are standard financial management clauses. The... systems: (1) 970.5232-7, Financial management system. (2) 970.5232-8, Integrated accounting. (c) Any...

  2. The Adoption of Management Systems Standards

    Directory of Open Access Journals (Sweden)

    Idris Mohd Azman

    2014-11-01

    Full Text Available Considers the extent to which Standards Based Management Systems and best practices are being successfully implemented in Malaysian organizations. A survey on Malaysian organizations was conducted in June 2011 and has produced 143 positive responses. Highlights the findings of the survey such as the status of ISO 9000, TQM, 5-S, QCCs and quality tools & techniques, the benefits and difficulties, best practices most frequently used and the future trend of Malaysian quality improvement activities. Also highlights a model for the implementation of TQM for Malaysian organizations.

  3. Integration of Standardized Management Systems: A Dilemma?

    Directory of Open Access Journals (Sweden)

    Manuel Ferreira Rebelo

    2015-06-01

    Full Text Available The growing proliferation of management systems standards (MSSs, and their individualized implementation, is a real problem faced by organizations. On the other hand, MSSs are aimed at improving efficiency and effectiveness of organizational responses in order to satisfy the requirements, needs and expectations of the stakeholders. Each organization has its own identity and this is an issue that cannot be neglected; hence, two possible approaches can be attended. First, continue with the implementation of individualized management systems (MSs; or, integrate the several MSSs versus related MSs into an integrated management system (IMS. Therefore, in this context, organizations are faced with a dilemma, as a result of the increasing proliferation and diversity of MSSs. This paper takes into account the knowledge gained through a case study conducted in the context of a Portuguese company and unveils some of the advantages and disadvantages of integration. A methodology is also proposed and presented to support organizations in developing and structuring the integration process of their individualized MSs, and consequently minimize problems that are generators of inefficiencies, value destruction and loss of competitiveness. The obtained results provide relevant information that can support Top Management decision in solving that dilemma and consequently promote a successful integration, including a better control of business risks associated to MSSs requirements and enhancing sustainable performance, considering the context in which organizations operate.

  4. 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

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

  5. Utilizing doctors' attitudes toward staff training to inform a chiropractic technology curriculum.

    Science.gov (United States)

    Eberhart, Catherine A; Martel, Stacie S

    2015-03-01

    The purpose of this study is to determine attitudes of doctors of chiropractic regarding the importance of staff training in specific skill areas to inform the curriculum management process of a chiropractic technology program. A survey was distributed to registrants of a chiropractic homecoming event. On a 5-point Likert scale, respondents were asked to rate the degree of importance that staff members be trained in specific skills. Descriptive statistics were derived, and a 1-way analysis of variance (ANOVA) was used to test differences between groups based on years in practice and level of staff training. Doctors place a high level of importance on oral communication skills and low importance on nutrition and physical examinations. Comparing groups based on years in practice revealed differences in the areas of passive physiotherapies (F = 3.61, p = .015), legal issues/regulations (F = 3.01, p = .032), occupational safety and health regulation (F = 4.27, p = .006), and marketing (F = 2.67, p = .049). Comparing groups based on level of staff training revealed differences in the areas of occupational safety and health regulations (F = 4.56, p = .005) and cardiopulmonary resuscitation (F = 4.91, p = .003). With regard to their assistants, doctors of chiropractic tend to place high importance on office skills requiring effective communication and place less importance on clinical skills such as physical examinations and physiotherapy.

  6. 7 CFR 277.6 - Standards for financial management systems.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 4 2010-01-01 2010-01-01 false Standards for financial management systems. 277.6... ADMINISTRATIVE COSTS OF STATE AGENCIES § 277.6 Standards for financial management systems. (a) General. This section prescribes standards for financial management systems in administering program funds by the State...

  7. 77 FR 33950 - Prudential Management and Operations Standards

    Science.gov (United States)

    2012-06-08

    ... FEDERAL HOUSING FINANCE AGENCY 12 CFR Part 1236 RIN 2590-AA13 Prudential Management and Operations... establish prudential standards (Standards) relating to the management and operations of the Federal National... establish other appropriate management and operations standards. 12 U.S.C. 4513b(a)(11). \\1\\ The authorizing...

  8. Risk of Carotid Stroke after Chiropractic Care

    DEFF Research Database (Denmark)

    Cassidy, J. David; Boyle, Eleanor; Côté, Pierre

    2017-01-01

    incident cases of carotid artery stroke admitted to hospitals over a 9-year period were identified. Cases served as their own controls. Exposures to chiropractic and PCP services were determined from health billing records. Results We compared 15,523 cases to 62,092 control periods using exposure windows...

  9. Chiropractic Colleges Seek Legitimacy amid Financial Woes

    Science.gov (United States)

    Fuller, Andrea

    2012-01-01

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

  10. The chiropractic profession in Norway 2011

    DEFF Research Database (Denmark)

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

    2014-01-01

    BACKGROUND: The chiropractic profession in Norway has increased five-fold in the last two decades. As there is no academic graduate program in Norway, all chiropractors have been trained outside of Norway, in either Europe, America or Australia. This might have given Norwegian chiropractors heter...

  11. Survey of standards applicable to a database management system

    Science.gov (United States)

    Urena, J. L.

    1981-01-01

    Industry, government, and NASA standards, and the status of standardization activities of standards setting organizations applicable to the design, implementation and operation of a data base management system for space related applications are identified. The applicability of the standards to a general purpose, multimission data base management system is addressed.

  12. 32 CFR 34.11 - Standards for financial management systems.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 1 2010-07-01 2010-07-01 false Standards for financial management systems. 34... ORGANIZATIONS Post-award Requirements Financial and Program Management § 34.11 Standards for financial management systems. (a) Recipients shall be allowed and encouraged to use existing financial management...

  13. 7 CFR 3019.21 - Standards for financial management systems.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 15 2010-01-01 2010-01-01 false Standards for financial management systems. 3019.21... Requirements Financial and Program Management § 3019.21 Standards for financial management systems. (a) Federal... cost information whenever practical. (b) Recipients' financial management systems shall provide for the...

  14. 24 CFR 84.21 - Standards for financial management systems.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Standards for financial management... and Program Management § 84.21 Standards for financial management systems. (a) HUD shall require.... (b) Recipients' financial management systems shall provide for the following: (1) Accurate, current...

  15. 7 CFR 550.20 - Standards for financial management systems.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 6 2010-01-01 2010-01-01 false Standards for financial management systems. 550.20... Management of Agreements Financial Management § 550.20 Standards for financial management systems. (a) REE agencies shall require Cooperators to relate financial data to performance data. (b) Cooperators' financial...

  16. 22 CFR 145.21 - Standards for financial management systems.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Standards for financial management systems. 145... Financial and Program Management § 145.21 Standards for financial management systems. (a) The Department... whenever practical. (b) Recipients' financial management systems shall provide for the following. (1...

  17. 32 CFR 32.21 - Standards for financial management systems.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 1 2010-07-01 2010-07-01 false Standards for financial management systems. 32... Program Management § 32.21 Standards for financial management systems. (a) DoD Components shall require... unit cost information. (b) Recipients' financial management systems shall provide for the following. (1...

  18. 2 CFR 215.21 - Standards for financial management systems.

    Science.gov (United States)

    2010-01-01

    ... 2 Grants and Agreements 1 2010-01-01 2010-01-01 false Standards for financial management systems... Financial and Program Management § 215.21 Standards for financial management systems. (a) Federal awarding... information whenever practical. (b) Recipients' financial management systems shall provide for the following...

  19. 40 CFR 30.21 - Standards for financial management systems.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Standards for financial management... Program Management § 30.21 Standards for financial management systems. (a) EPA shall require recipients to...) Recipients' financial management systems shall provide for the following. (1) Accurate, current and complete...

  20. 34 CFR 74.21 - Standards for financial management systems.

    Science.gov (United States)

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false Standards for financial management systems. 74.21... Requirements Financial and Program Management § 74.21 Standards for financial management systems. (a... practical. (b) Recipients' financial management systems shall provide for the following: (1) Accurate...

  1. 29 CFR 95.21 - Standards for financial management systems.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Standards for financial management systems. 95.21 Section 95... Requirements Financial and Program Management § 95.21 Standards for financial management systems. (a... practical. (b) Recipients' financial management systems shall provide for the following: (1) Accurate...

  2. Risk in Management Systems according to ISO standard

    Directory of Open Access Journals (Sweden)

    P. Królas

    2010-07-01

    Full Text Available The purpose of this article was to present selected management standards in context of risk management. It presents main ISOmanagement standards (ISO 9001, ISO 14001, OHSAS 18001, ISO 27001, BS 25999, ISO 31000 that apply to polish enterprises. In thefirst part of this article there are analyzed management standards regarding quality, environment, occupational health and safety,information security, as well as business continuity management and risk management. The second part of the article discusses the processof dealing with risk based on chosen management standard.

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

    Science.gov (United States)

    Homola, Samuel

    2016-02-01

    Chiropractors commonly treat children for a variety of ailments by manipulating the spine to correct a 'vertebral subluxation' or a 'vertebral subluxation complex' alleged to be a cause of disease. Such treatment might begin soon after a child is born. Both major American chiropractic associations - the International Chiropractic Association and the American Chiropractic Association - support chiropractic care for children, which includes subluxation correction as a treatment or preventive measure. I do not know of any credible evidence to support chiropractic subluxation theory. Any attempt to manipulate the immature, cartilaginous spine of a neonate or a small child to correct a putative chiropractic subluxation should be regarded as dangerous and unnecessary. Referral of a child to a chiropractor for such treatment should not be considered lest a bad outcome harms the child or leads to a charge of negligence or malpractice. © 2016 John Wiley & Sons Ltd.

  4. Development of the 2012 American Chiropractic Board of Sports Physicians position statement on concussion in athletics.

    Science.gov (United States)

    Moreau, William J; Nabhan, Dustin C

    2013-12-01

    The purpose of this article is to provide a summary of the development of the American Chiropractic Board of Sports Physicians (ACBSP) Position Statement on Concussion in Athletics regarding the management of concussion in sport and to offer suggestions to qualifying doctors of chiropractic (DCs) to make return-to-play decisions and clarify common concepts pertaining to evaluating and managing concussion in sport. A literature review of position statements from sports medicine organizations was performed. The authors reviewed each statement for content. Key issues in the management of concussion in sport were identified with special consideration to concussion management by DCs. A position statement on the management of concussion in sport was drafted by the authors and submitted to the Board of Directors of the ACBSP for review. The Board of Directors called for minor revision; and after all revisions were made, the document was resubmitted. The Board of Directors of the ACBSP accepted the document for publication and presentation. The document was presented and disseminated to certificants by the ACBSP at the 2011 Chiropractic Sports Sciences Symposium. The 2012 ACBSP Position Statement on Concussion in Athletics was accepted by the ACBSP Board of Directors. The Position Statement on Concussion in Athletics has been accepted by the ACBSP. This document offers guidance on the management of concussion in sport and provides qualifying DCs information to make return-to-play decisions.

  5. Best Practices for Chiropractic Care for Older Adults: A Systematic Review and Consensus Update.

    Science.gov (United States)

    Hawk, Cheryl; Schneider, Michael J; Haas, Mitchell; Katz, Paul; Dougherty, Paul; Gleberzon, Brian; Killinger, Lisa Z; Weeks, John

    2017-05-01

    The purpose of this study was to update evidence-based recommendations on the best practices for chiropractic care of older adults. The project consisted of a systematic literature review and a consensus process. The following were searched from October 2009 through January 2016: MEDLINE, Index to Chiropractic Literature, CINAHL (Cumulative Index to Nursing and Allied Health Literature), AMED (Allied and Complementary Medicine Database), Alt HealthWatch, Cochrane Database of Systematic Reviews, and Cochrane Registry of Controlled Trials. Search terms were: (manipulation, spinal OR manipulation, chiropractic OR chiropract*) AND (geriatric OR "older adult*"). Two reviewers independently screened articles and abstracts using inclusion and exclusion criteria. The systematic review informed the project steering committee, which revised the previous recommendations. A multidisciplinary panel of experts representing expertise in practice, research, and teaching in a variety of health professions serving older adults rated the revised recommendations. The RAND Corporation/University of California, Los Angeles methodology for a modified Delphi consensus process was used. A total of 199 articles were found; after exclusion criteria were applied, 6 articles about effectiveness or efficacy and 6 on safety were added. The Delphi process was conducted from April to June 2016. Of the 37 Delphi panelists, 31 were DCs and 6 were other health care professionals. Three Delphi rounds were conducted to reach consensus on all 45 statements. As a result, statements regarding the safety of manipulation were strengthened and additional statements were added recommending that DCs advise patients on exercise and that manipulation and mobilization contribute to general positive outcomes beyond pain reduction only. This document provides a summary of evidence-informed best practices for doctors of chiropractic for the evaluation, management, and manual treatment of older adult patients

  6. Best practices recommendations for chiropractic care for older adults: results of a consensus process.

    Science.gov (United States)

    Hawk, Cheryl; Schneider, Michael; Dougherty, Paul; Gleberzon, Brian J; Killinger, Lisa Z

    2010-01-01

    At this time, the scientific evidence base supporting the effectiveness of chiropractic care for musculoskeletal conditions has not yet definitively addressed its appropriateness for older adults. Expert consensus, as a form of evidence, must be considered when higher levels of evidence are lacking. The purpose of this project was to develop a document with evidence-based recommendations on the best practices for chiropractic care of older adults. A set of 50 seed statements was developed, based on the clinical experience of the multidisciplinary steering committee and the results of an extensive literature review. A formal Delphi process was conducted, following the rigorous RAND-UCLA (University of California, Los Angeles) methodology. The statements were circulated electronically to the Delphi panel until consensus was reached. Consensus was defined as agreement by at least 80% of the panelists. There were 28 panelists from 17 US states and Canada, including 24 doctors of chiropractic, 1 physical therapist, 1 nurse, 1 psychologist, and 1 acupuncturist. The Delphi process was conducted in January-February 2010; all 28 panelists completed the process. Consensus was reached on all statements in 2 rounds. The resulting best practice document defined the parameters of an appropriate approach to chiropractic care for older adults, and is presented in this article. A multidisciplinary panel of experienced chiropractors was able to reach a high level (80%) of consensus on evidence-informed best practices for the chiropractic approach to evaluation, management, and manual treatment for older adult patients. Copyright 2010 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.

  7. The chiropractic scope of practice in the United States: a cross-sectional survey.

    Science.gov (United States)

    Chang, Mabel

    2014-01-01

    The purpose of this study was to assess the current status of chiropractic practice laws in the United States. This survey is an update and expansion of 3 original surveys conducted in 1987, 1992, and 1998. A cross-sectional survey of licensure officials from the Federation of Chiropractic Licensing Boards e-mail list was conducted in 2011 requesting information about chiropractic practice laws and 97 diagnostic, evaluation, and management procedures. To evaluate content validity, the survey was distributed in draft form at the fall 2010 Federation of Chiropractic Licensing Boards regional meeting to regulatory board members and feedback was requested. Comments were reviewed and incorporated into the final survey. A duplicate question was imbedded in the survey to test reliability. Partial or complete responses were received from 96% (n = 51) of the jurisdictions in the United States. The states with the highest number of services that could be performed were Missouri (n = 92), New Mexico (n = 91), Kansas (n = 89), Utah (n = 89), Oklahoma (n = 88), Illinois (n = 87), and Alabama (n = 86). The states with the highest number of services that cannot be performed are New Hampshire (n = 49), Hawaii (n = 47), Michigan (n = 42), New Jersey (n = 39), Mississippi (n = 39), and Texas (n = 30). The scope of chiropractic practice in the United States has a high degree of variability. Scope of practice is dynamic, and gray areas are subject to interpretation by ever-changing board members. Although statutes may not address specific procedures, upon challenge, there may be a possibility of sanctions depending on interpretation. Copyright © 2014 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.

  8. Practice patterns of doctors of chiropractic with a pediatric diplomate: a cross-sectional survey.

    Science.gov (United States)

    Pohlman, Katherine A; Hondras, Maria A; Long, Cynthia R; Haan, Andrea G

    2010-06-14

    Complementary and alternative medicine (CAM) is growing in popularity, especially within the pediatric population. Research on CAM practitioners and their specialties, such as pediatrics, is lacking. Within the chiropractic profession, pediatrics is one of the most recently established post-graduate specialty programs. This paper describes the demographic and practice characteristics of doctors of chiropractic with a pediatric diplomate. 218 chiropractors with a pediatric diplomate were invited to complete our survey using either web-based or mailed paper survey methods. Practitioner demographics, practice characteristics, treatment procedures, referral patterns, and patient characteristics were queried with a survey created with the online survey tool, SurveyMonkey. A total of 135 chiropractors responded (62.2% response rate); they were predominantly female (74%) and white (93%). Techniques most commonly used were Diversified, Activator, and Thompson with the addition of cranial and extremity manipulation to their chiropractic treatments. Adjunctive therapies commonly provided to patients included recommendations for activities of daily living, corrective or therapeutic exercise, ice pack\\cryotherapy, and nutritional counseling. Thirty eight percent of respondents' patients were private pay and 23% had private insurance that was not managed care. Pediatrics represented 31% of the survey respondents' patients. Chiropractors also reported 63% of their work time devoted to direct patient care. Health conditions reportedly treated within the pediatric population included back or neck pain, asthma, birth trauma, colic, constipation, ear infection, head or chest cold, and upper respiratory infections. Referrals made to or from these chiropractors were uncommon. This mixed mode survey identified similarities and differences between doctors of chiropractic with a pediatric diplomate to other surveys of doctors of chiropractic, CAM professionals, and pediatric healthcare

  9. Constructing a philosophy of chiropractic: evolving worldviews and premodern roots().

    Science.gov (United States)

    Senzon, Simon A

    2011-12-01

    The philosophy of chiropractic can be framed as an attempt to correct the problems inherited from the Western Enlightenment. Its origins can be found in the long tradition of Western philosophy. The purpose of this article is to describe in a broad context chiropractic's roots in premodernity and establish the structural and hermeneutical differences between chiropractic's original philosophical ideas and those of premodern philosophers. The worldview or cultural mindset the philosophy arose from must be situated in the context of its time, the birth of the unique postmodern worldview, aperspectival consciousness, and the modern sense of self. This is accomplished by exploring several metatheories about the development of the self through history, with an emphasis on the premodern roots to the chiropractic terms; Universal Intelligence and Innate Intelligence. By contextualizing the philosophy of chiropractic in terms of a structural genealogy of the self and of ideas, a new approach to philosophy in chiropractic emerges. Without accounting for chiropractic's origins as a reflection of the unique time, place, and culture, in terms of the evolution of worldviews through history, any approach to construct or reconstruct a philosophy of chiropractic will potentially miss the seminal feature of chiropractic's emergence.

  10. EFFECTIVENESS OF CHIROPRACTIC ADJUSTMENT IN LUMBAR PAIN IN CROSSFIT PRACTITIONERS

    Directory of Open Access Journals (Sweden)

    DESIREE MOEHLECKE

    Full Text Available ABSTRACT Objective: To evaluate the efficacy of acute chiropractic adjustment in individuals who practice CrossFit with regard to complaints of low back pain and the joint range of motion in this region. Methods: A randomized clinical trial comprised of CrossFit practitioners from a box in Novo Hamburgo-RS, of both sexes and aged 18 to 40 years who had low back pain at the time of the study. The following tools were used: Semi-structured Anamnesis Questionnaire, Visual Analog Scale, McGill Pain Questionnaire, and SF-36 Quality of Life Questionnaire. Individuals in the control group answered the questionnaires before and after CrossFit training. The chiropractic group performed the same procedure, plus pre-training chiropractic adjustment and joint range of motion (ROM before and after lumbar adjustment. Results: There was a significant increase in pain in the control group, and a significant decrease in pain in the chiropractic group, including one day after the chiropractic adjustment. In the chiropractic group, the joint ranges of motion had a significant increase in flexion and extension of the lumbar spine after chiropractic adjustment. Conclusion: The chiropractic group achieved a significant improvement in pain level and joint range of motion, suggesting that acute chiropractic adjustment was effective in reducing low back pain.

  11. Informing a research agenda for the Canadian chiropractic profession.

    Science.gov (United States)

    French, Simon D; Parkes, Ronda; Bruno, Paul; Passmore, Steven; Hayden, Jill A; Srbely, John; Kawchuk, Greg

    2017-12-01

    Our research group recently published a Delphi study that identified Canadian chiropractic profession research priority areas. At the same time, the Canadian Chiropractic Research Foundation (CCRF) was developing their own research priority areas. In this commentary, we discuss the results of the Delphi study, compare and contrast these results to the research priorities of the CCRF, and report new data from a survey about where members of the chiropractic profession think that available research funding should be spent. Ongoing dialogue is needed with all Canadian chiropractic stakeholders to turn these research priorities into action.

  12. Leadership and capacity building in international chiropractic research: introducing the chiropractic academy for research leadership (CARL).

    Science.gov (United States)

    Adams, Jon; Kawchuk, Greg; Breen, Alexander; De Carvalho, Diana; Eklund, Andreas; Fernandez, Matthew; Funabashi, Martha; Holmes, Michelle M; Johansson, Melker S; de Luca, Katie; Moore, Craig; Pagé, Isabelle; Pohlman, Katherine A; Swain, Michael S; Wong, Arnold Y L; Hartvigsen, Jan

    2018-01-01

    In an evidence-based health care environment, healthcare professions require a sustainable research culture to remain relevant. At present however, there is not a mature research culture across the chiropractic profession largely due to deficiencies in research capacity and leadership, which may be caused by a lack of chiropractic teaching programs in major universities. As a response to this challenge the Chiropractic Academy for Research Leadership, CARL, was created with the aim of develop a global network of successful early-career chiropractic researchers under the mentorship of three successful senior academics from Australia, Canada, and Denmark. The program centres upon an annual week-long program residential that rotates continental locations over the first three-year cycle and between residentials the CARL fellows work on self-initiated research and leadership initiatives. Through a competivite application process, the first cohort was selected and consists of 13 early career researchers from five professions in seven countries who represent diverse areas of interests of high relevance for chiropractic. The first residential was held in Odense, Denmark, with the second being planned in April 2018 in Edmonton, Canada, and the final residential to be held in Sydney, Australia in 2019.

  13. 45 CFR 2543.21 - Standards for financial management systems.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Standards for financial management systems. 2543... OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Financial and Program Management § 2543.21 Standards for financial management systems. (a) Federal awarding agencies shall require recipients to relate...

  14. 14 CFR 1260.121 - Standards for financial management systems.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Standards for financial management systems... Requirements § 1260.121 Standards for financial management systems. (a) Recipients shall relate financial data...) Recipients' financial management systems shall provide for the following. (1) Accurate, current and complete...

  15. 15 CFR 14.21 - Standards for financial management systems.

    Science.gov (United States)

    2010-01-01

    ... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false Standards for financial management...-PROFIT, AND COMMERCIAL ORGANIZATIONS Post-Award Requirements Financial and Program Management § 14.21 Standards for financial management systems. (a) The Grants Officer shall require recipients to relate...

  16. 36 CFR 1210.21 - Standards for financial management systems.

    Science.gov (United States)

    2010-07-01

    ... Program Management § 1210.21 Standards for financial management systems. (a) The NHPRC shall require.... (b) Recipients' financial management systems shall provide for the following. (1) Accurate, current... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Standards for financial...

  17. 38 CFR 49.21 - Standards for financial management systems.

    Science.gov (United States)

    2010-07-01

    ... Program Management § 49.21 Standards for financial management systems. (a) Federal awarding agencies shall... practical. (b) Recipients' financial management systems shall provide for the following. (1) Accurate... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Standards for financial...

  18. 49 CFR 19.21 - Standards for financial management systems.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Standards for financial management systems. 19.21... ORGANIZATIONS Post-Award Requirements § 19.21 Standards for financial management systems. (a) Federal awarding... information whenever practical. (b) Recipients' financial management systems shall provide for the following...

  19. 10 CFR 600.311 - Standards for financial management systems.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Standards for financial management systems. 600.311... Requirements § 600.311 Standards for financial management systems. (a) Recipients are encouraged to use existing financial management systems to the extent that the systems comply with Generally Accepted...

  20. 22 CFR 518.21 - Standards for financial management systems.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 2 2010-04-01 2010-04-01 true Standards for financial management systems. 518... ORGANIZATIONS Post-Award Requirements Financial and Program Management § 518.21 Standards for financial management systems. (a) Federal awarding agencies shall require recipients to relate financial data to...

  1. 43 CFR 12.921 - Standards for financial management systems.

    Science.gov (United States)

    2010-10-01

    ... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Standards for financial management systems... Organizations Post-Award Requirements § 12.921 Standards for financial management systems. (a) Federal awarding... information whenever practical. (b) Recipients' financial management systems shall provide for the following...

  2. 28 CFR 70.21 - Standards for financial management systems.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Standards for financial management..., HOSPITALS AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Financial and Program Management § 70.21 Standards for financial management systems. (a) Recipients must relate financial data to...

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

    Directory of Open Access Journals (Sweden)

    Walker Bruce F

    2011-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Badwall Parminder

    2008-05-01

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

  5. Chiropractic care of acute low back pain and incidental spina bifida occulta: a case report.

    Science.gov (United States)

    Cofano, Gregory P; Anderson, Benjamin C; Stumpff, Eric R

    2014-12-01

    The purpose of this case report is to describe chiropractic care of an adolescent with acute low back pain and incidental finding of spina bifida occulta managed with high-velocity low-amplitude manipulation. A 10-year-old boy was referred for chiropractic care by his pediatrician for the management of low back pain after a fall 3 days prior. Examination and medical records revealed the patient also had spina bifida occulta at the level of L5. High-velocity low-amplitude treatment for lower back pain showed resolution of patient's pain after 6 visits. No adverse effects were reported. An adolescent patient with lower back pain and incidental finding of spina bifida occulta improved with a course of care that included with high-velocity low-amplitude manipulation therapy.

  6. Chiropractic biophysics technique: a linear algebra approach to posture in chiropractic.

    Science.gov (United States)

    Harrison, D D; Janik, T J; Harrison, G R; Troyanovich, S; Harrison, D E; Harrison, S O

    1996-10-01

    This paper discusses linear algebra as applied to human posture in chiropractic, specifically chiropractic biophysics technique (CBP). Rotations, reflections and translations are geometric functions studied in vector spaces in linear algebra. These mathematical functions are termed rigid body transformations and are applied to segmental spinal movement in the literature. Review of the literature indicates that these linear algebra concepts have been used to describe vertebral motion. However, these rigid body movers are presented here as applying to the global postural movements of the head, thoracic cage and pelvis. The unique inverse functions of rotations, reflections and translations provide a theoretical basis for making postural corrections in neutral static resting posture. Chiropractic biophysics technique (CBP) uses these concepts in examination procedures, manual spinal manipulation, instrument assisted spinal manipulation, postural exercises, extension traction and clinical outcome measures.

  7. Chiropractic Observation and Analysis Study (COAST): providing an understanding of current chiropractic practice.

    Science.gov (United States)

    French, Simon D; Charity, Melanie J; Forsdike, Kirsty; Gunn, Jane M; Polus, Barbara I; Walker, Bruce F; Chondros, Patty; Britt, Helena C

    2013-11-18

    COAST (Chiropractic Observation and Analysis Study) aimed to describe the clinical practices of chiropractors in Victoria, Australia. Cross-sectional study using the BEACH (Bettering the Evaluation and Care of Health) methods for general practice. 180 chiropractors in active clinical practice in Victoria were randomly selected from the list of 1298 chiropractors registered on Chiropractors Registration Board of Victoria. Twenty-four chiropractors were ineligible, 72 agreed to participate, and 52 completed the study. Each participating chiropractor documented encounters with up to 100 consecutive patients. For each chiropractor-patient encounter, information collected included patient health profile, patient reasons for encounter, problems and diagnoses, and chiropractic care. Data were collected on 4464 chiropractor-patient encounters from 52 chiropractors between 11 December 2010 and 28 September 2012. In most (71%) encounters, patients were aged 25-64 years; 1% of encounters were with infants (age chiropractic profession in workforce development, education and health care policy.

  8. 1993 DOE technical standards managers workshop: Proceedings

    Energy Technology Data Exchange (ETDEWEB)

    1993-12-31

    This workshop is focused on the benefits of the DOE technical standards program, which is focused toward the preferred use of non-Government standards for DOE activities and the development of DOE technical standards when non-Government standards are not available or are inappropriate. One goal of the program is to replace redundant site-specific standards with more universally accepted documents that have been scrutinized by experts. This replacement is discussed at the workshop along with the problems encountered and solutions found. The workshop provided an opportunity for geographically dispersed people to meet and advance their standards knowledge and efforts to support the program. Safety issues have been the driving force behind the program to date. Several companies offer products and services that support the development, processing, and retrieval of standards. This document mostly comprise vugraphs.

  9. Policy, Procedures and Standards for Enterprise Information Management

    Science.gov (United States)

    This policy establishes a standard approach for managing information produced by, funded by, or received per regulated reporting and/or federal-wide requirements and subsequently held or cataloged in information management systems by EPA.

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

    Science.gov (United States)

    Greiner, Keith

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

  11. 24 CFR 902.43 - Management operations performance standards.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Management operations performance... URBAN DEVELOPMENT PUBLIC HOUSING ASSESSMENT SYSTEM PHAS Indicator #3: Management Operations § 902.43 Management operations performance standards. (a) Management operations sub-indicators. The following sub...

  12. 44 CFR 13.20 - Standards for financial management systems.

    Science.gov (United States)

    2010-10-01

    ... management systems. 13.20 Section 13.20 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT... Standards for financial management systems. (a) A State must expand and account for grant funds in accordance with State laws and procedures for expending and accounting for its own funds. Fiscal control and...

  13. Characteristics of US Adults Who Have Positive and Negative Perceptions of Doctors of Chiropractic and Chiropractic Care.

    Science.gov (United States)

    Weeks, William B; Goertz, Christine M; Meeker, William C; Marchiori, Dennis M

    2016-01-01

    The purpose of this study was to compare characteristics, likelihood to use, and actual use of chiropractic care for US survey respondents with positive and negative perceptions of doctors of chiropractic (DCs) and chiropractic care. From a 2015 nationally representative survey of 5422 adults (response rate, 29%), we used respondents' answers to identify those with positive and negative perceptions of DCs or chiropractic care. We used the χ(2) test to compare other survey responses for these groups. Positive perceptions of DCs were more common than those for chiropractic care, whereas negative perceptions of chiropractic care were more common than those for DCs. Respondents with negative perceptions of DCs or chiropractic care were less likely to know whether chiropractic care was covered by their insurance, more likely to want to see a medical doctor first if they were experiencing neck or back pain, less likely to indicate that they would see a DC for neck or back pain, and less likely to have ever seen a DC as a patient, particularly in the recent past. Positive perceptions of chiropractic care and negative perceptions of DCs appear to have greater influence on DC utilization rates than their converses. We found that US adults generally perceive DCs in a positive manner but that a relatively high proportion has negative perceptions of chiropractic care, particularly the costs and number of visits required by such care. Characteristics of respondents with positive and negative perceptions were similar, but those with positive perceptions were more likely to plan to use-and to have already received-chiropractic care. Copyright © 2016 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.

  14. Prevalence of hip osteoarthritis in chiropractic practice in Denmark: a descriptive cross-sectional and prospective study.

    Science.gov (United States)

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

    2012-05-01

    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 chiropractic practitioner. A total of 2000 patient records and 1000 radiographs were reviewed retrospectively in 20 chiropractic clinics throughout Denmark. Information obtained included patients' primary complaint, physical examination and radiographic findings of hip OA, and treatment. Subsequently, the 20 clinics participated in a prospective survey where they collected equivalent information over a 2-week period. Retrospective review of records revealed that 1.4% of patients in Danish chiropractic practice had signs of clinical hip OA. Of these, 59% demonstrated radiographic signs of hip OA. Prospective data collection revealed that 3.4% of new patients had signs of clinical hip OA. Fifty-four percent of these demonstrated radiographic signs of hip OA, and of these 70% were diagnosed as having OA of the hip for the first time. Initial treatment involved manual treatment and advice on over-the-counter pain medication and/or supplements. Of all 1000 retrospectively reviewed radiographs in patients 40 years or older, 19.2% demonstrated radiographic signs of hip OA. Osteoarthritis of the hip is diagnosed and managed in primary care chiropractic practice in Denmark; however, it is likely underdiagnosed. In those newly presenting to chiropractic practitioners, first-time diagnosis with clinical and radiographic signs of hip OA appears to be common. Copyright © 2012 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.

  15. Diversity in the Chiropractic Profession: Preparing for 2050

    Science.gov (United States)

    Johnson, Claire D.; Green, Bart N.

    2012-01-01

    As the diversity of the United States (US) population continues to change, concerns about minority health and health disparities grow. Health professions must evolve to meet the needs of the population. The purpose of this editorial is to review current trends in the diversity of chiropractic students, faculty, and practitioners in the United States. This editorial was informed by a search of the literature, to include PubMed, using the terms chiropractic and diversity, minority, and cultural competency. Demographic information for the chiropractic profession was obtained from the National Board of Chiropractic Examiners and The Chronicle of Higher Education. These data were compared to diversity data for medical doctors and the national and state populations from the American Association of Medical Colleges and the US Census, respectively. Surprisingly little has been published in the peer-reviewed literature on the topic of diversity in the chiropractic profession. For the variables available (sex and race), the data show that proportions in the US chiropractic profession do not match the population. State comparisons to associated chiropractic colleges show similar relationships. No reliable data were found on other diversity characteristics, such as gender identity, religion, and socioeconomic status. The chiropractic profession in the United States currently does not represent the national population with regard to sex and race. Leaders in the profession should develop a strategy to better meet the changing demographics of the US population. More attention to recruiting and retaining students, such as underrepresented minorities and women, and establishing improved cultural competency is needed. PMID:22778525

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

    Science.gov (United States)

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

    2009-01-01

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

  17. 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 medic...

  18. Managing the financial cost of exception to contracting standards

    DEFF Research Database (Denmark)

    Henschel, Rene Franz

    2008-01-01

    In managing financial cost of exception to contracting standards, the first step is to put up an intelligent contract standards exception monitoring system The next step is to maintain tailor-made, fair and transparent contracting standards The third step is to eliminate unnecessary information...... and repetitiveness in contracting standards The fourth step is to enable your organization and the customers or suppliers to handle the necessary exceptions themselves Finally you should consider the use of independent contracting standards and elimination of your own standards as a tool in managing the cost...

  19. The integration of environmental management standards in ...

    African Journals Online (AJOL)

    This study investigates how hotel classification systems integrate environmental management practices in hotels. There is a growing awareness that hotel classification should be based on an integrated approach to quality, including environmental management practices. A content analysis of eight recently updated hotel ...

  20. Beyond the "Jim Crow" experience: blacks in chiropractic education.

    Science.gov (United States)

    Wiese, G

    1994-06-01

    Although the first chiropractic adjustment was given by D.D. Palmer to a black man in 1895, within two decades attendance at the Palmer School of Chiropractic was forbidden to blacks. Not until mid-century were blacks allowed entrance into the oldest and largest chiropractic college in the United states. Denied entry at the Palmer School, most blacks who entered chirporactic studied in "Jim Crow" schools run by white practitioners in the North. This paper explores the social, historicl and economic factors influencing the exclusion of blacks from medical education, and concludes that chirpractic education is at the stage medical education was twenty-five years ago in its attempts to recruit black students. The author recommends that the Association of Chiropractic Colleges establish a task force on minoritiy recruitment to expand the educational opportunities in chiropractic for blacks and other minorities.

