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

suggested that chiropractic care was cost-effective with a probability of 97%, given a threshold value of €30 000 per QALY gained. In both groups, there was an increase in the health-related quality of life, and the mean increases were similar over the 12-month evaluation period. The mean differences......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......-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...

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…

Chiropractic: MedlinePlus Health Topic

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... for back pain (Medical Encyclopedia) Also in Spanish Topic Image MedlinePlus Email Updates Get Chiropractic updates by ... ENCYCLOPEDIA Chiropractic care for back pain Related Health Topics Back Pain Complementary and Integrative Medicine National Institutes ...

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.

Chiropractic approach to the management of children

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Miller Joyce

2010-06-01

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

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.

Comparative analysis of individuals with and without chiropractic coverage: patient characteristics, utilization, and costs.

Science.gov (United States)

Legorreta, Antonio P; Metz, R Douglas; Nelson, Craig F; Ray, Saurabh; Chernicoff, Helen Oster; Dinubile, Nicholas A

2004-10-11

Back pain accounts for more than $100 billion in annual US health care costs and is the second leading cause of physician visits and hospitalizations. This study ascertains the effect of systematic access to chiropractic care on the overall and neuromusculoskeletal-specific consumption of health care resources within a large managed-care system. A 4-year retrospective claims data analysis comparing more than 700 000 health plan members with an additional chiropractic coverage benefit and 1 million members of the same health plan without the chiropractic benefit. Members with chiropractic insurance coverage, compared with those without coverage, had lower annual total health care expenditures ($1463 vs $1671 per member per year, P<.001). Having chiropractic coverage was associated with a 1.6% decrease (P = .001) in total annual health care costs at the health plan level. Back pain patients with chiropractic coverage, compared with those without coverage, had lower utilization (per 1000 episodes) of plain radiographs (17.5 vs 22.7, P<.001), low back surgery (3.3 vs 4.8, P<.001), hospitalizations (9.3 vs 15.6, P<.001), and magnetic resonance imaging (43.2 vs 68.9, P<.001). Patients with chiropractic coverage, compared with those without coverage, also had lower average back pain episode-related costs ($289 vs $399, P<.001). Access to managed chiropractic care may reduce overall health care expenditures through several effects, including (1) positive risk selection; (2) substitution of chiropractic for traditional medical care, particularly for spine conditions; (3) more conservative, less invasive treatment profiles; and (4) lower health service costs associated with managed chiropractic care. Systematic access to managed chiropractic care not only may prove to be clinically beneficial but also may reduce overall health care costs.

The Swiss Master in Chiropractic Medicine Curriculum: Preparing Graduates to Work Together With Medicine to Improve Patient Care.

Science.gov (United States)

Humphreys, B Kim; Peterson, Cynthia K

2016-12-01

In 2007, chiropractic became 1 of the 5 medical professions in Switzerland. This required a new chiropractic program that was fully integrated within a Swiss medical school. The purpose of this article was to discuss the Master in Chiropractic Medicine (MChiroMed) program at the University of Zürich, including advantages, opportunities, and challenges. In 2008, the MChiroMed program began with its first student cohort. The MChiroMed program is a 6-year Bologna model 2-cycle (bachelor and master) "spiral curriculum," with the first 4 years being fully integrated within the medical curriculum. A review of the main features of the curriculum revealed the advantages, opportunities, and challenges of this program in comparison with other contemporary chiropractic educational programs. Advantages and opportunities include an integrated curriculum within a university, medical school, and musculoskeletal hospital, with their associated human and physical resources. Many opportunities exist for high-level research collaborations. The rigorous entrance qualifications and small student cohorts result in bright, motivated, and enthusiastic students; appropriate assessments; and timely feedback on academic and clinical subjects. Early patient contact in hospitals and clinical facilities encourages the integration of academic theory and clinical practice. The main challenges faced by this program include difficulty recruiting a sufficient number of students because of the rigorous entrance requirements and curriculum overload resulting from undertaking a full medical curriculum and chiropractic modules. The MChiroMed program is a unique chiropractic curriculum that integrates medical and chiropractic education within a spiral curriculum at a world-class Swiss university medical school. The expectation is that graduates, with their expanded diagnostic and therapeutic knowledge, skills, and experience, will become future experts in primary spine care in Switzerland. It is hoped

Chiropractic and CAM utilization: a descriptive review.

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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.

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

Chiropractic and CAM Utilization: A Descriptive Review

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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.

How frequent are non-evidence-based health care beliefs in chiropractic students and do they vary across the pre-professional educational years.

Science.gov (United States)

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

2018-01-01

Evidence suggests that a students' beliefs already prior to entering a program may be important as a determinant in sustaining unsuitable health care beliefs. Our objectives were to investigate the proportion of Australian chiropractic students who hold non-evidence-based beliefs in the first year of study and the extent to which they may be involved in non-musculoskeletal health conditions. Finally, to see if this proportion varies over the course of the chiropractic program. In 2016, students from two Australian chiropractic programs answered a questionnaire on how often they would give advice on five common health conditions in their future practices as well as their opinion on whether chiropractic spinal adjustments could prevent or help seven health-related conditions. From a possible 831 students, 444 responded (53%). Students were highly likely to offer advice (often/quite often) on a range of non-musculoskeletal conditions. The proportions were lowest in first year and highest the final year. Also, high numbers of students held non-evidence-based beliefs about 'chiropractic spinal adjustments' which tended to occur in gradually decreasing in numbers in sequential years, except for fifth year when a reversal of the pattern occurred. New strategies are required for chiropractic educators if they are to produce graduates who understand and deliver evidence-based health care and able to be part of the mainstream health care system.

Assessment of Chiropractic Treatment for Low Back Pain, Military Readiness and Smoking Cessation in Military Active Duty Personnel

Science.gov (United States)

2017-03-01

anticipated likelihood of each for this study are included below: Rare but serious (event rate ə %) Fracture to the ribs or hip Nerve injury that may...Award Number: W81-XWH-11-2-0107 TITLE: Assessment of Chiropractic Treatment for Low Back Pain , Military Readiness and Smoking Cessation in...2016 – 02/14/2017 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER Assessment of Chiropractic Treatment for Low Back Pain , Military Readiness and Smoking

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...

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

2018-04-01

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

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

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Schulz Craig A

2011-03-01

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

Preliminary results after upper cervical chiropractic care in patients with chronic cerebro-spinal venous insufficiency and multiple sclerosis.

Science.gov (United States)

Mandolesi, Sandro; Marceca, Giuseppe; Moser, Jon; Niglio, Tarcisio; d'Alessandro, Aldo; Ciccone, Matteo Marco; Zito, Annapaola; Mandolesi, Dimitri; d'Alessandro, Alessandro; Fedele, Francesco

2015-01-01

The aim of the study is to evaluate the clinical and X-ray results of the Upper Cervical Chiropractic care through the specific adjustments (corrections) of C1-C2 on patients with chronic venous cerebral-spinal insufficiency (CCSVI) and multiple sclerosis (MS). We studied a sample of 77 patients before and after the Upper Cervical Chiropractic care, and we analyzed: A) The change of the X-ray parameters; B) The clinical results using a new set of questions. The protocol of the C1- C2 upper Cervical Chiropractic treatment, specific for these patients, lasts four months. From a haemodynamic point of view we divided the patients in 3 types: Type 1 - purely vascular with intravenous alterations; Type 2 - "mechanical" with of external venous compressions; Type 3 - mixed. We found an improvement in all kinds of subluxations after the treatment with respect to the pre-treatment X-ray evaluation, with a significant statistical difference. The differences between the clinical symptoms before and after the specific treatment of C1-C2 are statistically significant with pcerebro-spinal fluid.

A Narrative Review of Lumbar Fusion Surgery With Relevance to Chiropractic Practice.

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Daniels, Clinton J; Wakefield, Pamela J; Bub, Glenn A; Toombs, James D

2016-12-01

The purpose of this narrative review was to describe the most common spinal fusion surgical procedures, address the clinical indications for lumbar fusion in degeneration cases, identify potential complications, and discuss their relevance to chiropractic management of patients after surgical fusion. The PubMed database was searched from the beginning of the record through March 31, 2015, for English language articles related to lumbar fusion or arthrodesis or both and their incidence, procedures, complications, and postoperative chiropractic cases. Articles were retrieved and evaluated for relevance. The bibliographies of selected articles were also reviewed. The most typical lumbar fusion procedures are posterior lumbar interbody fusion, anterior lumbar interbody fusion, transforaminal interbody fusion, and lateral lumbar interbody fusion. Fair level evidence supports lumbar fusion procedures for degenerative spondylolisthesis with instability and for intractable low back pain that has failed conservative care. Complications and development of chronic pain after surgery is common, and these patients frequently present to chiropractic physicians. Several reports describe the potential benefit of chiropractic management with spinal manipulation, flexion-distraction manipulation, and manipulation under anesthesia for postfusion low back pain. There are no published experimental studies related specifically to chiropractic care of postfusion low back pain. This article describes the indications for fusion, common surgical practice, potential complications, and relevant published chiropractic literature. This review includes 10 cases that showed positive benefits from chiropractic manipulation, flexion-distraction, and/or manipulation under anesthesia for postfusion lumbar pain. Chiropractic care may have a role in helping patients in pain who have undergone lumbar fusion surgery.