  1. Spine Care as a Framework for the Chiropractic Identity

    DEFF Research Database (Denmark)

    Schneider, Michael; Murphy, Donald; Hartvigsen, Jan

    2016-01-01

    OBJECTIVE: The purpose of this commentary is to provide an argument for the role and identity of chiropractors as spine care providers within the context of the greater health care system. DISCUSSION: Surveys of the general public and chiropractors indicate that the majority of patients seek...... chiropractic services for back and neck pain. Insurance company utilization data confirm these findings. Regulatory and legal language found in chiropractic practice acts reveals that most jurisdictions define the chiropractic scope of practice as based on a foundation of spine care. Educational accrediting...... and testing organizations have been shaped around a chiropractic education that produces graduates who focus on the diagnosis and treatment of spine and musculoskeletal disorders. Spine care is thus the common denominator and theme throughout all aspects of chiropractic practice, legislation, and education...

  2. Professional Identity at Los Angeles College of Chiropractic.

    Science.gov (United States)

    Kimura, Melissa Nagare; Russell, Robb; Scaringe, John

    2016-12-01

    The objective of this article is to describe chiropractic professional identity as espoused by the Los Angeles College of Chiropractic. Professional identity is a construct that begins formation prior to career selection, can be considered the backbone of health care education, and has been linked to career success. Los Angeles College of Chiropractic's professional identity is shaped by a philosophy of health care that is focused on vitalism, holism, naturalism, therapeutic conservatism, critical rationalism, phenomenology, humanism, and interprofessionalism. Other distinguishing aspects include portal-of-entry professionals with broad diagnostic skills; a focus on spine care; promotion of public-health; and delivery of manual treatments. The chiropractic professional identity at the Los Angeles College of Chiropractic focuses on serving the needs of the people who entrust their health to its graduates and will continue to evolve on the basis of many factors, such as politics, social perceptions, and economic conditions.

  3. Influenza vaccination among chiropractic patients and other users of complementary and alternative medicine: are chiropractic patients really different?

    Science.gov (United States)

    Davis, Matthew A; Smith, Monica; Weeks, William B

    2012-01-01

    Previous studies suggest a possible association between using chiropractic care and lower influenza vaccination rates. We examined adult influenza vaccination rates for chiropractic patients to determine if they are different than those for users of other complementary and alternative medicine (CAM). We used the 2007 National Health Interview Survey to examine influenza vaccination rates among adult respondents who were considered high priority for the influenza vaccine (n=12,164). We separated respondents into clinically meaningful categories according to age and whether or not they had recently used chiropractic care, some other type of CAM, or neither. We used adjusted logistic regression to determine whether user status predicted influenza vaccination. Only 33% of younger and 64% of older high priority Chiropractic Users were vaccinated in 2007; these rates approximated those of Non-CAM Users. However, younger Non-Chiropractic CAM Users were more likely than Non-CAM Users to have been vaccinated (p-value=0.05). In adjusted logistic regressions, we found statistically insignificant differences when comparing Chiropractic Users to Non-CAM Users for younger adults (OR=0.93(95% CI:0.76-1.13), or for older adults OR=0.90 (95% CI:0.64-1.20). Chiropractic Users appear no less likely to be vaccinated for influenza; whereas, younger Non-chiropractic CAM Users are more likely than Non-CAM Users to be vaccinated. Copyright © 2011 Elsevier Inc. All rights reserved.

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

    NARCIS (Netherlands)

    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

  5. 29 CFR 1470.20 - Standards for financial management systems.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 4 2010-07-01 2010-07-01 false Standards for financial management systems. 1470.20 Section... Post-Award Requirements Financial Administration § 1470.20 Standards for financial management systems... expending and accounting for its own funds. Fiscal control and accounting procedures of the State, as well...

  6. 20 CFR 437.20 - Standards for financial management systems.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Standards for financial management systems... Financial Administration § 437.20 Standards for financial management systems. (a) A State must expend and... own funds. Fiscal control and accounting procedures of the State, as well as its subgrantees and cost...

  7. 34 CFR 80.20 - Standards for financial management systems.

    Science.gov (United States)

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false Standards for financial management systems. 80.20... Financial Administration § 80.20 Standards for financial management systems. (a) A State must expand and... own funds. Fiscal control and accounting procedures of the State, as well as its subgrantees and cost...

  8. 29 CFR 97.20 - Standards for financial management systems.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Standards for financial management systems. 97.20 Section 97... Standards for financial management systems. (a) A State must expand and account for grant funds in accordance with State laws and procedures for expending and accounting for its own funds. Fiscal control and...

  9. 45 CFR 92.20 - Standards for financial management systems.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Standards for financial management systems. 92.20...-Award Requirements Financial Administration § 92.20 Standards for financial management systems. (a) A... and accounting for its own funds. Fiscal control and accounting procedures of the State, as well as...

  10. 45 CFR 1174.20 - Standards for financial management systems.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 3 2010-10-01 2010-10-01 false Standards for financial management systems. 1174... Financial Administration § 1174.20 Standards for financial management systems. (a) A State must expand and... own funds. Fiscal control and accounting procedures of the State, as well as its subgrantees and cost...

  11. 7 CFR 3016.20 - Standards for financial management systems.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 15 2010-01-01 2010-01-01 false Standards for financial management systems. 3016.20... Standards for financial management systems. (a) A State must expand and account for grant funds in accordance with State laws and procedures for expending and accounting for its own funds. Fiscal control and...

  12. 45 CFR 1157.20 - Standards for financial management systems.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 3 2010-10-01 2010-10-01 false Standards for financial management systems. 1157... Administration § 1157.20 Standards for financial management systems. (a) A State must expand and account for.... Fiscal control and accounting procedures of the State, as well as its subgrantees and cost-type...

  13. 45 CFR 1183.20 - Standards for financial management systems.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 3 2010-10-01 2010-10-01 false Standards for financial management systems. 1183... Financial Administration § 1183.20 Standards for financial management systems. (a) A State must expand and... own funds. Fiscal control and accounting procedures of the State, as well as its subgrantees and cost...

  14. 45 CFR 602.20 - Standards for financial management systems.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 3 2010-10-01 2010-10-01 false Standards for financial management systems. 602.20... GOVERNMENTS Post-Award Requirements § 602.20 Standards for financial management systems. (a) A State must... accounting for its own funds. Fiscal control and accounting procedures of the State, as well as its...

  15. 49 CFR 18.20 - Standards for financial management systems.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Standards for financial management systems. 18.20... Administration § 18.20 Standards for financial management systems. (a) A State must expand and account for grant.... Fiscal control and accounting procedures of the State, as well as its subgrantees and cost-type...

  16. 10 CFR 600.220 - Standards for financial management systems.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Standards for financial management systems. 600.220... Post-Award Requirements § 600.220 Standards for financial management systems. (a) A State must expend... for its own funds. Fiscal control and accounting procedures of the State, as well as its subgrantees...

  17. 21 CFR 1403.20 - Standards for financial management systems.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Standards for financial management systems. 1403... Financial Administration § 1403.20 Standards for financial management systems. (a) A State must expend and... own funds. Fiscal control and accounting procedures of the State, as well as its subgrantees and cost...

  18. 22 CFR 135.20 - Standards for financial management systems.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Standards for financial management systems. 135... Financial Administration § 135.20 Standards for financial management systems. (a) A State must expand and... own funds. Fiscal control and accounting procedures of the State, as well as its subgrantees and cost...

  19. 14 CFR 1273.20 - Standards for financial management systems.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Standards for financial management systems... Requirements Financial Administration § 1273.20 Standards for financial management systems. (a) A State must... accounting for its own funds. Fiscal control and accounting procedures of the State, as well as its...

  20. 43 CFR 12.60 - Standards for financial management systems.

    Science.gov (United States)

    2010-10-01

    ... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Standards for financial management systems... AUDIT REQUIREMENTS AND COST PRINCIPLES FOR ASSISTANCE PROGRAMS Uniform Administrative Requirements for... Standards for financial management systems. (a) A State must expand and account for grant funds in...

  1. ISO 9001:2000--setting the standard for quality management.

    Science.gov (United States)

    Edelstein, M E

    2001-04-01

    How will you approach the next quality management initiative? This article offers an introduction to the ISO 9001:2000 quality management system standards that can be applied to the HIM industry and how these standards can improve your department's policies and procedures.

  2. Chiropractic episodes and the co-occurrence of chiropractic and health services use among older Medicare beneficiaries.

    Science.gov (United States)

    Weigel, Paula A M; Hockenberry, Jason M; Bentler, Suzanne E; Kaskie, Brian; Wolinsky, Fredric D

    2012-01-01

    The purpose of this study was to define and characterize episodes of chiropractic care among older Medicare beneficiaries and to evaluate the extent to which chiropractic services were used in tandem with conventional medicine. Medicare Part B claims histories for 1991 to 2007 were linked to the nationally representative survey on Assets and Health Dynamics among the Oldest Old baseline interviews (1993-1994) to define episodes of chiropractic sensitive care using 4 approaches. Chiropractic and nonchiropractic patterns of service use were examined within these episodes of care. Of the 7447 Assets and Health Dynamics among the Oldest Old participants, 971 used chiropractic services and constituted the analytic sample. There were substantial variations in the number and duration of episodes and the type and volume of services used across the 4 definitions. Depending on how the episode was constructed, the mean number of episodes per chiropractic user ranged from 3.74 to 23.12, the mean episode duration ranged from 4.7 to 28.8 days, the mean number of chiropractic visits per episode ranged from 0.88 to 2.8, and the percentage of episodes with co-occurrent use of chiropractic and nonchiropractic providers ranged from 4.9% to 10.9% over the 17-year period. Treatment for back-related musculoskeletal conditions was sought from a variety of providers, but there was little co-occurrent service use or coordinated care across provider types within care episodes. Chiropractic treatment dosing patterns in everyday practice were much lower than that used in clinical trial protocols designed to establish chiropractic efficacy for back-related conditions. Copyright © 2012 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.

  3. Management and Internal Standardization of Chemistry Terminology ...

    African Journals Online (AJOL)

    tailed account of issues pertaining to the planning of this dictionary is given in ... are not subject field experts, and as a result have no knowledge of the concept ... chemistry terms. Secondly, the issue of internal standardization is addressed, with particular reference to the potential role that target users can play in this regard.

  4. 10 CFR 600.121 - Standards for financial management systems.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Standards for financial management systems. 600.121... financial management systems. (a) Recipients shall relate financial data to performance data and develop....121(f) and 600.181, recipients' financial management systems shall provide for the following: (1...

  5. Records Management Standards and the Good Governance ...

    African Journals Online (AJOL)

    Many PSRP projects are donor funded under the auspices of New Partnership for African Development (NEPAD) so the importance of donor behaviour is addressed. The possibility that the 'transport pool problem' will be replicated in the domain of records management is considered. The possibility that South Africa may ...

  6. Regional vegetation management standards for commercial ...

    African Journals Online (AJOL)

    The intensity of vegetation management required to produce significant growth benefits decreased with increasing altitude, as did the area that needed to be kept free from competing vegetation. In contrast ... Keywords: across-site comparisons; altitude; cost-benefit comparisons; site specific; weed control; weeding intensity

  7. Chiropractic and children: Is more research enough?

    Directory of Open Access Journals (Sweden)

    Leboeuf-Yde Charlotte

    2010-06-01

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

  8. A systematic review comparing the costs of chiropractic care to other interventions for spine pain in the United States.

    Science.gov (United States)

    Dagenais, Simon; Brady, O'Dane; Haldeman, Scott; Manga, Pran

    2015-10-19

    Although chiropractors in the United States (US) have long suggested that their approach to managing spine pain is less costly than other health care providers (HCPs), it is unclear if available evidence supports this premise. A systematic review was conducted using a comprehensive search strategy to uncover studies that compared health care costs for patients with any type of spine pain who received chiropractic care or care from other HCPs. Only studies conducted in the US and published in English between 1993 and 2015 were included. Health care costs were summarized for studies examining: 1. private health plans, 2. workers' compensation (WC) plans, and 3. clinical outcomes. The quality of studies in the latter group was evaluated using a Consensus on Health Economic Criteria (CHEC) list. The search uncovered 1276 citations and 25 eligible studies, including 12 from private health plans, 6 from WC plans, and 7 that examined clinical outcomes. Chiropractic care was most commonly compared to care from a medical physician, with few details about the care received. Heterogeneity was noted among studies in patient selection, definition of spine pain, scope of costs compared, study duration, and methods to estimate costs. Overall, cost comparison studies from private health plans and WC plans reported that health care costs were lower with chiropractic care. In studies that also examined clinical outcomes, there were few differences in efficacy between groups, and health care costs were higher for those receiving chiropractic care. The effects of adjusting for differences in sociodemographic, clinical, or other factors between study groups were unclear. Although cost comparison studies suggest that health care costs were generally lower among patients whose spine pain was managed with chiropractic care, the studies reviewed had many methodological limitations. Better research is needed to determine if these differences in health care costs were attributable to the

  9. A treatise for a new philosophy of chiropractic medicine.

    Science.gov (United States)

    Mirtz, Timothy A

    2017-01-01

    The philosophy of chiropractic has been a much debated entity throughout the existence of the chiropractic profession. Much criticism has been passed upon the historical philosophy of chiropractic and propagated by contemporary adherents. To date, a new philosophy has not been detailed nor presented that demonstrates principles by which to follow. The purpose of this paper is to expand upon the work of Russell Kirk (b.1918, d. 1994), an American political theorist, as a basis for principles to guide the formation of a philosophy of chiropractic medicine (PCM). Each of Kirk's principles will be explained and expounded upon as applicable to a PCM. The addition of the term "medicine" to chiropractic is indicative of a new direction for the profession. The ten principles that provide a foundation for a PCM include: (a) moral order, (b) custom, convention and continuity, (c) prescription, (d) prudence, (e) variety, (f) imperfectability, (g) freedom and property linkage, (h) voluntary community and involuntary collectivism, (i) prudent restraints upon power and human passions, and (j) permanence and change. Each of these principles offers not a dogmatic approach but provides insight into the application of chiropractic medicine to the entire station of the patient and society at large especially that of the economic, social and political. These principles provide direction in not only the approach to the doctor-patient encounter but can be used to visualize the wider world and its potential impact. Instead, these principles examine many tangential issues worthy of discussion that may impact health, social, political, and economic policy and how the chiropractic profession can approach these issues. This paper provides the initial steps in formulating a PCM using principles from a sociological, political and economic standpoint which may impact on how chiropractic medicine approaches the patient and society in totality. In addition, these principles provide the necessary

  10. A qualitative exploration of chiropractic and physiotherapy teachers' experiences and conceptualizations of the educational environment

    Science.gov (United States)

    Palmgren, Per J.; Liljedahl, Matilda; Lindquist, Ingrid; Laksov, Klara Bolander

    2018-01-01

    Objective: There has been increasing scholarly interest in the role of environments in health care professional education, and the value of these has been widely acknowledged as an influential factor in educational quality. However, little is known about how teachers experience the environment, and there is a recognizable absence of a perspective from chiropractic and physiotherapy faculties. The aim of this study was to explore and contrast chiropractic and physiotherapy teachers' experiences and conceptualizations of the meaning of the educational environment. Methods: In this qualitative study, we performed semistructured interviews with 14 teachers, purposefully selected to obtain richness, variation, and breadth in the data. The data were analyzed using inductive qualitative content analysis. Results: The most noteworthy findings were, first, that chiropractic teachers experienced the meaning of the environment as motivating a vocational practice and modeling ideal, supporting and managing stressed students, and including students in the community of chiropractors. Physiotherapy teachers experienced the meaning of the environment as putting the pedagogical vision into practice, balancing students' expectations, and providing the prerequisites to grow within the profession. Second, both groups of teachers held common conceptualizations of the constituents of the environment as physical, organizational, relational, communicational, and pedagogical; however, they attached different connotations to these dimensions. Conclusion: The findings conveyed a variance in the experience of the meaning of the educational environment that can be attributed to contextual and cultural differences. PMID:29257707

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

    Science.gov (United States)

    Ernst, Edzard; Posadzki, Paul

    2011-05-01

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

  12. 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....

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

    OpenAIRE

    Di Duro, Joseph O

    2006-01-01

    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 respectivel...

  14. 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

  15. The association between students taking elective courses in chiropractic technique and their anticipated chiropractic technique choices in future practice.

    Science.gov (United States)

    Wanlass, Paul W; Sikorski, David M; Kizhakkeveettil, Anupama; Tobias, Gene S

    2018-03-12

    To assess students' opinions of the potential influence of taking elective courses in chiropractic techniques and their future practice preferences. An anonymous, voluntary survey was conducted among graduating students from a doctor of chiropractic program. The survey included questions regarding the chiropractic technique elective courses they had completed and the potential influence of these courses on their chiropractic technique choices in future practice. Surveys were pretested for face validity, and data were analyzed using descriptive and inferential statistics. Of the 56 surveys distributed, 46 were completed, for a response rate of 82%. More than half of the students reported having taken at least 1 elective course in diversified technique (80%), Cox technique (76%), Activator Methods (70%), or sacro-occipital technique (63%). Less than half of the respondents reported taking technique elective courses in Gonstead or Thompson techniques. More than half of the students stated they were more likely to use Activator (72%), Thompson (68%), diversified (57%), or Cox (54%) techniques in their future practice after taking an elective course in that technique. Females stated that they were more likely to use Activator Methods ( p = .006) in future practice. Chiropractic technique elective courses in the doctor of chiropractic curriculum may influence students' choices of future practice chiropractic technique.

  16. The impact of chiropractic manipulative therapy on chronic recurrent lateral ankle sprain syndrome in two young athletes.

    Science.gov (United States)

    Gillman, Scott F

    2004-01-01

    To describe two cases of abrupt resolution of chronic, recurrent, inversion sprain to ankles in young recreational athletes. A 13-year-old, female, avid recreational soccer player with ankles that would spontaneously invert during various inconsistent points in the weight bearing gait cycle, sometimes with acute pain or sprain to the ankle. No intervention was attempted prior to her entry to the chiropractic office. A 17-year-old male avid skate- boarder and snowboarder whose left ankle routinely "gave out" into inversion upon mundane weight bearing activity, usually with pain and with dependence on wearing an ankle support when skateboarding to lessen ankle pain. The patient had used an ankle support prior to seeking chiropractic care. High velocity, low amplitude chiropractic manipulative therapy applied to the spine, pelvis and extremity joints was the primary intervention in both cases, with particular focus on the ankle. Other procedures used included taping and orthotics, but not before the manipulation effect was noted. High velocity, low amplitude chiropractic manipulative therapy to the spine, pelvis, and extremities, particularly at the ankle, should be considered when managing young recreational athletes with functional chronic, recurrent, ankle inversion sprains.

  17. Treatment of severe glaucomatous visual field deficit by chiropractic spinal manipulative therapy: a prospective case study and discussion.

    Science.gov (United States)

    Wingfield, B R; Gorman, R F

    2000-01-01

    To discuss the case of a patient with severely reduced visual fields arising from terminal glaucomatous retinal damage and the treatment of this condition by spinal manipulation. A 25-year-old uniocular female patient with congenital glaucoma sought chiropractic treatment for spinal pain, headache, and classic migraine. Advanced optic disk cupping was present, and loss of vision was near complete. A 3-degree island of central vision and a small area of peripheral light sensitivity had remained relatively stable for 3 years after a trabeculectomy procedure that had resulted in intraocular hypotony. It was considered possible that chiropractic spinal manipulative therapy may have a positive outcome in visual performance. Before commencing chiropractic spinal manipulative therapy, an ophthalmologic examination was performed, and visual performance was monitored through a course of treatment. Immediately after the first treatment, significant visual field improvement was recorded in the remaining eye. Maximal improvement of vision was achieved after 1 week (4 treatment sessions). Total monocular visual field had increased from approximately 2% to approximately 20% of normal. Corrected central acuity had improved from 6/12 to 6/9. Independent reexamination by the patient's regular ophthalmic surgeon confirmed the results. Recovery of vision in this patient was an unexpected and remarkable outcome, raising the question of whether chiropractic spinal manipulative therapy may be of value in the management of glaucomatous visual field loss. More intensive research is required.

  18. 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

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

    Science.gov (United States)

    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, and wellness is not synonymous with health, although is often used that way. Wellness is a societal trend, and chiropractic as a health care profession may be a good fit for this concept. PMID:22693468

  20. Leadership and capacity building in international chiropractic research

    DEFF Research Database (Denmark)

    Adams, Jon; Kawchuk, Greg; Breen, Alexander

    2018-01-01

    successful senior academics from Australia, Canada, and Denmark. The program centres upon an annual week-long program residential that rotates continental locations over the first three-year cycle and between residentials the CARL fellows work on self-initiated research and leadership initiatives. Through......In an evidence-based health care environment, healthcare professions require a sustainable research culture to remain relevant. At present however, there is not a mature research culture across the chiropractic profession largely due to deficiencies in research capacity and leadership, which may...... be caused by a lack of chiropractic teaching programs in major universities. As a response to this challenge the Chiropractic Academy for Research Leadership, CARL, was created with the aim of develop a global network of successful early-career chiropractic researchers under the mentorship of three...

  1. 75 FR 57274 - Financial Management and Assurance; Government Auditing Standards

    Science.gov (United States)

    2010-09-20

    ... GOVERNMENT ACCOUNTABILITY OFFICE Financial Management and Assurance; Government Auditing Standards.... Dalkin, Director, Financial Management and Assurance. [FR Doc. 2010-23374 Filed 9-17-10; 8:45 am] BILLING... financial and performance auditing drawn from all levels of government, private enterprise, public...

  2. 15 CFR 24.20 - Standards for financial management systems.

    Science.gov (United States)

    2010-01-01

    ... Requirements Financial Administration § 24.20 Standards for financial management systems. (a) A State must... accounting for its own funds. Fiscal control and accounting procedures of the State, as well as its... prohibitions of applicable statutes. (b) The financial management systems of other grantees and subgrantees...

  3. 24 CFR 85.20 - Standards for financial management systems.

    Science.gov (United States)

    2010-04-01

    ... Administration § 85.20 Standards for financial management systems. (a) A State must expand and account for grant.... Fiscal control and accounting procedures of the State, as well as its subgrantees and cost-type... statutes. (b) The financial management systems of other grantees and subgrantees must meet the following...

  4. 13 CFR 143.20 - Standards for financial management systems.

    Science.gov (United States)

    2010-01-01

    ... Requirements Financial Administration § 143.20 Standards for financial management systems. (a) A State must... accounting for its own funds. Fiscal control and accounting procedures of the State, as well as its... prohibitions of applicable statutes. (b) The financial management systems of other grantees and subgrantees...

  5. 28 CFR 66.20 - Standards for financial management systems.

    Science.gov (United States)

    2010-07-01

    ... Requirements Financial Administration § 66.20 Standards for financial management systems. (a) A State must... accounting for its own funds. Fiscal control and accounting procedures of the State, as well as its... prohibitions of applicable statutes. (b) The financial management systems of other grantees and subgrantees...

  6. 45 CFR 2541.200 - Standards for financial management systems.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Standards for financial management systems. 2541... for expending and accounting for its own funds. Fiscal control and accounting procedures of the State... violation of the restrictions and prohibitions of applicable statutes. (b) The financial management systems...

  7. 32 CFR 33.20 - Standards for financial management systems.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 1 2010-07-01 2010-07-01 false Standards for financial management systems. 33... financial management systems. (a) A State must expand and account for grant funds in accordance with State laws and procedures for expending and accounting for its own funds. Fiscal control and accounting...

  8. IPMA Standard Competence Scope in Project Management Education

    Science.gov (United States)

    Bartoška, Jan; Flégl, Martin; Jarkovská, Martina

    2012-01-01

    The authors of the paper endeavoured to find out key competences in IPMA standard for educational approaches in project management. These key competences may be used as a basis for project management university courses. An incidence matrix was set up, containing relations between IPMA competences described in IPMA competence baseline. Further,…

  9. Management system - correlation study between new IAEA standards and the market standards

    Energy Technology Data Exchange (ETDEWEB)

    Oliveira, Dirceu Paulo de [Centro Tecnologico da Marinha em Sao Paulo (CTMSP), Ipero, SP (Brazil)], e-mail: dirceupo@hotmail.com; Zouain, Desiree Moraes [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)], e-mail: dmzouain@ipen.br

    2009-07-01

    In order to answer the growing concern of society with respect of the aspects that affect the quality of life, international and national regulatory bodies have developed standards that enable organizations to establish management systems for quality, environment and sustainable development, health, safety and social responsibility, among other functions. Within this context it is necessary to structure an integrated management system that promotes interests compatibility of several distinct and complementary functions involved. Considering this vision of the management system integration, the International Atomic Energy Agency (IAEA) decided to review the structure of safety standards on Quality Assurance - code and guides 50-C/SGQ1/ 14:1996, publishing, in 2006, IAEA GS-R-3 and IAEA GS-G-3.1 standards, enlarging the management approach of the previous standards, including the possibility of integrating the functions foremost mentioned. This paper presents the results about a correlation study between IAEA management system standards - IAEA GS-R-3: 2006, IAEA GS-G-3.1: 2006 and IAEA DS349 rev. 2007, this latter still a draft standard, with those market management system standards on quality - ISO 9001:2008, environmental - ISO 14001:2004, and occupational health and safety - BS OHSAS 18001:2007, identifying gaps, redundancies and complementarities among their requirements and guidances. The purpose of the study is to provide subsidies that could contribute to the structuring of a management system to nuclear facilities that satisfies, in an integrated manner, the common and complementary requirements and guidances of IAEA and market standards. (author)

  10. Management system - correlation study between new IAEA standards and the market standards

    International Nuclear Information System (INIS)

    Oliveira, Dirceu Paulo de; Zouain, Desiree Moraes

    2009-01-01

    In order to answer the growing concern of society with respect of the aspects that affect the quality of life, international and national regulatory bodies have developed standards that enable organizations to establish management systems for quality, environment and sustainable development, health, safety and social responsibility, among other functions. Within this context it is necessary to structure an integrated management system that promotes interests compatibility of several distinct and complementary functions involved. Considering this vision of the management system integration, the International Atomic Energy Agency (IAEA) decided to review the structure of safety standards on Quality Assurance - code and guides 50-C/SGQ1/ 14:1996, publishing, in 2006, IAEA GS-R-3 and IAEA GS-G-3.1 standards, enlarging the management approach of the previous standards, including the possibility of integrating the functions foremost mentioned. This paper presents the results about a correlation study between IAEA management system standards - IAEA GS-R-3: 2006, IAEA GS-G-3.1: 2006 and IAEA DS349 rev. 2007, this latter still a draft standard, with those market management system standards on quality - ISO 9001:2008, environmental - ISO 14001:2004, and occupational health and safety - BS OHSAS 18001:2007, identifying gaps, redundancies and complementarities among their requirements and guidances. The purpose of the study is to provide subsidies that could contribute to the structuring of a management system to nuclear facilities that satisfies, in an integrated manner, the common and complementary requirements and guidances of IAEA and market standards. (author)

  11. Chiropractic Identity: A Neurological, Professional, and Political Assessment

    OpenAIRE

    Rosner, Anthony L.

    2016-01-01

    Objective The purpose of this article is to propose a focused assessment of the identity of chiropractic and its profession, triangulating multiple viewpoints converging upon various aspects and definitions of neurology, manual medicine, and alternative or mainstream medicine. Discussion Over 120 years since its inception, chiropractic has struggled to achieve an identity for which its foundations could provide optimal health care. Despite recognition of the benefits of spinal manipulation in...

  12. A History of The Journal of Chiropractic Education

    Science.gov (United States)

    Green, Bart N.; Jacobs, Grace E.; Johnson, Claire D.; Phillips, Reed B.

    2011-01-01

    Purpose: The Journal of Chiropractic Education celebrates its 25th anniversary in the year 2011. The purpose of this article is to chronicle the history of the journal, which is unreported at this time. Methods: The entire collection of the journal was reviewed and information pertaining to important events and changes in the format, personnel, and processes of the journal were extracted. This information was used to create a chronology of the journal. The chronology was complemented with information obtained from people who were involved in the evolution of the journal and the Association of Chiropractic Colleges Educational Conferences. Results: Starting as a humble newsletter in 1987 and produced for a small cadre of readers primarily from the United States, the journal is now a full-sized and bound peer-reviewed international journal. Initially cataloged by the Index to Chiropractic Literature and MANTIS, the indexing expanded to interdisciplinary indexing systems such as CINAHL and ultimately PubMed. The journal has grown to serve the needs of chiropractic educators from around the world with representatives on the editorial board from 39 colleges and universities from 15 different countries. The journal has grown in tandem with the profession’s leading education and research conference and has been the primary repository for the scholarship of chiropractic education. Conclusion: The history of the journal represents a significant milestone in the development of the chiropractic profession, particularly the discipline of chiropractic education. The journal has had an interesting history and the future promises to bring more opportunities and challenges to the field of chiropractic education and to the journal. PMID:22069342

  13. Telemetry Standards, RCC Standard 106-17, Chapter 28, RF Network Management

    Science.gov (United States)

    2017-07-01

    28-1 28.2 RF Network Management Concepts and Definitions ... Management Concepts and Definitions 28.2.1 Data Link Layer Framing The RF network provides a standards-based IP network (Internet Engineering Task Force...information on all QoS transmit queue levels and receiver link quality to RF link management . An RF network message containing one or more TxOp Assignment

  14. A SURVEY ON INDIAN EXPERIENCE ON INTEGRATED MANAGEMENT STANDARDS (IMS

    Directory of Open Access Journals (Sweden)

    H. Khanna

    2009-09-01

    Full Text Available Adoption of management systems standards is a key issue in manufacturing industry in India. Following the global trend quality and environmental issues are gaining importance. However the number of ISO 14001 certified companies are much less in India as compared to ISO 9001. The integration of ISO 14001 with ISO 9001 may help companies to sustain competitive advantage and overcome disappointments with quality standards and in turn encourage companies to adopt good environmental practices. The aim of this research is to study the implementation of integrated management standards (IMS by the manufacturing organizations in India. The different aspects of integration and benefits of IMS implementation are analyzed. This r esearch is based on empirical study carried out in Indian manufacturing firms, involving the application of a questionnaire. This questionnaire was tested on 50 manufacturing companies in India. The study reveals that focus on stakeholders; top management commitment and training are critical success factors for implementation of IMS. The main benefits of integration are discussed. The small sample size is one of the major limitations of this study. The paper informs the managers in manufacturing organizations and practitioners of management system standards especially in developing countries about IMS and will enable them to adopt IMS in future so that those organizations may not implement multiple and overlapping MSS(Management System Standards.

  15. Developing and enforcing internal information systems standards: InduMaker’s Standards Management Process

    Directory of Open Access Journals (Sweden)

    Claudia Loebbecke

    2016-01-01

    Full Text Available It is widely agreed that standards provide numerous benefits when available and enforced. Company-internal Information Systems (IS management procedures and solutions, in the following coined IS ‘standards’, allow for harmonizing operations between company units, locations and even different service providers. However, many companies lack an organized process for defining and managing internal IS standards, which causes uncertainties and delays in decision making, planning, and design processes. In this case study of the globally operating InduMaker (anonymized company name, an established manufacturing supplier, we look into the company-internal management of IS standards. Theoretically grounded in the organizational and IS-focused literature on business process modelling and business process commoditization, we describe and investigate InduMaker’s newly developed Standard Management Process (SMP for defining and managing company-internal business and IS standards, with which the multinational pursues offering clear answers to business and IT departments about existing IS standards, their degree of obligation, applicability, and scope at any time.

  16. Business management and the environment of care standards.

    Science.gov (United States)

    Keil, O R

    1997-01-01

    In summary, the entire JCAHO manual is built around the concept of "know thyself." This expectation creates the need to engage in a substantial rework of existing practices to remove communication barriers and to eliminate turf warfare. The focus of the standards is on the patient. All aspects of the patient-care delivery cycle are examined during survey, as are key elements of the business-management activities. The EC standards are a case study of business management. They expect leadership and planning, development of human resources, management of information, and improvement of performance. They expect that all four of these management tools will be exercised by all managers and staff members who have an impact on or are impacted by the seven elements of the EC function. The primary focus is on teamwork among providers and maximizing benefits to patients.

  17. Combined chiropractic interventions for low-back pain.

    Science.gov (United States)

    Walker, Bruce F; French, Simon D; Grant, William; Green, Sally

    2010-04-14

    Chiropractors commonly use a combination of interventions to treat people with low-back pain (LBP). To determine the effects of combined chiropractic interventions (that is, a combination of therapies, other than spinal manipulation alone) on pain, disability, back-related function, overall improvement, and patient satisfaction in adults with LBP, aged 18 and older. We searched: The Cochrane Back Review Group Trials Register (May 2009), CENTRAL (The Cochrane Library 2009, Issue 2), and MEDLINE (from January 1966), EMBASE (from January 1980), CINAHL (from January 1982), MANTIS (from Inception) and the Index to Chiropractic Literature (from Inception) to May 2009. We also screened references of identified articles and contacted chiropractic researchers. All randomised trials comparing the use of combined chiropractic interventions (rather than spinal manipulation alone) with no treatment or other therapies. At least two review authors selected studies, assessed the risk of bias, and extracted the data using standardised forms. Both descriptive synthesis and meta-analyses were performed. We included 12 studies involving 2887 participants with LBP. Three studies had low risk of bias. Included studies evaluated a range of chiropractic procedures in a variety of sub-populations of people with LBP.No trials were located of combined chiropractic interventions compared to no treatment. For acute and subacute LBP, chiropractic interventions improved short- and medium-term pain (SMD -0.25 (95% CI -0.46 to -0.04) and MD -0.89 (95%CI -1.60 to -0.18)) compared to other treatments, but there was no significant difference in long-term pain (MD -0.46 (95% CI -1.18 to 0.26)). Short-term improvement in disability was greater in the chiropractic group compared to other therapies (SMD -0.36 (95% CI -0.70 to -0.02)). However, the effect was small and all studies contributing to these results had high risk of bias. There was no difference in medium- and long-term disability. No

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

    Science.gov (United States)

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

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

  19. Policies, standards and managements associated with PG utilization

    Science.gov (United States)

    Chuan, L. M.; Zheng, H. G.; Zhao, J. J.; Wang, A. L.; Sun, S. F.

    2017-08-01

    With rapid growth in the production of high concentration phosphate and compound fertilizers in China, PG production is increasing every year. However, its utilization is not increasing at the same pace. Phosphogypsum is usually stored in such a way that not only it occupies lot of land, but also leads to minimal environmental pollution. This paper summarized the policies, standards and managements issues associated with PG utilization, and in order to help the PG utilization and management effectively.

  20. International Financial Reporting Standards and Earnings Management in Latin America

    OpenAIRE

    Alex Augusto Timm Rathke; Verônica de Fátima Santana; Isabel Maria Estima Costa Lourenço; Flávia Zóboli Dalmácio

    2016-01-01

    Abstract This study analyzes the level of earnings management in Latin America after the adoption of the International Financial Reporting Standards (IFRS) and analyzes the role of cross-listing in the United States. The literature on earnings management in less developed countries is still under construction, and few studies focus on this issue, especially with respect to Latin America, despite its relevant role in the global economy. This paper fills this gap in the literature as it analyze...

  1. Relationship between chiropractic teaching institutions and practice characteristics among Canadian doctors of chiropractic: a random sample survey.

    Science.gov (United States)

    Puhl, Aaron A; Reinhart, Christine J; Doan, Jon B; McGregor, Marion; Injeyan, H Stephen

    2014-01-01

    The objectives of this study were to determine if faction membership among Canadian doctors of chiropractic (DCs) is associated with differences in educational program characteristics among English-speaking Canadian and United States chiropractic colleges and to determine if those differences are expressed in terms of surveyed attitudes and behaviors regarding treatment efficacy, radiographic imaging, vaccinations, and interprofessional referrals. This study also aims to identify if educational programs may be a potential source of multiple professional identities. A randomly selected sample of Canadian DCs, stratified across the English-speaking provinces, was surveyed by mail. Survey items included school of graduation, self-categorization by chiropractic subgroup, perceptions of condition-specific treatment efficacy, use of plain film radiographic imaging, vaccination attitudes/behaviors, and patient referral patterns. Self-categorization by chiropractic subgroup included: the unorthodox faction (associates the chiropractic subluxation as an encumbrance to the expression of health) and the orthodox perspective (associates with musculoskeletal joint dysfunction, public health, and lifestyle concerns). For data analysis, chiropractic schools were divided into 2 groups according to location: English-speaking Canada and the US. The US was further clustered into liberal ("interested in mixing elements of modern and alternative therapies into the practice of chiropractic") and conservative categories ("chiropractors who believe in continuing the traditions of chiropractic"). Of 740 deliverable questionnaires, 503 were returned for a response rate of 68%. χ(2) Testing revealed significant differences in self-categorized faction membership associated with the clustering of colleges based on ideological viewpoints (χ(2) = 27.06; P = .000). Descriptive results revealed a relationship between school of origin and perceived treatment efficacy, use of radiographic imaging

  2. Integrated management system - management standards evolution and the IAEA new approach

    International Nuclear Information System (INIS)

    Oliveira, Dirceu Paulo de; Zouain, Desiree Moraes

    2007-01-01

    The management standards application began in military and nuclear areas towards the end of Second World War, when some westerns countries developed quality standards to improve their means to assess suppliers' conditions to assure their products conformance, which was increasingly complex and required a higher degree of reliability. Afterwards, the quality standards application was extended to the consumer market focused on consumers' requirements satisfaction. Coming along the society crescent concern about quality of life, other management standards were developed, such as those dealing with environmental and sustainable development, occupational health and safety, social accountability and so on. As a consequence, the management process became complex. The management system integrated form approach makes possible the compatibility of distinct and complementary interests from several functions and disciplines involved and supply the absence of the organizations' holistic approach. According to this integrated management approach, the Agency - 'International Atomic Energy Agency' (IAEA) - decided to review the structure of the 50-C-Q standard - 'Quality Assurance for Safety in Nuclear Power Plants and Other Nuclear Installations', from 1996, publishing in 2006 the new GS-R-3 standard - 'The Management System for Facilities and Activities - Safety Requirements'. This work presents a brief evolution of management standards and integrated management approach, showing the Agency's new vision concerning this issue with the GS-R-3 standard publication. (author)

  3. Standardized safety management of AP1000 nuclear power plant

    International Nuclear Information System (INIS)

    Li Xingwen; Cao Zhiqiang; Cong Jiuyuan

    2011-01-01

    In 2002, China published and implemented the Law of the People's Republic of China on Work Safety and promulgated a series of guidelines and policies, which strengthened the safety management supervision. Standardization of safety, as another important step on safety supervision, comes after safety assesment and safety production licensing system, is also a permanent solution. Standardization of safety is a strategic, long term and fundamental work, which is also the basic access to achieving scientific safety management and increasing the inherent safety of an enterprise. Haiyang AP1000 nuclear power plant, adopting the modularized, 'open-top' and parallel construction means, overturned the traditional construction theory of installation work comes after the civil work and greatly shorten the construction period. At the same time, the notable increase of oversize module transportation and lifting and parallel construction raises higher demands for safety management. This article combines the characteristics and difficulties of safety management for Haiyang AP1000 nuclear power plant, puts forward ideas and methods for standardized safety management, and could also serve as reference to the safety management for other AP1000 projects. (authors)

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

    Science.gov (United States)

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

    2011-08-01

    Of the multitude of treatment options for the management of neck pain, no obvious single treatment modality has been shown to be most efficacious. As such, the clinician should consider alternative treatment modalities if a modality is engaging, available, financially feasible, potentially efficacious, and is low risk for the patient. As evidence-based medicine for neck pain develops, the clinician is faced with the challenge of which treatments to encourage patients to pursue. Treatment modalities explored in this article, including chiropractic, acupuncture, TENS, massage, yoga, Tai Chi, and Feldenkrais, represent reasonable complementary and alternative medicine methods for patients with neck pain. Copyright © 2011 Elsevier Inc. All rights reserved.

  5. Issues in Quality Management: ISO in Relation to Islamic Standards

    Directory of Open Access Journals (Sweden)

    Khaliq Ahmad

    2003-06-01

    Full Text Available The International Standard Organization (ISO is an international consensus on quality management practice. Recently, an Islamic standard certification services known as ISI 2020 is offered by the Islamic Standard Institute, Malaysia. A sample survey was conducted to investigate managers’ and executives’ perceptions regarding ISO 9002 and ISI 2020. The study found that the respondents understand and are supportive of ISO but the support for ISI 2020 is relatively poor. There is a need for better marketing of ISI 2020 if it is to have a wider appeal.

  6. ASME nuclear codes and standards risk management strategic planning

    International Nuclear Information System (INIS)

    Hill, Ralph S. III; Balkey, Kenneth R.; Erler, Bryan A.; Wesley Rowley, C.

    2007-01-01

    This paper is prepared in honor and in memory of the late Professor Emeritus Yasuhide Asada to recognize his contributions to ASME Nuclear Codes and Standards initiatives, particularly those related to risk-informed technology and System Based Code developments. For nearly two decades, numerous risk-informed initiatives have been completed or are under development within the ASME Nuclear Codes and Standards organization. In order to properly manage the numerous initiatives currently underway or planned for the future, the ASME Board on Nuclear Codes and Standards (BNCS) has an established Risk Management Strategic Plan (Plan) that is maintained and updated by the ASME BNCS Risk Management Task Group. This paper presents the latest approved version of the plan beginning with a background of applications completed to date, including the recent probabilistic risk assessment (PRA) standards developments for nuclear power plant applications. The paper discusses planned applications within ASME Nuclear Codes and Standards that will require expansion of the ASME PRA Standard to support new advanced light water reactor and next generation reactor developments, such as for high temperature gas-cooled reactors. Emerging regulatory developments related to risk-informed, performance- based approaches are summarized. A long-term vision for the potential development and evolution to a nuclear systems code that adopts a risk-informed approach across a facility life-cycle (design, construction, operation, maintenance, and closure) is also summarized. Finally, near term and long term actions are defined across the ASME Nuclear Codes and Standards organizations related to risk management, including related U.S. regulatory activities. (author)

  7. The Standard of Management and Application of Cultural Heritage Documentation

    Directory of Open Access Journals (Sweden)

    Yen Ya Ning

    2011-12-01

    Full Text Available Using digital technology for cultural heritage documentation is a global trend in the 21 st century. Many important techniques are currently under development, including 3D digital imaging, reverse engineering, GIS (Geographic Information Systems etc. However, no system for overall management or data integration is yet available. Therefore, we urgently need such a system to efficiently manage and interpret data for the preservation of cultural heritages. This paper presents a digitizing process developed in Taiwan by the authors. To govern and manage cultural property, three phases of property conservation, registration, restoration and management, has been set up along a timeline. In accordance with the laws of cultural property, a structural system has been built for project management, including data classification and data interpretation with self-documenting characteristics. Through repository information and metadata, a system catalogue (also called data dictionary (Figure 1 was created. The primary objective of the study is to create an integrated technology for an efficient management of databases. Several benefits could be obtained from this structural standard: (1 cultural heritage management documentation can be centralized to minimize the possibility of data re-entry resulting inconsistency, and also to facilitate simultaneous updating of data; (2 since multiple data can be simultaneously retrieved and saved in real time, the incidence of errors can be reduced; (3 this system could be easily tailored to meet the administrative requirements for the standardization of documentation exchanged between cultural properties institutions and various county and city governments.

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

    Science.gov (United States)

    Myburgh, Corrie; Boyle, Eleanor; Larsen, Johanne Brinch; Christensen, Henrik Wulff

    2016-01-01

    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. 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. 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 and 36 follow-up patients and finally video recorded 11 new and 24 follow-up consultations. Categorization and analysis led to the emergence six consumer touch point themes: 'the internet', 'the physical environment', 'practice models', 'administrative staff', 'the consultation sequence and timing' and 'a consultation that adds value'. The Internet functions as a tool when choosing/confirming a clinic as appropriate, developing and initial image and managing appointments. The administrative hub appears integral to the shaping of positive consumer experiences outside of the consultation. Clinic location, practice model and interior design may contribute to context effects and thus may influence value perception during the clinical encounter. The duration of hands-on treatment received from the chiropractor is not an apparent consumer focus point. Rather, through a seven stage clinical procedure patients value consultations with clinicians who demonstrate professional competence by effective communication diagnosis/management and facilitating satisfactory treatment outcomes. At least six

  9. 40 CFR 35.6270 - Standards for financial management systems.

    Science.gov (United States)

    2010-07-01

    ... § 35.6270 Standards for financial management systems. (a) Accounting system standards—(1) General. The... Agreement. (6) Accounting system control procedures. Except as provided for in paragraph (a)(3) of this section, accounting system control procedures must ensure that accounting information is: (i) Accurate...

  10. 75 FR 61143 - Financial Management and Assurance; Government Auditing Standards

    Science.gov (United States)

    2010-10-04

    ... GOVERNMENT ACCOUNTABILITY OFFICE Financial Management and Assurance; Government Auditing Standards Correction In notice document 2010-23374 beginning on page 57274 in the issue of Monday, September 20, 2010 make the following corrections: 1. On page 57275, in the first column, under the ADDRESSES section, in...

  11. Compliance with standard treatment guidelines in the management ...

    African Journals Online (AJOL)

    Compliance with standard treatment guidelines in the management of hypertension: A review of practice of healthcare workers in Potchefstroom, North West Province, South ... Conclusions: As the adherence to hypertension guidelines in primary care by healthcare workers in general is suboptimal, continuous professional ...

  12. Emerging Network Storage Management Standards for Intelligent Data Storage Subsystems

    Science.gov (United States)

    Podio, Fernando; Vollrath, William; Williams, Joel; Kobler, Ben; Crouse, Don

    1998-01-01

    This paper discusses the need for intelligent storage devices and subsystems that can provide data integrity metadata, the content of the existing data integrity standard for optical disks and techniques and metadata to verify stored data on optical tapes developed by the Association for Information and Image Management (AIIM) Optical Tape Committee.

  13. Attitudes toward chiropractic: a survey of North American orthopedic surgeons.

    Science.gov (United States)

    Busse, Jason W; Jacobs, Craig; Ngo, Trung; Rodine, Robert; Torrance, David; Jim, Janey; Kulkarni, Abhaya V; Petrisor, Brad; Drew, Brian; Bhandari, Mohit

    2009-12-01

    Questionnaire survey. To elicit orthopedic surgeons' attitudes toward chiropractic. Orthopedic surgeons and chiropractors often attend to similar patient populations, but little is known about the attitudes of orthopedic surgeons toward chiropractic. We administered a 43-item cross-sectional survey to 1000 Canadian and American orthopedic surgeons that inquired about demographic variables and their knowledge and use of chiropractic. Imbedded in our survey was a 20-item chiropractic attitude questionnaire (CAQ). 487 surgeons completed the survey (response rate, 49%). North American orthopedic surgeons' attitudes toward chiropractic were diverse, with 44.5% endorsing a negative impression, 29.4% holding favorable views, and 26.1% being neutral. Approximately half of respondents referred patients for chiropractic care each year, mainly due to patient request.The majority of surgeons believed that chiropractors provide effective therapy for some musculoskeletal complaints (81.8%), and disagreed that chiropractors could provide effective relief for nonmusculoskeletal conditions (89.5%). The majority endorsed that chiropractors provide unnecessary treatment (72.7%), engage in overly-aggressive marketing (63.1%) and breed dependency in patients on short-term symptomatic relief (52.3%). In our adjusted generalized linear model, older age (-2.62 points on the CAQ for each 10 year increment; 95% confidence interval [CI] = -3.74 to -1.50), clinical interest in foot and ankle (-2.77; 95% CI = -5.43 to -0.10), and endorsement of the research literature (-4.20; 95% CI = -6.29 to -2.11), the media (-3.05; 95% CI = -5.92 to -0.19), medical school (-7.42; 95% CI = -10.60 to -4.25), or 'other' (-4.99; 95% CI = -8.81 to -1.17) as a source of information regarding chiropractic were associated with more negative attitudes; endorsing a relationship with a specific chiropractor (5.05; 95% CI = 3.00 to 7.10) or residency (3.79;95% CI = 0.17 to 7.41) as sources of information regarding

  14. Professional Standards Development and Implementation in the Higher School Management

    Directory of Open Access Journals (Sweden)

    Y. A. Yelbayev

    2012-01-01

    Full Text Available The paper looks at the higher school management oriented on the innovative qualification structure and professional standards in the light of the competence approach. The authors demonstrate the possible ways of developing and implementing the above standards with the reference to the different categories of educational personnel: professorial and teaching, scientific, administrative and auxiliary staff. The higher school management system, based on the personnel continuing training and advancing education, can facilitate the further social and economic development. Such functional organization can overcome the urgent educational problems of harmonizing the further training requirements, developing the consistent model of qualification levels, systemizing the qualification criteria for the candidates selection, introducing the unified certification standards of the staff training and assessment, coordinating the qualification requirements within the Russian and European qualification framework. 

  15. Standard Practice for Quality Management Systems for Nondestructive Testing Agencies

    CERN Document Server

    American Society for Testing and Materials. Philadelphia

    2009-01-01

    1.1 This practice covers general requirements for the establishment and maintenance of a quality management system for agencies engaged in nondestructive testing (NDT). 1.2 This practice utilizes criteria contained in Practice E 543. 1.3 This practice utilizes criteria contained in American National Standard ANSI/ISO/ASQ Q9001–2000, Quality management systems—Requirements. 1.4 This practice recognizes the importance of establishing minimum safety criteria. 1.5 The use of SI or inch-pound units, or combinations thereof, will be the responsibility of the technical committee whose standards are referred to in this standard. 1.6 This practice does not purport to address all of the safety concerns, if any, associated with its use. It is the responsibility of the user of this practice to establish appropriate safety and health practices and determine the applicability of regulatory limitations prior to use.

  16. Multinational survey of chiropractic patients: reasons for seeking care

    Science.gov (United States)

    Blum, Charles; Globe, Gary; Terre, Lisa; Mirtz, Timothy A.; Greene, Leon; Globe, Denise

    2008-01-01

    Introduction This study explores the extent to which consumers seek wellness care when choosing chiropractors whose practice methods are known to include periodic evaluative and interventional methods to maintain wellness and prevent illness. Methods Using an international convenience sample of Sacro-Occipital Technique (SOT) practitioners, 1316 consecutive patients attending 27 different chiropractic clinics in the USA, Europe and Australia completed a one-page survey on intake to assess reason for seeking care. A forced choice response was obtained characterizing the patient’s reason for seeking chiropractic care. Results More than 40% of chiropractic patient visits were initiated for the purposes of health enhancement and/or disease prevention. Conclusion Although prudence dictates great caution when generalizing from this study, if confirmed by subsequent research among other similar cohorts, the present results may lend support to continued arguments of consumer demand for a more comprehensive paradigm of chiropractic care, beyond routine musculoskeletal complaints, that conceptualizes the systemic, nonspecific effects of the chiropractic encounter in much broader terms. PMID:18769601

  17. Ethics education in chiropractic colleges: a North American survey.

    Science.gov (United States)

    Kinsinger, Stuart; Soave, David

    2012-07-01

    The purposes of this study were to survey Council on Chiropractic Education-accredited chiropractic colleges in North America and to describe curricular details on the teaching of bioethics. A custom-designed survey was sent to chiropractic colleges. Total number of contact hours, whether the ethics was a stand-alone course or integrated elsewhere, type of instructor, and if there was a required or recommended course text were queried. Of 19 surveys sent by mail, 15 surveys were returned. The average time in ethics instruction was 18.7 hours including lecture format, small group tutorial, and self-study. Chiropractic ethics education includes 8 areas of content (boundaries, law and jurisprudence, professionalism, basic ethic tenets/principles, ethical codes of conduct, prevention of financial and of sexual abuse, and resolving an ethical dilemma). Some colleges include content taught to students under the domain of law and jurisprudence. The results of this survey indicate that there are opportunities to further develop the educational ethics program at Council on Chiropractic Education-accredited colleges. All colleges currently offer bioethics teaching. An expanded role for this content is recommended so as to offer optimal benefit for students and practitioners. Copyright © 2012 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.

  18. Constructing a philosophy of chiropractic: evolving worldviews and premodern roots☆

    Science.gov (United States)

    Senzon, Simon A.

    2011-01-01

    Objective The philosophy of chiropractic can be framed as an attempt to correct the problems inherited from the Western Enlightenment. Its origins can be found in the long tradition of Western philosophy. The purpose of this article is to describe in a broad context chiropractic’s roots in premodernity and establish the structural and hermeneutical differences between chiropractic’s original philosophical ideas and those of premodern philosophers. Discussion The worldview or cultural mindset the philosophy arose from must be situated in the context of its time, the birth of the unique postmodern worldview, aperspectival consciousness, and the modern sense of self. This is accomplished by exploring several metatheories about the development of the self through history, with an emphasis on the premodern roots to the chiropractic terms; Universal Intelligence and Innate Intelligence. By contextualizing the philosophy of chiropractic in terms of a structural genealogy of the self and of ideas, a new approach to philosophy in chiropractic emerges. Conclusion Without accounting for chiropractic’s origins as a reflection of the unique time, place, and culture, in terms of the evolution of worldviews through history, any approach to construct or reconstruct a philosophy of chiropractic will potentially miss the seminal feature of chiropractic’s emergence. PMID:22693478

  19. COMPETITIVE ADVANTAGES THROUGH THE IMPLEMENTATION OF INTERNATIONAL ENERGY MANAGEMENT STANDARDS

    Directory of Open Access Journals (Sweden)

    PALIEKHOVA L. L.

    2016-03-01

    Full Text Available Purpose. The purpose of the presented research is to explore the potential of international energy management standards to increase competitiveness of industrial enterprises under conditions of Ukrainian transitional economy. The study had the following objectives: to trace the evolution of fundamental energy efficiency standards; to discuss experience in their use in various countries; to identify factors that are key to achieving competitive advantage under the implementation ISO 50001. Methodology. This article presents a historical overview of the standardisation of principles and approaches for the purpose of the energy-efficient management. The research was carried out by studying the international documents, voluntary standards and national practices in the field of energy efficiency. Conclusions. The study examines the experiences of different countries in the field of energy management systems. The authors conducted a comparative analysis of the ISO 50001 with the other basic standards for the organisation of management. The system approach enables to identify the main factors and their impact on capacity to achieve competitive advantages, which are possible to obtain after certification to ISO 50001. Originality. The study reviewed and analysed the energy management penetration within its dynamics at time and country level. After analysing the statistical data and the results of the interviews, the authors identified 20 key factors affecting the competitiveness of enterprises that are certified to ISO 50001. All of these factors were divided into four groups, two groups represent external environment – opportunities and threats, and two groups – internal capacity – strengths and weaknesses of enterprises. Practical value. The proposed system of factors may be useful for the planning of actions towards strengthening the capacity of energy management systems in the context of the formation competitive advantages on the industrial

  20. 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.

  1. Attitudes and views on chiropractic: a survey of United States midwives.

    Science.gov (United States)

    Mullin, Linda; Alcantara, Joel; Barton, Derek; Dever, Lydia

    2011-08-01

    A survey of midwives' knowledge and views about chiropractic. Cross-sectional descriptive survey. An anonymous on-line self-administered survey. United States midwives. Respondent demographics, professional training, personal and professional clinical experience, opinions on safety of chiropractic, and scope of chiropractic practice. A total of 187 midwife respondents completed the questionnaire resulting in a superficial response rate of 2.1%. Responders were certified nurse-midwives and had some form of training regarding chiropractic. The responders were aware that chiropractors worked with "birthing professionals" and attended to patients with both musculoskeletal and non-musculoskeletal disorders. A vast majority indicated a positive personal and professional clinical experience with chiropractic and that chiropractic was safe for pregnant patients and children. There is great awareness of and positive personal and professional experience with chiropractic on the part of midwives who participated in this survey. We encourage further research in this field. Copyright © 2010 Elsevier Ltd. All rights reserved.

  2. Risk Management Standards: Towards a contemporary, organisation-wide management approach

    OpenAIRE

    Koutsoukis, Nikitas-Spiros

    2010-01-01

    Risk management has been progressively evolving into a systemic approach for organisational decision making in today’s dynamic economic environment of the global era. In this context, risk management is reaching beyond its traditional finance and insurance application context and is entering the sphere of generic, organisation-wide management approaches. In support of this argument we consider four generic risk management standards issued at the institutional, national or international level...

  3. The importance of international ISO standards application for enterprise management and ensuring customer satisfaction

    Directory of Open Access Journals (Sweden)

    Babić Jasna

    2011-01-01

    Full Text Available ISO standards contain requirements for quality management, environmental management, food safety management, information security systems management, risks management, social responsibility management, etc. The organizations, whose employees at all organizational levels understand the importance of correct use of standards and effects of their use, make efforts for continuous improvement of management systems. The improvements are realized through the application of requirements of certificated standardized quality systems and similar non certified standards and through application of different business excellence models.

  4. Standardization and quality management in next-generation sequencing.

    Science.gov (United States)

    Endrullat, Christoph; Glökler, Jörn; Franke, Philipp; Frohme, Marcus

    2016-09-01

    DNA sequencing continues to evolve quickly even after > 30 years. Many new platforms suddenly appeared and former established systems have vanished in almost the same manner. Since establishment of next-generation sequencing devices, this progress gains momentum due to the continually growing demand for higher throughput, lower costs and better quality of data. In consequence of this rapid development, standardized procedures and data formats as well as comprehensive quality management considerations are still scarce. Here, we listed and summarized current standardization efforts and quality management initiatives from companies, organizations and societies in form of published studies and ongoing projects. These comprise on the one hand quality documentation issues like technical notes, accreditation checklists and guidelines for validation of sequencing workflows. On the other hand, general standard proposals and quality metrics are developed and applied to the sequencing workflow steps with the main focus on upstream processes. Finally, certain standard developments for downstream pipeline data handling, processing and storage are discussed in brief. These standardization approaches represent a first basis for continuing work in order to prospectively implement next-generation sequencing in important areas such as clinical diagnostics, where reliable results and fast processing is crucial. Additionally, these efforts will exert a decisive influence on traceability and reproducibility of sequence data.

  5. Integrated Pest Management as European standard – is it possible?

    Directory of Open Access Journals (Sweden)

    Lisa Nilsen

    2011-08-01

    Full Text Available As part of the work within the European Committee for Standardization (CEN, standards for conservation of cultural property are being developed in CEN/TC (Technical Committee 346, Conservation of Cultural Property. In Working Group 4 Environment, a draft is being prepared to create a proposal for standardised Integrated Pest Management. The author of this paper welcomes delegates to the Meeting on Cultural Heritage Pests in Piacenza to contribute to the discussion regarding standardised methods for pest control in the cultural heritage sector.

  6. Understanding information retrieval systems management, types, and standards

    CERN Document Server

    Bates, Marcia J

    2011-01-01

    In order to be effective for their users, information retrieval (IR) systems should be adapted to the specific needs of particular environments. The huge and growing array of types of information retrieval systems in use today is on display in Understanding Information Retrieval Systems: Management, Types, and Standards, which addresses over 20 types of IR systems. These various system types, in turn, present both technical and management challenges, which are also addressed in this volume. In order to be interoperable in a networked environment, IR systems must be able to use various types of

  7. Training to Support Standardization and Improvement of Configuration Management Activities

    Energy Technology Data Exchange (ETDEWEB)

    Dauber, V.; Scheffer, N.; Schoenfelder, C.

    2015-07-01

    In recent years AREVA has conducted several measures to enhance the effectiveness and efficiency of configuration management-related activities within a nuclear power plant (NPP) new build as well as modernization projects, thereby further strengthening its commitment to achieving the highest level of safety in nuclear facilities. This paper describes a new training course that shall support the standardization and improvement of configuration management activities. Recommendations will be given that should be considered when designing and developing comparable training programs to support change processes within engineering units. (Author)

  8. EP&R Standards Project Report: Technical Review of National Incident Management Standards

    Energy Technology Data Exchange (ETDEWEB)

    Stenner, Robert D.

    2007-04-24

    The importance and necessity for a fully developed and implemented National Incident Management System (NIMS) has been demonstrated in recent years by the impact of national events such as Hurricane Katrina in 2005. Throughout the history of emergency response to major disasters, especially when multiple response organizations are involved, there have been systemic problems in the consistency and uniformity of response operations. Identifying national standards that support the development and implementation of NIMS is key to helping solve these systemic problems. The NIMS seeks to provide uniformity and consistency for incident management by using common terminology and protocols that will enable responders to coordinate their efforts to ensure an efficient response.

  9. The role of chiropractic care in older adults

    OpenAIRE

    Dougherty, Paul E; Hawk, Cheryl; Weiner, Debra K; Gleberzon, Brian; Andrew, Kari; Killinger, Lisa

    2012-01-01

    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 spin...

  10. The chiropractic heritage of Paul Caster: magnetic healer.

    Science.gov (United States)

    Jackson, R B

    1996-12-01

    Magnetic healers were a phenomenon in America's heartland, from Iowa, Kansas, Missouri in Illinois in the late 1860s. Three noted magnetics in this region were Paul Caster, Andrew Still and Daniel Palmer; the first and third would have a chiropractic legacy, while Dr. Andrew Taylor Still would found osteopathy. This is the story of the chiropractic heritage from Paul Caster via his son, Jacob, to his grandson, Charles E. Caster, D.C. Magnetic healing in this family was considered by Paul to be a divine gift, while Still and Palmer would be rejected by the clergy and believed their skills could be learned, thus passed on.

  11. Public Perceptions of Doctors of Chiropractic: Results of a National Survey and Examination of Variation According to Respondents' Likelihood to Use Chiropractic, Experience With Chiropractic, and Chiropractic Supply in Local Health Care Markets.

    Science.gov (United States)

    Weeks, William B; Goertz, Christine M; Meeker, William C; Marchiori, Dennis M

    2015-10-01

    The purpose of this study was to determine whether general perceptions of doctors of chiropractic (DCs) varied according to likeliness to use chiropractic care, whether particular demographic characteristics were associated with chiropractic care use, and whether perception of DCs varied according to the per-capita supply of DCs in local health care markets. We performed a secondary analysis of results from a 26-item nationally representative survey of 5422 members of The Gallup Panel that was conducted in the spring of 2015 (response rate, 29%) that sought to elicit the perceptions and use of DCs by US adults. We compared survey responses across: (1) respondents who had different likelihoods to use DCs for treatment of neck or back pain and (2) respondents who had different experiences using DCs. We linked respondents' zip codes to hospital referral regions for which we had the per-capita supply of DCs. Using the χ(2) test, we examined relationships between likeliness to use a DC, experience using a DC, respondent demographic variables, perceptions of DCs, and the per-capita supply of DCs in the local health care market. Most (61.4%) respondents believed that chiropractic care was effective at treating neck and back pain, 52.6% thought DCs were trustworthy, and 24.2% thought chiropractic care was dangerous; however, as respondents' likelihood to use a DC increased, perceptions of effectiveness and trustworthiness increased, and perceptions of danger decreased. Of all 5422 survey respondents, 744 or 13.7% indicated that they had seen a DC within the last 12 months. As one moved from distant to more recent experience using a DC, respondents were more likely to be female, married, white, and employed; those who had a distant history of using a DC were older and more likely to be retired than the other groups. A higher per-capita supply of DCs was associated with higher utilization rates and showed a more favorable regard for DCs. US adults often use chiropractic

  12. Biometric identity management for standard mobile medical networks.

    Science.gov (United States)

    Egner, Alexandru; Soceanu, Alexandru; Moldoveanu, Florica

    2012-01-01

    The explosion of healthcare costs over the last decade has prompted the ICT industry to respond with solutions for reducing costs while improving healthcare quality. The ISO/IEEE 11073 family of standards recently released is the first step towards interoperability of mobile medical devices used in patient environments. The standards do not, however, tackle security problems, such as identity management, or the secure exchange of medical data. This paper proposes an enhancement of the ISO/IEEE 11073-20601 protocol with an identity management system based on biometry. The paper describes a novel biometric-based authentication process, together with the biometric key generation algorithm. The proposed extension of the ISO/IEEE 11073-20601 is also presented.

  13. [Wound information management system: a standardized scheme for acquisition, storage and management of wound information].

    Science.gov (United States)

    Liu, Hu; Su, Rong-jia; Wu, Min-jie; Zhang, Yi; Qiu, Xiang-jun; Feng, Jian-gang; Xie, Ting; Lu, Shu-liang

    2012-06-01

    To form a wound information management scheme with objectivity, standardization, and convenience by means of wound information management system. A wound information management system was set up with the acquisition terminal, the defined wound description, the data bank, and related softwares. The efficacy of this system was evaluated in clinical practice. The acquisition terminal was composed of the third generation mobile phone and the software. It was feasible to get access to the wound information, including description, image, and therapeutic plan from the data bank by mobile phone. During 4 months, a collection of a total of 232 wound treatment information was entered, and accordingly standardized data of 38 patients were formed automatically. This system can provide standardized wound information management by standardized techniques of acquisition, transmission, and storage of wound information. It can be used widely in hospitals, especially primary medical institutions. Data resource of the system makes it possible for epidemiological study with large sample size in future.

  14. Performance Measurement of Management System Standards Using the Balanced Scorecard

    Directory of Open Access Journals (Sweden)

    Jan Kopia

    2017-11-01

    Full Text Available Management system standards (MSS, such as ISO standards, TQM, etc. are widely-used standards adopted by millions of organizations worldwide. It is still an unclear question whether these standards are beneficial for an organization, besides the fact that they might be required or expected by law or customers. The question, whether MSS increase the efficiency, the output, or the performance of an organization is still discussed in scientific research. One reason might be that performance measurement itself is not fully understood or in constant development ranging from pure financial evaluations over intellectual capital rating to calculating of levels of environmental, social or economic expectations known as the Trible Bottom Line. The Balanced Scorecard is one possible solution for performance measurement on a strategic and operational level and therefore useful for the measurement of the influence of MSS within organizations. This study summarized current research in the field of performance measurement in the context of MSS and IMS and the use of BSC and quantitatively and qualitatively tests the usefulness of BSC in measuring the effect of MSSs using the Execution Premium. It was found that BSC is often used, that an average number of companies integrate their measurement initiatives of their MSSs into the BSC-process, and that a high integration of MSS into the BSC improves the organizational performance. This research is useful for researchers and practitioners in order to understand the benefits of the usage of the BSC in the context of MSS or Integrated Management Systems.

  15. International Financial Reporting Standards and Earnings Management in Latin America

    Directory of Open Access Journals (Sweden)

    Alex Augusto Timm Rathke

    2016-05-01

    Full Text Available This study analyzes the level of earnings management in Latin America after the adoption of the International Financial Reporting Standards (IFRS and analyzes the role of cross-listing in the United States. The literature on earnings management in less developed countries is still under construction, and few studies focus on this issue, especially with respect to Latin America, despite its relevant role in the global economy. This paper fills this gap in the literature as it analyzes the level of IFRS earnings management regarding the first and main Latin American countries applying IFRS (Brazil and Chile, when compared to the main Anglo-Saxon countries with IFRS tradition (United Kingdom and Australia, and with the main Continental European economies (France and Germany. The results show that Latin American firms present a higher level of earnings management than Continental European and Anglo-Saxon firms, and this opportunistic behavior remains significant when only global players with cross-listing in the United States are analyzed. Thus, even with a unique set of high quality accounting standards (IFRS and strong reporting incentives, countries’ specific characteristics still play an important role in the way IFRS is implemented in each country.

  16. The treatment of migraine patients within chiropractic: analysis of a nationally representative survey of 1869 chiropractors.

    Science.gov (United States)

    Moore, Craig; Adams, Jon; Leaver, Andrew; Lauche, Romy; Sibbritt, David

    2017-12-04

    While the clinical role of manual therapies in migraine management is unclear, the use of chiropractors for this condition is considerable. The aim of this study is to evaluate the prevalence and characteristics of chiropractors who frequently manage patients with migraine. A national cross-sectional survey of chiropractors collected information on practitioner characteristics, clinical management characteristics and practice settings. A secondary analysis was conducted on 1869 respondents who reported on their migraine caseload to determine the predictors associated with the frequent management of patients with migraine. A large proportion of chiropractors report having a high migraine caseload (HMC) (n = 990; 53.0%). The strongest factors predicting a chiropractor having a HMC include the frequent treatment of patients with axial neck pain (OR = 2.89; 95%CI: 1.18, 7.07), thoracic pain (referred/radicular) (OR = 2.52; 95%CI: 1.58, 3.21) and non-musculoskeletal disorders (OR = 3.06; 95%CI: 2.13, 4.39). Several practice-setting and clinical management characteristics are associated with chiropractors managing a HMC. These findings raise key questions about the therapeutic approach to chiropractic migraine management that deserves further examination. There is a need for more primary research to assess the approach to headache and migraine management provided by chiropractors and to understand the prevalence, burden and comorbidities associated with migraine found within chiropractic patient populations. This information is vital in helping to inform safe, effective and coordinated care for migraine sufferers within the wider health system.

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

    Science.gov (United States)

    2013-01-01

    Background Two recent surveys of chiropractors in Great Britain suggest that there are discrepancies between chiropractic practice as defined in regulatory guidelines and day-to-day chiropractic clinical practice and there is in general a paucity of information regarding the characteristics of contemporary chiropractic practice in the United Kingdom. This field study describes the daily practice of a contemporary British UK-trained chiropractor. Methods The fieldwork took place during the spring and summer of 2008 when the author spent one day per week observing consultations and interviewing patients in a chiropractic clinic. The chiropractor was subjected to interviews on two occasions. The author also registered as a patient. Field notes were taken by the author, interviews were recorded and the transcripts were corrected and analysed by the author. Results A total of 25 patients took part in the study. The interaction that took place between patients and staff in reception could be considered as a prelude to consultation facilitating the transformation from individual to patient and back to individual. Coupled with the continuous physical contact between the chiropractor and each patient there was a substantial amount of verbal and non-verbal communication throughout treatment visits. The patients presented with predominantly musculo-skeletal pain and the majority had consulted the chiropractor as a result of recommendations from others in their close social environment. The majority of the interviewed patients had either an inaccurate or at best rudimentary understanding of the mechanisms of chiropractic treatment. A few of the interviewed patients indicated that they had at first experienced concerns about the nature of chiropractic treatment or getting undressed. The author was able to gain some insight into how the chiropractor's experiences, opinions and beliefs had shaped his approach to chiropractic treatment and how this formed the basis of his clinical

  18. The modulation of upper extremity musculoskeletal disorders for a knowledge worker with chiropractic care and applied ergonomics: a case study

    Science.gov (United States)

    Sherrod, Charles W.; Casey, George; Dubro, Robert E.; Johnson, Dale F.