Process versus outcome: challenges of the chiropractic wellness paradigm

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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

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

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Hannah Kern

2010-10-01

Full Text Available Attitudes toward traditional and chiropractic medicine were compared using Milgram's lost letter technique. A total of 192 letters were placed on the windshields of vehicles in parking lots at six restaurants and department stores in each of four quadrants of a medium-sized, Southeastern city. These letters were addressed to "Admissions" at either a fictitious Institute of Medicine or Institute of Chiropractic Care. Return addresses included either a male or a female name. Thus, those who found a lost letter were faced with the option of returning or not returning a letter from either a male or a female, addressed to an Institute of traditional or non-traditional medicine. After examining previous studies which had used the lost letter technique, numerous methodological improvements were implemented. For example, letters were randomly assigned to potential drop spots for each of 24 study locations (six study locations in each of four city quadrants, and a Latin square design was used to control for possible order effects in the four study conditions that were implemented. Nearly 65% of the letters (124 of 192 were returned. We found: 1 letters addressed to a fictitious Institute of Chiropractic Care were just as likely to be returned as those addressed to a fictitious Institute of Medicine; 2 letters with female return addresses were as likely to be returned as those with male return addresses; 3 there was no interaction between study conditions; 4 based on what was essentially a replication study, a comparison of the pattern of returns using the first and second cycle of lost letters (n = 96 for each cycle revealed an equivalent pattern of no-difference findings. DOI: 10.2458/azu_jmmss.v1i1.78

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

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

2013-01-01

Objective 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. Clinical features 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. Intervention and outcome 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. Conclusion 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. PMID:24396330

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

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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.

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

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.

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.

Description of the case mix experienced by chiropractic students during a clinical internship.

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Puhl, Aaron A; Reinhart, Christine J; Injeyan, H Stephen; Tibbles, Anthony

2017-10-01

The primary objective of this study was to describe the case mix experienced by chiropractic students during their clinical internship at the Canadian Memorial Chiropractic College. Secondary objectives were to characterize teaching clinic patient populations, assess the similarity to previously published data for practicing chiropractors, and describe the treatment plans being recommended by interns. A prospective, observational study was conducted using a convenience sample of 24 chiropractic interns. Data were collected by interns using a standardized form that was completed for each new patient and each new complaint examined during the 1-year internship. Standardized forms included data regarding patient demographics, complaint characteristics, and treatment recommendations. Data were included for 23 of 24 participating interns, who described 828 patients and a total of 948 unique complaint presentations. Overall, 60% of patients were female, 86% were 18 to 64 years old, and 23% were naive to chiropractic care. Of all presenting complaints, 93% were pain-based, 67% were chronic, 65% included spinal complaints, and 7% presented with red flags; individual interns' experiences were variable and are described. On average, treatment recommendations called for 9.4 visits and often included multimodal treatment approaches, most commonly soft-tissue therapies (91%), home-based active care (84%), and spine manipulation (70%). The findings of this study suggest that patients presenting to CMCC teaching clinics are similar to those reported previously to attend private chiropractic clinics. While all participating interns encountered multiple complex clinical cases, very few had experience with pediatric populations. This study adds to the few that detail the characteristics of patients attending chiropractic teaching clinics; to our knowledge it is the first to describe average case loads of chiropractic interns.

The United States Chiropractic Workforce: An alternative or complement to primary care?

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Davis Matthew A

2012-11-01

Full Text Available Abstract Background In the United States (US a shortage of primary care physicians has become evident. Other health care providers such as chiropractors might help address some of the nation’s primary care needs simply by being located in areas of lesser primary care resources. Therefore, the purpose of this study was to examine the distribution of the chiropractic workforce across the country and compare it to that of primary care physicians. Methods We used nationally representative data to estimate the per 100,000 capita supply of chiropractors and primary care physicians according to the 306 predefined Hospital Referral Regions. Multiple variable Poisson regression was used to examine the influence of population characteristics on the supply of both practitioner-types. Results According to these data, there are 74,623 US chiropractors and the per capita supply of chiropractors varies more than 10-fold across the nation. Chiropractors practice in areas with greater supply of primary care physicians (Pearson’s correlation 0.17, p-value  Conclusion These findings suggest that chiropractors practice in areas of greater primary care physician supply. Therefore chiropractors may be functioning in more complementary roles to primary care as opposed to an alternative point of access.

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

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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

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

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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.

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

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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.

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

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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.

Core and Complementary Chiropractic: Lowering Barriers to Patient Utilization of Services.

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Triano, John J; McGregor, Marion

2016-12-01

The use of chiropractic services has stalled while interest in accessing manipulation services is rising. The purpose of this paper is to consider this dilemma in the context of the dynamics of professional socialization, surveys of public attitudes, and a potential strategic action. This is a reflection work grounded in the literature on professional socialization and the attitudes held regarding chiropractic in modern society, to include its members, and in original data on training programs. Data were interpreted on the background of the authors' cross-cultural experiences spanning patient care, research, education, and interprofessional collaboration. Recommendation on a strategic action to counter barriers in patient referrals was synthesized. Professional socialization is the process by which society enables professional privilege. Illustration of typical and divergent professional socialization models emerged that explain cognitive dissonance toward the profession. Questions of trust are commensurate with the experiences during patient encounters rather than with a common identity for the profession. Diversity among encounters perpetuates the uncertainty that affects referral sources. Commonality as an anchor for consistent professional identity and socialization through the content of core chiropractic, defined by training and practice, offers a means to offset uncertainty. Complementary chiropractic, analogous to complementary medicine, provides an outlet under professional socialization for the interests to explore additional methods of care. The practice workplace is an effective lever for altering barriers to the use of services. Clarifying rhetoric through conceptualization of core and complementary practices simplifies the socialization dynamic. Further, it takes advantage of accepted cultural semantics in meaningful analogy while continuing to empower practical diversity in care delivery in response to evolving scientific evidence.

Ted L. Shrader, D.C., F.I.C.C.: a gentle force for improvement in chiropractic. 1998 Lee-Homewood Chiropractic Heritage Award recipient.

Science.gov (United States)

Green, B N; Johnson, C D; Keating, J C

1998-06-01

Long before technology assessment and continuous quality improvement were in vogue in chiropractic, Ted L. Shrader, D.C., F.I.C.C., was working toward these goals in the profession. Convinced that chiropractic must change from within for the benefit of society, Dr. Shrader has made a career-long commitment to evaluating chiropractic procedures and establishing consensus statements regarding chiropractic principle. Determined in mind, moral by nature, and unobtrusive in manner, Dr. Shrader has been decidedly effective in his endeavors. He has encouraged in chiropractic a mind for critical thinking. The fruits of his labor can be seen today in chiropractic publication, among chiropractic scholars, within the American Chiropractic Association Council on Technique, in conference proceedings, and in our institutions.

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

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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.

Feasibility study of short-term effects of chiropractic manipulation on older adults with impaired balance.

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Hawk, Cheryl; Pfefer, Mark T; Strunk, Richard; Ramcharan, Michael; Uhl, Nathan

2007-12-01

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. 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 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 risk of falls. At visit 16, 2 CMT and 1 of the 3 remaining EX patients had BBS scores One mild and transient adverse event was noted. Further investigation of the possible role of chiropractic care in reducing fall risk in this population appears feasible.

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

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

DEFF Research Database (Denmark)

Myburgh, Corrie; Mouton, Johan

2007-01-01

OBJECTIVE: This study explores pertinent aspects of chiropractic practice in contemporary South Africa in terms of the domains of beliefs, philosophy, professional matters, and education. METHODS: Ten practitioners were purposively sampled. From these, 3 were used as gatekeepers to access 6...... in the chiropractor's office. However, some patients seem confused by the lack of health care system integration and consequently display uncertainty of the status the chiropractor can claim professionally and educationally. Practitioners portrayed a view, indicating that chiropractic cannot claim coherence in any...... health care practices as part of the education process and the concomitant perceived lack of exposure especially to black South Africans emerged as interesting and pertinent developmental themes in the local context. CONCLUSIONS: The international discourse related to issues in the domains of philosophy...

Chiropractic & Osteopathy. A new journal

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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.

An exploratory, descriptive study of consumer opinions and behaviors regarding health products sales at 4 chiropractic practices in a large, western Canadian urban center.

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Page, Stacey A; Mbadiwe, Chinyere; McMorland, D Gordon; Grod, Jaroslaw P

2015-01-01

This study describes the opinions and behaviors of chiropractic patients in a large, western Canadian urban center regarding the sale of health products by doctors of chiropractic. A brief, descriptive survey consisting of both fixed-choice and open-ended questions was distributed by clinic reception staff at 4 chiropractic offices in Calgary, Alberta, Canada. Each practice sold a range of health products, including those relating to musculoskeletal care and nutrition, and served between 275 and 320 clients per week. After a 10-week recruitment interval between January and March 2013, a convenience sample of 103 chiropractic patients was obtained. Most patients supported the sale of health products by doctors of chiropractic (n = 101; 98.1%), and most had made health product purchases from a doctor of chiropractic at some point (n = 73; 70.9%). Products relating to muscular care, exercise/rehabilitation products, and pillows were purchased most often (>40%). Consumers were most supportive of doctors of chiropractic selling products they perceived to be directly related to musculoskeletal care. Some participants believed that there should be limits placed on the range of products sold including the products had to be consistent with the practitioner's area of expertise and had to have some demonstrated level of effectiveness. Primary reasons for health product purchase included the doctor's recommendations, convenience, and perception that the product would improve well-being (>50%). This study found that chiropractic patients were supportive of health product sales by doctors of chiropractic, assuming certain conditions were met. Consumers believed that product sales should be undertaken with integrity and should be consistent with the doctor's area of expertise. Consumer beliefs appeared to impact their purchasing behaviors. Copyright © 2015 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.

Multimodal Chiropractic Care for Pain and Disability in a Patient Diagnosed With Ehlers-Danlos Syndrome-Hypermobility Type: A Case Report.

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Strunk, Richard G

2017-06-01

The purpose of this article is to describe the clinical response to multimodal chiropractic treatment of a patient diagnosed with Ehlers-Danlos syndrome, hypermobility type (EDS-HT), and chronic pain. A 22-year-old woman presented with severe chronic neck and low back pain, headaches, and bilateral hand pain and stiffness. In addition to these pain complaints, the patient had a family history of EDS, weekly or daily recurring joint dislocations, and upper and lower extremity joint hypermobility. As a result of her significant history and examination findings, which met the Brighton and Villefranche criteria, she was diagnosed with EDS-HT. Treatment primarily consisted of low force joint manipulative therapy and soft tissue therapy intermittently over 21 months concurrently with conventional and complementary medical care. Multiple outcome questionnaires were administered pragmatically at follow-up intervals of 3, 5½, 8½, 19, and 21 months, including but not limited to the Headache and Neck Disability Indices and the Oswestry Low Back Questionnaire. The patient had clinically meaningful improvements on the Neck Disability Index, the Headache Disability Index, and the Revised Oswestry after 3, 5½, 8½, and 21 months from baseline. This patient with EDS-HT had clinically meaningful decreases in disability, headache, and spine pain after a course of multimodal chiropractic care combined with conventional and complementary medical care.

EFFECTIVENESS OF CHIROPRACTIC ADJUSTMENT IN LUMBAR PAIN IN CROSSFIT PRACTITIONERS

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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.

The Use of the Patient Reported Outcomes Measurement Information System and the RAND VSQ9 to Measure the Quality of Life and Visit-Specific Satisfaction of Pregnant Patients Under Chiropractic Care Utilizing the Webster Technique.

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

2018-01-01

To quantify the quality of life (QoL) and visit-specific satisfaction of pregnant women. A prospective cohort within a practice-based research network (PBRN). Setting/Locations: Individual chiropractic offices. Pregnant women (age ≥18 years) attending chiropractic care. Chiropractic care (i.e., The Webster Technique, spinal adjustments, and adjunctive therapies). The RAND VSQ9 to measure visit-specific satisfaction and the Patient Reported Outcomes Measurement Information System (PROMIS ® )-29 to measure QoL. A convenience sample of 343 pregnant patients (average age = 30.96 years) comprised their study population. They were highly educated with 75% attaining a 2-year associate's degree or higher. The pregnant patients presented for chiropractic care with a mean week of gestation of 25.67 weeks (median = 28 weeks; range = 0-42 weeks) and parity (i.e., the number of live births) of 0.92 live births (median = 1; range = 0-6). From baseline (i.e., at study entrance with minimum first visit) and comparative (i.e., following a course of chiropractic care), the VSQ9 measurements revealed increasingly high satisfaction on the part of the subjects (i.e., the mean difference of baseline minus comparative measures = -0.7322; p < 0.005). The median number of visits (i.e., visits attended) at baseline and comparative measures was 1.00 (standard deviation [SD] = 22.69) and 3.30 (SD = 22.71), respectively. Across outcomes, QoL improved from baseline to comparative measurement after holding constant for visit number and time lapse, trimester of pregnancy, and care provider type. There was a reduction in mean T scores associated with fatigue (p < 0.05), pain interference (p < 0.05), sleep disturbance (p < 0.05), and an improvement in satisfaction with social roles (p < 0.05). A significant decrease was also found with pain interference (p < 0.05). No evidence was found that anxiety (p = 0.1404) or depression (p = 0

A qualitative exploration of key informant perspectives regarding the nature and impact of contemporary legislation on professional development: a grounded theory study of chiropractic in Denmark.

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Myburgh, Corrie

2014-01-01

The purpose of this study was to construct a substantive framework of the manner in which the Danish government interacts with the Danish chiropractic profession and influences professional practice. An exploratory, qualitative study was performed using a substantive grounded theory (GT) approach. Unstructured, face-to-face, individual interviews were conducted during the years 2012 and 2013 and thematically analyzed. Six people were interviewed for this study including a gatekeeper and witness to legislative history, a previous chiropractic political representative and witness to legislative history, a previous Department of Health negotiator and previous administrator of chiropractic affairs and witness to legislative history, a current administrator of chiropractic affairs, an active chiropractic political representative and witness to legislative history, and a chief negotiator for Danish Regional Health Care Services. Open and axial coding yielded 2 themes centering on licensing chiropractors in Denmark and the resultant developmental issues encountered. Through further selective coding, the GT core construct, "chiropractic practice in the Danish heath care system" emerged. The GT highlights the tension between the strategic political importance of legislation and the restrictive nature of the overly specific act currently regulating chiropractic practice. Moreover, the GT also revealed the perceived negative effect that the National Board of Health may exert on clinical practice due to its conservative interpretation of the act. The Danish government is perceived to act as a countervailing power related to chiropractic practice. The derived substantive GT suggests that the Danish government's dualistic action relative to the Danish chiropractic community may inhibit the spontaneous evolution of contemporary Danish chiropractic practice. Although historically narrow legislation may limit chiropractic practice, conservative interpretations by the Danish

Core Competencies of the Certified Pediatric Doctor of Chiropractic

DEFF Research Database (Denmark)

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

2016-01-01

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

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.

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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.

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

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Rupert Ronald

2006-10-01

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

Prognostic factors for recurrences in neck pain patients up to 1 year after chiropractic care.

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Langenfeld, Anke; Humphreys, B Kim; Swanenburg, Jaap; Peterson, Cynthia K

2015-09-01

Information about recurrence and prognostic factors is important for patients and practitioners to set realistic expectations about the chances of full recovery and to reduce patient anxiety and uncertainty. Therefore, the purpose of this study was to assess recurrence and prognostic factors for neck pain in a chiropractic patient population at 1 year from the start of the current episode. Within a prospective cohort study, 642 neck pain patients were recruited by chiropractors in Switzerland. After a course of chiropractic therapy, patients were followed up for 1 year regarding recurrence of neck pain. A logistic regression analysis was used to assess prognostic factors for recurrent neck pain. The independent variables age, pain medication usage, sex, work status, duration of complaint, previous episodes of neck pain and trauma onset, numerical rating scale, and Bournemouth questionnaire for neck pain were analyzed. Prognostic factors that have been identified in previous studies to influence recovery of neck pain are psychologic distress, poor general health at baseline, and a previous history of pain elsewhere. Five hundred forty five patients (341 females), with a mean age of 42.1 years (SD, 13.1) completed the 1-year follow-up period. Fifty-four participants (11%) were identified as "recurrent." Prognostic factors associated with recurrent neck pain were previous episodes of neck pain and increasing age. The results of this study suggest that recurrence of neck pain within 1 year after chiropractic intervention in Swiss chiropractic patients presenting from varied onsets is low. This study found preliminary findings that older age and a previous episode of neck may be useful predictors of neck pain recurrence within 1 year. Copyright © 2015 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.

The forgotten cousins : dental and chiropractic radiography

International Nuclear Information System (INIS)

Stirling, G.; Cartwright, P.

1996-01-01

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

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

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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.

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

DEFF Research Database (Denmark)

Myburgh, Corrie; Mouton, Johan

2008-01-01

OBJECTIVE: The purpose of this study was to capture the experience of key stakeholders regarding the development, structure, and influence of the local education program on the Danish chiropractic profession. METHODS: A gatekeeper was initially interviewed, after which a snowball sampling approach...... led to a further 11 respondents being identified. Semistructured interviews were conducted, and computer-assisted thematic analysis was used to interpret data. RESULTS: Seven themes emerged. Two described pertinent historical aspects during the development of the local education, 4 related to status...... quo issues around education at the University of Southern Denmark, and 1 explored perceived health care integration benefits attributable to the chosen model of education. CONCLUSION: The Danish chiropractic profession's incentive to raise its legitimacy lay in the access it stood to gain, through...