    2013-01-01

    Objective This report describes the case management of musculoskeletal disorders for an employee in a college work environment using both chiropractic care and applied ergonomics. Clinical Findings A 54-year-old male office worker presented with decreased motor function in both wrists; intermittent moderate-to-severe headaches; and pain or discomfort in the neck, both shoulders, left hand and wrist, and lumbosacral region resulting from injuries sustained during recreational soccer and from excessive forces and awkward postures when interacting with his home and office computer workstations. Intervention and Results Ergonomic training, surveillance, retrofitted equipment with new furniture, and an emphasis on adopting healthy work-style behaviors were applied in combination with regular chiropractic care. Baseline ergonomic job task analysis identified risk factors and delineated appropriate control measures to improve the subject's interface with his office workstation. Serial reevaluations at 3-month, 1-year, and 2-year periods recorded changes to the participant's pain, discomfort, and work-style behaviors. At end of study and relative to baseline, pain scale improved from 4/10 to 2/10; general disability improved from 4 to 0; and hand grip strength (pounds) increased from 20 to 105 (left) and 45 to 100 (right). Healthy work habits and postures adopted in the 3-month to 1-year period regressed to baseline exposures for 3 of 6 risk priorities identified in the ergonomic job task analysis. Conclusion The patient responded positively to the intervention of chiropractic care and applied ergonomics. PMID:23997724

  19. Opinions of sports clinical practice chiropractors, with sports specialty training and those without, about chiropractic research priorities in sports health care: a centering resonance analysis

    Science.gov (United States)

    Lee, Alexander D; Szabo, Kaitlyn; McDowell, Kirstie; Granger, Sydney

    2016-01-01

    Introduction: A Canadian sports chiropractic research agenda has yet to be defined. The Delphi method can be utilized to achieve this purpose; however, the sample of experts who participate can influence the results. To better inform sample selection for future research agenda development, we set out to determine if differences in opinions about research priorities exist between chiropractors who have their sports specialty designation and those who do not. Methods: Fifteen sports clinical practice chiropractors who have their sports fellowship designation and fifteen without, were interviewed with a set of standardized questions about sports chiropractic research priorities. A centering resonance analysis and cluster analysis were conducted on the interview responses. Results: The two practitioner groups differed in their opinions about the type of research that they would like to see conducted, the research that would impact their clinical practice the most, and where they believed research was lacking. However, both groups were similar in their opinions about research collaborations. Conclusion: Sports clinical practice chiropractors, with their sports specialty designation and those without, differed in their opinions about sports chiropractic research priorities; however, they had similar opinions about research collaborations. These results suggest that it may be important to sample from both practitioner groups in future studies aimed at developing research agendas for chiropractic research in sport. PMID:28065995

  20. Trends and predictors of publicly subsidized chiropractic service use among adults age 50+.

    Science.gov (United States)

    Votova, Kristine; Penning, Margaret J; Zheng, Chi; Brackley, Moyra E

    2010-09-01

    This article examines trends in and predictors of publicly subsidized chiropractic use from 1991 to 2000, a decade characterized by health care system reforms throughout North America. The sample included adults age 50+ who visited a publicly subsidized chiropractor in the Canadian province of British Columbia during the study period. Administrative claims data for chiropractic service use were drawn from the Medical Services Plan (MSP) Master file in the British Columbia Linked Health Data resource. The MSP Master file contains claims reported for every provincially insured medical service and supplementary health benefit including chiropractic visits. Joinpoint regression analyses demonstrate that while annual rates of chiropractic users did not change over the decade, visit rates decreased during this period. Predictors of a greater number of chiropractic visits include increasing age, female gender, urban residence, low to moderate income, and use of chiropractic services earlier in the decade. The trend toward decreasing visit rates over the 1990s both conflicts with and is consistent with findings from other North American chiropractic studies using similar time periods. Results indicating that low and moderate income and advancing age predict more frequent chiropractic service are novel. However, given that lower income and older individuals were exempted from chiropractic service limits during this period, these results suggest support for the responsive nature of chiropractic use to financial barriers.

  1. The influence of curricular and extracurricular learning activities on students' choice of chiropractic technique.

    Science.gov (United States)

    Sikorski, David M; KizhakkeVeettil, Anupama; Tobias, Gene S

    2016-03-01

    Surveys for the National Board of Chiropractic Examiners indicate that diversified chiropractic technique is the most commonly used chiropractic manipulation method. The study objective was to investigate the influences of our diversified core technique curriculum, a technique survey course, and extracurricular technique activities on students' future practice technique preferences. We conducted an anonymous, voluntary survey of 1st, 2nd, and 3rd year chiropractic students at our institution. Surveys were pretested for face validity, and data were analyzed using descriptive and inferential statistics. We had 164 students (78% response rate) participate in the survey. Diversified was the most preferred technique for future practice by students, and more than half who completed the chiropractic technique survey course reported changing their future practice technique choice as a result. The students surveyed agreed that the chiropractic technique curriculum and their experiences with chiropractic practitioners were the two greatest bases for their current practice technique preference, and that their participation in extracurricular technique clubs and seminars was less influential. Students appear to have the same practice technique preferences as practicing chiropractors. The chiropractic technique curriculum and the students' experience with chiropractic practitioners seem to have the greatest influence on their choice of chiropractic technique for future practice. Extracurricular activities, including technique clubs and seminars, although well attended, showed a lesser influence on students' practice technique preferences.

  2. The toilet sanitation management to meet healthy house standards

    Science.gov (United States)

    Studyanto, Anung B.; Musfiroh, Mujahidatul; Sholahuddin

    2018-03-01

    To increase the community participation in the toilet sanitation management at house to making a house according the healthy house standart. The toilet sanitation management is becoming complex with increasing population growth, and limited land for sanitation. The community participation determines the success of the toilet sanitation management and improving the health status of the community. This study used an observation method for the availability of latrines according the healthy house criteria, spatial layout and pit layout that meet health and safety standards. Spatial and layout include bathroom area, type of material used for wall and floor bathroom, type of latrine, distance the waste storage distance with water source, and sewerage. The respondents in this study are the people who live in Jaten Village taken by accidental sampling. The number of respondents in this study were 15 respondents.This study shows that all respondents (100%) already have toilet and 8 respondents (53%) have a good toilet sanitation management. Respondents have provided latrines as an effort to manage household waste and according the healthy house standart. The latrine spatial plan has been well implemented, but the latrine layout plan has not been properly.

  3. 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 ...

  4. The self-concept of chiropractic students as science students

    Science.gov (United States)

    Shields, Robert F.

    2005-01-01

    Abstract Purpose To determine the self-concepts of chiropractic students as science students and if any personal variable affect their self-concepts. Participants Students in their first trimester and eighth trimester at the Los Angeles College of Chiropractic during the 1993 academic year (n=158). Methods Peterson-Yaakobi Q-Sort, National Assessment of Educational Progress, two-tailed T-test, one way analysis of variance and Spearman-rho correlation. Results The majority of students have positive self- concepts as science students and although there was a difference between the 2 trimesters, it was not significant. As a group they generally had less exposure to science compared to undergraduates from a selected science program. Variables of socio-economic status, undergraduate major, and highest completed level of education did not statistically affect their self-concept. Conclusion Chiropractic students had the self-concept that enables them to subscribe to the philosophical foundations of science and better engage in basic sciences and, later, science-based clinical research. Knowledge of this self- concept can be used in the development of a more rigorous basic science curricula and clinical research programs at chiropractic colleges with the ultimate goal of providing a more firm scientifically based foundation for the profession. PMID:19674649

  5. Capacity Management as a Service for Enterprise Standard Software

    Directory of Open Access Journals (Sweden)

    Hendrik Müller

    2017-12-01

    Full Text Available Capacity management approaches optimize component utilization from a strong technical perspective. In fact, the quality of involved services is considered implicitly by linking it to resource capacity values. This practice hinders to evaluate design alternatives with respect to given service levels that are expressed in user-centric metrics such as the mean response time for a business transaction. We argue that utilized historical workload traces often contain a variety of performance-related information that allows for the integration of performance prediction techniques through machine learning. Since enterprise applications excessively make use of standard software that is shipped by large software vendors to a wide range of customers, standardized prediction models can be trained and provisioned as part of a capacity management service which we propose in this article. Therefore, we integrate knowledge discovery activities into well-known capacity planning steps, which we adapt to the special characteristics of enterprise applications. Using a real-world example, we demonstrate how prediction models that were trained on a large scale of monitoring data enable cost-efficient measurement-based prediction techniques to be used in early design and redesign phases of planned or running applications. Finally, based on the trained model, we demonstrate how to simulate and analyze future workload scenarios. Using a Pareto approach, we were able to identify cost-effective design alternatives for an enterprise application whose capacity is being managed.

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

    Science.gov (United States)

    von Kuster, Thomas, Jr.

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

  7. Chiropractic in North America: toward a strategic plan for professional renewal--outcomes from the 2006 Chiropractic Strategic Planning Conference.

    Science.gov (United States)

    Triano, John J; Goertz, Christine; Weeks, John; Murphy, Donald R; Kranz, Karl C; McClelland, George C; Kopansky-Giles, Deborah; Morgan, William; Nelson, Craig F

    2010-06-01

    This report describes the process, participation, and recommendations of a set of consensus conferences on strategy for professional growth that emphasized elements of public trust and alignment between the chiropractic profession and its stakeholders. In February and August 2006, an invitational group of leaders in the chiropractic profession convened an ad hoc Chiropractic Strategic Planning Conference. Public notice was given and support solicited through the Foundation of Chiropractic Education and Research. A series of international and interdisciplinary speakers gave presentations on the shifting of external social dynamics and medical culture, illuminating opportunities for the profession to extend its privilege and service. A systematic round-robin discussion was followed by group breakout sessions to develop recommendations on priorities for the profession to respond to challenges and opportunities. Recommendations were reviewed by the group as a whole and voted to consensus requiring more than 70% agreement. Participants determined a series of recommendations within 5 key domains for improving health professions practice: education, research, regulation, workplace, and leadership. The action steps proposed by the Strategic Planning Committee are first steps to provide better service to the public while making use of the inherent strengths of the profession. Copyright (c) 2010 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.

  8. Prevalence and associated risk factors of burnout among US doctors of chiropractic.

    Science.gov (United States)

    Williams, Shawn P; Zipp, Genevieve P

    2014-01-01

    The purpose of this study was to establish the frequency of burnout among doctors of chiropractic in the United States. Using a nonprobability convenience sampling methodology, we e-mailed the Maslach Burnout Inventory-Human Services Survey and a sociodemographic questionnaire to a randomized sample of licensed doctors of chiropractic (n = 8000). The survey return rate was 16.06%. Twenty-one percent of the participants had high emotional exhaustion (EE), 8% had low personal accomplishment, and 8% had high depersonalization. Significant differences (P chiropractic college, self-perception of burnout, the effect of suffering from a work-related injury, the varying chiropractic philosophical perspectives, and the public's opinion of chiropractic. Although doctors of chiropractic in the United States who responded to the survey had a relatively low frequency of burnout, higher levels of EE remain workplace issues for this professional group. Copyright © 2014 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.

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

    DEFF Research Database (Denmark)

    Sorensen, Line Press; Stochkendahl, Mette Jensen; Hartvigsen, Jan

    2006-01-01

    of activities of daily living, mode of referral, duration of sick leave, previous treatments, comorbidity, SF-12, smoking habits, and use of x-ray. RESULTS: Eighty-five percent of all chiropractic clinics in Denmark participated in the study, and 1595 patients (81%) filled out a self-administered questionnaire...... treatment of the same or a similar problem. Thirty percent of first-time chiropractic patients were x-rayed. Compared with general population measures, Danish chiropractic patients had significantly worse physical health status measured by the SF-12. CONCLUSIONS: Most Danish chiropractic patients complain......OBJECTIVE: The purpose of this study is to provide an expanded description of Danish chiropractic patients and to compare characteristics seen in a survey from 1999 with those seen in 2002. METHODS: All chiropractic clinics in Denmark were asked to collect information on new patients during 1...

  10. A narrative review of medical, chiropractic, and alternative health practices in the treatment of primary dysmenorrhea

    Science.gov (United States)

    Spears, Lolita G.

    2005-01-01

    Abstract Objective Primary dysmenorrhea and related issues are discussed as they influence the gynecological and social health of females during adolescence, adulthood, and senior maturity. Health practitioners are exposed to multiple approaches towards the management of menstrual pain. Clinical and social viewpoints target the causation, development, diagnosis, manifestation and management of primary dysmenorrhea. This narrative review includes the topic of the doctor-patient relationship in efforts of cultivating effectively communicative health practitioners. Controversial topics related to primary dysmenorrhea and the quality of life for women are addressed. Data Sources A search for literature reviews, case studies, laboratory research, and clinical trials from 1985–2004 was performed using the MEDLINE database. Sources of additional information included textbooks, national organizational literature and contemporary articles. Discussion Menstrual pain is a prevalent experience yet it is socially taboo for conversation; as such, it poses a hindrance to its management. The communication between the doctor and patient is a critical barrier point between establishing a diagnosis and determining an appropriate treatment plan. A multi-disciple treatment plan varies as much as patients themselves vary in personal experiences, needs, and preferences. Conclusions Medicinal prophylactics, physical therapeutics, non-acidic diets, herbal supplements, eastern therapies and the chiropractic manual adjustments of the spine are effective methods for the management of primary dysmenorrhea. The non-invasive management of primary dysmenorrhea includes the chiropractic adjustment with complimentary modalities, and other alternative health care practices. Medicinal prophylactics are invasive and pose a higher risk to long-term chemical exposure, side effects or irreversible conditions. PMID:19674650

  11. Assessment of chiropractic treatment for active duty, U.S. military personnel with low back pain: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Goertz, Christine M; Long, Cynthia R; Vining, Robert D; Pohlman, Katherine A; Kane, Bridget; Corber, Lance; Walter, Joan; Coulter, Ian

    2016-02-09

    Low back pain is highly prevalent and one of the most common causes of disability in U.S. armed forces personnel. Currently, no single therapeutic method has been established as a gold standard treatment for this increasingly prevalent condition. One commonly used treatment, which has demonstrated consistent positive outcomes in terms of pain and function within a civilian population is spinal manipulative therapy provided by doctors of chiropractic. Chiropractic care, delivered within a multidisciplinary framework in military healthcare settings, has the potential to help improve clinical outcomes for military personnel with low back pain. However, its effectiveness in a military setting has not been well established. The primary objective of this study is to evaluate changes in pain and disability in active duty service members with low back pain who are allocated to receive usual medical care plus chiropractic care versus treatment with usual medical care alone. This pragmatic comparative effectiveness trial will enroll 750 active duty service members with low back pain at three military treatment facilities within the United States (250 from each site) who will be allocated to receive usual medical care plus chiropractic care or usual medical care alone for 6 weeks. Primary outcomes will include the numerical rating scale for pain intensity and the Roland-Morris Disability Questionnaire at week 6. Patient reported outcomes of pain, disability, bothersomeness, and back pain function will be collected at 2, 4, 6, and 12 weeks from allocation. Because low back pain is one of the leading causes of disability among U.S. military personnel, it is important to find pragmatic and conservative treatments that will treat low back pain and preserve low back function so that military readiness is maintained. Thus, it is important to evaluate the effects of the addition of chiropractic care to usual medical care on low back pain and disability. The trial discussed in this

  12. Practical standard for nuclear power plant life management programs: 2007

    International Nuclear Information System (INIS)

    2006-03-01

    The standard specifies the method of implementing nuclear power plant life management programs. The plant life management programs evaluate the integrity of the plant structures, systems and components, assessing if appropriate measures are taken against existing aging phenomena, if there are possibilities of occurrence and development of aging phenomena and if a sufficient level of margin is maintained to assure the integrity throughout the future operating period. The programs also assess the validity of the current maintenance activities, such as trend monitoring, walkdowns, periodic tests and inspections, repair and replacement work for the purpose of preventive maintenance, and utilization of lessons learned from past trouble experience, in order to newly identify maintenance measures. The technical evaluation on aging phenomena is conducted to establish the 10 year maintenance program for nuclear power plants until the plant reaches 30 years of service. The standard was established and issued by the Atomic Energy Society of Japan (AESJ) through the discussion of experts in the associated fields. (T. Tanaka)

  13. Standard hazard analysis, critical control point and hotel management

    Directory of Open Access Journals (Sweden)

    Vujačić Vesna

    2017-01-01

    Full Text Available Tourism is a dynamic category which is continuously evolving in the world. Specificities that have to be respected in the execution in relation to the food industry are connected with the fact that the main differences which exist regarding the food serving procedure in catering, numerous complex recipes and production technologies, staff fluctuation, old equipment. For an effective and permanent implementation, the HACCP concept is very important for building a serious base. In this case, the base is represented by the people handling the food. This paper presents international ISO standards, the concept of HACCP and the importance of its application in the tourism and hospitality industry. The concept of HACCP is a food safety management system through the analysis and control of biological, chemical and physical hazards in the entire process, from raw material production, procurement, handling, to manufacturing, distribution and consumption of the finished product. The aim of this paper is to present the importance of the application of HACCP concept in tourism and hotel management as a recognizable international standard.

  14. FEDERAL PERFORMANCE STANDARDS OF SELF-REGULATING ORGANIZATIONS OF ARBITRATION MANAGERS AND ARBITRATION MANAGERS: PROBLEMS AND PROSPECTS

    Directory of Open Access Journals (Sweden)

    V. N. Alferov

    2014-01-01

    Full Text Available This paper analyzes the practical aspects of the formation of the federal standards, internal standards and rules of self-regulating organizations of arbitration managers and arbitration managers. Identifi cation of unsolved problems concerning maintenance decision-making mechanisms in bankruptcy proceedings requiring refl ection in federal standards is carried, and appropriate proposals for inclusion in the federal standards are considered.

  15. Do informed consent documents for chiropractic clinical research studies meet readability level recommendations and contain required elements: a descriptive study.

    Science.gov (United States)

    Twist, Elissa; Lawrence, Dana J; Salsbury, Stacie A; Hawk, Cheryl

    2014-01-01

    Informed consent documents (ICD) in research are designed to educate research participants about the nature of the research project in which he or she may participate. United States (US) law requires the documents to contain specific elements present and be written in a way that is understandable to research participants. The purpose of this research is to determine if ICDs from randomized controlled trials conducted at chiropractic colleges meet recommended readability standards and contain the 13 content items required by US law. This study was approved by Palmer College of Chiropractic's IRB #2012-12-3-T and was conducted between December 3, 2012 and February 14, 2013. We contacted the research directors of five chiropractic colleges that have received federal funding supporting their clinical research. A total of 13 informed consent documents from four chiropractic colleges were analyzed using the Flesch-Kincaid measurement. We assigned a grade-level readability score to the document based on the average of three separate grade level scores conducted on the three largest uninterrupted blocks of text. Content of the 13 ICDs was assessed using a 13-element checklist. A point was given for every element present in the document, giving a score range of "0, no elements are present", to "13, all elements are present." The mean Flesch-Kincaid grade level readability was 10.8 (range 7.2 -14.0). Our sample had a mean readability score 2.8 grade levels above the generally-accepted US average reading level. Content varied among the 13 informed consent forms, ranging from only nine elements present in one document to all 13 required in five documents. Additionally, we collated the risks presented in each document. These results strongly suggest that chiropractic clinical researchers are not developing ICDs at a readability level congruent with the national average acceptable level. The low number of elements in some of the informed consent documents raises concern that not

  16. The Quality of Life of Children Under Chiropractic Care Using PROMIS-25: Results from a Practice-Based Research Network.

    Science.gov (United States)

    Alcantara, Joel; Lamont, Andrea E; Ohm, Jeanne; Alcantara, Junjoe

    2017-12-20

    To characterize pediatric chiropractic and assess pediatric quality of life (QoL). A prospective cohort. Setting/Locations: Individual offices within a practice-based research network located throughout the United States. A convenience sample of children (8-17 years) under chiropractic care and their parents. Chiropractic spinal adjustments and adjunctive therapies. Survey instrument measuring sociodemographic information and correlates from the clinical encounter along with the Patient Reported Outcomes Measurement Information System (PROMIS)-25 to measure QoL (i.e., depression, anxiety, and pain interference). Sociodemographic and clinical correlates were analyzed using descriptive statistics (i.e., frequencies/percentages, means, and standard deviations). The PROMIS-25 data were analyzed using scoring manuals, converting raw scores to T score metric (mean = 50; SD = 10). A generalized linear mixed model was utilized to examine covariates (i.e., sex, number of visits, and motivation for care) that may have played an important role on the PROMIS outcome. The original data set consisted of 915 parent-child dyads. After data cleaning, a total of 881 parents (747 females, 134 males; mean age = 42.03 years) and 881 children (467 females and 414 males; mean age = 12.49 years) comprised this study population. The parents were highly educated and presented their child for mainly wellness care. The mean number of days and patient visits from baseline to comparative QoL measures was 38.12 days and 2.74 (SD = 2.61), respectively. After controlling for the effects of motivation for care, patient visits, duration of complaint, sex, and pain rating, significant differences were observed in the probability of experiencing problems (vs. no reported problems) across all QoL domains (Wald = 82.897, df = 4, p < 0.05). Post hoc comparisons demonstrated the children were less likely to report any symptoms of depression (Wald = 6.1474, df = 1

  17. ADOPTION OF ISO 9001 QUALITY MANAGEMENT STANDARD IN AFRICA

    Directory of Open Access Journals (Sweden)

    Erlantz Allur

    2014-03-01

    Full Text Available This article analyzes the dissemination of ISO 9001, the main global management standards, within Africa. The work refers to the diffusion of ISO 9001 standard in terms of its certification intensity. In this article, the dissemination of ISO 9001 in Africa has been analyzed. The findings reveal that the diffusion of the standard in this continent is not very relevant, what might be seen as an indicator of the process of Africa's trade marginalization in the age of globalization. The general certification intensity of the continet is of 0.18; in other words, the proportion of the contribution of Africa to the global GDP of the world is more than five times superior to the proportion of ISO 9001 certificates located in Africa. By means of the logistic model the dissemination of ISO 9001 is forecasted, and it has been observed that the diffusion of ISO 9001 in Africa is in an 85% of its saturation point. Taking into account this model, it's expected that the dissemination of ISO 9001 will be growing until 2020.

  18. Domain management OSSs: bridging the gap between legacy and standards-based network management systems

    Science.gov (United States)

    Lemley, Todd A.

    1996-11-01

    The rapid change in the telecommunications environment is forcing carriers to re-assess not only their service offering, but also their network management philosophy. The competitive carrier environment has taken away the luxury of throwing technology at a problem by using legacy and proprietary systems and architectures. A more flexible management environment is necessary to effectively gain, and maintain operating margins in the new market era. Competitive forces are driving change which gives carriers more choices than those that are available in legacy and standards-based solutions alone. However, creating an operational support system (OSS) with this gap between legacy and standards has become as dynamic as the services which it supports. A philosophy which helps to integrate the legacy and standards systems is domain management. Domain management relates to a specific service or market 'domain,'and its associated operational support requirements. It supports a companies definition of its business model, which drives the definition of each domain. It also attempts to maximize current investment while injecting new technology available in a practical approach. The following paragraphs offer an overview of legacy systems, standards-based philosophy, and the potential of domain management to help bridge the gap between the two types of systems.

  19. GPs opinions and perceptions of chiropractic in Sweden and Norway: a descriptive survey

    Science.gov (United States)

    2013-01-01

    Background In Sweden, chiropractic is not included in mainstream health care. In Norway chiropractic is a recognized health care profession. The aim of this study was to explore the perceptions of chiropractic among Swedish and Norwegian General Practitioners (GPs). Methods Eight hundred surveys in each country were distributed randomly by post to Swedish and Norwegian GPs offices. The survey contained two main sections: Experiences and opinions about chiropractic and referral patterns. The data were then described and compared between the countries. Results In Sweden the response rate was 44.8% and in Norway 45.3%. More than half of the Swedish GPs participating in this study stated that they had poor knowledge about chiropractic, while just a tenth of Norwegian GPs stated the same. Nearly all Norwegian GPs had some experience of chiropractic treatment whilst a fairly large number of the Swedish GPs said that they had no experience at all of chiropractic. It was twice as common for GPs in Norway to refer patients to a chiropractor as compared to Sweden. However, Swedish and Norwegian GPs agreed that chiropractors were competent to treat musculo-skeletal conditions with an adequate education to be part of mainstream medicine. Conclusions Swedish and Norwegian GPs agree that chiropractors are competent to treat musculoskeletal conditions. However, there are many differences in GPs perceptions of chiropractic between the two countries and the overall picture indicates that chiropractic is more accepted and recognised as a health care profession in Norway. PMID:24128386

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

    Science.gov (United States)

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

    2013-02-01

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

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

    DEFF Research Database (Denmark)

    Hviid, Carsten; Salomonsen, Mette; Gelineck, John

    2009-01-01

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

  2. Constructing a philosophy of chiropractic: evolving worldviews and modern foundation☆

    Science.gov (United States)

    Senzon, Simon A.

    2011-01-01

    Objective The purpose of this article is to trace the foundations of DD Palmer's sense of self and philosophy of chiropractic to its sources in modern Western philosophy as well as current metatheories about modernity. Discussion DD Palmer's sense of self was indicative of a modern self. A modern self is characterized as a self that developed after the Western Enlightenment and must come to terms with the insights of modernity such as Cartesian dualism, Spinoza's substance, Rousseau's expressivism, and Kant's critiques. It is argued that Palmer's philosophy can be viewed as part of the this tradition alongside his involvement in the 19th century American metaphysical religious culture, which was itself a response to these challenges of the modern self of modernity. Conclusion Palmer's development of chiropractic and its philosophy was a reaction to the challenges and promises of modernity. PMID:22693479

  3. The System 80+ Standard Plant Information Management System

    International Nuclear Information System (INIS)

    Turk, R.S.; Bryan, R.E.

    1998-01-01

    Historically, electric nuclear power plant owners, following the completion of construction and startup, have been left with a mountain of hard-copy documents and drawings. Hundreds of thousands of hours are spent searching for relevant documents and, in most cases, the documents found require many other documents and drawings to fully understand the design basis. All too often the information is incomplete, and eventually becomes obsolete. In the U.S., utilities spend millions of dollars to discover design basis information and update as-built data for each plant. This information must then be stored in an easily accessed usable form to assist satisfy regulatory requirements and to improve plant operating efficiency. ABB Combustion Engineering Nuclear Systems (ABB-CE) has an active program to develop a state-of-the-art Plant Information Management System (IMS) for its advanced light water reactor, the System 80+TM Standard Plant Design. This program is supported by ABB's Product Data Management (PDM) and Computer Aided Engineering (CAE) efforts world wide. This paper describes the System 80+ plant IMS and how it will be used during the entire life cycle of the plant. (author)

  4. The System 80+ Standard Plant Information Management System

    Energy Technology Data Exchange (ETDEWEB)

    Turk, R.S.; Bryan, R.E. [ABB Combuions Engineering Nuclear Systems (United States)

    1998-07-01

    Historically, electric nuclear power plant owners, following the completion of construction and startup, have been left with a mountain of hard-copy documents and drawings. Hundreds of thousands of hours are spent searching for relevant documents and, in most cases, the documents found require many other documents and drawings to fully understand the design basis. All too often the information is incomplete, and eventually becomes obsolete. In the U.S., utilities spend millions of dollars to discover design basis information and update as-built data for each plant. This information must then be stored in an easily accessed usable form to assist satisfy regulatory requirements and to improve plant operating efficiency. ABB Combustion Engineering Nuclear Systems (ABB-CE) has an active program to develop a state-of-the-art Plant Information Management System (IMS) for its advanced light water reactor, the System 80+TM Standard Plant Design. This program is supported by ABB's Product Data Management (PDM) and Computer Aided Engineering (CAE) efforts world wide. This paper describes the System 80+ plant IMS and how it will be used during the entire life cycle of the plant. (author)

  5. Stress management standards: a warning indicator for employee health.

    Science.gov (United States)

    Kazi, A; Haslam, C O

    2013-07-01

    Psychological stress is a major cause of lost working days in the UK. The Health & Safety Executive (HSE) has developed management standards (MS) to help organizations to assess work-related stress. To investigate the relationships between the MS indicator tool and employee health, job attitudes, work performance and environmental outcomes. The first phase involved a survey employing the MS indicator tool, General Health Questionnaire-12 (GHQ-12), job attitudes, work performance and environmental measures in a call centre from a large utility company. The second phase comprised six focus groups to investigate what employees believed contributed to their perceived stress. Three hundred and four call centre employees responded with a response rate of 85%. Significant negative correlations were found between GHQ-12 and two MS dimensions; demands (Rho = -0.211, P relationships (Rho= -0.134, P relationship with GHQ-12. Higher levels of stress were associated with reduced job performance, job motivation and increased intention to quit but low stress levels were associated with reduced job satisfaction. Lack of management support, recognition and development opportunities were identified as sources of stress. The findings support the utility of the MS as a measure of employee attitudes and performance.

  6. 41 CFR 105-72.301 - Standards for financial management systems.

    Science.gov (United States)

    2010-07-01

    ... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Standards for financial... Management § 105-72.301 Standards for financial management systems. (a) Federal awarding agencies shall... practical. (b) Recipients' financial management systems shall provide for the following. (1) Accurate...

  7. A framework for chiropractic training in clinical preventive services

    OpenAIRE

    Hawk, Cheryl; Evans, Marion Willard

    2013-01-01

    The 2010 Patient Protection and Affordable Care Act provides incentives for both patients and providers to engage in evidence-based clinical preventive services recommended by the United States Preventive Services Task Force (USPSTF). Depending upon the application of the new health care act, Doctors of Chiropractic (DC) may be considered to be covered providers of many of these services. It is therefore essential that DCs? training prepare them to competently deliver them. The aim of this co...

  8. Empowerment of chiropractic faculty: a profile in context.

    Science.gov (United States)

    Marchiori, Dennis M; Henkin, Alan B

    2003-01-01

    The primary resource base and core human capital in chiropractic education is found among its faculty. The chiropractic profession depends on a motivated faculty for continuous quality improvement and innovation in areas of curriculum, scholarship, and practice. Empowerment has been associated with increased intrinsic motivation. Assessments of attitudes of faculty in terms of empowerment, a set of cognitions created by the work environment, may inform executive decision making related to development of a productive professional work environment. The goal of this exploratory study is to provide an initial understanding of empowerment among faculty in the organizational context of chiropractic education, to construct a profile of perceived faculty empowerment, and to inquire into potential associations between perceived empowerment and faculty demographic and workplace characteristics. This was a full faculty survey using descriptive statistics and multivariable analysis. Surveys were distributed to full- and part-time faculty working in the United States and Canada. The survey was composed of Spreitzer's multidimensional measure of psychologic empowerment and additional items designed to measure faculty demographics and workplace variables including academic rank, years at the institution, years in higher education, sex, age, area of assignment, employment status, and academic rank. More than 54% of the study population (N = 609) completed and returned the instrument. The respondents were typically male (68.4%) and employed full-time (81.6%). Almost half (47.5%) of the respondents were assigned to the area of patient care at their institution. Area of assignment and employment status emerged as important variables for explaining the variance in dependent variable scores. The findings of this research provide a basic profile and some initial perspectives of empowerment in the context of the work environment of the chiropractic profession's learning institutions.

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

    OpenAIRE

    2012-01-01

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

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

  11. 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

  12. 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.

  13. The efficacy of chiropractic manipulation for back pain : Blinded review of relevant randomized clinical trials

    NARCIS (Netherlands)

    Assendelft, W. J J; Koes, B. W.; Van der Heijden, G. J M G; Bouter, L. M.

    1992-01-01

    Objective: To assess the efficacy of chiropractic for patients with back pain. Data Sources: Randomized clinical trials (RCTs) on spinal manipulation were identified with a Medline search (1966-1990), by citation tracking, and by manual examination of the relevant chiropractic reference systems

  14. The chiropractic care of patients with cancer: a systematic review of the literature.

    Science.gov (United States)

    Alcantara, Joel; Alcantara, Joey D; Alcantara, Junjoe

    2012-12-01

    Cancer is the leading cause of death worldwide and accounted for 7.4 million deaths in 2004. By 2030, deaths from cancer have been estimated at 12 million with 30% being preventable. Complementary and alternative medicine remains popular among cancer patients; particularly with chiropractic services. However, the nature of the chiropractic clinical encounter and its reported benefits remains to be fully investigated. Towards these efforts, we begin with a systematic review of the literature on the chiropractic care of patients with cancer. The following electronic databases were searched: MANTIS [1965-2010]; Index to Chiropractic Literature [1984-2010]; Pubmed [1966-2010]; Medline [1965-2010] EMBASE [1974-2010], AMED [1975-2010], CINAHL Plus [1965-2010], Alt-Health Watch [1965-2010] and PsychINFO [1965-2010]. Key words used were "cancer" and "neoplasm" in Boolean combination with "chiropractic." Primary investigation/reports in peer-reviewed English journals involving chiropractic care were reviewed. Our review revealed 60 case reports, 2 case series, 21 commentaries, 2 survey studies, and 2 literature reviews. The case reports were diagnostic with commentaries highlighting the importance of recognizing the patient presenting with NMS complaints due to an underlying neoplasm. The chiropractic clinical encounter prior to cancer diagnosis and subsequent medical referral is poorly characterized in the literature. Patients with cancer seek the care of chiropractors. The literature does not reflect or describe the totality of the chiropractic clinical encounter. We encourage further research in this field.

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

    Science.gov (United States)

    2011-01-01

    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. PMID:21599991

  16. Straight chiropractic philosophy as a barrier to Medicare compliance: a discussion of 5 incongruent issues

    Science.gov (United States)

    Seaman, David R.; Soltys, Jonathan R.

    2013-01-01

    Objective The purpose of this commentary is to discuss potential 5 factors within straight chiropractic philosophy and practice that may prevent Medicare compliance. Discussion The national Medicare Benefit Policy Manual and the Florida Local Coverage Determination were reviewed to identify documentation and conceptual issues regarding chiropractic practice. Five Medicare positions were contrasted with tenets of straight chiropractic philosophy. Based on Medicare’s documentation requirements, Medicare defines subluxation and chiropractic practice from the perspective of treating spinal pain and related functional disability. In contrast, traditional straight chiropractic philosophy is not based on the treatment of spinal pain and disability or other symptomatic presentations. In this context, 5 potential areas of conflict are discussed. Conclusion The Medicare version of chiropractic practice is not consistent with traditional straight chiropractic philosophy, which may play a role in preventing Medicare compliance. The chiropractic profession may need to consider the fashion in which “philosophy” as it relates to technique and practice is presented to students and doctors to facilitate compliance with the documentation requirements of Medicare. PMID:25067928

  17. Straight chiropractic philosophy as a barrier to Medicare compliance: a discussion of 5 incongruent issues.

    Science.gov (United States)

    Seaman, David R; Soltys, Jonathan R

    2013-12-01

    The purpose of this commentary is to discuss potential 5 factors within straight chiropractic philosophy and practice that may prevent Medicare compliance. The national Medicare Benefit Policy Manual and the Florida Local Coverage Determination were reviewed to identify documentation and conceptual issues regarding chiropractic practice. Five Medicare positions were contrasted with tenets of straight chiropractic philosophy. Based on Medicare's documentation requirements, Medicare defines subluxation and chiropractic practice from the perspective of treating spinal pain and related functional disability. In contrast, traditional straight chiropractic philosophy is not based on the treatment of spinal pain and disability or other symptomatic presentations. In this context, 5 potential areas of conflict are discussed. The Medicare version of chiropractic practice is not consistent with traditional straight chiropractic philosophy, which may play a role in preventing Medicare compliance. The chiropractic profession may need to consider the fashion in which "philosophy" as it relates to technique and practice is presented to students and doctors to facilitate compliance with the documentation requirements of Medicare.

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

    DEFF Research Database (Denmark)

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

    2014-01-01

    BACKGROUND: Adverse events are commonly observed in all parts of health care and have been reported extensively following manual therapy, including chiropractic. The majority of reported adverse events following chiropractic care are mild, transitory and self-limiting. However, little is known...

  19. 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.