Chiropractic: An Introduction

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... 354–362. Kaptchuk TJ, Eisenberg DM. Chiropractic: origins, controversies, and contributions. Archives of Internal Medicine . 1998;158( ... external links LinkedIn E-mail Updates NCCIH Home Privacy and Policies Accessibility en Español FOIA Site Map ...

Concussion assessment and management knowledge among chiropractic fourth year interns and residents.

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Kazemi, Mohsen; Pichini, Alessandro; Scappaticci, Steven; Savic, Mitchell

2016-12-01

To investigate the degree of knowledge chiropractic fourth year interns and post-graduate chiropractic residents have in regard to concussion diagnosis and management. A survey modified from a study conducted by Boggild and Tator (2012), was administered to fourth year chiropractic interns and post-graduate residents via SurveyMonkey.com. Chiropractic fourth year interns and postgraduate chiropractic specialty college residents scored 5.2 and 5.25 out of 9 respectively, which compares well with Bogglid and Tator's reports on medical students and residents. Several knowledge gaps were identified in the sample population. The results from this survey show that the concussion knowledge among Canadian fourth year chiropractic interns and specialty college residents compares favorably with the knowledge of fourth year medical students and residents in diagnosing and managing concussions. Chiropractors appear to possess the skills and knowledge to diagnose and manage concussion equal to their medical counterparts. However, knowledge gaps regarding concussion diagnosis and management were found among chiropractic students and residents.

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

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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

Chiropractic and children: Is more research enough?

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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.

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

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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.

Ethics education in chiropractic colleges: a North American survey.

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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.

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

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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.

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

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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

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

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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.

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.

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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.

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

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Jones Michael P

2010-12-01

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

The life and contribution of Dr. Ronald Gitelman: a pioneer of modern chiropractic science.

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Vernon, Howard

2013-03-01

The life and contribution to chiropractic science of Dr. Ronald Gitelman is reviewed. Sources for this article included review of the notes prepared by Dr. Joseph Keating in his "biography" of the Canadian Memorial Chiropractic College (CMCC); review of the important articles published by Dr. Gitelman; review of the important projects undertaken by him along with various colleagues; notes from reminiscences obtained from many of these colleagues and discussions with his family. Dr. Gitelman's academic career spanned from 1963 to the late 1980's. During that time, he made foundational contributions to the development of chiropractic science including: developing the Archives (1974), the first collection of scientific articles supporting chiropractic science (which was subsequently published as the Chiropractic Archives Research Collection (CRAC)); delivering one of the few chiropractic papers at the seminal NINCDS conference (1975) and, developing the collaboration between CMCC and Dr. Kirkaldy-Willis at the University of Saskatoon (1976). He practiced in Toronto from 1961 to 2007. Dr. Gitelman was a pioneer in the development of chiropractic science. He died on October 7, 2012.

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

Frequently Asked Questions about Chiropractic

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... Marketing Patient Fact Sheets Contact the ACA State Licensing Boards Research JMPT Abstracts Latest Issue Evidence in ... Chiropractic Posture Backpack Safety Spinal Health Winter Activities Kids and Sports Exercising Outdoors with Baby Gardening Chronic ...

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

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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.

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.

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...

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.

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

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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

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

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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.

The self-concept of chiropractic students as science students

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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

Financial attitudes, knowledge, and habits of chiropractic students: A descriptive survey

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Lorence, Julie; Lawrence, Dana J.; Salsbury, Stacie A.; Goertz, Christine M.

2014-01-01

Objective: Our purpose was to describe the financial knowledge, habits and attitudes of chiropractic students. Methods: We designed a cross-sectional survey to measure basic financial knowledge, current financial habits, risk tolerance, and beliefs about future income among 250 students enrolled in business courses at one US chiropractic college. Descriptive statistical analyses were performed. Results: We received 57 questionnaires (23% response rate). Most respondents would accumulate over $125,000 in student loan debt by graduation. Financial knowledge was low (mean 77%). Most respondents (72%) scored as average financial risk takers. Chiropractic students reported recommended short-term habits such as having checking accounts (90%) and health insurance (63%) or paying monthly bills (88%) and credit cards (60%). Few saved money for unplanned expenses (39%) or long-term goals (26%), kept written budgets (32%), or had retirement accounts (19%). Conclusion: These chiropractic students demonstrated inadequate financial literacy and did not engage in many recommended financial habits. PMID:24587498

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

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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.

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

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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.

Cross-Sectional Analysis of Per Capita Supply of Doctors of Chiropractic and Opioid Use in Younger Medicare Beneficiaries.

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Weeks, William B; Goertz, Christine M

2016-05-01

The purpose of this study was to determine whether the per-capita supply of doctors of chiropractic (DCs) or Medicare spending on chiropractic care was associated with opioid use among younger, disabled Medicare beneficiaries. Using 2011 data, at the hospital referral region level, we correlated the per-capita supply of DCs and spending on chiropractic manipulative therapy (CMT) with several measures of per-capita opioid use by younger, disabled Medicare beneficiaries. Per-capita supply of DCs and spending on CMT were strongly inversely correlated with the percentage of younger Medicare beneficiaries who had at least 1, as well as with 6 or more, opioid prescription fills. Neither measure was correlated with mean daily morphine equivalents per opioid user or per chronic opioid user. A higher per-capita supply of DCs and Medicare spending on CMT were inversely associated with younger, disabled Medicare beneficiaries obtaining an opioid prescription. However, neither measure was associated with opioid dosage among patients who obtained opioid prescriptions. Copyright © 2016. Published by Elsevier Inc.

"Research" and "science" in the first half of the chiropractic century.

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Keating, J C; Green, B N; Johnson, C D

1995-01-01

In the first 50 years of the chiropractic profession, a variety of unorthodox meanings for the terms "research," "science" and related words were in evidence. In harmony with popular conceptions of the day, science was constructed as a relatively static body of knowledge and was thought to reflect the will of God. Research was an ill-defined activity, and acquisition of new knowledge did not involve the experimental methodology that increasingly took hold in biology and medicine in the twentieth century. Chiropractors often viewed science and research as marketing strategies. Clinical data collection, when it occurred at all, was not described in sufficient detail to permit replication. Results were enthusiastically interpreted as indisputable proof of investigators' a priori assumptions about the effectiveness of chiropractic methods. A few in the profession recognized the general lack of understanding of the scientific method and sought reform from within. However, the colleges were unwilling to introduce coursework in research methods. At the end of World War II, the broad-scope national association of chiropractors in the United States established a nonprofit foundation for the purpose of raising funds for chiropractic research and education. Research plans were poorly conceived and grandiose: the first major initiative of the Chiropractic Research Foundation involved a nationwide publicity and fund-raising campaign modeled after the March of Dimes. When these efforts failed and the possibility of establishing free-standing research centers collapsed, the Foundation sought to shift responsibility for research to the schools. The poverty-stricken chiropractic colleges lacked the research sophistication for this task. Several more decades would pass before a sustained research effort and interest in clinical experimentation would become evident in chiropractic.

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

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Polus Barbara I

2011-03-01

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

Treatment of a patient with posterior cortical atrophy (PCA) with chiropractic manipulation and Dynamic Neuromuscular Stabilization (DNS): A case report.

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Francio, Vinicius T; Boesch, Ron; Tunning, Michael

2015-03-01

Posterior cortical atrophy (PCA) is a rare progressive neurodegenerative syndrome which unusual symptoms include deficits of balance, bodily orientation, chronic pain syndrome and dysfunctional motor patterns. Current research provides minimal guidance on support, education and recommended evidence-based patient care. This case reports the utilization of chiropractic spinal manipulation, dynamic neuromuscular stabilization (DNS), and other adjunctive procedures along with medical treatment of PCA. A 54-year-old male presented to a chiropractic clinic with non-specific back pain associated with visual disturbances, slight memory loss, and inappropriate cognitive motor control. After physical examination, brain MRI and PET scan, the diagnosis of PCA was recognized. Chiropractic spinal manipulation and dynamic neuromuscular stabilization were utilized as adjunctive care to conservative pharmacological treatment of PCA. Outcome measurements showed a 60% improvement in the patient's perception of health with restored functional neuromuscular pattern, improvements in locomotion, posture, pain control, mood, tolerance to activities of daily living (ADLs) and overall satisfactory progress in quality of life. Yet, no changes on memory loss progression, visual space orientation, and speech were observed. PCA is a progressive and debilitating condition. Because of poor awareness of PCA by physicians, patients usually receive incomplete care. Additional efforts must be centered on the musculoskeletal features of PCA, aiming enhancement in quality of life and functional improvements (FI). Adjunctive rehabilitative treatment is considered essential for individuals with cognitive and motor disturbances, and manual medicine procedures may be consider a viable option.