  20. The Five Eras of Chiropractic & the future of chiropractic as seen through the eyes of a participant observer

    Science.gov (United States)

    2012-01-01

    Chiropractic has endured a turbulent history, marked by tremendous advances in areas such as education and licensing while marred by interprofessional conflict and a poor public image. The prolonged interprofessional conflict was instrumental in shaping the culture of chiropractic. These obstacles have long-since been removed although there are lingering effects from them. This article examines the chiropractic profession's history by dividing it into five Eras and suggests that there are three options available for the future of the profession. One: maintaining the status quo. Two: uniting under an evidence based scientific approach as partners in the health care delivery system that has buried the "one-cause, one-cure" sacred cow. The steps required to achieve this outcome are outlined. Three: openly dividing the profession into evidence based practitioners and subluxation based practitioners. Adopting this option would allow each branch of the profession to move forward in the health care delivery system unhindered by the other. It is unclear which option the profession will choose and whether the profession is mature enough to follow option two remains to be seen. What is evident is that the time to act is now. PMID:22260381

  1. Impact of chiropractic services at an on-site health center.

    Science.gov (United States)

    Kindermann, Sylvia L; Hou, Qingjiang; Miller, Ross M

    2014-09-01

    To compare the influence of employer-sponsored, on-site chiropractic care against community-obtained care on health care utilization. This was a retrospective claims analysis of members of a single employee health plan receiving chiropractic care on-site or off-site from 2010 to 2012. Utilization differences were evaluated by having 1 health care event or more, including radiology or clinical visits. There were 876 on-site and 759 off-site participants. The off-site group received more radiology services overall (55.5% vs 38.2%; P chiropractic care and physical therapy (both P chiropractic services are associated with lower health care utilization. These results support the value of chiropractic services offered at on-site health centers.

  2. 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. © The Author(s) 2016.

  3. Non-standard constraints within In-Core Fuel Management

    International Nuclear Information System (INIS)

    Maldonado, G.I.; Torres, C.; Marrote, G.N.; Ruiz U, V.

    2004-01-01

    Recent advancements in the area of nuclear fuel management optimization have been considerable and widespread. Therefore, it is not surprising that the design of today's nuclear fuel reloads can be a highly automated process that is often accompanied by sophisticated optimization software and graphical user interfaces to assist core designers. Most typically, among other objectives, optimization software seeks to maximize the energy efficiency of a fuel cycle while satisfying a variety of safety, operational, and regulatory constraints. Concurrently, the general industry trend continues to be one of pursuing higher generating capacity (i.e., power up-rates) alongside cycle length extensions. As these increasingly invaluable software tools and ambitious performance goals are pursued in unison, more aggressive core designs ultimately emerge that effectively minimize the margins to limits and, in some cases, may turn out less forgiving or accommodating to changes in underlying key assumptions. The purpose of this article is to highlight a few 'non-standard', though common constraints that can affect a BWR core design but which are often difficult, if not impossible, to implement into an automated setting. In a way, this article indirectly emphasizes the unique and irreplaceable role of the experienced designer in light of 'real life' situations. (Author)

  4. Employee engagement and management standards: a concurrent evaluation.

    Science.gov (United States)

    Ravalier, J M; Dandil, Y; Limehouse, H

    2015-08-01

    The UK Health & Safety Executive's Management Standards Indicator Tool (MSIT) has been used to assess areas of work design, which may act as psychosocial hazards leading to burnout. These have not been assessed as predictors of employee engagement. To determine the utility of the MSIT in evaluating employee engagement as measured by the Utrecht Work Engagement Scale (UWES). A cross-sectional survey of employees from two sales organizations in London was performed using the MSIT and UWES. MSIT scores were analysed stratifying medium-high versus low engagement. Multivariate linear regression evaluated the association of all MSIT scores with UWES factors. Control, managerial support, peer support and employee role differed by engagement level. Demands, peer support and role exceeded MSIT benchmark guidance that would warrant urgent improvement. Role ambiguity was the only factor significantly associated with all subdomains of engagement. Role appears to play a major part in determining employee engagement. Assessment of the relationship between factors measured by the MSIT and UWES requires further investigation in wider organizational settings, particularly the influence of employee role on positive psychological outcomes. © The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  5. 36 CFR 64.12 - Standards for grantee financial management systems.

    Science.gov (United States)

    2010-07-01

    ... financial management systems. 64.12 Section 64.12 Parks, Forests, and Public Property NATIONAL PARK SERVICE... RIGHTS-OF-WAY § 64.12 Standards for grantee financial management systems. The grantees' Financial Management Systems shall meet the minimum standards set forth in OMB Circular A-102, Attachment G. ...

  6. 76 FR 63509 - Small Business Size Standards: Administrative and Support, Waste Management and Remediation Services

    Science.gov (United States)

    2011-10-12

    ... Small Business Size Standards: Administrative and Support, Waste Management and Remediation Services... Standards: Administrative and Support, Waste Management and Remediation Services AGENCY: U.S. Small Business...) Sector 56, Administrative and Support, Waste Management and Remediation Services. As part of its ongoing...

  7. 20 CFR 627.425 - Standards for financial management and participant data systems.

    Science.gov (United States)

    2010-04-01

    ... Administrative Standards § 627.425 Standards for financial management and participant data systems. (a)(1) General. The financial management system and the participant data system of each recipient and... the financial management system and participant data system of any recipient/subrecipient as part of a...

  8. 36 CFR 223.218 - Consistency with plans, environmental standards, and other management requirements.

    Science.gov (United States)

    2010-07-01

    ..., environmental standards, and other management requirements. 223.218 Section 223.218 Parks, Forests, and Public... Special Forest Products § 223.218 Consistency with plans, environmental standards, and other management... with applicable land management plans. Each contract, permit, or other authorizing instrument shall...

  9. Complementary and Alternative Medicine in an Integrated Health Care Delivery System: Users of Chiropractic, Acupuncture, and Massage Services

    Science.gov (United States)

    McCubbin, Tracy; Kempe, Karin L; Beck, Arne

    2017-01-01

    Introduction Complementary and alternative medicine research has relied primarily on survey data from community populations rather than from patient populations receiving these services in integrated health care delivery systems (IHDS). Objectives To describe patients seeking chiropractic, acupuncture, or massage therapy in a dedicated Center for Complementary Medicine (CCM) within an IHDS. Methods Patient surveys at the initial CCM visit included chief complaint, prior treatments, and relief with treatment (0% to 100% relief). A modified Brief Pain Inventory assessed average and current pain (0 = no pain; 10 = unbearable pain) and interference with life domains (1 = does not interfere; 10 = completely interferes). Demographics and CCM provider type were obtained from medical records. Analysis included patients who completed the survey. Results Between 2007 and 2014, a total of 27,225 patients sought CCM services (median age = 50 years). Most (62%) were female, and 73% were white. Modalities included chiropractic (66.9%), acupuncture (18.1%), and massage (15.0%). Spine/truncal pain was most commonly reported (70.5%). A majority of patients (59%) saw their physician for their condition, 59% had not used CCM services previously, and 60% received medications for their condition. Mean ratings included pain relief with prior treatment (30.07%, standard deviation [SD] = 27.01%), current pain (4.33, SD = 2.4), and functional impairment ranging from 3.03 (SD = 3.09) for relationships to 5.42 (SD = 3.22) for enjoyment of life. Conclusion Spine/truncal pain was the most common complaint and chiropractic the most common modality among patients receiving CCM services in an IHDS. More than one-third of patients self-referred to the CCM. PMID:28746026

  10. Realizing business benefits from company IT standardization : Case study research into the organizational value of IT standards, towards a company IT standardization management framework

    NARCIS (Netherlands)

    van Wessel, R.M.

    2008-01-01

    From a practical point of view, this research provides insight into how company IT standards affect business process performance. Furthermore it gives recommendations on how to govern and manage such standards successfully with regard to their selection, implementation and usage. After evaluating

  11. Exploring chiropractic students' experiences of the educational environment in healthcare professional training: a qualitative study.

    Science.gov (United States)

    Palmgren, Per J; Laksov, Klara Bolander

    2015-08-05

    The educational environment has a significant impact on students' behavior, sense of well-being, and academic advancement. While various research methodologies have been used to explore the educational environment, there is a paucity of studies employing qualitative research methods. This study engages in an in-depth exploration of chiropractic students' experiences of the meaning of the educational environment. A qualitative approach was employed by interviewing 26 students in four focus group interviews at two different points in time. A conventional manifest and latent content analysis was chosen to investigate and interpret the experiences of the educational environment in an undergraduate chiropractic training institution in Sweden. The analysis resulted in five overarching themes: Personal growth; Being part of a community; A place of meaningfulness; Trust in a regulated system; and Scaffolding relationships. Early in the training, the meaning of the educational environment was experienced as part of a vocational community and the scaffolding of intra-institutional relationships. In later stages, the environment was experienced in terms of personal growth - balancing academic pressures and progress within the professional community - thus laying the foundations for autonomy and motivation. During the clinical training, the environment was experienced as where learning happens, thus creating a place of meaningfulness. Throughout the training, the formal and clinical environments were experienced as isolating, with little bridging between the two. A regulated system - conveying an operative organization with clear communication regarding what to expect - was experienced as important for an apt educational environment. We found that experiences of an educational environment are dynamic and change over time. When restructuring or evaluating curriculums, educational managers can consider the emerged themes as constituting facets relating to the educational

  12. The HSE Management Standards Indicator Tool: concurrent and construct validity.

    Science.gov (United States)

    Marcatto, F; Colautti, L; Larese Filon, F; Luis, O; Ferrante, D

    2014-07-01

    The Health & Safety Executive Management Standards Indicator Tool (HSE-MS IT) is a questionnaire commonly used to assess work-related stress risks at an organizational level. A critical factor in determining whether this instrument is actually useful is that higher levels of stress risk in the work-design domains should predict higher levels of stress and stress-related outcomes in workers. Only a few studies, however, have addressed this issue. To test both the concurrent and construct validity of the HSE-MS IT, by relating it with another widely used instrument, the Job Content Questionnaire (JCQ), and by examining its relationships with a set of work-related stress outcomes. An anonymous cross-sectional questionnaire was administered to a sample of employees in an Italian municipality. The questionnaire included the HSE-MS IT, self-reported measures of job satisfaction, job motivation and stress at work, the Satisfaction with Life Scale and the reduced form of the JCQ. A total of 760 out of 779 employees completed the questionnaire. Results showed moderate to strong correlation among the corresponding HSE-MS IT and JCQ scales. Hierarchical regression highlighted the specific contribution of each of the HSE-MS IT scales in predicting three relevant work-related stress outcomes (self-reported stress, job satisfaction and job motivation), after controlling for gender, age and life satisfaction. Our findings consolidated the HSE-MS IT validity and showed the specific sensitivity of its scales to assess different aspects of work-related distress, including self-perception of stress at work. These results can have practical implications for the occupational well-being of employees. © The Author 2014. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  13. Developing standardized strategic response categories for fire management units

    Science.gov (United States)

    Matthew P. Thompson; Crystal S. Stonesifer; Robert C. Seli; Marlena Hovorka

    2013-01-01

    Federal wildland fire policy requires that publicly owned lands with burnable vegetation have a fire management plan (FMP); this applies to the five primary Federal fire agencies (Bureau of Indian Affairs, Bureau of Land Management, National Park Service, U.S. Fish and Wildlife Service, and Forest Service). FMPs are based on land and resource management plans and are...

  14. 76 FR 35791 - Prudential Management and Operations Standards

    Science.gov (United States)

    2011-06-20

    ... strategy for managing market risk. The strategy should specify a target account, or target accounts, for... strategy for managing market risk should take into account the importance of maintaining the market value... market risk; adequacy of liquidity and reserves; management of growth in assets and in the investment...

  15. The Development of a Skills Standard for Hazardous Materials Management Technology Technicians.

    Science.gov (United States)

    Johnson, James; Bear, Robert L.

    1995-01-01

    A multifaceted program, Goals 2000: Educate America," has as one of its top priorities the development of skills standards for certain key occupations. This articles examines the development of standards for Hazardous Materials Management Technology technicians. (LZ)

  16. Connected vehicle data capture and management (DCM) and dynamic mobility applications (DMA) : focused standards coordination plan.

    Science.gov (United States)

    2012-11-01

    The Connected Vehicle Mobility Standards Coordination Plan project links activities in three programs (Data Capture and Management, Dynamic Mobility Applications, and ITS Standards). The plan coordinates the timing, intent and relationship of activit...

  17. Applicability Evaluation of Job Standards for Diabetes Nutritional Management by Clinical Dietitian

    OpenAIRE

    Baek, Young Jin; Oh, Na Gyeong; Sohn, Cheong-Min; Woo, Mi-Hye; Lee, Seung Min; Ju, Dal Lae; Seo, Jung-Sook

    2017-01-01

    This study was conducted to evaluate applicability of job standards for diabetes nutrition management by hospital clinical dietitians. In order to promote the clinical nutrition services, it is necessary to present job standards of clinical dietitian and to actively apply these standardized tasks to the medical institution sites. The job standard of clinical dietitians for diabetic nutrition management was distributed to hospitals over 300 beds. Questionnaire was collected from 96 clinical di...

  18. Study of China green supply chain management policies and standard

    Science.gov (United States)

    Zhang, Xiaoxin; Huang, Jin; Lin, Ling

    2017-11-01

    With the highlight of the environment issues, manufacturing industry needs to be environmentally managed with integrated methods in system aspect. Green supply chain management, integrating the environment aspect into each step of the implement of supply chain management, is the key measure to improve the efficiency of environmental management and to remit the pollution. It also helps to make best use and configuration of the resources and has been attracting much attention from our government, enterprises and academia in recent years. This paper introduced the definition and content of green supply chain management, concluded the research progress of green supply chain management by domestic scholars, stated the characteristic and achievement of the implement of green supply chain management in China as well as analyzed the current existing problems and suggestions in the future.

  19. Best practices in selecting performance measures and standards for effective asset management.

    Science.gov (United States)

    2011-06-01

    "This report assesses and provides guidance on best practices in performance measurement, management and standards : setting for effective Transportation Asset Management (TAM). The study is conducted through a literature review, a : survey of the 50...

  20. Paying for quality not quantity: a wisconsin health maintenance organization proposes an incentive model for reimbursement of chiropractic services.

    Science.gov (United States)

    Pursel, Kevin J; Jacobson, Martin; Stephenson, Kathy

    2012-07-01

    The purpose of this study is to describe a reimbursement model that was developed by one Health Maintenance Organization (HMO) to transition from fee-for-service to add a combination of pay for performance and reporting model of reimbursement for chiropractic care. The previous incentive program used by the HMO provided best-practice education and additional reimbursement incentives for achieving the National Committee for Quality Assurance Back Pain Recognition Program (NCQA-BPRP) recognition status. However, this model had not leveled costs between doctors of chiropractic (DCs). Therefore, the HMO management aimed to develop a reimbursement model to incentivize providers to embrace existing best-practice models and report existing quality metrics. The development goals included the following: it should (1) be as financially predictable as the previous system, (2) cost no more on a per-member basis, (3) meet the coverage needs of its members, and (4) be able to be operationalized. The model should also reward DCs who embraced best practices with compensation, not simply tied to providing more procedures, the new program needed to (1) cause little or no disruption in current billing, (2) be grounded achievable and defined expectations for improvement in quality, and (3) be voluntary, without being unduly punitive, should the DC choose not to participate in the program. The generated model was named the Comprehensive Chiropractic Quality Reimbursement Methodology (CCQRM; pronounced "Quorum"). In this hybrid model, additional reimbursement, beyond pay-for-procedures will be based on unique payment interpretations reporting selected, existing Physician Quality Reporting System (PQRS) codes, meaningful use of electronic health records, and achieving NCQA-BPRP recognition. This model aims to compensate providers using pay-for-performance, pay-for-quality reporting, pay-for-procedure methods. The CCQRM reimbursement model was developed to address the current needs of one

  1. Regional Supply of Chiropractic Care and Visits to Primary Care Physicians for Back and Neck Pain

    Science.gov (United States)

    Davis, Matthew A.; Yakusheva, Olga; Gottlieb, Daniel J.; Bynum, Julie P.W.

    2015-01-01

    Background Whether availability of chiropractic care affects use of primary care physician (PCP) services is unknown. Methods We performed a cross-sectional study of 17.7 million older adults who were enrolled in Medicare from 2010 to 2011. We examined the relationship between regional supply of chiropractic care and PCP services using Spearman correlation. Generalized linear models were used to examine the association between regional supply of chiropractic care and number of annual visits to PCPs for back and/or neck pain. Results We found a positive association between regional supply of chiropractic care and PCP services (rs = 0.52; P neck pain was apparent. The number of PCP visits for back and/or neck pain was 8% lower (rate ratio, 0.92; 95% confidence interval, 0.91–0.92) in the quintile with the highest supply of chiropractic care compared to the lowest quintile. We estimate chiropractic care is associated with a reduction of 0.37 million visits to PCPs nationally, at a cost of $83.5 million. Conclusions Greater availability of chiropractic care in some areas may be offsetting PCP services for back and/or neck pain among older adults. (J Am Board Fam Med 2015;28:000–000.) PMID:26152439

  2. A survey of interprofessional education in chiropractic continuing education in the United States.

    Science.gov (United States)

    Bednarz, Edward M; Lisi, Anthony J

    2014-10-01

    Objective : The purpose of this study is to describe the state of chiropractic continuing education vis-à-vis interprofessional education (IPE) with medical doctors (MD) in a survey of a sample of US doctors of chiropractic (DC) and through a review of policies. Methods : Forty-five chiropractors with experience in interprofessional settings completed an electronic survey of their experiences and perceptions regarding DC-MD IPE in chiropractic continuing education (CE). The licensing bodies of the 50 US states and the District of Columbia were queried to assess the applicability of continuing medical education (CME) to chiropractic relicensure. Results : The majority (89.1%) of survey respondents who attend CE-only events reported that they rarely to never experienced MD-IPE at these activities. Survey respondents commonly attended CME-only events, and 84.5% stated that they commonly to very commonly experienced MD-IPE at these activities. More than half (26 of 51) of the licensing bodies did not provide sufficient information to determine if CME was applicable to DC relicensure. Thirteen jurisdictions (25.5%) do not, and 12 jurisdictions (23.5%) do accept CME credits for chiropractic relicensure. Conclusion : The majority of integrated practice DCs we surveyed reported little to no IPE occurring at CE-only events, yet significant IPE occurring at CME events. However, we found only 23.5% of chiropractic licensing bodies allow CME credit to apply to chiropractic relicensure. These factors may hinder DC-MD IPE in continuing education.

  3. Utilization and expenditures on chiropractic care in the United States from 1997 to 2006.

    Science.gov (United States)

    Davis, Matthew A; Sirovich, Brenda E; Weeks, William B

    2010-06-01

    To investigate national utilization and expenditures on chiropractic care between 1997 and 2006. The nationally representative Medical Expenditure Panel Survey (MEPS). We performed descriptive analyses and generated national estimates from data obtained from U.S. adult (>or=18 years) MEPS respondents who reported having visited a chiropractor (annual sample size between 789 and 1,082). For each year, we examined the estimated total national expenditure, the total number of U.S. adults who received chiropractic care, the total number of ambulatory visits to U.S. chiropractors, and the inflation-adjusted charges and expenditures per U.S. adult chiropractic patient. The total number of U.S. adults who visited a chiropractor increased 57 percent from 7.7 million in 2000 to 12.1 million in 2003. From 1997 to 2006, the inflation-adjusted national expenditures on chiropractic care increased 56 percent from U.S.$3.8 billion to U.S.$5.9 billion. Inflation-adjusted total mean expenditures per patient and expenditures per office visit remained unchanged. The large increase in U.S. adult expenditures on chiropractic care between 1997 and 2006 was due to a 57 percent increase in the total number of U.S. adult chiropractic patients that occurred from 2000 to 2003. From 2003 to 2006, the total number of U.S. adult chiropractic patients has remained stable.

  4. The Role of Standardization in Improving the Effectiveness of Integrated Risk Management

    OpenAIRE

    Ciocoiu, Carmen Nadia; Dobrea, Razvan Catalin

    2010-01-01

    The need of standardization in risk management is justified by the efforts to develop and introduce, during the last few years, integrated risk management frameworks inside the organizations. The financial crisis has underscored the fact that significant improvements in risk management organizations and capabilities are required. The business community and also the experts recognize that the risk management standards have an important role in improving the effectiveness of integrated risk man...

  5. A framework for chiropractic training in clinical preventive services.

    Science.gov (United States)

    Hawk, Cheryl; Evans, Marion Willard

    2013-08-20

    The 2010 Patient Protection and Affordable Care Act provides incentives for both patients and providers to engage in evidence-based clinical preventive services recommended by the United States Preventive Services Task Force (USPSTF). Depending upon the application of the new health care act, Doctors of Chiropractic (DC) may be considered to be covered providers of many of these services. It is therefore essential that DCs' training prepare them to competently deliver them. The aim of this commentary is to describe a framework for training in clinical preventive services, based largely on the USPSTF recommendations, which could be readily integrated into existing DC educational programs.

  6. 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. Copyright 2010 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.

  7. Before Nugent took charge: early efforts to reform chiropractic education, 1919-1941

    OpenAIRE

    Keating, Joseph C

    2003-01-01

    John J. Nugent, D.C. is remembered by many as either the “Abraham Flexner of Chiropractic” or the “anti-Christ of Chiropractic.” From 1941 until his forced retirement in 1959, the Irish-born Palmer graduate was one of the most important factors in the profession's educational reforms. Yet Nugent's work as the National Chiropractic Association's (NCA's) director of research was not the beginning of the campaign to upgrade chiropractic education. This paper looks at earlier influences and event...

  8. 38 CFR 43.20 - Standards for financial management systems.

    Science.gov (United States)

    2010-07-01

    ... management systems. 43.20 Section 43.20 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS... management systems. (a) A State must expand and account for grant funds in accordance with State laws and procedures for expending and accounting for its own funds. Fiscal control and accounting procedures of the...

  9. 40 CFR 35.6335 - Property management standards.

    Science.gov (United States)

    2010-07-01

    ... the property; (5) Provisions for financial control and accounting in the financial management system... with CERCLA funds. The recipient may use its own property management system if it meets the following... include the contents specified in § 35.6700(c); (2) A control system that ensures adequate safeguards for...

  10. 40 CFR 31.20 - Standards for financial management systems.

    Science.gov (United States)

    2010-07-01

    ... management systems. (a) A State must expand and account for grant funds in accordance with State laws and procedures for expending and accounting for its own funds. Fiscal control and accounting procedures of the... violation of the restrictions and prohibitions of applicable statutes. (b) The financial management systems...

  11. 36 CFR 1207.20 - Standards for financial management systems.

    Science.gov (United States)

    2010-07-01

    ... management systems. 1207.20 Section 1207.20 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS... financial management systems. (a) A State must expand and account for grant funds in accordance with State laws and procedures for expending and accounting for its own funds. Fiscal control and accounting...

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

    Science.gov (United States)

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

    2012-09-01

    The purpose of this collaborative summary is to document current chiropractic involvement in the public health movement, reflect on social ecological levels of influence as a profession, and summarize the relationship of chiropractic to the current public health topics of: safety, health issues through the lifespan, and effective participation in community health issues. The questions that are addressed include: Is spinal manipulative therapy for neck and low-back pain a public health problem? What is the role of chiropractic care in prevention or reduction of musculoskeletal injuries in children? What ways can doctors of chiropractic stay updated on evidence-based information about vaccines and immunization throughout the lifespan? Can smoking cessation be a prevention strategy for back pain? Does chiropractic have relevance within the VA Health Care System for chronic pain and comorbid disorders? How can chiropractic use cognitive behavioral therapy to address chronic low back pain as a public health problem? What opportunities exist for doctors of chiropractic to more effectively serve the aging population? What is the role of ethics and the contribution of the chiropractic profession to public health? What public health roles can chiropractic interns perform for underserved communities in a collaborative environment? Can the chiropractic profession contribute to community health? What opportunities do doctors of chiropractic have to be involved in health care reform in the areas of prevention and public health? What role do citizen-doctors of chiropractic have in organizing community action on health-related matters? How can our future chiropractic graduates become socially responsible agents of change? Copyright © 2012 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.

  13. Similarities and differences of graduate entry-level competencies of chiropractic councils on education: a systematic review.

    Science.gov (United States)

    Innes, Stanley I; Leboeuf-Yde, Charlotte; Walker, Bruce F

    2016-01-01

    Councils of Chiropractic Education (CCE) indirectly influence patient care and safety through their role of ensuring the standards of training delivered by chiropractic educational institutions. This is achieved by CCEs defining competence and creating lists of descriptive statements to establish the necessary standards for students to attain before graduating. A preliminary review suggested that these definitions and descriptive lists lacked consensus. This creates the potential for variations in standards between the CCE jurisdictions and may compromise patient care and safety and also inter-jurisdictional mutual recognition. The purposes of this study were 1) to investigate similarities and differences between the CCEs in their definitions of competence, domains of educational competencies, components of the domains of competencies, as represented by assessment and diagnosis, ethics, intellectual development, and 2) to make recommendations, if significant deficiencies were found. We undertook a systematic review of the similarities and differences between various CCEs definitions of competence and the descriptive lists of educational competencies they have adopted. CCEs were selected on the basis of WHO recommendations. Blinded investigators selected the data from CCE websites and direct contact with CCEs. This information was tabulated for a comparative analysis. All CCEs' definitions of competence included the elements of "knowledge", "skills" and "attitudes" whereas only one CCE included the expected "abilities" element. The educational application of the definition of competency among CCEs varied. A high level of similarity when comparing the domains of competence adopted by CCEs was found despite variations in the structure. Differences between CCEs became increasingly apparent when the three selected representative domains were compared. CCEs were found to stipulate varying levels of prescriptiveness for graduate entry level standards. A series of

  14. Development of a Field Management Standard for Improving Human Factors

    International Nuclear Information System (INIS)

    Yun, Young Su; Son, Il Moon; Son, Byung Chang; Kwak, Hyo Yean

    2009-07-01

    This project is to develop a management guideline for improving human performances as a part of the Human Factors Management System of Kori unit 1 which is managing all of human factors items such as man-machine system interfaces, work procedures, work environments, and human reliabilities in nuclear power plants. Human factors engineering includes an human factors suitability analysis and improvement of human works, an analysis of accidents by human error, an improvement of work environment, an establishment of human factors management rules and a development of human resources to manage and perform those things consistently. For assisting these human factors engineering tasks, we developed human factors management guidelines, checklists and work procedures to be used in staffing, qualification, training, and human information requirements and workload. We also provided a software tool for managing the above items. Additionally, contents and an item pool for a human factors qualifying examination and training programs were developed. A procedures improvement and a human factors V and V on the Kori unit 1 have been completed as a part of this project, too

  15. Development of a Field Management Standard for Improving Human Factors

    Energy Technology Data Exchange (ETDEWEB)

    Yun, Young Su [Chosun University, Gwangju (Korea, Republic of); Son, Il Moon [Dongmyung University, Busan (Korea, Republic of); Son, Byung Chang [Korea Nazarene University, Cheonan (Korea, Republic of); Kwak, Hyo Yean [Suwon Science Collage, Suwon (Korea, Republic of)

    2009-07-15

    This project is to develop a management guideline for improving human performances as a part of the Human Factors Management System of Kori unit 1 which is managing all of human factors items such as man-machine system interfaces, work procedures, work environments, and human reliabilities in nuclear power plants. Human factors engineering includes an human factors suitability analysis and improvement of human works, an analysis of accidents by human error, an improvement of work environment, an establishment of human factors management rules and a development of human resources to manage and perform those things consistently. For assisting these human factors engineering tasks, we developed human factors management guidelines, checklists and work procedures to be used in staffing, qualification, training, and human information requirements and workload. We also provided a software tool for managing the above items. Additionally, contents and an item pool for a human factors qualifying examination and training programs were developed. A procedures improvement and a human factors V and V on the Kori unit 1 have been completed as a part of this project, too

  16. 36 CFR 223.30 - Consistency with plans, environmental standards, and other management requirements.

    Science.gov (United States)

    2010-07-01

    ..., environmental standards, and other management requirements. 223.30 Section 223.30 Parks, Forests, and Public... land and resource management plans and environmental quality standards and includes, as appropriate... Timber Sale Contracts Contract Conditions and Provisions § 223.30 Consistency with plans, environmental...

  17. 75 FR 62323 - Pesticide Management and Disposal; Standards for Pesticide Containers and Containment; Change to...

    Science.gov (United States)

    2010-10-08

    ... Pesticide Management and Disposal; Standards for Pesticide Containers and Containment; Change to Labeling... compliance date from December 16, 2010 to August 16, 2011. This change is being made to provide additional... titled ``Pesticide Management and Disposal; Standards for Pesticide Containers and Containment'' (71 FR...

  18. The Chiropractic Care of Infants with Breastfeeding Difficulties.

    Science.gov (United States)

    Alcantara, Joel; Alcantara, Joey D; Alcantara, Junjoe

    2015-01-01

    Chiropractors have long advocated on the benefits of breastfeeding and given the realized and potential role of chiropractors in the care of infants with breastfeeding difficulties, we performed this review of the literature on the subject to inform clinical practice. For this article, we searched Pubmed [1966-2013], Manual, Alternative and Natural Therapy Index System (MANTIS) [1964-2013] and Index to Chiropractic Literature [1984-2013] for the relevant literature. The search terms utilized "breastfeeding", "breast feeding", "breastfeeding difficulties", "breastfeeding difficulty", "TMJ dysfunction", "temporomandibular joint", "birth trauma" and "infants", in the appropriate Boolean combinations. We also examined non-peer-reviewed articles as revealed by Index to Chiropractic Literature and secondary analysis of references. Inclusion criteria for review included breastfeeding difficulties regardless of peer-review and written in the English language. A total of 24 articles met our inclusion criteria. These consisted of 8 case reports, 2 case series, and 3 cohort studies. We were also able to identify 6 manuscripts (5 case reports and a case series) that involved breastfeeding difficulties as a secondary complaint. Our findings reveal a theoretical and clinical framework based on the detection of spinal and extraspinal subluxations involving the cervico-cranio-mandibular complex and assessment of the infant while breastfeeding. Chiropractors care of infants with breastfeeding difficulties by addressing spinal and extraspinal subluxations involving the cervico-cranio-mandibular complex. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Chiropractic Treatment of Temporomandibular Dysfunction: A Retrospective Case Series.

    Science.gov (United States)

    Pavia, Steven; Fischer, Rebecca; Roy, Richard

    2015-12-01

    The purpose of this study is to describe chiropractic treatment of 14 patients who presented with signs and symptoms of temporomandibular joint dysfunction (TMD). This is a retrospective case series of 14 patients, including 13 adults and 1 child. The majority of these patients were undergoing chiropractic care for spine-related conditions when they presented with additional TMD signs and symptoms. They were evaluated and treated with Activator Methods International published protocols relative to the temporomandibular joint before the addition of treatment to the suprahyoid muscles. All pre- and postadjustment assessments were recorded using a numeric pain scale. The resulting average showed a reduction in the patients' pain scores from the initial visit of 8.3 ± 1.6 to the last visit at 1.4 ± 1.1 with an 80.9% ± 15.4% improvement. The average number of visits was 13.6 ± 8.2. All patients selected for this case series showed a reduction of temporomandibular dysfunction symptoms.

  20. Clean Air Act Guidelines and Standards for Waste Management

    Science.gov (United States)

    This page contains the stationary sources of air pollution for the waste management industries, and their corresponding air pollution regulations. To learn more about the regulations for each industry, just click on the links below.

  1. A review on the risk management terminology for the use in standards

    International Nuclear Information System (INIS)

    Lee, Yong Hee; Lee, Jung Woon

    2001-03-01

    This technical report describes a result of reviews on the risk management terminology for the use in standards. Experiences in related technical fields and their definitions are reviewed according to the concepts and operational definitions of risk terminologies. It results into a draft standard for KS in the fields of product safety. Quality Assurance, Industrial and Occupational Safety, Financial Management and Risk Management, and others may show many different definitions for their own technical purpose. A draft KS standard for risk terminology must be revised and enhanced to be adopted to the product safety. However, this review does not provide a strict guide for use in the operational definitions of risk terms, but does provide a common base among application areas. The result of this review is submitted to Korea Standard Association in form of a draft KS standards, KS X 0000 : 2001 (ISO TBD : 1999), titled as ' Risk management terminology - Guidelines for use in standards '

  2. Teaching, leadership, scholarly productivity, and level of activity in the chiropractic profession: a study of graduates of the Los Angeles College of Chiropractic radiology residency program.

    Science.gov (United States)

    Young, Kenneth J; Siordia, Lawrence

    2012-12-01

    The purpose of this study was to track the graduates of the Los Angeles College of Chiropractic (LACC) radiology residency program, review their scholarly productivity, and report those involved in teaching and leadership positions. Former LACC residents' career information was identified through publicly available electronic documents including Web sites and social media. PubMed and the Index to Chiropractic Literature databases were searched for chiropractic graduate job surveys, and proportional comparisons were made between the career paths of LACC radiology residency graduates and those of non-residency-trained chiropractors. Of 47 former LACC residents, 28 (60%) have or previously had careers in tertiary (chiropractic) education; and 12 (26%) have attained a department chair position or higher at tertiary teaching institutions. Twenty-two (47%) have or previously had private radiology practices, whereas 11 (23%) have or previously had clinical chiropractic practices. Often, residency graduates hold or have held 2 of these positions at once; and one, all 3. Chapters or books were authored by 13 (28%). Radiology residency LACC graduates are professionally active, particularly in education, and demonstrate scholarly productivity.

  3. Trust Management in P2P systems using Standard TuLiP

    NARCIS (Netherlands)

    Czenko, M.R.; Doumen, J.M.; Etalle, Sandro

    2008-01-01

    In this paper we introduce Standard TuLiP - a new logic based Trust Management system. In Standard TuLiP, security decisions are based on security credentials, which can be issued by different entities and stored at different locations. Standard TuLiP directly supports the distributed credential

  4. 75 FR 17163 - Formaldehyde Standard; Extension of the Office of Management and Budget's (OMB) Approval of...

    Science.gov (United States)

    2010-04-05

    ... Occupational Safety and Health Administration Formaldehyde Standard; Extension of the Office of Management and... specified in the Standard on Formaldehyde (29 CFR 1910.1048). The standard protects workers from the adverse health effects from occupational exposure to Formaldehyde. DATES: Comments must be submitted (postmarked...

  5. Trust Management in P2P Systems Using Standard TuLiP

    NARCIS (Netherlands)

    Czenko, M.R.; Doumen, J.M.; Etalle, Sandro

    2008-01-01

    In this paper we introduce Standard TuLiP - a new logic based Trust Management system. In Standard TuLiP, security decisions are based on security credentials, which can be issued by different entities and stored at different locations. Standard TuLiP directly supports the distributed credential

  6. Norms and international standards related to reduce risk management: A literature review

    Directory of Open Access Journals (Sweden)

    César Fuentes

    2011-09-01

    Full Text Available The current work aims to develop a revision of the literature within the main concepts in the international rules and standards related to risk management in companies. By this way, there will be an analysis of issues such as the COSO - ERM model, an introduction to the ISO 27000 and 31000 standards; and the Project Management according to PMI targeted at risk management

  7. 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.

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

    DEFF Research Database (Denmark)

    Hestbaek, Lise; Jørgensen, Anette; Hartvigsen, Jan

    2009-01-01

    OBJECTIVE: The purpose of this study was to describe Danish chiropractic patients younger than 18 years. METHODS: Questionnaires were mailed to all chiropractic clinics in Denmark during a randomly assigned month between September 2007 and September 2008. All patients younger than 18 years...... than 2 years had experienced symptoms for more than 1 year before seeing the chiropractor. These health complaints were reported to restrict activity as well as alter mood, and 39% of the 2- to 17-year olds used analgesics. There was limited referral of patients from other health care professionals....... 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...