Amount of health care and self-care following a randomized clinical trial comparing flexion-distraction with exercise program for chronic low back pain

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Keenum Michael

2006-08-01

Full Text Available Abstract Background Previous clinical trials have assessed the percentage of participants who utilized further health care after a period of conservative care for low back pain, however no chiropractic clinical trial has determined the total amount of care during this time and any differences based on assigned treatment group. The objective of this clinical trial follow-up was to assess if there was a difference in the total number of office visits for low back pain over one year after a four week clinical trial of either a form of physical therapy (Exercise Program or a form of chiropractic care (Flexion Distraction for chronic low back pain. Methods In this randomized clinical trial follow up study, 195 participants were followed for one year after a four-week period of either a form of chiropractic care (FD or a form of physical therapy (EP. Weekly structured telephone interview questions regarded visitation of various health care practitioners and the practice of self-care for low back pain. Results Participants in the physical therapy group demonstrated on average significantly more visits to any health care provider and to a general practitioner during the year after trial care (p Conclusion During a one-year follow-up, participants previously randomized to physical therapy attended significantly more health care visits than those participants who received chiropractic care.

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

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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

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

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Newell Dave

2010-07-01

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

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...... physical functioning when compared with only standard care, for men and women between 18 and 35 years of age with acute LBP........ The primary outcome measures were changes in back-related pain on the numerical rating scale and physical functioning at 4 weeks on the Roland-Morris Disability Questionnaire and back pain functional scale (BPFS).Results. Mean Roland-Morris Disability Questionnaire scores decreased in both groups during...

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

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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.

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

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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.

Nontraditional Therapies (Traditional Chinese Veterinary Medicine and Chiropractic) in Exotic Animals.

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Marziani, Jessica A

2018-05-01

The nontraditional therapies of Traditional Chinese Veterinary Medicine and chiropractic care are adjunct treatments that can be used in conjunction with more conventional therapies to treat a variety of medical conditions. Nontraditional therapies do not need to be alternatives to Western medicine but, instead, can be used simultaneously. Exotic animal practitioners should have a basic understanding of nontraditional therapies for both client education and patient referral because they can enhance the quality of life, longevity, and positive outcomes for various cases across multiple taxa. Copyright © 2018 Elsevier Inc. All rights reserved.

Low Back Pain in Primary Care

DEFF Research Database (Denmark)

Hestbæk, Lise; Munck, Anders; Hartvigsen, Lisbeth

2014-01-01

Study Design. Baseline description of a multicenter cohort study. Objective. To describe patients with low back pain (LBP) in both chiropractic and general practice in Denmark. Background. To optimize standards of care in the primary healthcare sector, detailed knowledge of the patient populations...... in different settings is needed. In Denmark, most LBP-patients access primary healthcare through chiropractic or general practice. Methods. Chiropractors and general practitioners recruited adult patients seeking care for LBP. Extensive baseline questionnaires were obtained and descriptive analyses presented...... of five patients had had previous episodes, one-fourth were on sick leave, and the LBP considerably limited daily activities. The general practice patients were slightly older and less educated, more often females, and generally worse on all disease-related parameters than chiropractic patients. All...

Alternative futures: Fields, boundaries, and divergent professionalisation strategies within the Chiropractic profession.

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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.

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

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Raheleh Khorsan

2013-01-01

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

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

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Ndetan Harrison T

2009-03-01

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

English language proficiency and the accommodations for language non-concordance amongst patients utilizing chiropractic college teaching clinics.

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Saporito, Richard P

2013-02-01

The number of households in the United States that are not proficient in the English language is growing and presenting a challenge to the health care system. Over nineteen percent of the US population speak a language other than English in the home. This increase in language discordance generates a greater need to find and implement accommodations in the clinical setting to insure accurate and efficient diagnosis and treatment as well as provide for patient safety. The purpose of this study is to determine the percentage of patients accessing the chiropractic college teaching clinics who are not proficient in the English language and to what extent the colleges provide accommodations for that language disparity. The clinic directors and deans of the Association of Chiropractic Colleges were surveyed via an on-line survey engine. The survey queried the percentage of the patient population that is not English language proficient, the accommodations the college currently has in place, if the college has a language specific consent to treat document and if the college has a written policy concerning patients without English proficiency. Fifty percent of the contacted chiropractic colleges responded to the survey. In the respondent college clinics 16.5% of the patient population is not proficient in English, with over 75% speaking Spanish. All but one of the respondents provide some level of accommodation for the language non-concordance. Forty five percent of the responding colleges employ a language specific consent to treat form. The implementation of accommodations and the use of a language specific consent to treat form is more prevalent at colleges with a higher percentage of non-English speaking patients. The percentage of patients with limited English proficiency accessing services at the teaching clinics of the chiropractic colleges mirrors the numbers in the general population. There is a wide disparity in the accommodations that the individual colleges make

Evidence-based practice, research utilization, and knowledge translation in chiropractic: a scoping review.

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Bussières, André E; Al Zoubi, Fadi; Stuber, Kent; French, Simon D; Boruff, Jill; Corrigan, John; Thomas, Aliki

2016-07-13

Evidence-based practice (EBP) gaps are widespread across health disciplines. Understanding factors supporting the uptake of evidence can inform the design of strategies to narrow these EBP gaps. Although research utilization (RU) and the factors associated with EBP have been reported in several health disciplines, to date this area has not been reviewed comprehensively in the chiropractic profession. The purpose of this review was to report on the current state of knowledge on EBP, RU, and knowledge translation (KT) in chiropractic. A scoping review using the Arksey and O'Malley framework was used to systematically select and summarize existing literature. Searches were conducted using a combination of keywords and MeSH terms from the earliest date available in each database to May 2015. Quantitative and thematic analyses of the selected literature were conducted. Nearly 85 % (56/67) of the included studies were conducted in Canada, USA, UK or Australia. Thematic analysis for the three categories (EBP, RU, KT) revealed two themes related to EBP (attitudes and beliefs of chiropractors; implementation of EBP), three related to RU (guideline adherence; frequency and sources of information accessed; and perceived value of websites and search engines), and three related to KT (knowledge practice gaps; barriers and facilitators to knowledge use; and selection, tailoring, and implementation of interventions). EBP gaps were noted in the areas of assessment of activity limitation, determination of psychosocial factors influencing pain, general health indicators, establishing a prognosis, and exercise prescription. While most practitioners believed EBP and research to be important and a few studies suggested that traditional and online educational strategies could improve patient care, use of EBP and guideline adherence varied widely. Findings suggest that the majority of chiropractors hold favourable attitudes and beliefs toward EBP. However, much remains to be done for

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...

Active versus passive adverse event reporting after pediatric chiropractic manual therapy: study protocol for a cluster randomized controlled trial.

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

2017-12-01

Patient safety performance can be assessed with several systems, including passive and active surveillance. Passive surveillance systems provide opportunity for health care personnel to confidentially and voluntarily report incidents, including adverse events, occurring in their work environment. Active surveillance systems systematically monitor patient encounters to seek detailed information about adverse events that occur in work environments; unlike passive surveillance, active surveillance allows for collection of both numerator (number of adverse events) and denominator (number of patients seen) data. Chiropractic manual therapy is commonly used in both adults and children, yet few studies have been done to evaluate the safety of chiropractic manual therapy for children. In an attempt to evaluate this, this study will compare adverse event reporting in passive versus active surveillance systems after chiropractic manual therapy in the pediatric population. This cluster randomized controlled trial aims to enroll 70 physicians of chiropractic (unit of randomization) to either passive or active surveillance system to report adverse events that occur after treatment for 60 consecutive pediatric (13 years of age and younger) patient visits (unit of analysis). A modified enrollment process with a two-phase consent procedure will be implemented to maintain provider blinding and minimize dropouts. The first phase of consent is for the provider to confirm their interest in a trial investigating the safety of chiropractic manual therapy. The second phase ensures that they understand the specific requirements for the group to which they were randomized. Percentages, incidence estimates, and 95% confidence intervals will be used to describe the count of reported adverse events in each group. The primary outcome will be the number and quality of the adverse event reports in the active versus the passive surveillance group. With 80% power and 5% one-sided significance

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

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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

Chiropractic Care for a Patient with Spasmodic Dysphonia Associated with Cervical Spine Trauma

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Waddell, Roger K.

2005-01-01

Abstract Objective To discuss the diagnosis and response to treatment of spasmodic dysphonia in a 25-year-old female vocalist following an auto accident. Clinical Features The voice disorder and neck pain appeared after the traumatic incident. Examination of the cervical spine revealed moderate pain, muscle spasm and restricted joint motion at C-1 and C-5 on the left side. Cervical range of motion was reduced on left rotation. Bilateral manual muscle testing of the trapezius and sternocleidomastoid muscles, which share innervation with the laryngeal muscles by way of the spinal accessory nerve, were weak on the left side. Pre and post accident voice range profiles (phonetograms) that measure singing voice quality were examined. The pre- and post-accident phonetograms revealed significant reduction in voice intensity and fundamental frequency as measured in decibels and hertz. Intervention and Outcome Low-force chiropractic spinal manipulative therapy to C-1 and C-5 was employed. Following a course of care, the patient's singing voice returned to normal, as well as a resolution of her musculo- skeletal complaints. Conclusion It appears that in certain cases, the singing voice can be adversely affected if neck or head trauma is severe enough. This case proposes that trauma with irritation to the cervical spine nerve roots as they communicate with the spinal accessory, and in turn the laryngeal nerves, may be contributory in some functional voice disorders or muscle tension dysphonia. PMID:19674642

Sports chiropractic management at the World Ice Hockey Championships

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Vitiello Andrew L

2010-12-01

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

Who consults chiropractors in Victoria, Australia?: Reasons for attending, general health and lifestyle habits of chiropractic patients.

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

2016-01-01

COAST (Chiropractic Observational and Analysis STudy) reported the clinical practices of chiropractors. The aims of this study were to: 1) describe the chiropractic patient demographic and health characteristics; 2) describe patient-stated reasons for visiting a chiropractor; 3) describe chiropractic patient lifestyle characteristics; 4) compare, where possible, chiropractic patient characteristics to the general Australian population. Fifty-two chiropractors in Victoria, Australia, provided information for up to 100 consecutive encounters. If patients attended more than once during the 100 encounters, only data from their first encounter were included in this study. Where possible patient characteristics were compared with the general Australian population. Data were collected from December 2010 to September 2012. Data were provided for 4464 encounters, representing 3287 unique individuals. The majority of chiropractic encounters were for musculoskeletal conditions or for wellness/maintenance. The majority of patient comorbidities were musculoskeletal, circulatory or endocrine/metabolic in nature. Eight hundred chiropractic patients (57 %, 95 % CI: 53-61) described their self-reported health as excellent or very good and 138 patients (10 %, 95 % CI: 8-12) as fair or poor. Seventy-one percent of adult male patients (18 years and older), and 53 % of adult female patients, were overweight or obese. Fourteen percent (n = 188, 95 % CI: 12-16) were current smokers and 27 % (n = 359, 95 % CI: 24-31) did not meet Australian alcohol consumption guidelines. Less than half of the chiropractic patients participated in vigorous exercise at least twice per week. Approximately 20 % ate one serving of vegetables or less each day, and approximately 50 % ate one serve of fruit or less each day. Compared to the general Australian population, chiropractic patients were less likely to smoke, less likely to be obese and more likely to describe their health in positive terms

The chiropractic profession in Denmark 2010-2014

DEFF Research Database (Denmark)

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

2015-01-01

BACKGROUND: The chiropractic profession has been well established in Denmark for several decades with state authorization, partial reimbursement by the state and a formal academic education. Biennial systematic data collections among all chiropractors and clinics have been performed since 2010 in...

The American Chiropractic Board of Sports Physicians Position Statement on Pre-Participation Examinations: An Expert Consensus

Science.gov (United States)

Moreau, William J.; Nabhan, Dustin C.; Roecker, Christopher; Kimura, Melissa Nagare; Klein, Andrew; Guimard, Brett; Pierce, Kevin; Helma, Patrick; Nelson, Robert; Bahr, Kelly Shockley; Nelson, Laney; Williams, Perry

2015-01-01

Objective The purpose of this paper is to present a position statement of best practices for the provision of a safe and high-quality pre-participation examination (PPE) and to provide recommendations on education requirements for doctors of chiropractic providing the PPE. Methods In 2014, the American Chiropractic Board of Sports Physicians (ACBSP) Board of Directors identified a need to review and update the ACBSP position statements and practice guidelines in order to be current with evolving best practices. Twelve ACBSP certificants, 10 Diplomates of the ACBSP, and 2 Certified Chiropractic Sports Physicians, met in April 2015 to author a pre-participation position statement using an expert consensus process. Panel members excluded anyone with commercial conflicts of interest and included individuals with expertise in clinical sports medicine and the performance of PPEs. A literature review was performed and circulated in advance for use by the panel in addressing the topic. The position statement was written through a consensus process and accepted by the ACBSP Board of Directors in May of 2015. Results The ACBSP Position Statement on Pre-participation Examinations identifies the qualifications and best practices for doctors of chiropractic to perform a PPE. Conclusion This position statement states that doctors of chiropractic with post graduate education and current Diplomates of the ACBSP or Certified Chiropractic Sports Physicians certification have the prerequisite education and qualifying skills to perform PPEs. PMID:26778931

The American Chiropractic Board of Sports Physicians Position Statement on Pre-Participation Examinations: An Expert Consensus.

Science.gov (United States)

Moreau, William J; Nabhan, Dustin C; Roecker, Christopher; Kimura, Melissa Nagare; Klein, Andrew; Guimard, Brett; Pierce, Kevin; Helma, Patrick; Nelson, Robert; Bahr, Kelly Shockley; Nelson, Laney; Williams, Perry

2015-09-01

The purpose of this paper is to present a position statement of best practices for the provision of a safe and high-quality pre-participation examination (PPE) and to provide recommendations on education requirements for doctors of chiropractic providing the PPE. In 2014, the American Chiropractic Board of Sports Physicians (ACBSP) Board of Directors identified a need to review and update the ACBSP position statements and practice guidelines in order to be current with evolving best practices. Twelve ACBSP certificants, 10 Diplomates of the ACBSP, and 2 Certified Chiropractic Sports Physicians, met in April 2015 to author a pre-participation position statement using an expert consensus process. Panel members excluded anyone with commercial conflicts of interest and included individuals with expertise in clinical sports medicine and the performance of PPEs. A literature review was performed and circulated in advance for use by the panel in addressing the topic. The position statement was written through a consensus process and accepted by the ACBSP Board of Directors in May of 2015. The ACBSP Position Statement on Pre-participation Examinations identifies the qualifications and best practices for doctors of chiropractic to perform a PPE. This position statement states that doctors of chiropractic with post graduate education and current Diplomates of the ACBSP or Certified Chiropractic Sports Physicians certification have the prerequisite education and qualifying skills to perform PPEs.

A cross-sectional study of chiropractic students' research readiness using the Academic Self-Concept Analysis Scale.

Science.gov (United States)

Whillier, Stephney; Au, Kent; Feng, Louie; Su, Helen

2017-10-01

The shift toward evidence-based health care has reoriented tertiary clinical education in a way that necessitates and incorporates research. This study assesses the inclination and suitability of chiropractic students for research over a 5-year educational program. Research attributes of chiropractic students were assessed in this cross-sectional study using a validated and modified academic self-concept analysis scale. Students in first and final year were assessed in 4 domains: creativity, motivation, self-regulation, and general intellectual ability. Univariable differences were assessed using Welch 2-sample t tests, and multivariable analysis was carried out with multiple linear regression models. The response rate was 71% (n = 165). First- and fifth-year students scored highly on all 4 domains (80% to 96%). Compared to first-year students, fifth-year students rated themselves significantly lower in 3 of the domains: general intellectual abilities (t[126] = -2.01; p = 0.047), motivation (t[115] = -4.82; p < 0.001), and creativity (t[136] = -3.00; p = 0.003). Research suitability is high in chiropractic students. Both cohorts scored high in all domains despite the disparity between first and fifth years. First-year students outperformed fifth-year students in 3 domains, indicating a potential decline in the inclination to do research over time. However, unaccounted factors, such as the Dunning-Kruger effect, life changes, and "burnout," may have contributed to these differences. Future studies should include questions about stress, fatigue, clinical orientation, and educational environment to inform the interpretation of findings.

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

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

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

A comparative analysis of chiropractic and general practitioner patients in North America: Findings from the joint Canada/United States survey of health, 2002–03

Directory of Open Access Journals (Sweden)

Chiang Lu-May

2006-04-01

Full Text Available Abstract Background Scientifically rigorous general population-based studies comparing chiropractic with primary-care medical patients within and between countries have not been published. The objective of this study is to compare care seekers of doctors of chiropractic (DCs and general practitioners (GPs in the United States and Canada on a comprehensive set of sociodemographic, quality of life, and health-related variables. Methods Data are from the Joint Canada/U.S. Survey of Health (JCUSH, 2002–03, a random sample of adults in Canada (N = 3505 and the U.S. (N = 5183. Respondents were categorized according to their pattern of health-care use in the past year. Distributions, percentages, and estimates (adjusted odds ratios weighted to reflect the complex survey design were produced. Results Nearly 80% of respondents sought care from GPs; 12% sought DC care. Compared with GP only patients, DC patients in both countries tend to be under 65 and white, with arthritis and disabling back or neck pain. U.S. DC patients are more likely than GP only patients to be obese and to lack a regular doctor; Canadian DC patients are more likely than GP only patients to be college educated, to have higher incomes, and dissatisfied with MD care. Compared with seekers of both GP and DC care, DC only patients in both countries have fewer chronic conditions, take fewer drugs, and have no regular doctor. U.S. DC only patients are more likely than GP+DC patients to be uninsured and dissatisfied with health care; Canadian DC only patients are more likely than GP+DC patients to be under 45, male, less educated, smokers, and not obese, without disabling back or neck pain, on fewer drugs, and lacking a regular doctor. Conclusion Chiropractic and GP patients are dissimilar in both Canada and the U.S., with key differences between countries and between DC patients who do and do not seek care from GPs. Such variation has broad and potentially far-reaching health policy and

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.