  9. Are chiropractic tests for the lumbo-pelvic spine reliable and valid? A systematic critical literature review

    DEFF Research Database (Denmark)

    Hestbaek, L; Leboeuf-Yde, C

    2000-01-01

    OBJECTIVE: To systematically review the peer-reviewed literature about the reliability and validity of chiropractic tests used to determine the need for spinal manipulative therapy of the lumbo-pelvic spine, taking into account the quality of the studies. DATA SOURCES: The CHIROLARS database...... was searched for the years 1976 to 1995 with the following index terms: "chiropractic tests," "chiropractic adjusting technique," "motion palpation," "movement palpation," "leg length," "applied kinesiology," and "sacrooccipital technique." In addition, a manual search was performed at the libraries...... of the Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark, and the Anglo-European College of Chiropractic, Bournemouth, United Kingdom. STUDY SELECTION: Studies pertaining to intraexaminer reliability, interexaminer reliability, and/or validity of chiropractic evaluation of the lumbo...

  10. Earnings Management and Participation in Accounting Standard-Setting

    NARCIS (Netherlands)

    Koenigsgruber, R.; Palan, S.

    2015-01-01

    Recent economic and political science research suggests that the way public policy is set, and in particular the participation of those affected by it, impacts upon the outcome of the policy. Accounting standard setting has long offered such a possibility to participate via the due process approach

  11. 41 CFR 105-71.120 - Standards for financial management systems.

    Science.gov (United States)

    2010-07-01

    ... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Standards for financial... violation of the restrictions and prohibitions of applicable statutes. (b) The financial management systems... the financial management system of any applicant for financial assistance as part of a preaward review...

  12. 77 FR 72691 - Small Business Size Standards: Administrative and Support, Waste Management and Remediation Services

    Science.gov (United States)

    2012-12-06

    ...: Administrative and Support, Waste Management and Remediation Services AGENCY: U.S. Small Business Administration..., Administrative and Support, Waste Management and Remediation Services. As part of its ongoing comprehensive... receipts-based size standards in NAICS Sector 56, Administrative and Support, Waste Management and...

  13. 7 CFR 205.206 - Crop pest, weed, and disease management practice standard.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 3 2010-01-01 2010-01-01 false Crop pest, weed, and disease management practice... Requirements § 205.206 Crop pest, weed, and disease management practice standard. (a) The producer must use management practices to prevent crop pests, weeds, and diseases including but not limited to: (1) Crop...

  14. A theoretical basis for maintenance spinal manipulative therapy for the chiropractic profession

    OpenAIRE

    Taylor, David N.

    2011-01-01

    Object The purpose of this article is to discuss a theoretical basis for wellness chiropractic manipulative care and to develop a hypothesis for further investigation. Methods A search of PubMed and of the Manual, Alternative, and Natural Therapy Index System was performed with a combination of key words: chiropractic, maintenance and wellness care, maintenance manipulative care, preventive spinal manipulation, hypomobility, immobility, adhesions, joint degeneration, and neuronal degeneration...

  15. Multiple views to address diversity issues: an initial dialog to advance the chiropractic profession

    Science.gov (United States)

    Johnson, Claire; Killinger, Lisa Zaynab; Christensen, Mark G.; Hyland, John K.; Mrozek, John P.; Zuker, R. Fred; Kizhakkeveettil, Anupama; Perle, Stephen M.; Oyelowo, Tolu

    2012-01-01

    The purpose of this article is to provide expert viewpoints on the topic of diversity in the chiropractic profession, including cultural competency, diversity in the profession, educational and clinical practice strategies for addressing diversity, and workforce issues. Over the next decades, changing demographics in North America will alter how the chiropractic profession functions on many levels. As the population increases in diversity, we will need to prepare our workforce to meet the needs of future patients and society. PMID:23966884

  16. Philosophy of chiropractic: lessons from the past — guidance for the future 1

    OpenAIRE

    Donahue, Joseph

    1990-01-01

    In this paper, the argument will be made that present day “chiropractic philosophy” must be rejected as a professional obstacle. It is an unscientific relic of D.D. Palmer’s personal religious beliefs. A philosophy of chiropractic can only emerge from the application of philosophy of science to our scientific and clinical practices. This new philosophy should incorporate the general healing perspective of the ancient Coan tradition which will be described. This perspective can be made distinc...

  17. 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.

  18. 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....

  19. Research Highlights: Changing Views of Chiropractic ... and a National Reappraisal of Nontraditional Health Care

    National Research Council Canada - National Science Library

    2001-01-01

    .... "In the last decade of the 20th century, chiropractic has begun to shed its status as a marginal or deviant approach to care and is becoming more mainstream," said Paul Shekelle, M.D. and director of RAND's Southern California Evidence-Based Practice Center. He played a key role in RAND's land-mark investigations of chiropractic that stimulated a national reappraisal of this and other nontraditional health care approaches.

  20. A TWELVE MONTH CLINICAL TRIAL OF CHIROPRACTIC SPINAL MANIPULATIVE THERAPY FOR MIGRAINE

    OpenAIRE

    Tuchin, Peter J.

    1999-01-01

    Objective: To assess the efficacy of Chiropractic spinal manipulative therapy (SMT) in the treatment of migraine. Design: A prospective clinical trial of twelve months duration. The trial consisted of 3 stages: two month pre-treatment, two month treatment, and two months post treatment. Comparison of outcomes to the initial baseline factors was made and also 6 months after the cessation of the study. Setting: Chiropractic Research Centre of Macquarie University. Participants: Thirty two volun...

  1. HACCP: Integrating Science and Management through ASTM Standards

    Science.gov (United States)

    From a technical perspective, hazard analysis-critical control point (HACCP) evaluation may be considered a risk management tool suited to a wide range of applications. As one outcome of a symposium convened by American Society for Testing and Materials (ASTM) in August, 2005, th...

  2. Current Standards in the Management of Cerebral Metastases

    Directory of Open Access Journals (Sweden)

    Pablo Goetz

    2012-01-01

    Full Text Available The last 30 years have seen major changes in attitude toward patients with cerebral metastases. This paper aims to outline the major landmarks in this transition and the therapeutic strategies currently used. The controversies surrounding control of brain disease are discussed, and two emerging management trends are reviewed: tumor bed radiosurgery and salvage radiation.

  3. Perineal trauma in children: a standardized management approach

    African Journals Online (AJOL)

    primary perineal repair with covering colostomy (group 2, n= 11), or fecal diversion and wound drainage with delayed sphincter repair if needed (group 3, n= 5). Each patient was assigned to a particular management depending on the presence or absence of full-thickness anorectal injuries, anorectal lacerations, degree of ...

  4. Human Factors Standards and implementation plan for waste management programs

    Energy Technology Data Exchange (ETDEWEB)

    Banks, W.W.

    1993-04-01

    The Department of Energy (DOE) is dedicated to assuring safety and public confidence by conducting a thorough assessment and upgrade of its nuclear policies and procedures. To ensure that DOE field operations protect the health and safety of employees, the general public and the environment, new operational procedures, standards, and implementation plans are both required and forthcoming from DOE Headquarters, NE-74. Part of this effort requires the establishment and integration of human factors engineering design standards and implementation methods to reduce the probability of human error, human injury and radiological exposure. Human Factors professionals work to assure that technology is designed and utilized safely and efficiently to serve the needs and capabilities of the people who must use this technology. The primary goal of human factors engineering is to ensure compatibility and congruence between the people, equipment, tasks, procedures and training so as to minimize human error and assure that ``total systems performance and reliability`` are achieved.

  5. Integrated neuroscience program: an alternative approach to teaching neurosciences to chiropractic students.

    Science.gov (United States)

    He, Xiaohua; La Rose, James; Zhang, Niu

    2009-01-01

    Most chiropractic colleges do not offer independent neuroscience courses because of an already crowded curriculum. The Palmer College of Chiropractic Florida has developed and implemented an integrated neuroscience program that incorporates neurosciences into different courses. The goals of the program have been to bring neurosciences to students, excite students about the interrelationship of neuroscience and chiropractic, improve students' understanding of neuroscience, and help the students understand the mechanisms underpinning the chiropractic practice. This study provides a descriptive analysis on how the integrated neuroscience program is taught via students' attitudes toward neuroscience and the comparison of students' perceptions of neuroscience content knowledge at different points in the program. A questionnaire consisting of 58 questions regarding the neuroscience courses was conducted among 339 students. The questionnaire was developed by faculty members who were involved in teaching neuroscience and administered in the classroom by faculty members who were not involved in the study. Student perceptions of their neuroscience knowledge, self-confidence, learning strategies, and knowledge application increased considerably through the quarters, especially among the 2nd-year students. The integrated neuroscience program achieved several of its goals, including an increase in students' confidence, positive attitude, ability to learn, and perception of neuroscience content knowledge. The authors believe that such gains can expand student ability to interpret clinical cases and inspire students to become excited about chiropractic research. The survey provides valuable information for teaching faculty to make the course content more relevant to chiropractic students.

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

    Science.gov (United States)

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

    2013-01-01

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

  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. Background, expectations and beliefs of a chiropractic student population: a cross-sectional survey.

    Science.gov (United States)

    Gliedt, Jordan A; Briggs, Shaun; Williams, Joshua S M; Smith, Derek P; Blampied, Joseph

    2012-01-01

    Research encompassing the characteristics of chiropractic students is limited. The purpose of our study was to evaluate a current chiropractic student population enrolled at a chiropractic college concerning demographics, expectations, and beliefs. A 44-item survey was administered to volunteer participants. Direct verbal interaction in a classroom setting to potential participants was the recruitment strategy used. Data were collected and stored on a safe network. Percentages for all responses were calculated and means were recorded where appropriate. A total of 664 students participated of 877 potential eligible candidates (75%). The respondents tended to be 21-25 years of age, Caucasian, and male. Most respondents expected to work in a private practice immediately following graduation and anticipated an annual income of at least $100,000 eventually. Respondents preferred the retaining of the term, "subluxation," and identified the importance of new and emerging scientific data. Additionally, respondents held the viewpoint that some non-musculoskeletal diseases can be treated effectively with spinal manipulation as a primary treatment. The majority of chiropractic students in our study were represented by specific demographic characteristics, and a strong favoritism toward the expectations of working in a private practice setting and earning at least $100,000 per year at some point in their career. Distinct beliefs are shared between chiropractic students and practicing chiropractors in North America, and certain aspects of students in our study are comparable to chiropractic students in similar studies.

  9. 77 FR 66638 - The Standard on Process Safety Management of Highly Hazardous Chemicals; Extension of the Office...

    Science.gov (United States)

    2012-11-06

    ... Standard on Process Safety Management of Highly Hazardous Chemicals; Extension of the Office of Management...) approval of the information collection requirements specified in the Standard on Process Safety Management...: The Standard on Process Safety Management of Highly Hazardous Chemicals (29 CFR 1910.119). OMB Number...

  10. Improving global environmental management with standard corporate reporting

    Science.gov (United States)

    Kareiva, Peter M.; McNally, Brynn W.; McCormick, Steve; Miller, Tom; Ruckelshaus, Mary

    2015-01-01

    Multinational corporations play a prominent role in shaping the environmental trajectory of the planet. The integration of environmental costs and benefits into corporate decision-making has enormous, but as yet unfulfilled, potential to promote sustainable development. To help steer business decisions toward better environmental outcomes, corporate reporting frameworks need to develop scientifically informed standards that consistently consider land use and land conversion, clean air (including greenhouse gas emissions), availability and quality of freshwater, degradation of coastal and marine habitats, and sustainable use of renewable resources such as soil, timber, and fisheries. Standardization by itself will not be enough—also required are advances in ecosystem modeling and in our understanding of critical ecological thresholds. With improving ecosystem science, the opportunity for realizing a major breakthrough in reporting corporate environmental impacts and dependencies has never been greater. Now is the time for ecologists to take advantage of an explosion of sustainability commitments from business leaders and expanding pressure for sustainable practices from shareholders, financial institutions, and consumers. PMID:26082543

  11. Improving global environmental management with standard corporate reporting.

    Science.gov (United States)

    Kareiva, Peter M; McNally, Brynn W; McCormick, Steve; Miller, Tom; Ruckelshaus, Mary

    2015-06-16

    Multinational corporations play a prominent role in shaping the environmental trajectory of the planet. The integration of environmental costs and benefits into corporate decision-making has enormous, but as yet unfulfilled, potential to promote sustainable development. To help steer business decisions toward better environmental outcomes, corporate reporting frameworks need to develop scientifically informed standards that consistently consider land use and land conversion, clean air (including greenhouse gas emissions), availability and quality of freshwater, degradation of coastal and marine habitats, and sustainable use of renewable resources such as soil, timber, and fisheries. Standardization by itself will not be enough--also required are advances in ecosystem modeling and in our understanding of critical ecological thresholds. With improving ecosystem science, the opportunity for realizing a major breakthrough in reporting corporate environmental impacts and dependencies has never been greater. Now is the time for ecologists to take advantage of an explosion of sustainability commitments from business leaders and expanding pressure for sustainable practices from shareholders, financial institutions, and consumers.

  12. The ecological sustainability of tropical forest management: evaluation of the national forest management standards of Costa Rica and Nicaragua, with emphasis on the need for adaptive. management

    Science.gov (United States)

    Kathleen McGinleya; Bryan Fineganb

    2003-01-01

    From a conceptual point of view, national forest management standards in Latin American countries have progressed significantly in recent years.Examples include the Costa Rican Standards and Procedures for Sustainable Forest Management and Certification, developed by the National Commission for Forest Certification and in Nicaragua, the National Institute of Forestry...

  13. Grading standards, prepared by the Configuration Management Office

    International Nuclear Information System (INIS)

    Cort, G.; Donahue, S.; Frank, J.; Perkins, B.; Wrye, J.

    1994-01-01

    This report describes the grading methodology used by the organization to determine the required levels of configuration management for all controlled elements that are part of the nuclear facility and its operation. The goal is to have a flexible grading system that accurately reflects the overall operational environment. The grading methodology should identify which items, processes, and information should be incorporated into facility baselines as controlled elements; and specify the level of formality that should be applied to activities that employ or impact these controlled elements. Evaluation categories include the following: radiological damage to workers; toxicological damage to workers; industrial safety; environmental damage; property damage; facility availability; cost effect; reputation; and commitments

  14. 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

  15. Standard requirements for GCP-compliant data management in multinational clinical trials

    DEFF Research Database (Denmark)

    Ohmann, Christian; Kuchinke, Wolfgang; Canham, Steve

    2011-01-01

    A recent survey has shown that data management in clinical trials performed by academic trial units still faces many difficulties (e.g. heterogeneity of software products, deficits in quality management, limited human and financial resources and the complexity of running a local computer centre......). Unfortunately, no specific, practical and open standard for both GCP-compliant data management and the underlying IT-infrastructure is available to improve the situation. For that reason the "Working Group on Data Centres" of the European Clinical Research Infrastructures Network (ECRIN) has developed...... a standard specifying the requirements for high quality GCP-compliant data management in multinational clinical trials....

  16. SNL/CA Facilities Management Design Standards Manual

    Energy Technology Data Exchange (ETDEWEB)

    Rabb, David [Sandia National Lab. (SNL-CA), Livermore, CA (United States); Clark, Eva [Sandia National Lab. (SNL-CA), Livermore, CA (United States)

    2014-12-01

    At Sandia National Laboratories in California (SNL/CA), the design, construction, operation, and maintenance of facilities is guided by industry standards, a graded approach, and the systematic analysis of life cycle benefits received for costs incurred. The design of the physical plant must ensure that the facilities are "fit for use," and provide conditions that effectively, efficiently, and safely support current and future mission needs. In addition, SNL/CA applies sustainable design principles, using an integrated whole-building design approach, from site planning to facility design, construction, and operation to ensure building resource efficiency and the health and productivity of occupants. The safety and health of the workforce and the public, any possible effects on the environment, and compliance with building codes take precedence over project issues, such as performance, cost, and schedule.

  17. Proceedings of the DOE standards managers workshop, Gaithersburg, Maryland, October 26--28, 1992

    Energy Technology Data Exchange (ETDEWEB)

    1992-12-31

    On May 19, 1992, the Secretary of Energy signed the revised DOE Order 1300.2A, Department of Energy Technical Standards Program, which set the policy and assigned responsibility for activities within the program. The purpose of the revision to the order was to place greater emphasis on the use of technical standards for design, construction, testing, modification, operation, decommissioning, decontamination, and remediation of DOE`s facilities and activities. Within the context of this order, Standards Managers have been assigned for each DOE Secretarial office, each DOE Field Office, and each management and operating (M&O) contractor or site manager to be responsible for and provide the appropriate amount of emphasis on consistent use of standards at DOE facilities. Office of Management and Budget (OMB) Circular A-119 also stresses the importance of the use of standards within Government facilities and directs that activities first attempt to locate and adopt non-Government standards (NGSs) for DOE use. If an NGS is not complete enough for the intended application, it should be adopted for the activity and tailored for the need by development of a Government (DOE) standard. When these NGS documents are unavailable, DOE components will develop an appropriate Government standard to satisfy the need. This expanded DOE program will provide all the information necessary to adopt, tailor, or develop these standards and track the activities. A key to the proper implementation of technical standards and governing requirements is establishing a culture of knowledge and commitment. The workshop provided an in-depth orientation on the Technical Standards Program to participating DOE and M&O Standards Managers.

  18. ISO 31000:2009--Setting a new standard for risk management.

    Science.gov (United States)

    Purdy, Grant

    2010-06-01

    Last year saw the publication of IS0 31000:2009, a new globally accepted standard for risk management together with a new, associated vocabulary in ISO Guide 73:2009. These were developed through a consensus-driven process over four years, through seven drafts, and involving the input of hundreds of risk management professionals around the world. The new standard supports a new, simple way of thinking about risk and risk management and is intended to begin the process of resolving the many inconsistencies and ambiguities that exist between many different approaches and definitions. While most decisionmakers seem to welcome the new standard and it has so far received very good reviews, it does create challenges for those who use language and approaches that are unique to their area of work but different from the new standard and guide. The need for compromise and change is the inevitable consequence of standardization.

  19. Succeeding in process standardization: Explaining the fit with international management strategy

    DEFF Research Database (Denmark)

    Rahimi, Fatemeh; Møller, Charles; Hvam, Lars

    2016-01-01

    Purpose: The purpose of this paper is to explore the fit between process standardization and international management strategy of multinational corporations (MNCs) by assessing the compatibility between process standardization and corporate structural characteristics in terms of asset configuration...... and headquarters-subsidiary relationships. Design/methodology/approach: First, after a literature review on MNCs’ strategy and process standardization, the study suggests two propositions on the fit between corporate international management strategy and process standardization. Second, to empirically examine....../value: The study provides in-depth understanding of how the international management strategy and consequent structural characteristics of MNCs affects process standardization in the course of a global enterprise resource planning implementation. The study proposes conditions of fit for aligning process...

  20. ISO 14000 Environmental Management System Standards and Their Application at Schools

    OpenAIRE

    Yalçınkaya, Mustafa

    2003-01-01

    Today, the issue of environmental pollution, which is spreading and threatening life, is now being considered with greater attention. For this reason, the ISO 14000 Standards of Environmental Management System has been created through designing the environment in an international framework together with the concepts of management and standardization. Starting such an understanding with schools will let new generations have a new perspective towards the environment. In this article the followi...

  1. Adherence of Pain Assessment to the German National Standard for Pain Management in 12 Nursing Homes

    Directory of Open Access Journals (Sweden)

    Jürgen Osterbrink

    2014-01-01

    Full Text Available BACKGROUND: Pain is very common among nursing home residents. The assessment of pain is a prerequisite for effective multiprofessional pain management. Within the framework of the German health services research project, ‘Action Alliance Pain-Free City Muenster’, the authors investigated pain assessment adherence according to the German national Expert Standard for Pain Management in Nursing, which is a general standard applicable to all chronic/acute pain-affected persons and highly recommended for practice.

  2. Key elements on implementing an occupational health and safety management system using ISO 45001 standard

    Directory of Open Access Journals (Sweden)

    Darabont Doru Costin

    2017-01-01

    Full Text Available Occupational health and safety (OHS management system is one of the main elements of the company’s general management system. During last decade, Romanian companies gained a valuable experience on implementing this type of management systems, using OHSAS 18001 referential and standard. However, the projected release of the ISO 45001 represents a new approach which requires the companies to take in consideration new key elements for a successful implementation of the OHS management system. The aim of the paper is to identify and analyse these key elements, by integration of the following issues: standard requirements, Romanian OHS legislation and good practice examples, including the general control measures for new and emerging risks such as psycho-social risks, workforce ageing and new technologies. The study results represent an important work instrument for each company interested to implement or upgrade its OHS management system using ISO 45001 standard and could be used regardless the company size or activity domain.

  3. Gold standards for primary care of burn management

    Directory of Open Access Journals (Sweden)

    Fatih Zor

    2009-01-01

    Full Text Available Every year, about 2.5 million people are affected from burns in the world. In our country there is no reliable database related to this subject. There are ongoing studies about the epidemiology of burns in Turkey. After burn injury had represent many various complications, such as myocardial infarction, cardiac deficiency, acute hypertension, endocarditis, thromboembolism, pulmonary edema, pneumonia, respiratuar failure, renal failure, gastric ulcus, ileus, sepsis, coagulopathy and anemia. Such complications can preventable or treatable. In this respect, preventive management in the first step burn treatment had very importantly in burn cases. Skin is a barrier which protects evaporative heat loss. In cases of acute burn, hypothermia occurs related to skin loss. For these cases, care must be taken to keep the patient warm. In addition fluid resuscitation is very important in these cases. Furthermore, the damaged tissues are highly susceptible to infection in burned patients. Burn care and rehabilitation includes challenging and complex procedures. Briefly, treatments of burn cases require a multidisciplinary and meticulous approach.

  4. Academy of Nutrition and Dietetics: standards of practice and standards of professional performance for registered dietitian nutritionists (competent, proficient, and expert) in adult weight management.

    Science.gov (United States)

    Jortberg, Bonnie; Myers, Eileen; Gigliotti, Linda; Ivens, Barbara J; Lebre, Monica; Burke March, Susan; Nogueira, Isadora; Nwankwo, Robin; Parkinson, Meredith R; Paulsen, Barbara; Turner, Tonya

    2015-04-01

    Weight management encompasses the inter-relationship of nutrition, physical activity, and health behavior change. Nutrition is key for the prevention and treatment of obesity and chronic disease and maintenance of overall health. Thus, the Weight Management Dietetic Practice Group, with guidance from the Academy of Nutrition and Dietetics Quality Management Committee, has developed Standards of Practice and Standards of Professional Performance for Registered Dietitian Nutritionists (RDNs) in Adult Weight Management as a resource for RDNs working in weight management. This document allows RDNs to assess their current skill levels and to identify areas for further professional development in this expanding practice area. This document describes the current standards for weight management practice for RDNs. The Standards of Practice represent the four steps in the Nutrition Care Process as applied to the care of patients/clients. The Standards of Professional Performance consist of six domains of professionalism: Quality in Practice, Competence and Accountability, Provision of Services, Application of Research, Communication and Application of Knowledge, and Utilization and Management of Resources. Within each standard, specific indicators provide measurable action statements that illustrate how the standard can be applied to practice. The indicators describe three skill levels (competent, proficient, and expert) for RDNs working in weight management. The Standards of Practice and Standards of Professional Performance are complementary resources for the Registered Dietitian Nutritionist in weight management. Copyright © 2015 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  5. Chiropractic spinal manipulation and the risk for acute lumbar disc herniation: a belief elicitation study.

    Science.gov (United States)

    Hincapié, Cesar A; Cassidy, J David; Côté, Pierre; Rampersaud, Y Raja; Jadad, Alejandro R; Tomlinson, George A

    2017-09-18

    Chiropractic spinal manipulation treatment (SMT) is common for back pain and has been reported to increase the risk for lumbar disc herniation (LDH), but there is no high quality evidence about this. In the absence of good evidence, clinicians can have knowledge and beliefs about the risk. Our purpose was to determine clinicians' beliefs regarding the risk for acute LDH associated with chiropractic SMT. Using a belief elicitation design, 47 clinicians (16 chiropractors, 15 family physicians and 16 spine surgeons) that treat patients with back pain from primary and tertiary care practices were interviewed. Participants' elicited incidence estimates of acute LDH among a hypothetical group of patients with acute low back pain treated with and without chiropractic SMT, were used to derive the probability distribution for the relative risk (RR) for acute LDH associated with chiropractic SMT. Chiropractors expressed the most optimistic belief (median RR 0.56; IQR 0.39-1.03); family physicians expressed a neutral belief (median RR 0.97; IQR 0.64-1.21); and spine surgeons expressed a slightly more pessimistic belief (median RR 1.07; IQR 0.95-1.29). Clinicians with the most optimistic views believed that chiropractic SMT reduces the incidence of acute LDH by about 60% (median RR 0.42; IQR 0.29-0.53). Those with the most pessimistic views believed that chiropractic SMT increases the incidence of acute LDH by about 30% (median RR 1.29; IQR 1.11-1.59). Clinicians' beliefs about the risk for acute LDH associated with chiropractic SMT varied systematically across professions, in spite of a lack of scientific evidence to inform these beliefs. These probability distributions can serve as prior probabilities in future Bayesian analyses of this relationship.

  6. Impact of Chiropractic Manipulation on Bone and Skeletal Muscle of Ovariectomized Rats.

    Science.gov (United States)

    López-Herradón, A; Fujikawa, R; Gómez-Marín, M; Stedile-Lovatel, J P; Mulero, F; Ardura, J A; Ruiz, P; Muñoz, I; Esbrit, P; Mahíllo-Fernández, I; Ortega-de Mues, A

    2017-11-01

    Evidence suggests that chiropractic manipulation might exert positive effects in osteoporotic patients. The aim of this study was to evaluate the effects of chiropractic manipulation on bone structure and skeletal muscle in rats with bone loss caused by ovariectomy (OVX). The 6-month old Sprague-Dawley rats at 10 weeks following OVX or sham operation (Sh) did not suffer chiropractic manipulation (NM group) or were submitted to true chiropractic manipulation using the chiropractic adjusting instrument Activator V ® three times/week for 6 weeks as follows: Force 1 setting was applied onto the tibial tubercle of the rat right hind limb (TM group), whereas the corresponding left hind limb received a false manipulation (FM group) consisting of ActivatorV ® firing in the air and slightly touching the tibial tubercle. Bone mineral density (BMD) and bone mineral content (BMC) were determined in long bones and L3-L4 vertebrae in all rats. Femora and tibia were analyzed by μCT. Mechano growth factor (MGF) was detected in long bones and soleus, quadriceps and tibial muscles by immunohistochemistry and Western blot. The decrease of BMD and BMC as well as trabecular bone impairment in the long bones of OVX rats vs Sh controls was partially reversed in the TM group versus FM or NM rats. This bone improvement by chiropractic manipulation was associated with an increased MGF expression in the quadriceps and the anterior tibial muscle in OVX rats. These findings support the notion that chiropractic manipulation can ameliorate osteoporotic bone at least partly by targeting skeletal muscle.

  7. Tobacco cessation via doctors of chiropractic: results of a feasibility study.

    Science.gov (United States)

    Gordon, Judith S; Istvan, Joseph; Haas, Mitchell

    2010-03-01

    There is a sizeable and growing body of empirical literature on the effects of physician advice to quit smoking. Because of the association between tobacco use and the health problems that may provoke referral to chiropractic care, doctors of chiropractic (DCs) may be able to give patients personalized proximal health feedback that may motivate them to quit. However, DCs have not been utilized in this role. The primary aim of this study was to design and refine a brief office-based tobacco intervention for use within chiropractic settings. This study was conducted in 20 private chiropractic practices in 2 phases: (a) intervention development, in which we created and focus tested practitioner and patient materials, and (b) feasibility, in which we evaluated the impact of the intervention on 210 tobacco-using chiropractic patients. Analyses were conducted on 156 patients who exclusively smoked cigarettes. Using an intent-to-treat approach, assuming all nonresponders to be smokers, 13 (8.3%) reported 7-day abstinence at 6 weeks, 22 (14.1%) at the 6-month follow-up, and 35 (22.4%) at the 12-month assessment. Eleven participants (7.1%) reported prolonged abstinence at the 6-month follow-up, and 15 (9.6%) reported prolonged abstinence at 12 months. To our knowledge, this is the first study to refine a brief office-based treatment for tobacco dependence for use in chiropractic settings. The results of this study were promising and will lead to a randomized clinical trial. If found to be effective, this model could be disseminated to chiropractic practitioners throughout the United States.

  8. Fall risk profile and quality-of-life status of older chiropractic patients.

    Science.gov (United States)

    Holt, Kelly R; Noone, Paul L; Short, Krystal; Elley, C Raina; Haavik, Heidi

    2011-02-01

    The primary aim of this study was to estimate the prevalence of fall risk factors in older chiropractic patients. The secondary aim was to investigate the quality-of-life status of older chiropractic patients and to see whether a history of falling was related to quality-of-life status. A cross-sectional study was conducted at 12 chiropractic practices throughout Auckland, New Zealand, and Melbourne, Australia. The study involved gaining a profile of health status, fall history, and fall risk from active chiropractic patients who were 65 years or older. One hundred ten older chiropractic patients were approached, and 101 agreed to participate in this study (response rate, 91.8%). Thirty-five percent of participants had experienced at least 1 fall in the previous 12 months. Of those that had fallen, 80% had at least a minor injury, with 37% of fallers requiring medical attention and 6% suffering a serious injury. The prevalence of most fall risk factors was consistent with published data for community-dwelling older adults. Quality of life of older chiropractic patients appeared to be good, but fallers reported a lower physical component summary score compared with nonfallers (P = .04). A portion of the older chiropractic patients sampled in this study had a substantial risk of falling. This risk could be assessed on a regular basis for the presence of modifiable fall risk factors, and appropriate advice, given when fall risks are identified. Copyright © 2011 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Husbands Chris

    2007-06-01

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

  10. Data Management Standards in Computer-aided Acquisition and Logistic Support (CALS)

    Science.gov (United States)

    Jefferson, David K.

    1990-01-01

    Viewgraphs and discussion on data management standards in computer-aided acquisition and logistic support (CALS) are presented. CALS is intended to reduce cost, increase quality, and improve timeliness of weapon system acquisition and support by greatly improving the flow of technical information. The phase 2 standards, industrial environment, are discussed. The information resource dictionary system (IRDS) is described.

  11. 77 FR 61431 - Hexavalent Chromium Standards; Extension of the Office of Management and Budget's (OMB) Approval...

    Science.gov (United States)

    2012-10-09

    ...] Hexavalent Chromium Standards; Extension of the Office of Management and Budget's (OMB) Approval of... requirements specified in the Hexavalent Chromium Standards for General Industry (29 CFR 1910.1026), Shipyard... information (29 U.S.C. 657). The information collection requirements specified in the Hexavalent Chromium (Cr...

  12. Regional Standards for Rangeland Health and Guidelines for Livestock Grazing Management ... A Progress Report

    OpenAIRE

    1996-01-01

    In August 1995, new BLM regulations for rangeland administration went into effect. The new regulations require BLM to establish regional standards for rangeland health and guidelines for grazing management. This publication is a report on the alternatives being considered for the Montana/Dakotas Rangeland Health Standards and Guidelines process.

  13. a Standardized Approach to Topographic Data Processing and Workflow Management

    Science.gov (United States)

    Wheaton, J. M.; Bailey, P.; Glenn, N. F.; Hensleigh, J.; Hudak, A. T.; Shrestha, R.; Spaete, L.

    2013-12-01

    An ever-increasing list of options exist for collecting high resolution topographic data, including airborne LIDAR, terrestrial laser scanners, bathymetric SONAR and structure-from-motion. An equally rich, arguably overwhelming, variety of tools exists with which to organize, quality control, filter, analyze and summarize these data. However, scientists are often left to cobble together their analysis as a series of ad hoc steps, often using custom scripts and one-time processes that are poorly documented and rarely shared with the community. Even when literature-cited software tools are used, the input and output parameters differ from tool to tool. These parameters are rarely archived and the steps performed lost, making the analysis virtually impossible to replicate precisely. What is missing is a coherent, robust, framework for combining reliable, well-documented topographic data-processing steps into a workflow that can be repeated and even shared with others. We have taken several popular topographic data processing tools - including point cloud filtering and decimation as well as DEM differencing - and defined a common protocol for passing inputs and outputs between them. This presentation describes a free, public online portal that enables scientists to create custom workflows for processing topographic data using a number of popular topographic processing tools. Users provide the inputs required for each tool and in what sequence they want to combine them. This information is then stored for future reuse (and optionally sharing with others) before the user then downloads a single package that contains all the input and output specifications together with the software tools themselves. The user then launches the included batch file that executes the workflow on their local computer against their topographic data. This ZCloudTools architecture helps standardize, automate and archive topographic data processing. It also represents a forum for discovering and

  14. A feasibility study comparing two chiropractic protocols in the treatment of patellofemoral pain syndrome.

    Science.gov (United States)

    Brantingham, James W; Globe, Gary A; Jensen, Muffit L; Cassa, Tammy K; Globe, Denise R; Price, Jennifer L; Mayer, Stephan N; Lee, Felix T

    2009-09-01

    The purpose of this pilot study was to determine the feasibility of (1) using the existing clinic, clinicians, interns, faculty, and staff from our college in conducting all components of a planned randomized controlled clinical trial; (2) successfully recruiting patients with patellofemoral pain syndrome (PFPS); and (3) consistently, effectively, and safely implementing the study protocols and therapy. Diagnostic, treatment, and blind assessment procedures were carried out while recruitment and administrative techniques for managing long-term storage of data and files were developed. Thirty-one patients were randomized into a local manipulative group (group A) or to a full kinetic chain manipulative therapy group (group B), each combined with exercise and soft tissue treatment. The Anterior Knee Pain Scale, visual analog scale, and Patient Satisfaction Scale were used. All phases of the feasibility study including use of the clinic, staff, recruitment techniques, treatment protocols, data collection, input, and analysis were effectively and safely carried out. A feasibility study investigating the ability to conduct a randomized controlled trial of a manipulative therapy protocol for PFPS using available chiropractic college infrastructure was accomplished. A fully powered PFPS trial is feasible and merited.

  15. Forest management practices and the occupational safety and health administration logging standard

    Science.gov (United States)

    John R. Myers; David Elton Fosbroke

    1995-01-01

    The Occupational Safety and Health Administration (OSHA) has established safety and health regulations for the logging industry. These new regulations move beyond the prior OSHA pulpwood harvesting standard by including sawtimber harvesting operations. Because logging is a major tool used by forest managers to meet silvicultural goals, managers must be aware of what...

  16. 7 CFR 205.203 - Soil fertility and crop nutrient management practice standard.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 3 2010-01-01 2010-01-01 false Soil fertility and crop nutrient management practice... Requirements § 205.203 Soil fertility and crop nutrient management practice standard. (a) The producer must... nutrients and soil fertility through rotations, cover crops, and the application of plant and animal...

  17. 77 FR 64920 - Revisions to Reliability Standard for Transmission Vegetation Management

    Science.gov (United States)

    2012-10-24

    ... management program (TVMP) that includes, inter alia, a Clearance 1 distance to be achieved at the time of vegetation management work, and a Clearance 2 distance to be maintained at all times. The Clearance 2... specific clearance distances into the standard itself based on ``an established method for calculating the...

  18. The Assessment Of The Level Of Management Control Standards Completion In Treasury Sector

    Directory of Open Access Journals (Sweden)

    Kulińska Ewa

    2015-06-01

    Full Text Available This paper concerns the rules of the functioning of management control standards used in the Treasury Control Office. Its purpose is to present research results conducted in the years 2013–2014 in Polish Treasury Control Offices. Obtained results are the effect of applying author’s model of the assessment of management control implementation. The research was conducted for management personnel and the rest of offices employees separately. Significant discrepancies between these two groups of respondents were indicated. Based on the results, the areas of deviation from expected level of management control standards were established and the areas where implementation of control mechanisms relying on increasing the supervision of board of directors over managers were indicated, providing permanent and efficient elements of managers supervision over subordinate employees and making purposes and tasks put on the Treasury Control Office for given year more precise and familiarization of employees and carrying out trainings and series of other corrective measures.

  19. [The practice and proposals for standardized management of neonatal insulation technology].

    Science.gov (United States)

    Wang, Xi; Xiong, Ying; Hu, Yanling; Zhang, Xuelong

    2012-05-01

    In clinical practice, incubators can contribute to better diagnosis and treatment of diseases. Currently, insulation medical equipment used for the newborn are mainly warm-boxes. With the use popularity of warm-boxes in the country, medical accidents caused by improper use are on the increase. According to neonatal insulation technology and standardized management of practice, this article puts forward technical requirements of infant incubators with constant temperature and humidity, operation regulations and management specifications to better regulate the use of such devices. Meanwhile, it also suggests national related departments to formulate "incubator technology management norms" and "warm-box technology and practice", intending to standardize industry behaviors and ensure medical safety.

  20. Network management and signalling standards for CCSDS advanced orbiting system communication systems

    Science.gov (United States)

    Pietras, John

    The Consultative Committee for Space Data Systems (CCSDS) is an international organization chartered to develop and adopt communications protocols and data processing standards suitable for use in space-related communication and data processing systems. This paper briefly describes the CCSDS network management environment and reviews the current status of CCSDS recommendations for network management functional capability, use of internal standard for network management, and composition of signaling systems in support of the advanced orbiting systems services typified by the international Space Station Freedom Program. A timetable for future work in this area is presented.

  1. Beyond spinal manipulation: should Medicare expand coverage for chiropractic services? A review and commentary on the challenges for policy makers

    OpenAIRE

    Whedon, James M.; Goertz, Christine M.; Lurie, Jon D.; Stason, William B.

    2013-01-01

    Objectives: Private insurance plans typically reimburse doctors of chiropractic for a range of clinical services, but Medicare reimbursements are restricted to spinal manipulation procedures. Medicare pays for evaluations performed by medical and osteopathic physicians, nurse practitioners, physician assistants, podiatrists, physical therapists, and occupational therapists; however, it does not reimburse the same services provided by chiropractic physicians. Advocates for expanded coverage of...

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

    NARCIS (Netherlands)

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

    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

  3. The effectiveness of chiropractic for treatment of low back pain : An update and attempt at statistical pooling

    NARCIS (Netherlands)

    Assendelft, W. J J; Koes, B. W.; Van der Heijden, G. J M G; Bouter, L. M.

    1996-01-01

    Objective: To determine the effectiveness of chiropractic treatment for patients with low back pain by means of a systematic review of the literature. Data Sources: Randomized clinical trials (RCTs) on chiropractic were identified with a Medline and Embase search (1966-1995), by citation tracking,

  4. Primary benign tumors in chiropractic practice and the importance of x-ray diagnosis: A report of two cases

    OpenAIRE

    Pelletier, Jacques C.

    1987-01-01

    Two cases of primary benign bone tumors were diagnosed radiographically in a chiropractic practice. Although primary osseous tumors are somewhat uncommon, their potential presence emphasizes the importance of x-ray diagnosis as an essential adjunct to chiropractic practice. This procedure may preclude underlying lesions before considering treatment of seemingly uncomplicated injuries. Two such cases are presented: unicameral bone cyst and osteochondroma.

  5. Thinking Globally: How ISO 50001 - Energy Management can make industrial energy efficiency standard practice

    Energy Technology Data Exchange (ETDEWEB)

    McKane, Aimee; Desai, Deann; Matteini, Marco; Meffert, William; Williams, Robert; Risser, Roland

    2009-08-01

    Industry utilizes very complex systems, consisting of equipment and their human interface, which are organized to meet the production needs of the business. Effective and sustainable energy efficiency programs in an industrial setting require a systems approach to optimize the integrated whole while meeting primary business requirements. Companies that treat energy as a manageable resource and integrate their energy program into their management practices have an organizational context to continually seek opportunities for optimizing their energy use. The purpose of an energy management system standard is to provide guidance for industrial and commercial facilities to integrate energy efficiency into their management practices, including fine-tuning production processes and improving the energy efficiency of industrial systems. The International Organization for Standardization (ISO) has identified energy management as one of its top five priorities for standards development. The new ISO 50001 will establish an international framework for industrial, commercial, or institutional facilities, or entire companies, to manage their energy, including procurement and use. This standard is expected to achieve major, long-term increases in energy efficiency (20percent or more) in industrial, commercial, and institutional facilities and to reduce greenhouse gas (GHG) emissions worldwide.This paper describes the impetus for the international standard, its purpose, scope and significance, and development progress to date. A comparative overview of existing energy management standards is provided, as well as a discussion of capacity-building needs for skilled individuals to assist organizations in adopting the standard. Finally, opportunities and challenges are presented for implementing ISO 50001 in emerging economies and developing countries.

  6. ISO 14000 - the International Environmental Management Standard: Potential impacts on environmental management and auditing in the electric power generation industry

    International Nuclear Information System (INIS)

    Gauntlett, S.B.; Pierce, J.L.; Pierce, J.L.

    1995-01-01

    In the framework of environmental management, the concept of voluntary environmental compliance auditing is not in itself a new development. Environmentally conscious firms have for more than a decade, undertaken voluntary audits to help achieve and maintain compliance with environmental regulations and to help identify and correct unregulated or poorly regulated environmental hazard. The firms undertaking the audits were motivated by a desire to mitigate legal and financial risks and/or the desire to be a highly responsible member of the corporate community. Much of the early attention to environmental auditing was in the chemical process industries. Today, there are four current trends affecting environmental auditing: (1) the practice is becoming widespread in all industry groups in both large and small firms; (2) environmental management and audit methodolgies and approaches are being codified in the form of written national and International standards; (3) environmental management programs and in-house audits are increasingly being certified by independent auditors (who are not associated with regulatory agencies); and (4) the certifications are being viewed as marketing and public relations tools. The adoption of ISO 14000 is destined to become the most significant development in international environmental management and auditing. International standards for the development of Environmental Management Systems and the execution of environmental audits do not currently exist. Individual countries, such as England and France, have national standards. One multi-national standard currently exists--the European Economic Community's Eco-Management and Audit Scheme (EMAS). The United States does not have a national environmental management and auditing standard

  7. The chiropractic profession: a scoping review of utilization rates, reasons for seeking care, patient profiles, and care provided.

    Science.gov (United States)

    Beliveau, Peter J H; Wong, Jessica J; Sutton, Deborah A; Simon, Nir Ben; Bussières, André E; Mior, Silvano A; French, Simon D

    2017-01-01

    Previous research has investigated utilization rates, who sees chiropractors, for what reasons, and the type of care that chiropractors provide. However, these studies have not been comprehensively synthesized. We aimed to give a global overview by summarizing the current literature on the utilization of chiropractic services, reasons for seeking care, patient profiles, and assessment and treatment provided. Systematic searches were conducted in MEDLINE, CINAHL, and Index to Chiropractic Literature using keywords and subject headings (MeSH or ChiroSH terms) from database inception to January 2016. Eligible studies: 1) were published in English or French; 2) were case series, descriptive, cross-sectional, or cohort studies; 3) described patients receiving chiropractic services; and 4) reported on the following theme(s): utilization rates of chiropractic services; reasons for attending chiropractic care; profiles of chiropractic patients; or, types of chiropractic services provided. Paired reviewers independently screened all citations and data were extracted from eligible studies. We provided descriptive numerical analysis, e.g. identifying the median rate and interquartile range (e.g., chiropractic utilization rate) stratified by study population or condition. The literature search retrieved 14,149 articles; 328 studies (reported in 337 articles) were relevant and reported on chiropractic utilization (245 studies), reason for attending chiropractic care (85 studies), patient demographics (130 studies), and assessment and treatment provided (34 studies). Globally, the median 12-month utilization of chiropractic services was 9.1% (interquartile range (IQR): 6.7%-13.1%) and remained stable between 1980 and 2015. Most patients consulting chiropractors were female (57.0%, IQR: 53.2%-60.0%) with a median age of 43.4 years (IQR: 39.6-48.0), and were employed (median: 77.3%, IQR: 70.3%-85.0%). The most common reported reasons for people attending chiropractic care were

  8. Alternative futures: Fields, boundaries, and divergent professionalisation strategies within the Chiropractic profession.

    Science.gov (United States)

    Brosnan, Caragh

    2017-10-01

    Sociological studies of the complementary and alternative medicine (CAM) occupations have documented the professionalisation strategies these groups use to establish boundaries between themselves and their competitors, including seeking educational accreditation and statutory regulation/licensure. Chiropractic has been particularly successful at professionalising and in Australia and the UK it is taught within public universities. Recent events have threatened chiropractic's university foothold, however, showing that professionalisation needs to be understood as an ongoing process of negotiation. Based on interviews with chiropractors in Australia and the UK, this paper examines the professionalisation strategies deployed by chiropractors within and outside of the university. Highly divergent strategies are identified across different sectors of the profession, relating to defining the chiropractic paradigm, directing education and constructing professional identity. In each domain, chiropractic academics tended to prioritise building the evidence base and becoming more aligned with medicine and other allied health professions. Although some practitioners supported this agenda, others strove to preserve chiropractic's vitalistic philosophy and professional distinction. Following Bourdieu, these intra-professional struggles are interpreted as occurring within a field in which chiropractors compete for different forms of capital, pulled by two opposing poles. The differing orientations and strategies pursued at the two poles of the field point to a number of possible futures for this CAM profession, including a potential split within the profession itself. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. A narrative review of the published chiropractic literature regarding older patients from 2001–2010

    Science.gov (United States)

    Gleberzon, Brian J.

    2011-01-01

    Introduction: The purpose of this article was to perform a narrative review of the chiropractic literature regarding older patients between 2001 and 2010. Methods: A three step search strategy of the literature involved electronic searching, hand searching and reference tracking. Results: One hundred and eighty eight articles germane to chiropractic geriatric practice and education were retrieved. Discussion: Compared to the review of the literature conducted prior to 2000, the number of references on chiropractic geriatric education increased from 3 to 11, the number of demographic studies increased from 9 to 18, the number of case reports increased from 25 to 83, the number of clinical trials increased from 4 to 21 (only two RCTs found) and the number of references on clinical guidelines and general clinical information increased from 18 to 55. Conclusion: This review found 188 retrievable articles available to practitioners to effectively care plan for their older patients, a better than three fold increase in the number of references found during a similar review conducted at the end of the previous decade. However, there is clearly a gap in the evidence base of chiropractic geriatric care, particularly the under-representation of clinical trials of all kinds involving older chiropractic patients. PMID:21629461

  10. Variations in the implementation and characteristics of chiropractic services in VA.

    Science.gov (United States)

    Lisi, Anthony J; Khorsan, Raheleh; Smith, Monica M; Mittman, Brian S

    2014-12-01

    In 2004, the US Department of Veterans Affairs expanded its delivery of chiropractic care by establishing onsite chiropractic clinics at select facilities across the country. Systematic information regarding the planning and implementation of these clinics and describing their features and performance is lacking. To document the planning, implementation, key features and performance of VA chiropractic clinics, and to identify variations and their underlying causes and key consequences as well as their implications for policy, practice, and research on the introduction of new clinical services into integrated health care delivery systems. Comparative case study of 7 clinics involving site visit-based and telephone-based interviews with 118 key stakeholders, including VA clinicians, clinical leaders and administrative staff, and selected external stakeholders, as well as reviews of key documents and administrative data on clinic performance and service delivery. Interviews were recorded, transcribed, and analyzed using a mixed inductive (exploratory) and deductive approach. Interview data revealed considerable variations in clinic planning and implementation processes and clinic features, as well as perceptions of clinic performance and quality. Administrative data showed high variation in patterns of clinic patient care volume over time. A facility's initial willingness to establish a chiropractic clinic, along with a higher degree of perceived evidence-based and collegial attributes of the facility chiropractor, emerged as key factors associated with higher and more consistent delivery of chiropractic services and higher perceived quality of those services.

  11. 1998 Annual Study Report. Standardization of color reproduction management; 1998 nendo seika hokokusho. Iro saigen kanri (color management) no hyojunka

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-03-01

    Standardization of color reproduction management is aimed at realization of the most urgently needed areas of the color reproduction management for international standardization. This R and D program is aimed at drafting the standards for color information devices and their characteristics, and proposing the drafts. Factors which deteriorate color reproduction stability of input and output devices are classified and analyzed, devices for evaluation are selected, and extents of the deterioration are measured and evaluated, in order to extract the problems involved in the color reproduction models for the current input and output devices. Standardization of color management on the multi-spectrum color images is attempted for business printing, where effectiveness of a fluorescent ink containing a fluorescent material is noted for expansion of the color reproduction range for printing color images with the conventional YMCK inks. Basic aspects of the fluorescent colors are measured, to verify the methods for measuring fluorescent body colors. As a result, new knowledge is obtained. The standard images for flesh color evaluation are produced, and the methods for analyzing the data obtained by the tests, including the subjective tests, are established. These lead to establishment of the standards for preferred flesh color of the yellow races. (NEDO)

  12. Trust Management in P2P systems using Standard TuLiP

    OpenAIRE

    Czenko, M.R.; Doumen, J.M.; Etalle, Sandro

    2008-01-01

    In this paper we introduce Standard TuLiP - a new logic based Trust Management system. In Standard TuLiP, security decisions are based on security credentials, which can be issued by different entities and stored at different locations. Standard TuLiP directly supports the distributed credential storage by providing a sound and complete Lookup and Inference AlgoRithm (LIAR). In this paper we focus on (a) the language of Standard TuLiP and (b) on the practical considerations which arise when d...

  13. Management control and status reports documentation standard and Data Item Descriptions (DID). Volume of the information system life-cycle and documentation standards, volume 5

    Science.gov (United States)

    Callender, E. David; Steinbacher, Jody

    1989-01-01

    This is the fifth of five volumes on Information System Life-Cycle and Documentation Standards. This volume provides a well organized, easily used standard for management control and status reports used in monitoring and controlling the management, development, and assurance of informations systems and software, hardware, and operational procedures components, and related processes.

  14. Case Management Ethics: High Professional Standards for Health Care's Interconnected Worlds.

    Science.gov (United States)

    Sminkey, Patrice V; LeDoux, Jeannie

    2016-01-01

    The purpose of this discussion is to draw attention to the considerable pressure on professional case managers today to coordinate with multiple stakeholders, with responsibilities that put them at the forefront of contact with payers and providers. This discussion raises awareness of how case managers, and board-certified case managers in particular, must demonstrate that they adhere to the highest ethical standards, as codified by the Commission for Case Manager Certification's Code of Professional Conduct for Case Managers. This discussion applies to case management practices and work settings across the full continuum of health care. As advocates for clients (individuals receiving case management services) and their families/support systems, case managers must adhere to the highest of ethical and professional standards. The Code of Professional Conduct for Case Managers is an indispensable resource for case managers to ensure that they place the public interest above their own, respect the rights and inherent dignity of clients, maintain objectivity in their relationships with clients, and act with integrity and fidelity with clients and others, as stipulated by the code.

  15. Contribution to Energy Management of the Main Standards for Environmental Management Systems: The Case of ISO 14001 and EMAS

    Directory of Open Access Journals (Sweden)

    Iker Laskurain

    2017-11-01

    Full Text Available The adoption of Energy Management Systems (EnMSs based on international standards has gained momentum since the ISO 50001 standard was launched in 2011. Before that, the potential to improve the energy management with Environmental Management Systems (EMSs based on ISO 14001 and EMAS was identified in the literature. However, no in-depth analysis reported in the literature has explored this claim. The need for research is now even more evident with the development of new versions of the standards for environmental management―ISO 14001:2015 and EMAS III. Since many companies that already have a certified EMSs might be uncertain whether to adopt an ISO 50001 based EnMSs, the present work aims to shed light on the contribution of ISO 14001:2015 and EMAS III to energy management. Furthermore, the work summarizes the results of an empirical exploratory study carried out in eight Spanish organizations, four with an EMS implemented and certified based on ISO 14001:2015 and four more with an EMS registered to EMAS III. The findings show that both ISO14001 and EMAS certified organizations carry out energy management practices, even though they have no formal EnMSs implemented. Implications for managers and policy makers are discussed, together with avenues for further research.

  16. Hospital-based chiropractic integration within a large private hospital system in Minnesota: a 10-year example.

    Science.gov (United States)

    Branson, Richard A

    2009-01-01

    The purpose of this article is to describe a model of chiropractic integration developed over a 10-year period within a private hospital system in Minnesota. Needs were assessed by surveying attitudes and behaviors related to chiropractic and complementary and alternative medicine (CAM) of physicians associated with the hospital. Analyzing referral and utilization patterns assessed chiropractic integration into the hospital system. One hundred five surveys were returned after 2 mailings for a response rate of 74%. Seventy-four percent of respondents supported integration of CAM into the hospital system, although 45% supported the primary care physician as the gatekeeper for CAM use. From 2006 to 2008, there were 8294 unique new patients in the chiropractic program. Primary care providers (medical doctors and physician assistants) were the most common referral source, followed by self-referred patients, sports medicine physicians, and orthopedic physicians. Overall examination of the program identified that facilitators of chiropractic integration were (1) growth in interest in CAM, (2) establishing relationships with key administrators and providers, (3) use of evidence-based practice, (4) adequate physical space, and (5) creation of an integrated spine care program. Barriers were (1) lack of understanding of chiropractic professional identity by certain providers and (2) certain financial aspects of third-party payment for chiropractic. This article describes the process of integrating chiropractic into one of the largest private hospital systems in Minnesota from a business and professional perspective and the results achieved once chiropractic was integrated into the system. This study identified key factors that facilitated integration of services and demonstrates that chiropractic care can be successfully integrated within a hospital system.

  17. Development of a document management system for the standardization of clinical laboratory documents.

    Science.gov (United States)

    Hwang, Sang-Hyun; Jung, Seon-Kyung; Kang, Soo-Jin; Cha, Hyo Soung; Chung, Seung Hyun; Lee, Do-Hoon

    2013-11-01

    Documentation is very important; a considerable number of documents exist for use in accreditation inspection. However, most laboratories do not effectively manage the processes of documentation, organization, and storage. The purpose of this study was to facilitate the establishment of a strategically effective and sustainably standardized document management system. A document code formatting system was modified by comparing the document list data received from 3 major university hospitals. In addition, a questionnaire regarding document code standardization was created and sent to 268 institutes to establish document classifications and generate a standard coding scheme. A computerized document management system was developed. Only 32% (8 out of 25 institutes) answered that they were able to identify all of the document types and their numbers. In total, 76% of institutes (19 out of 25) answered that a systematic document management system was necessary. Disorganized document files were systemized by classifying them into 8 major groups according to their characteristics: patient test records (T), test quality control (Q), manuals (M), equipment and environment management (E), statistics (S), division administration (A), department administration (R), and others (X). Our documentation system may serve as a basis for the standardization of documents and the creation of a document management system for all hospital laboratories.

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

    DEFF Research Database (Denmark)

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

    2009-01-01

    PURPOSE: Non-cognitive admission criteria are typically used in chiropractic student selection to supplement grades. The reliability of non-cognitive student admission criteria in chiropractic education has not previously been examined. In addition, very few studies have examined the overall test...... generalizability of composites of non-cognitive admission variables in admission to health science programs. The aim of this study was to estimate the generalizability of a composite selection to a chiropractic program, consisting of: application form information, a written motivational essay, a common knowledge...... 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...

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

    Directory of Open Access Journals (Sweden)

    E Ernst

    2011-01-01

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

  20. EMPIRICAL ANALYSIS OF INTEGRATION WITHIN THE STANDARDS-BASED INTEGRATED MANAGEMENT SYSTEMS

    Directory of Open Access Journals (Sweden)

    Stanislav Karapetrović

    2010-03-01

    Full Text Available The overall goal of this paper is to empirically analyze the augmentation and integration of ISO 9001 - based quality management systems with ISO 14001 - based environmental and other standardized management systems. Results from a survey of 298 organizations headquartered in the Spanish regions of Catalonia and the Basque Country are presented. All surveyed organizations were registered to both ISO 9001: 2000 and ISO 14001: 2004, while some had further management system standard certificates, for example in occupational health and safe ty and social responsibility. Various aspects of augmentation and integration, such as the usage of additional subsystem standards, the process of integration and the conduct of audits, are discussed through largely descriptive analyses.

  1. 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

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

    Science.gov (United States)

    Walker, Bruce F; Losco, Barrett; Clarke, Brenton R; Hebert, Jeff; French, Simon; Stomski, Norman J

    2011-10-31

    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. 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. Australia and New Zealand Clinical Trials Register (ANZCTR

  3. Survey of health attitudes and behaviors of a chiropractic college population.

    Science.gov (United States)

    DuMonthier, William N; Haneline, Michael T; Smith, Monica

    2009-01-01

    We gathered information about health behaviors on a chiropractic campus, including compliance with recent guidelines for exercise as well as diet, smoking, and binge drinking. We also assessed the perceived importance of the chiropractic physician in role modeling and teaching healthy behaviors to patients. A survey instrument composed of 16 questions was designed and distributed to 279 students, faculty, and staff at a chiropractic college campus in northern California. Confidentiality was maintained throughout the process, and a response rate of 92% was obtained. Statistical analysis was performed on the data collected. The levels of obesity, inactivity, and smoking on this college campus are lower than the levels reported for the metropolitan area, the state, and the nation. The level of binge drinking among our students was high but similar to the reported rates for college students generally. We found interesting and significant relationships between the behaviors of physical activity and diet (red meat consumption), obesity, and self-reported perceived health in our surveyed chiropractic college population. Without exception, all surveyed members of our campus community view doctors of chiropractic as having a responsibility to role model healthy behaviors and to educate their patients with regard to healthy behaviors; however, we also found that less importance was placed on role modeling and patient education by those who were obese or who consumed red meat in excess. This chiropractic college campus places a high level of importance on both educating patients and role modeling healthy behaviors. In the behavioral domain, the rates of smoking, obesity, and inactivity are lower than what is seen in the general population. However, there remains room for considerable improvement to bring actual health behaviors closer in line with evidence-informed behavioral health practices.

  4. Familiarity with and advocacy of Healthy People 2010 goals by Mississippi Chiropractic Association members.

    Science.gov (United States)

    Leach, Robert A; Cossman, Ronald E; Yates, Joyce M

    2011-01-01

    The purpose of this study was to determine the familiarity with and stated advocacy of Healthy People 2010 objectives by member doctors of the Mississippi Chiropractic Association. Peer experts established face validity of a questionnaire regarding the Leading Health Indicators. This survey was distributed to 157 Mississippi Chiropractic Association members in 2009 during a conference and a follow-up by postal mail. Most doctors of chiropractic in the sample (n = 68, or 43% response) consider themselves wellness-oriented health care providers. Forty-two percent had read, 29% had not read, and another 29% were unsure whether they had read the Healthy People 2010 national objectives. Almost half (44%) strongly or somewhat agreed that their office practice reflects support for the Healthy People 2010 objective. In contrast, 27% disagree and 29% were unsure if their practice reflects the Healthy People 2010 objectives. There were differences between support and practice behaviors for some of the objectives. Chiropractors who have read the objectives tend to be more supportive of the national goals. Doctors of chiropractic in this sample are supportive of most Leading Health Indicators, and the majority reports that they incorporate these public health goals into their practices. Familiarity with reading the Health People objectives seems to be related to reported practice behaviors. There is a need to improve the percentage of practicing doctors of chiropractic who are familiar with Healthy People objectives. Future health education initiatives may assist doctors of chiropractic in further incorporating public health objectives into their practice behaviors and improving quality health care. Copyright © 2011 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.

  5. Prevalence of burnout among doctors of chiropractic in the northeastern United States.

    Science.gov (United States)

    Williams, Shawn; Zipp, Genevieve P; Cahill, Terrence; Parasher, Raju K

    2013-01-01

    The purpose of this study was to measure the prevalence of burnout among doctors of chiropractic (DCs) in the New York, New Jersey, and Pennsylvania geographical region and compare these results with burnout data from other health care professions. This exploratory study applied cross-sectional data collection methods. Using nonprobability convenience sampling, a New York-New Jersey-Pennsylvania chiropractic governance body provided contact information of a randomized sample of licensed DCs from their membership directory. Participants included any DC licensed to practice chiropractic whose primary occupation encompassed the chiropractic profession. The Maslach Burnout Inventory-Human Services Survey (MBI-HSS) and a demographic questionnaire were e-mailed to a randomized sample of licensed DCs. Of the 772 surveys deployed, 90 returned the survey with usable data. Nearly 40% of the DCs reported a moderate (24%) or high (18%) level of emotional exhaustion, whereas the majority of respondents scored a high (72%) level of personal accomplishment. In total, only 2 participants (2%) met the criteria for high burnout, whereas 42 participants (47%) were low. Statistically significant relationships (P chiropractic philosophical perspectives, the public's opinion of chiropractic, and the effect of suffering from a work-related injury. When compared with data from previously published studies using the MBI-HSS for other health professions (ie, medical, nursing, physical therapy, occupational therapy, and dentistry), the values for DCs were significantly lower. The sample of DCs in this study fared more favorably on all 3 dimensions of burnout. They reported lower emotional exhaustion and depersonalization scores and higher personal accomplishment scores than their medical, nursing, physical therapy, occupational therapy, and dentistry colleagues who have been evaluated using the MBI-HSS. However, the levels of emotional exhaustion remain a concern for this professional group

  6. How can chiropractic become a respected mainstream profession? The example of podiatry

    Directory of Open Access Journals (Sweden)

    Schneider Michael J

    2008-08-01

    Full Text Available Abstract Background The chiropractic profession has succeeded to remain in existence for over 110 years despite the fact that many other professions which had their start at around the same time as chiropractic have disappeared. Despite chiropractic's longevity, the profession has not succeeded in establishing cultural authority and respect within mainstream society, and its market share is dwindling. In the meantime, the podiatric medical profession, during approximately the same time period, has been far more successful in developing itself into a respected profession that is well integrated into mainstream health care and society. Objective To present a perspective on the current state of the chiropractic profession and to make recommendations as to how the profession can look to the podiatric medical profession as a model for how a non-allopathic healthcare profession can establish mainstream integration and cultural authority. Discussion There are several key areas in which the podiatric medical profession has succeeded and in which the chiropractic profession has not. The authors contend that it is in these key areas that changes must be made in order for our profession to overcome its shrinking market share and its present low status amongst healthcare professions. These areas include public health, education, identity and professionalism. Conclusion The chiropractic profession has great promise in terms of its potential contribution to society and the potential for its members to realize the benefits that come from being involved in a mainstream, respected and highly utilized professional group. However, there are several changes that must be made within the profession if it is going to fulfill this promise. Several lessons can be learned from the podiatric medical profession in this effort.

  7. Interprofessional collaboration and job satisfaction of chiropractic physicians.

    Science.gov (United States)

    Konrad, Thomas R; Fletcher, Grant S; Carey, Timothy S

    2004-05-01

    Despite the fact that chiropractic physicians (DCs) are growing in number and legitimacy in the community of health care professionals, little recent research describes how their relationships with medical doctors (MDs) affect their job and career perceptions. This study explores interprofessional relations by identifying factors associated with variations in how DCs evaluate their interaction with MDs. It also adapts a previously validated multifaceted measure of MD job satisfaction for use with DCs. Cross-sectional survey of 311 DC physicians in North Carolina. The hypothesized multifaceted nature of DC job satisfaction was confirmed. Four distinct job facets and global career satisfaction were measured effectively in DCs. DCs' career satisfaction is related to satisfaction with compensation, intrinsic motivation of relating to patients, and having positive relationships with DC colleagues. DCs report referring patients to MDs more often than they report MDs referring patients to them. Satisfaction with relationships between DCs and MDs is relatively low and is strongly linked to the quantity of referrals from MDs and the perception that MDs practice collaboratively with DCs. However, DCs' global career satisfaction is unrelated to their relationships with MDs. Global career satisfaction of DCs is relatively high and unaffected by the low level of satisfaction DCs report having with their relationships with MDs. These findings suggest that despite increasing interaction and interdependence, DCs' relationship with MDs is of minor importance in their professional self-image.

  8. Conventional Microscopy vs. Computer Imagery in Chiropractic Education.

    Science.gov (United States)

    Cunningham, Christine M; Larzelere, Elizabeth D; Arar, Ilija

    2008-01-01

    As human tissue pathology slides become increasingly difficult to obtain, other methods of teaching microscopy in educational laboratories must be considered. The purpose of this study was to evaluate our students' satisfaction with newly implemented computer imagery based laboratory instruction and to obtain input from their perspective on the advantages and disadvantages of computerized vs. traditional microscope laboratories. This undertaking involved the creation of a new computer laboratory. Robbins and Cotran Pathologic Basis of Disease, 7(th)ed, was chosen as the required text which gave students access to the Robbins Pathology website, including complete content of text, Interactive Case Study Companion, and Virtual Microscope. Students had experience with traditional microscopes in their histology and microbiology laboratory courses. Student satisfaction with computer based learning was assessed using a 28 question survey which was administered to three successive trimesters of pathology students (n=193) using the computer survey website Zoomerang. Answers were given on a scale of 1-5 and statistically analyzed using weighted averages. The survey data indicated that students were satisfied with computer based learning activities during pathology laboratory instruction. The most favorable aspect to computer imagery was 24-7 availability (weighted avg. 4.16), followed by clarification offered by accompanying text and captions (weighted avg. 4.08). Although advantages and disadvantages exist in using conventional microscopy and computer imagery, current pathology teaching environments warrant investigation of replacing traditional microscope exercises with computer applications. Chiropractic students supported the adoption of computer-assisted instruction in pathology laboratories.

  9. Development of criteria and standards for management of low-level radioactive waste

    International Nuclear Information System (INIS)

    Grey, A.E.; Falconer, K.L.

    1980-08-01

    The basic need for criteria and standards for radioactive waste management is to ensure compliance with Federal and State regulations applicable to this activity. In addition, criteria and standards can establish the parameters by which a radioactive waste disposal site is selected, the form in which the waste is to be disposed, how a disposal site is to be operated, and how that site is to be closed when it reaches the end of its useful life. For developing criteria and standards, this report discusses the nature of low-level radioactive waste and the role government agencies play in regulating its management. It describes subject areas for which criteria and standards could be developed, current and evolving requirements, and future suggested analyses

  10. Experiences from Implementation of Lean Production: Standardization versus Self-management: A Swedish Case Study

    Directory of Open Access Journals (Sweden)

    Margareta Oudhuis

    2013-01-01

    Full Text Available In this article, we discuss important aspects of the perceived problematic relationship between self-management and standardization. The article presents data from three case studies conducted within manufacturing companies in Sweden, where the popularity of lean production has led to a renaissance for short-cycle and standardized assembly work in settings that traditionally have made use of sociotechnical production design. The data suggest that the implementation has not contributed to an increased commitment, smooth operations, and capacity for change and innovation. Despite these not so positive results, it is argued that it is possible to combine self-management principles with lean production and standardization if 1 the implementation of lean is done with a contextual sensitivity, 2 a balance is reached between the use of standards on the one hand and work enrichment on the other, and 3 a feeling of ownership as regards both implementation and production process is upheld among the product on personnel.

  11. MUSQA: a CS method to build a multi-standard quality management system

    Science.gov (United States)

    Cros, Elizabeth; Sneed, Isabelle

    2002-07-01

    CS Communication & Systèmes, through its long quality management experience, has been able to build and evolve its Quality Management System according to clients requirements, norms, standards and models (ISO, DO178, ECSS, CMM, ...), evolving norms (transition from ISO 9001:1994 to ISO 9001:2000) and the TQM approach, being currently deployed. The aim of this paper is to show how, from this enriching and instructive experience, CS has defined and formalised its method: MuSQA (Multi-Standard Quality Approach). This method allows to built a new Quality Management System or simplify and unify an existing one. MuSQA objective is to provide any organisation with an open Quality Management System, which is able to evolve easily and turns to be a useful instrument for everyone, operational as well as non-operational staff.

  12. Analysis, Design and Implementation of a Database Management System for a Generating Technical/Medical Reports by Chiropractors

    National Research Council Canada - National Science Library

    Bolling, Rodney

    1997-01-01

    A medical center specializing in chiropractic care is burdened with the enormous task of managing numerous patient's records, preparing error free billing statements, and writing official business/medical...

  13. 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.

  14. An automated standardized system for managing adverse events in clinical research networks.

    Science.gov (United States)

    Richesson, Rachel L; Malloy, Jamie F; Paulus, Kathleen; Cuthbertson, David; Krischer, Jeffrey P

    2008-01-01

    Multi-site clinical protocols and clinical research networks require tools to manage and monitor adverse events (AEs). To be successful, these tools must be designed to comply with applicable regulatory requirements, reflect current data standards, international directives and advances in pharmacovigilance, and be convenient and adaptable to multiple needs. We describe an Adverse Event Data Management System (AEDAMS) that is used across multiple study designs in the various clinical research networks and multi-site studies for which we provide data and technological support. Investigators enter AE data using a standardized and structured web-based data collection form. The automated AEDAMS forwards the AE information to individuals in designated roles (investigators, sponsors, Data Safety and Monitoring Boards) and manages subsequent communications in real time, as the entire reporting, review and notification is done by automatically generated emails. The system was designed to adhere to timelines and data requirements in compliance with Good Clinical Practice (International Conference on Harmonisation E6) reporting standards and US federal regulations, and can be configured to support AE management for many types of study designs and adhere to various domestic or international reporting requirements. This tool allows AEs to be collected in a standard way by multiple distributed users, facilitates accurate and timely AE reporting and reviews, and allows the centralized management of AEs. Our design justification and experience with the system are described.

  15. Effects of ISO 9001 Standard on Critical Factors of Project Management in Construction Industry

    OpenAIRE

    Neyestani, Behnam; Juanzon, Joseph Berlin P.

    2017-01-01

    This paper provides a significant contribution to the knowledge by identifying the impact of ISO 9001 implementation on the most vital factors of project management within large scale (AAA) construction firms in Metro Manila, Philippines. Thus, the study was accomplished an extensive literature review for identifying the main factors of project management, ISO 9001 standard, and other concepts, for developing an appropriate survey instrument. Then the questionnaires were distribu...

  16. Implementing an integrated standards-based management system to ensure compliance at Los Alamos National Laboratory

    International Nuclear Information System (INIS)

    Hjeresen, D.; Roybal, S.; Bertino, P.; Gherman, C.; Hosteny, B.