Chiropractic claims in the English-speaking world.

Science.gov (United States)

Ernst, Edzard; Gilbey, Andrew

2010-04-09

Some chiropractors and their associations claim that chiropractic is effective for conditions that lack sound supporting evidence or scientific rationale. This study therefore sought to determine the frequency of World Wide Web claims of chiropractors and their associations to treat, asthma, headache/migraine, infant colic, colic, ear infection/earache/otitis media, neck pain, whiplash (not supported by sound evidence), and lower back pain (supported by some evidence). A review of 200 chiropractor websites and 9 chiropractic associations' World Wide Web claims in Australia, Canada, New Zealand, the United Kingdom, and the United States was conducted between 1 October 2008 and 26 November 2008. The outcome measure was claims (either direct or indirect) regarding the eight reviewed conditions, made in the context of chiropractic treatment. We found evidence that 190 (95%) chiropractor websites made unsubstantiated claims regarding at least one of the conditions. When colic and infant colic data were collapsed into one heading, there was evidence that 76 (38%) chiropractor websites made unsubstantiated claims about all the conditions not supported by sound evidence. Fifty-six (28%) websites and 4 of the 9 (44%) associations made claims about lower back pain, whereas 179 (90%) websites and all 9 associations made unsubstantiated claims about headache/migraine. Unsubstantiated claims were made about asthma, ear infection/earache/otitis media, neck pain, The majority of chiropractors and their associations in the English-speaking world seem to make therapeutic claims that are not supported by sound evidence, whilst only 28% of chiropractor websites promote lower back pain, which is supported by some evidence. We suggest the ubiquity of the unsubstantiated claims constitutes an ethical and public health issue.

Chiropractic treatment of lateral epicondylitis: a case report utilizing active release techniques.

Science.gov (United States)

Gliedt, Jordan A; Daniels, Clinton J

2014-06-01

The purpose of this report is to describe the chiropractic management of a case of lateral epicondylitis with active release techniques (ART). A 48-year-old white man presented to a chiropractic clinic with a complaint of left lateral elbow pain that began 2 years previous with insidious onset. The patient reported an inability to play 18 consecutive holes of golf due to the pain. Treatment consisted of 5 sessions of ART (a soft tissue technique that is applied to muscles, fascia, tendons, ligaments, and nerves) applied to the left elbow soft tissue over a duration of 3 weeks. The patient reported an absence of pain and ability to consistently play 18 consecutive holes of golf up to 3 times per week at 4 and 8 weeks post-treatment. This patient with lateral epicondylitis responded favorably to chiropractic treatment using the application of ART, as demonstrated by reduced pain and increased functional outcomes.

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

Directory of Open Access Journals (Sweden)

DeBar Lynn L

2011-11-01

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

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

Science.gov (United States)

DeBar, Lynn L; Elder, Charles; Ritenbaugh, Cheryl; Aickin, Mikel; Deyo, Rick; Meenan, Richard; Dickerson, John; Webster, Jennifer A; Jo Yarborough, Bobbi

2011-11-25

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

Themes Underlying Australian General Practitioner Views towards Chiropractic and Osteopathy: An Assessment of Free Text Data from a Cross-Sectional Survey

Directory of Open Access Journals (Sweden)

Sandra Grace

2018-01-01

Full Text Available The Australian chiropractic and osteopathic professions underwent a period of significant transformation between 1960 and 2000. This resulted in an improvement in the views held by the medical profession towards the two professions. However, a recent survey of Australian general practitioners (GPs reported that a number of GPs still hold negative views towards chiropractors and osteopaths. This paper examines these views from the perspective of critical realism and explores the generative mechanisms that can influence the willingness of health practitioners to collaborate over patient care. A qualitative analysis of open-ended responses to a survey of 630 Australian GPs was conducted. Unfavourable attitudes of GPs towards chiropractors and osteopaths included perceived lack of safety, efficacy, and inadequacy of training, despite chiropractic’s and osteopathy’s reliance on the same evidence base and similar training to those of other manual therapy professions such as physiotherapy. These attitudes may be underpinned by the professional biases against chiropractic and osteopathy that continue to marginalise the professions within the Australian healthcare system. Continued investment in the research base for chiropractic and osteopathic practice is required, along with raising the awareness of GPs about the education and skills of chiropractors and osteopaths.

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

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…

Pathologic evaluation of the cervical spine following surgical and chiropractic interventions.

Science.gov (United States)

Matshes, Evan W; Joseph, Jeffrey

2012-01-01

When patients die after chiropractic or surgical interventions of the cervical spine, pathologists tasked with the autopsy are frequently overwhelmed by the complicated anatomy, laborious dissections, complex operative procedures and surgical hardware, and the necessity to differentiate artifacts from trauma and disease. However, abundant data can be obtained from careful evaluation of the cervical spine in situ; extensive postmortem diagnostic imaging procedures; detailed dissections of the removed, formalin-fixed and decalcified spine; and histology. This study presents a regimented, stepwise approach to the evaluation of the cervical spine in these difficult cases, promotes uniform assessment, facilitates diagnoses, and supports the accumulation of otherwise hard-to-come-by reference material that can be of value in future cases. The resultant detailed autopsy findings may prove useful in the medico-legal death investigation process. Autopsy findings may also be of great value to health care providers involved in quality assurance processes. © 2011 American Academy of Forensic Sciences.

Chiropractic management of Bell palsy with low level laser and manipulation: a case report.

Science.gov (United States)

Rubis, Lisa M

2013-12-01

The purpose of this case report is to describe chiropractic management including the use of cold laser and chiropractic manipulation in the treatment of a patient with Bell palsy. A 40-year-old male patient had a 10-day history of facial paralysis on his left side, including the inability to close his left eye, which also had tearing and a burning sensation. The patient had trouble lifting his left lip and complained of drooling while brushing his teeth. There was no previous history of similar symptoms or a recent infection. Prior treatment had included oral steroids. The patient was treated with low-level laser therapy and chiropractic manipulation 2 times in 4 days. The laser was applied along the course of the facial nerve for 30 seconds at each point and for 1 minute at the stylomastoid foramen. The laser used was a GaAs class 4 laser with a wavelength of 910 nm. The patient perceived a 70% to 80% improvement of facial movement after the first treatment. After the second treatment, the patient reported full control of his facial movements. A patient with acute facial paralysis appeared to have complete resolution of his symptoms following the application of low-level laser therapy and chiropractic manipulation.

An audit of health products advertised for sale on chiropractic Web sites in Canada and consideration of these practices in the context of Canadian chiropractic codes of ethics and conduct.

Science.gov (United States)

Page, Stacey A; Grod, Jaroslaw P

2009-01-01

This study describes the extent to which chiropractors with Web sites practicing in Canada advertise health products for sale and considers this practice in the context of chiropractic codes of ethics and conduct. Chiropractic Web sites in Canada were identified using a public online business directory (Canada 411). The Web sites were searched, and an inventory of the health products for sale was taken. The influences of type of practice and province of practice on the sale of health product were assessed. Textual comments about health product marketing were summarized. National and provincial codes of ethics were reviewed, and the content on health product advertising was summarized. Two hundred eighty-seven Web sites were reviewed. Just more than half of the Web sites contained information on health products for sale (n = 158, 54%). Orthotics were advertised most often (n = 136 practices, 47%), followed by vitamins/nutritional supplements (n = 53, 18%), pillows and supports (n = 40, 14%), and exercise/rehabilitation products (n = 20, 7%). Chiropractors in solo or group chiropractic practices were less likely to advertise health products than those in multidisciplinary practice (P advertise nutritional supplements (P ethics and conduct varied in their guidelines regarding health product sales. Variations in codes of ethics and in the proportions of practitioners advertising health products for sales across the country suggest that opinions may be divided on the acceptability of health product sales. Such practices raise questions and considerations for the chiropractic profession.

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

2 CFR 376.147 - Does an exclusion from participation in Federal health care programs under Title XI of the Social...

Science.gov (United States)

2010-01-01

... Federal health care programs under Title XI of the Social Security Act affect a person's eligibility to..., Medicaid, and other Federal health care programs under Title XI of the Social Security Act, 42 U.S.C. 1320a... Federal Agency Regulations for Grants and Agreements DEPARTMENT OF HEALTH AND HUMAN SERVICES...

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...

Chiropractic manipulative therapy of the thoracic spine in ...

African Journals Online (AJOL)

Kim Castello Branco

postural kyphosis but Group 2's treatment protocol, consisting of chiropractic spinal manipulative therapy to ... In older women (twenty five to forty five years of age), the increased .... angle of kyphosis measured, which had to fall within the angle of ... with the application of a controlled force, leverage, direction and velocity to ...