    1995-01-01

    Los Alamos National Laboratory (LANL or the Laboratory) is developing and implementing a comprehensive, Integrated Standards-Based Management System (ISBMS) to enhance environmental, safety, and health (ESH) compliance efforts and streamline management of ESH throughout the Laboratory. The Laboratory recognizes that to be competitive in today's business environment and attractive to potential Partnerships, Laboratory operations must be efficient and cost-effective. The Laboratory also realizes potential growth opportunities for developing ESH as a strength in providing new or improved services to its customers. Overall, the Laboratory desires to establish and build upon an ESH management system which ensures continuous improvement in protecting public health and safety and the environment and which fosters a working relationship with stakeholders. A team of process experts from the LANL Environmental Management (EM) Program Office, worked with management system consultants, and the Department of Energy (DOE) to develop an ESH management systems process to compare current LANL ESH management Systems and programs against leading industry standards. The process enabled the Laboratory to gauge its performance in each of the following areas: Planning and Policy Setting; Systems and Procedures; Implementation and Education; and Monitoring and Reporting. The information gathered on ESH management systems enabled LANL to pinpoint and prioritize opportunities for improvement in the provision of ESH services throughout the Laboratory and ultimately overall ESH compliance

  17. Standard requirements for GCP-compliant data management in multinational clinical trials

    LENUS (Irish Health Repository)

    Ohmann, Christian

    2011-03-22

    Abstract Background A recent survey has shown that data management in clinical trials performed by academic trial units still faces many difficulties (e.g. heterogeneity of software products, deficits in quality management, limited human and financial resources and the complexity of running a local computer centre). Unfortunately, no specific, practical and open standard for both GCP-compliant data management and the underlying IT-infrastructure is available to improve the situation. For that reason the "Working Group on Data Centres" of the European Clinical Research Infrastructures Network (ECRIN) has developed a standard specifying the requirements for high quality GCP-compliant data management in multinational clinical trials. Methods International, European and national regulations and guidelines relevant to GCP, data security and IT infrastructures, as well as ECRIN documents produced previously, were evaluated to provide a starting point for the development of standard requirements. The requirements were produced by expert consensus of the ECRIN Working group on Data Centres, using a structured and standardised process. The requirements were divided into two main parts: an IT part covering standards for the underlying IT infrastructure and computer systems in general, and a Data Management (DM) part covering requirements for data management applications in clinical trials. Results The standard developed includes 115 IT requirements, split into 15 separate sections, 107 DM requirements (in 12 sections) and 13 other requirements (2 sections). Sections IT01 to IT05 deal with the basic IT infrastructure while IT06 and IT07 cover validation and local software development. IT08 to IT015 concern the aspects of IT systems that directly support clinical trial management. Sections DM01 to DM03 cover the implementation of a specific clinical data management application, i.e. for a specific trial, whilst DM04 to DM12 address the data management of trials across the unit

  18. Research on the management and endorsement of nuclear safety standards in the United States and its revelation for China

    Science.gov (United States)

    Liu, Ting; Tian, Yu; Yang, Lili; Gao, Siyi; Song, Dahu

    2018-01-01

    This paper introduces the American standard system, the Nuclear Regulatory Commission (NRC)’s responsibility, NRC nuclear safety regulations and standards system, studies on NRC’s standards management and endorsement mode, analyzes the characteristics of NRC standards endorsement management, and points out its disadvantages. This paper draws revelation from the standard management and endorsement model of NRC and points suggestion to China’s nuclear and radiation safety standards management.The issue of the “Nuclear Safety Law”plays an important role in China’s nuclear and radiation safety supervision. Nuclear and radiation safety regulations and standards are strong grips on the implementation of “Nuclear Safety Law”. This paper refers on the experience of international advanced countriy, will effectively promote the improvement of the endorsed management of China’s nuclear and radiation safety standards.

  19. 75 FR 61413 - Notice of Availability of Biotechnology Quality Management System Audit Standard and Evaluation...

    Science.gov (United States)

    2010-10-05

    ...We are advising the public that the Animal and Plant Health Inspection Service has developed an audit standard for its biotechnology compliance assistance program. The audit standard, which was made available in draft form for comment in an earlier notice, will be used by participating regulated entities to develop and implement sound management practices, thus enhancing compliance with the regulatory requirements for field trials and movement of genetically engineered organisms in 7 CFR part 340. We are also making available a document containing our evaluation of the comments we received on the draft audit standard.

  20. 25 CFR 900.43 - What are the general financial management system standards that apply to a tribal organization...

    Science.gov (United States)

    2010-04-01

    ... ASSISTANCE ACT Standards for Tribal or Tribal Organization Management Systems Standards for Financial... 25 Indians 2 2010-04-01 2010-04-01 false What are the general financial management system standards that apply to a tribal organization carrying out a self-determination contract? 900.43 Section 900...

  1. Technical Review of Law Enforcement Standards and Guides Relative to Incident Management

    Energy Technology Data Exchange (ETDEWEB)

    Stenner, Robert D.; Salter, R.; Stanton, J. R.; Fisher, D.

    2009-03-24

    In an effort to locate potential law enforcement-related standards that support incident management, a team from the Pacific Northwest National Laboratory (PNNL) contacted representatives from the National Institute of Standards-Office of Law Enforcement Standards (NIST-OLES), National Institute of Justice (NIJ), Federal Bureau of Investigation (FBI), Secret Service, ASTM International committees that have a law enforcement focus, and a variety of individuals from local and regional law enforcement organizations. Discussions were held with various state and local law enforcement organizations. The NIJ has published several specific equipment-related law enforcement standards that were included in the review, but it appears that law enforcement program and process-type standards are developed principally by organizations that operate at the state and local level. Input is provided from state regulations and codes and from external non-government organizations (NGOs) that provide national standards. The standards that are adopted from external organizations or developed independently by state authorities are available for use by local law enforcement agencies on a voluntary basis. The extent to which they are used depends on the respective jurisdictions involved. In some instances, use of state and local disseminated standards is mandatory, but in most cases, use is voluntary. Usually, the extent to which these standards are used appears to depend on whether or not jurisdictions receive certification from a “governing” entity due to their use and compliance with the standards. In some cases, these certification-based standards are used in principal but without certification or other compliance monitoring. In general, these standards appear to be routinely used for qualification, selection for employment, and training. In these standards, the term “Peace Officer” is frequently used to refer to law enforcement personnel. This technical review of national law

  2. 10 CFR 603.620 - Financial management standards for nonprofit participants.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Financial management standards for nonprofit participants. 603.620 Section 603.620 Energy DEPARTMENT OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS TECHNOLOGY INVESTMENT AGREEMENTS Award Terms Affecting Participants' Financial, Property, and Purchasing Systems...

  3. 32 CFR 37.620 - What financial management standards do I include for nonprofit participants?

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 1 2010-07-01 2010-07-01 false What financial management standards do I include... SECRETARY OF DEFENSE DoD GRANT AND AGREEMENT REGULATIONS TECHNOLOGY INVESTMENT AGREEMENTS Award Terms Affecting Participants' Financial, Property, and Purchasing Systems Financial Matters § 37.620 What...

  4. 10 CFR 603.615 - Financial management standards for-profit firms.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Financial management standards for-profit firms. 603.615 Section 603.615 Energy DEPARTMENT OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS TECHNOLOGY INVESTMENT AGREEMENTS Award Terms Affecting Participants' Financial, Property, and Purchasing Systems Financial Matters...

  5. 78 FR 37409 - Small Business Size Standards: Finance and Insurance and Management of Companies and Enterprises

    Science.gov (United States)

    2013-06-20

    ... SMALL BUSINESS ADMINISTRATION 13 CFR Part 121 RIN 3245-AG45 Small Business Size Standards: Finance and Insurance and Management of Companies and Enterprises AGENCY: U.S. Small Business Administration. ACTION: Final rule. SUMMARY: The U.S. Small Business Administration (SBA) is increasing small business...

  6. A Case Study of Implications and Applications of Standardized Nomenclature for Asset Management in Healthcare

    Science.gov (United States)

    DeFrancesco, Jennifer A.

    2016-01-01

    Healthcare organizations strive to adapt to the continuous change in what has become a fast-paced, high technology environment. Many organizations are charged to find efficiencies to better manage medical device assets. Increasingly, healthcare leaders opt to adopt a standardized medical device nomenclature under the purview of a set of national…

  7. Strategic Management and Innovation: A Checklist for Readiness Evaluation of AACSB Standards

    Science.gov (United States)

    Kundu, Goutam Kumar; Bairi, Jayachandra

    2016-01-01

    Purpose: The purpose of this paper is to introduce the concept of a checklist, focusing on the detailed analysis of the requirement of the Association to Advance Collegiate Schools of Business (AACSB) standards related to strategic management and innovation area, for evaluation of implementation readiness in a business school setting.…

  8. 25 CFR 276.7 - Standards for grantee financial management systems.

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Standards for grantee financial management systems. 276.7... of the financial results of each grant program in accordance with Federal reporting requirements and... law, the Bureau wll not require financial reporting on the accrual basis from tribal organizations...

  9. 75 FR 33744 - Pesticide Management and Disposal; Standards for Pesticide Containers and Containment; Proposed...

    Science.gov (United States)

    2010-06-15

    ... Pesticide Management and Disposal; Standards for Pesticide Containers and Containment; Proposed Change to... is proposing to amend the pesticide container and containment regulations to provide a 1-year...-5805. Instructions: Direct your comments to docket ID number EPA-HQ-OPP- 2005-0327. EPA's policy is...

  10. 77 FR 36485 - Alternative Personnel Management System (APMS) at the National Institute of Standards and Technology

    Science.gov (United States)

    2012-06-19

    ... comments to Amy K. Cubert, Supervisory Human Resources Specialist, National Institute of Standards and... is more competitive for talent, and NIST managers report significantly more authority to make... v. Department of Health & Human Services, 197 F.3d 1144 (Fed. Cir. 1999), and McCormick v...

  11. 40 CFR 262.103 - What is the scope of the laboratory environmental management standard?

    Science.gov (United States)

    2010-07-01

    ... University Laboratories XL Project-Laboratory Environmental Management Standard § 262.103 What is the scope... 40 Protection of Environment 25 2010-07-01 2010-07-01 false What is the scope of the laboratory... limitations, emergency response notification provisions, or other legal requirements applicable to University...

  12. Review of Special Standards in Quality Management Systems Audits in Automotive Production

    Science.gov (United States)

    Šurinová, Yulia

    2013-12-01

    Quality management systems (QMS) in automotive industry generally have several differences in comparison with other industrial branches. Different customers have their own specific requirements, including requirements for quality audits. Audits are one of the coretools of quality management to make the PDCA (Plan - Do - Check - Act) cycle work. As a matter of fact, compliance with ISO/TS 16949:2009 requirements is a condition for supplying the automotive industry. However, there are some standards which co-exist together with the ISO 9001 based management systems and technical specification for QMS in automotive ISO/TS16949. Which are those specific standards in automotive industry and what standard to use and why - those are the questions to be answered in this paper. The aim of the paper is to review what standards are used for audits implementation in automotive industry in the Slovak Republic, and why the organizations keep following those "extra" standards even if certification for ISO/TS 16949 is required by all the car makers. The paper is structured as follows: after short introduction to the topic and related terms, presented is our methodology. . In the third section, the achieved results are discussed. And finally, the principal findings of the paper, limitations and conclusions are presented.

  13. REVIEW OF EXISTING ENERGY MANAGEMENT STANDARDS AND POSSIBILITIES FOR ITS INTRODUCTION IN SERBIA

    Directory of Open Access Journals (Sweden)

    Dubravka N Jelić

    2010-01-01

    Full Text Available Until recent times, energy management practices primarily consisted in replacing inefficient equipment and then using any number of methods to estimate obtained savings. Experience shows that positive effects of energy efficient improvements were decreased over time. There have been significant efforts over the last decade to define appropriate standards and best practices and implement the consistent energy management system to increase and maintain the energy savings. The knowledge gained from thousands of energy efficient projects is driving a transition from traditional tactical practice (one-time "build and forget" projects to energy management strategies proposed and endorsed by a number of international organizations. The current status of internationally developed energy management standards, including an analysis of their shared features and differences is presented in this paper. The purpose of the analysis is to describe the current state of "best practices" for this emerging area of energy efficiency policymaking in order to study the possibility of implementation of energy management standards in Serbia and to estimate the effects and the potential for energy saving that would be made by its implementation.

  14. Refocusing acute psychiatry, performance management, standards and accountability, a new context for mental health nursing.

    LENUS (Irish Health Repository)

    Harnett, P J

    2009-06-01

    The term \\'performance management\\' has an aversive \\'managerial\\' aspect, is unappealing to many public sector staff and has an \\'image problem\\'. Perhaps as a consequence, it has failed to make a significant impact on Irish public sector workers, notably mental health nurses. In this paper, performance management is introduced and examined within an Irish healthcare context and with reference to its use in other countries. Some of the challenges faced by Irish mental health nurses and the potential benefits of working within a performance managed workplace are discussed. The paper concludes that performance management is likely to increasingly affect nurses, either as active agents or as passive recipients of a change that is thrust on them. The authors anticipate that the performance management \\'image problem\\' will give way to recognition that this is a fundamental change which has the potential to enable health services to change. This change will bring high standards of transparency, worker involvement in decision making, an explicit value base for health services and individual teams. It provides the potential for clear practice standards and high standards of transparency as well as worker welfare in all aspects, including supporting employment and career progression.

  15. Standardi za upravljanje sigurnošću podataka / Standards for management data security

    Directory of Open Access Journals (Sweden)

    Dejan Vuletić

    2006-10-01

    Full Text Available U radu su analizirani osnovni pojmovi vezani za upravljanje sigurnošću podataka. Ukazano je na potrebu i značaj standardizacije u oblasti informaciono-komunikacionih tehnologija, naročito prema standardima Međunarodne organizacije za standardizaciju (International Standardization Organization - ISO. U završnom delu rada prikazane su proaktivne i reaktivne aktivnosti u upravljanju sigurnošću podataka. / In this article basic notions of management data security are analyzed. We indicated demand and importance of standardization in information-communication technology domain, especially according to International Standardization Organization. In the final part of the article we illustrated both proactive and reactive activities in management data security.

  16. Standards for the management of swabs, needles and instruments in the operating theatre

    Directory of Open Access Journals (Sweden)

    A. Astrop

    1996-05-01

    Full Text Available The management of swabs, needles and instruments in the operating theatre is a high-risk and problem-prone area for the operating theatre nurse. The purpose of this research is to formulate specific standards on the management of swabs, needles and instruments in the operating theatre to ensure the safety of the patient. An exploratory and descriptive research design was used and executed in 3 hospitals of a private hospital group in Gauteng. A structured two phase process was followed, ie the development phase and the validation phase. This last phase was done by means of deliberate debate. It is recommended that these standards be implemented, tested and validated on a national basis and a monitoring and evaluation system should be developed to ensure nursing compliance with these standards.

  17. An audit of health products and services marketed on chiropractic websites in Alberta and consideration of these practices in the context of chiropractic codes of conduct and ethics.

    Science.gov (United States)

    Page, Stacey A

    2007-06-01

    Chiropractic's success as a health care profession is evidenced in part by the rising number of practitioners. Paradoxically, this success may start to cost the profession, as the number of consumers may not be increasing proportionally. Fewer patients mean less income for practitioners. Some chiropractors are responding to these pressures by marketing health products, and services. To describe the extent to which Alberta chiropractors with websites sold health products and the extent to which fee discounts/service inducements were advertised. To consider these practices in the context of chiropractic codes of conduct and ethics. Chiropractic websites in the province of Alberta were identified using the online Telus Business Finder and cross-referenced with the Yellow Pages print directories. The websites were searched and an inventory of the health products for sale was recorded. Fee discounts and service inducements were also recorded. 56 websites were identified and reviewed. Just under two-thirds of the chiropractic websites surveyed contained information on health products for sale. Orthotics were sold most often (N = 29 practices; 51.8%), followed by pillows and supports (N = 15: 26.8%), vitamins/nutritional supplements (N = 15; 26.8%) and exercise/rehabilitation products (N = 10; 17.9%). Nine practices (16.1%) offered some type of inducement to potential customers. These included discounts on treatment packages (N = 2; 3.6%), free gait/ posture analyses (N = 2; 3.6%) and free general consultations with the chiropractors (N = 3; 5.4%) The marketing of health care products and services by chiropractors in Alberta is common. Such practices raise ethical considerations for the profession. Professional guidelines vary on the acceptability of these practices. Consumer and practitioner perspectives and practices regarding retailing need to be further examined.

  18. [Standardized management of acupuncture-moxibustion clinic in Singapore General Hospital].

    Science.gov (United States)

    Cui, Shu-Li; Tan, Kian Hian; Ong, Biauw Chi; Lim, Shih hui; Yong, Yang; Seah, Cheng Ngee; Huang, Youyi; Han, Seong Ng

    2014-02-01

    The standardized management of acupuncture-moxibustion in Singapore General Hospital is introduced. With gradual improvement of outpatient infrastructure, re-training of medical staff, strict disinfection of manipulation, periodical inspection of medical instruments, unified management of writing, saving and processing in medical records and public education of TCM knowledge, a standardized management system in accordance with modernized hospital is gradually established. As a result, efficiency and quality of clinical treatment is continuously increasing. From April of 1998 to December of 2012, a total of 74 654 times of treatment were performed, and treatment amount per day is gradually increased. The unusual condition of acupuncture is avoided. Periodical strict inspection of joint committee authenticated by domestic and overseas medical health organization is repeatedly passed and accepted. Additionally, three clinical researches funded by Singapore Health-care Company are still in progress in acupuncture-moxibustion department.

  19. [Effect of standardized PICC training and management on the clinical effect and complication of catheterization].

    Science.gov (United States)

    Zhang, Jinghui; Tang, Siyuan; He, Lianxiang; Chen, Wenfeng; Jiang, Pinglan; Hu, Yuanping; Chen, Hua

    2014-06-01

    To determine the clinical effect of standardized training and management of peripherally inserted central catheter (PICC) and catheter-related complications. A total of 610 patients were divided into a control group and an observation group, the control group (n=300) were catheterized by trainees who received "short-term intensive training", the observation group (n=310) by "system standardized training and management". The clinical efficacy of catheterization and the rate of catheter-related complications were compared. There was significant difference in the one-time puncture success rate, one-time cannulation success rate, the time for operation and the pain score between the 2 groups (all PPICC training and management can improve the effect of catheterization and reduce the incidence of PICC-related complication.

  20. Primary care physicians, acupuncture and chiropractic clinicians, and chronic pain patients: a qualitative analysis of communication and care coordination patterns.

    Science.gov (United States)

    Penney, Lauren S; Ritenbaugh, Cheryl; Elder, Charles; Schneider, Jennifer; Deyo, Richard A; DeBar, Lynn L

    2016-01-25

    A variety of people, with multiple perspectives, make up the system comprising chronic musculoskeletal pain (CMP) treatment. While there are frequently problems in communication and coordination of care within conventional health systems, more opportunities for communicative disruptions seem possible when providers use different explanatory models and are not within the same health management system. We sought to describe the communication system surrounding the management of chronic pain from the perspectives of allopathic providers, acupuncture and chiropractor (A/C) providers, and CMP patients. We collected qualitative data from CMP patients (n = 90) and primary care physicians (PCPs) (n = 25) in a managed care system, and community acupuncture and chiropractic care providers (n = 14) who received high levels of referrals from the system, in the context of a longitudinal study of CMP patients' experience. Multiple points of divergence and communicative barriers were identified among the main stakeholders in the system. Those that were most frequently mentioned included issues surrounding the referral process (requesting, approving) and lack of consistent information flow back to providers that impairs overall management of patient care. We found that because of these problems, CMP patients were frequently tasked and sometimes overwhelmed with integrating and coordinating their own care, with little help from the system. Patients, PCPs, and A/C providers desire more communication; thus systems need to be created to facilitate more open communication which could positively benefit patient outcomes.

  1. National Incident Management System (NIMS) Standards Review Panel Workshop Summary Report

    Energy Technology Data Exchange (ETDEWEB)

    Stenner, Robert D.; Kirk, Jennifer L.; Stanton, James R.; Shebell, Peter; Schwartz, Deborah S.; Judd, Kathleen S.; Gelston, Gariann M.

    2006-02-07

    The importance and need for full compliant implementation of NIMS nationwide was clearly demonstrated during the Hurricane Katrina event, which was clearly expressed in Secretary Chertoff's October 4, 2005 letter addressed to the State's governors. It states, ''Hurricane Katrina was a stark reminder of how critical it is for our nation to approach incident management in a coordinated, consistent, and efficient manner. We must be able to come together, at all levels of government, to prevent, prepare for, respond to, and recover from any emergency or disaster. Our operations must be seamless and based on common incident management doctrine, because the challenges we face as a nation are far greater than capabilities of any one jurisdiction.'' The NIMS is a system/architecture for organizing response on a ''national'' level. It incorporations ICS as a main component of that structure (i.e., it institutionalizes ICS in NIMS). In a paper published on the NIMS Website, the following statements were made: ''NIMS represents a core set of doctrine, principles, terminology, and organizational processes to enable effective, efficient and collaborative incident management at all levels. To provide the framework for interoperability and compatibility, the NIMS is based on a balance between flexibility and standardization.'' Thus the NIC is challenged with the need to adopt quality SDO generated standards to support NIMS compliance, but in doing so maintain the flexibility necessary so that response operations can be tailored for the specific jurisdictional and geographical needs across the nation. In support of this large and complex challenge facing the NIC, the Pacific Northwest National Laboratory (PNNL) was asked to provide technical support to the NIC, through their DHS Science and Technology ? Standards Portfolio Contract, to help identify, review, and develop key standards for NIMS compliance. Upon

  2. Lean environmental management integration system for sustainability of ISO 14001:2004 standard implementation

    Directory of Open Access Journals (Sweden)

    Perumal Puvanasvaran

    2014-10-01

    Full Text Available Purpose: The purpose of this study is to present a model for integrating Lean Principles with ISO 14001 Environmental Management System.Design/methodology/approach: To achieve the objective of the study, the methodology used in this study is based on preliminary literature review of ISO 14001 standards and Lean Principles as well as certain case reports from various proponents and authors of ISO 14001 and Lean as noted in various articles and journals and some books.Findings and Originality/value: The findings of this study are a new model called Lean Environmental Management Integration System (LEMIS has been developed and leads to the creation of these measurement standards for evaluating the organization, making its environmental efforts more realistic, focused and attainable.Research limitations/implications: Future research should be conducted case studies in this direction are required to be conducted for examining the feasibility of amalgamation and implementing ISO 14001:2004 standards with the philosophy of Lean Principles to enable the achievement of world class standards.Practical implications: This model helps to eliminate any wasteful processes in the organization’s implementation of the ISO 14001 standard thus leading to higher environmental performance.  Integrating the standard with Lean principles through LEMIS model helps to specify these performance measures making the standard achieve sustainability and continual improvement.Originality/value: This study presents a unique approach of integrating the two main models, namely Lean Principles and ISO 14001 Environmental Management System, as a single framework benefiting contemporary organizations.

  3. 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.

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

    Science.gov (United States)

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

    2012-01-01

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

  5. 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…

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

    Science.gov (United States)

    Scaringe, John G.

    2010-01-01

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

  7. 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…

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

    DEFF Research Database (Denmark)

    Myburgh, Corrie; Mouton, Johan

    2007-01-01

    patients. Semistructured interviews were conducted with the 16 respondents, and computer-assisted thematic analysis was used to interpret data. RESULTS: The practitioners in this study distinguish between 2 main views of the chiropractic identity--the "technician" and "physician." The patients interviewed...

  9. Predictors of adverse events following chiropractic care for patients with neck pain

    NARCIS (Netherlands)

    Rubinstein, S.M.; Leboeuf-Yde, C.; Knol, D.L.; de Koekkoek, T.E.; Pfeifle, C.E.; van Tulder, M.W.

    2008-01-01

    Objective: This study examines which variables may predict adverse events in subjects undergoing chiropractic treatment for neck pain. Methods: This was a prospective, multi-center, cohort study. All new patients, 18 to 65 years of age with neck pain of any duration, who had not undergone

  10. Implementation of a standardized out-of-hospital management method for Parkinson dysphagia

    Directory of Open Access Journals (Sweden)

    Hongying Wei

    Full Text Available Summary Objective: Our objective is to explore the effectiveness and feasibility of establishing a swallowing management clinic to implement out-of-hospital management for Parkinson disease (PD patients with dysphagia. Method: Two-hundred seventeen (217 voluntary PD patients with dysphagia in a PD outpatient clinic were divided into a control group with 100 people, and an experimental group with 117 people. The control group was given dysphagia rehabilitation guidance. The experimental group was presented with the standardized out-of-hospital management method as overall management and information and education materials. Rehabilitation efficiency and incidence rate of dysphagia, as well as relevant complications of both groups were compared after a 6-month intervention. Results: Rehabilitation efficiency and the incidence rate of dysphagia including relevant complications of patients treated with the standardized out-of-hospital management were compared with those seen in the control group. The differences have distinct statistics meaning (p<0.01. Conclusion: Establishing a swallowing management protocol for outpatient setting can effectively help the recovery of the function of swallowing, reduce the incidence rate of dysphagia complications and improve the quality of life in patients with PD.

  11. A comparative analysis of quality management standards for contract research organisations in clinical trials.

    Science.gov (United States)

    Murray, Elizabeth; McAdam, Rodney

    2007-01-01

    This article compares and contrasts the main quality standards in the highly regulated pharmaceutical industry with specific focus on Good Clinical Practice (GCP), the standard for designing, conducting, recording and reporting clinical trials involving human participants. Comparison is made to ISO quality standards, which can be applied to all industries and types of organisation. The study is then narrowed to that of contract research organisations (CROs) involved in the conduct of clinical trials. The paper concludes that the ISO 9000 series of quality standards can act as a company-wide framework for quality management within such organisations by helping to direct quality efforts on a long-term basis without any loss of compliance. This study is valuable because comparative analysis in this domain is uncommon.

  12. Management plan documentation standard and Data Item Descriptions (DID). Volume of the information system life-cycle and documentation standards, volume 2

    Science.gov (United States)

    Callender, E. David; Steinbacher, Jody

    1989-01-01

    This is the second of five volumes of the Information System Life-Cycle and Documentation Standards. This volume provides a well-organized, easily used standard for management plans used in acquiring, assuring, and developing information systems and software, hardware, and operational procedures components, and related processes.

  13. Development of image and information management system for Korean standard brain

    Science.gov (United States)

    Chung, Soon Cheol; Choi, Do Young; Tack, Gye Rae; Sohn, Jin Hun

    2004-04-01

    The purpose of this study is to establish a reference for image acquisition for completing a standard brain for diverse Korean population, and to develop database management system that saves and manages acquired brain images and personal information of subjects. 3D MP-RAGE (Magnetization Prepared Rapid Gradient Echo) technique which has excellent Signal to Noise Ratio (SNR) and Contrast to Noise Ratio (CNR) as well as reduces image acquisition time was selected for anatomical image acquisition, and parameter values were obtained for the optimal image acquisition. Using these standards, image data of 121 young adults (early twenties) were obtained and stored in the system. System was designed to obtain, save, and manage not only anatomical image data but also subjects' basic demographic factors, medical history, handedness inventory, state-trait anxiety inventory, A-type personality inventory, self-assessment depression inventory, mini-mental state examination, intelligence test, and results of personality test via a survey questionnaire. Additionally this system was designed to have functions of saving, inserting, deleting, searching, and printing image data and personal information of subjects, and to have accessibility to them as well as automatic connection setup with ODBC. This newly developed system may have major contribution to the completion of a standard brain for diverse Korean population since it can save and manage their image data and personal information.

  14. Research on a Valuation Standard and the Actual Condition About Security Management in PACS

    International Nuclear Information System (INIS)

    Jeong, Jae Ho; Son, Gi Gyeong; Kang, Hee Doo; Dong, Kyung Rae; Kweon, Dae Cheol; Kim, Hyun Soo

    2008-01-01

    This study is to prepare an evaluation standard about personal information protection and security management of a medical institution and to build up a grade standard of evaluation in PACS environment. We built up evaluation index based on 10 detailed items in four big categories (political security, technical security, data management security and physical security) by referring to ISO17799 (BS 7799), HIPPA (Health Insurance and Portability and Accountability Act of 1996) and domestic medical law. We have investigated at the thirty places where medical facility with the extracted security criteria and security evaluation index. Average score of physical security list, one of the big categories, was 18.5/20 (93%) at all medical institutions. Political security score was 18.5/30 (62%), data management security score was 12/20 (60%) and technical security score was 17.5/30 (58%). Therefore, security evaluation score was average 67 in 30 general hospitals, which was 4th level. The results showed that it is necessary to establish evaluation and management standard about personal information protection and security consciousness which are weak in PACS environment.

  15. [Management of quality in an Intensive Care Unit: implementation of ISO 9001:2008 international standard].

    Science.gov (United States)

    Lorenzo Torrent, R; Sánchez Palacios, M; Santana Cabrera, L; Cobian Martinez, J L; García del Rosario, C

    2010-10-01

    The Quality Management Systems make it possible to prioritize actions to maintain the safety and efficacy of health technologies. The Intensive Care Unit of our hospital has implemented a quality management plan, which has obtained accreditation as "Service Certificate that manages its activities according to UNE-EN ISO 9001:2008" standard. With the application of quality management system, it has been possible to detect the needs that the Service can cover in order to obtain the satisfaction of the patient, relative or health personnel of the other services of the hospital, to improve communications inside and outside of service, to secure greater understanding of the processes of the organization and control of risk, to delimit responsibilities clearly to all the personnel, to make better use of the time and resources and, finally, to improve the motivation of the personnel. Copyright © 2009 Elsevier España, S.L. y SEMICYUC. All rights reserved.

  16. Feasibility study of short-term effects of chiropractic manipulation on older adults with impaired balance

    Science.gov (United States)

    Hawk, Cheryl; Pfefer, Mark T.; Strunk, Richard; Ramcharan, Michael; Uhl, Nathan

    2007-01-01

    Abstract Objective The purpose of this study was to collect preliminary information on the effects of chiropractic spinal manipulation on reducing risk of falls in older adults with impaired balance, as assessed by the Berg Balance Scale (BBS). This information is necessary to develop a line of investigation into the role of chiropractic care on reduction of fall risk in this population. Methods Randomized, 2-group pretest/posttest design feasibility study with a target sample size of 10 (5 per group), conducted within the outpatient health center of a chiropractic college. Inclusion criteria were as follows: aged 60 years or older, able to stand on one leg <5 seconds, and able to attend all sessions. Patients were assigned to chiropractic care (CMT) or supervised exercise (EX) and scheduled for 2 visits per week for 8 weeks. Results A total of 26 people responded to recruitment; and 11 were enrolled: 6 in the CMT and 5 in the EX group. Two patients dropped out at the baseline visit when they were assigned to the EX group. One CMT patient dropped out in the seventh week because of a fall at home resulting in a leg fracture. All remaining patients were compliant with treatment protocols. Five of 6 CMT patients and 4 of 5 EX patients had baseline BBS scores <45, indicating increased risk of falls. At visit 16, 2 CMT and 1 of the 3 remaining EX patients had BBS scores <45. One mild and transient adverse event was noted. Conclusion Further investigation of the possible role of chiropractic care in reducing fall risk in this population appears feasible. PMID:19674706

  17. Practice analysis of chiropractic radiology: identifying items for part I of the clinical competency examination.

    Science.gov (United States)

    Smith, Sara Dawn; Beran, Tanya N

    2012-01-01

    The purpose of this study was to describe the current scope of practice of chiropractic radiologists by identifying frequent tasks conducted as well as those conditions most often seen and those that present the greatest risk of harm to patients. A mixed-methods approach was used. An online survey was conducted with 91 diplomates listed with the American Chiropractic Board of Radiology. Participants rated the frequency of tasks they perform and conditions they see on a 5-point scale from "never" to "daily." They also rated the level of risk each condition presents to patients on a 5-point scale from "no risk" to "severe risk." Frequency and risk ratings were then presented in rank order to 22 subject matter experts at 3 focus groups. The most frequent task reported was writing radiology reports (mean [SD], 4.29 [1.58]). Ratings of the frequency of conditions seen in practice and the risk they present to patients were ranked from the highest to lowest for frequency and risk separately. The most frequent conditions seen were reportedly those with structural or joint derangement; the highest risk conditions seen are those that are systemic. Focus group members recommended that some conditions receive higher rankings and that certain conditions be recategorized for future practice analyses. This study helps to define the current scope of practice of chiropractic radiologists and identify frequent tasks and conditions. These results inform the development of a new test outline for Part I of the chiropractic radiology certification examination to ensure that examinees are tested on the most important conditions chiropractic radiologists see in practice. Copyright © 2012 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.

  18. Human subject research: reporting ethics approval and informed consent in 3 chiropractic journals.

    Science.gov (United States)

    Lawrence, Dana J

    2011-11-01

    To date, there have been no reports of ethics board approval or informed consent within the chiropractic literature or within chiropractic research. The purpose of this study was to assess the reporting of ethics approval and informed consent in articles published during the 2008 volume year of 3 chiropractic research journals included in PubMed. A quantitative assessment of the articles published in each journal for the 2008 volume year was performed. Information collected included if the article involved human subject research, if it reported ethics board approval, and if informed consent was given to subjects. Data were collected as descriptive statistics (frequency counts and percentages). In aggregate, 50 articles of a total of 143 published involved human subject research (35%). 44 reported ethics board approval (88%), and 28 reported that informed consent had been obtained (56%). Forty-five percent of articles published in the Journal of Manipulative and Physiological Therapeutics involved human subject research (39/87), of which 95% reported ethics board approval (37/39) and 64% reported informed consent (25/39); 12.5% of articles from the Journal of the Canadian Chiropractic Association involved human subject research (5/40), of which 80% reported ethics board approval (4/5) and 40% reported informed consent (2/5); and 37.5% of articles published in Chiropractic and Osteopathy involved human subject research (6/16), of which 50% reported ethics board approval (3/6) and 17% reported informed consent (1/6). Overall, most articles reported ethics approval, and more than half reported consent. This was harmonious with research on this topic from other disciplines. This situation indicates a need for continued quality improvement and for better instruction and dissemination of information on these issues to researchers, to manuscript reviewers, to journal editors, and to the readers. Copyright © 2011 National University of Health Sciences. Published by Mosby

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

    Science.gov (United States)

    O'Neill, Lotte D; Korsholm, Lars; Wallstedt, Birgitta; Eika, Berit; Hartvigsen, Jan

    2009-01-01

    Non-cognitive admission criteria are typically used in chiropractic student selection to supplement grades. The reliability of non-cognitive student admission criteria in chiropractic education has not previously been examined. In addition, very few studies have examined the overall test generalizability of composites of non-cognitive admission variables in admission to health science programs. The aim of this study was to estimate the generalizability of a composite selection to a chiropractic program, consisting of: application form information, a written motivational essay, a common knowledge test, and an admission interview. Data from 105 Chiropractic applicants from the 2007 admission at the University of Southern Denmark were available for analysis. Each admission parameter was double scored using two random, blinded, and independent raters. Variance components for applicant, rater and residual effects were estimated for a mixed model with the restricted maximum likelihood method. The reliability of obtained applicant ranks (generalizability coefficients) was calculated for the individual admission criteria and for the composite admission procedure. Very good 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, which was a weighted composite of all 4 admission variables was good (G(c) = 0.80). Good generalizability for a composite admission to a chiropractic program was found. Optimal weighting and adequate sampling are important for obtaining optimal generalizability. Limitations and suggestions for future research are discussed.

  20. A Lifecycle Approach to Brokered Data Management for Hydrologic Modeling Data Using Open Standards.

    Science.gov (United States)

    Blodgett, D. L.; Booth, N.; Kunicki, T.; Walker, J.

    2012-12-01

    The U.S. Geological Survey Center for Integrated Data Analytics has formalized an information management-architecture to facilitate hydrologic modeling and subsequent decision support throughout a project's lifecycle. The architecture is based on open standards and open source software to decrease the adoption barrier and to build on existing, community supported software. The components of this system have been developed and evaluated to support data management activities of the interagency Great Lakes Restoration Initiative, Department of Interior's Climate Science Centers and WaterSmart National Water Census. Much of the research and development of this system has been in cooperation with international interoperability experiments conducted within the Open Geospatial Consortium. Community-developed standards and software, implemented to meet the unique requirements of specific disciplines, are used as a system of interoperable, discipline specific, data types and interfaces. This approach has allowed adoption of existing software that satisfies the majority of system requirements. Four major features of the system include: 1) assistance in model parameter and forcing creation from large enterprise data sources; 2) conversion of model results and calibrated parameters to standard formats, making them available via standard web services; 3) tracking a model's processes, inputs, and outputs as a cohesive metadata record, allowing provenance tracking via reference to web services; and 4) generalized decision support tools which rely on a suite of standard data types and interfaces, rather than particular manually curated model-derived datasets. Recent progress made in data and web service standards related to sensor and/or model derived station time series, dynamic web processing, and metadata management are central to this system's function and will be presented briefly along with a functional overview of the applications that make up the system. As the separate