Horizontal integration of the basic sciences in the chiropractic curriculum.

Science.gov (United States)

Ward, Kevin P

2010-01-01

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

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

Horizontal Integration of the Basic Sciences in the Chiropractic Curriculum

Science.gov (United States)

Ward, Kevin P.

2010-01-01

Basic science curricula at most chiropractic colleges consist of courses (eg, general anatomy, physiology, biochemistry, etc) that are taught as stand-alone content domains. The lack of integration between basic science disciplines causes difficulties for students who need to understand how the parts function together as an integrated whole and apply this understanding to solving clinical problems. More horizontally integrated basic science curricula could be achieved by several means: integrated Part I National Board of Chiropractic Examiners questions, a broader education for future professors, an increased emphasis on integration within the current model, linked courses, and an integrated, thematic basic science curriculum. Horizontally integrating basic science curricula would require significant efforts from administrators, curriculum committees, and instructional faculty. Once in place this curriculum would promote more clinically relevant learning, improved learning outcomes, and superior vertical integration. PMID:21048882

Selecting and training opinion leaders and best practice collaborators:Experience from the Canadian Chiropractic Guideline Initiative

OpenAIRE

Bussières, André E.; Maiers, Michele; Grondin, Diane; Brockhusen, Simon

2017-01-01

Objectives: To describe the process for selecting and training chiropractic opinion leaders (OLs) and best practice collaborators (BPCs) to increase the uptake of best practice. Methods: In Phase 1, OLs were identified using a cross-sectional survey among Canadian chiropractic stakeholders. A 10-member committee ranked nominees. Top-ranked nominees were invited to a training workshop. In Phase 2, a national e-survey was administered to 7200 Canadian chiropractors to identify additional OLs an...

Fostering critical thinking skills: a strategy for enhancing evidence based wellness care

Directory of Open Access Journals (Sweden)

Jamison Jennifer R

2005-09-01

Full Text Available Abstract Chiropractic has traditionally regarded itself a wellness profession. As wellness care is postulated to play a central role in the future growth of chiropractic, the development of a wellness ethos acceptable within conventional health care is desirable. This paper describes a unit which prepares chiropractic students for the role of "wellness coaches". Emphasis is placed on providing students with exercises in critical thinking in an effort to prepare them for the challenge of interfacing with an increasingly evidence based health care system. Methods This case study describes how health may be promoted and disease prevented through development of personalized wellness programs. As critical thinking is essential to the provision of evidence based wellness care, diverse learning opportunities for developing and refining critical thinking skills have been created. Three of the learning opportunities are an intrinsic component of the subject and, taken together, contributed over 50% of the final grade of the unit. They include a literature review, developing a client wellness contract and peer evaluation. In addition to these 3 compulsory exercises, students were also given an opportunity to develop their critical appraisal skills by undertaking voluntary self- and unit evaluation. Several opportunities for informal self-appraisal were offered in a structured self-study guide, while unit appraisal was undertaken by means of a questionnaire and group discussion at which the Head of School was present. Results Formal assessment showed all students capable of preparing a wellness program consistent with current thinking in contemporary health care. The small group of students who appraised the unit seemed to value the diversity of learning experiences provided. Opportunities for voluntary unit and self-appraisal were used to varying degrees. Unit evaluation provided useful feedback that led to substantial changes in unit structure

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 ...

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

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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.

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

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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

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

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Breen Alan C

2007-03-01

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

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

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

2015-01-01

Problem-based learning (PBL) is usually conducted in small-group learning sessions with approximately eight students per facilitator. In this study, we implemented a modified version of PBL involving collaborative groups in an undergraduate chiropractic program and assessed its pedagogical effectiveness. This study was conducted at the International Medical University, Kuala Lumpur, Malaysia, and involved the 2012 chiropractic student cohort. Six PBL cases were provided to chiropractic students, consisting of three PBL cases for which learning resources were provided and another three PBL cases for which learning resources were not provided. Group discussions were not continuously supervised, since only one facilitator was present. The students' perceptions of PBL in collaborative groups were assessed with a questionnaire that was divided into three domains: motivation, cognitive skills, and perceived pressure to work. Thirty of the 31 students (97%) participated in the study. PBL in collaborative groups was significantly associated with positive responses regarding students' motivation, cognitive skills, and perceived pressure to work (Plearning resources increased motivation and cognitive skills (Plearning resources.

Self-Regulation of a Chiropractic Association through Participatory Action Research

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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…

24 CFR 232.595 - Eligibility of title.

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2010-04-01

... URBAN DEVELOPMENT MORTGAGE AND LOAN INSURANCE PROGRAMS UNDER NATIONAL HOUSING ACT AND OTHER AUTHORITIES MORTGAGE INSURANCE FOR NURSING HOMES, INTERMEDIATE CARE FACILITIES, BOARD AND CARE HOMES, AND ASSISTED... Fire Safety Equipment Title § 232.595 Eligibility of title. In order for the property which is to be...

Primary benign tumors in chiropractic practice and the importance of x-ray diagnosis: A report of two cases

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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. ImagesFigure 1Figure 2Figure 3

Individualized chiropractic and integrative care for low back pain: the design of a randomized clinical trial using a mixed-methods approach

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Evans Roni L

2010-03-01

Full Text Available Abstract Background Low back pain (LBP is a prevalent and costly condition in the United States. Evidence suggests there is no one treatment which is best for all patients, but instead several viable treatment options. Additionally, multidisciplinary management of LBP may be more effective than monodisciplinary care. An integrative model that includes both complementary and alternative medicine (CAM and conventional therapies, while also incorporating patient choice, has yet to be tested for chronic LBP. The primary aim of this study is to determine the relative clinical effectiveness of 1 monodisciplinary chiropractic care and 2 multidisciplinary integrative care in 200 adults with non-acute LBP, in both the short-term (after 12 weeks and long-term (after 52 weeks. The primary outcome measure is patient-rated back pain. Secondary aims compare the treatment approaches in terms of frequency of symptoms, low back disability, fear avoidance, self-efficacy, general health status, improvement, satisfaction, work loss, medication use, lumbar dynamic motion, and torso muscle endurance. Patients' and providers' perceptions of treatment will be described using qualitative methods, and cost-effectiveness and cost utility will be assessed. Methods and Design This paper describes the design of a randomized clinical trial (RCT, with cost-effectiveness and qualitative studies conducted alongside the RCT. Two hundred participants ages 18 and older are being recruited and randomized to one of two 12-week treatment interventions. Patient-rated outcome measures are collected via self-report questionnaires at baseline, and at 4, 12, 26, and 52 weeks post-randomization. Objective outcome measures are assessed at baseline and 12 weeks by examiners blinded to treatment assignment. Health care cost data is collected by self-report questionnaires and treatment records during the intervention phase and by monthly phone interviews thereafter. Qualitative interviews

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

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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

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...

From theory to application: using performance measures for contraceptive care in the Title X family planning program.

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Loyola Briceno, Ana Carolina; Kawatu, Jennifer; Saul, Katie; DeAngelis, Katie; Frederiksen, Brittni; Moskosky, Susan B; Gavin, Lorrie

2017-09-01

The objective was to describe a Performance Measure Learning Collaborative (PMLC) designed to help Title X family planning grantees use new clinical performance measures for contraceptive care. Twelve Title X grantee-service site teams participated in an 8-month PMLC from November 2015 to June 2016; baseline was assessed in October 2015. Each team documented their selected best practices and strategies to improve performance, and calculated the contraceptive care performance measures at baseline and for each of the subsequent 8 months. PMLC sites implemented a mix of best practices: (a) ensuring access to a broad range of methods (n=7 sites), (b) supporting women through client-centered counseling and reproductive life planning (n=8 sites), (c) developing systems for same-day provision of all methods (n=10 sites) and (d) utilizing diverse payment options to reduce cost as a barrier (n=4 sites). Ten sites (83%) observed an increase in the clinical performance measures focused on most and moderately effective methods (MME), with a median percent change of 6% for MME (from a median of 73% at baseline to 77% post-PMLC). Evidence suggests that the PMLC model is an approach that can be used to improve the quality of contraceptive care offered to clients in some settings. Further replication of the PMLC among other groups and beyond the Title X network will help strengthen the current model through lessons learned. Using the performance measures in the context of a learning collaborative may be a useful strategy for other programs (e.g., Federally Qualified Health Centers, Medicaid, private health plans) that provide contraceptive care. Expanded use of the measures may help increase access to contraceptive care to achieve national goals for family planning. Published by Elsevier Inc.

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

DEFF Research Database (Denmark)

Kongsted, Alice; Aambakk, Benedicte; Bossen, Sanne

2014-01-01

Depression is an important prognostic factor in low back pain (LBP) that appears to be infrequent in chiropractic populations. Identification of depression in few patients would consequently implicate screening of many. It is therefore desirable to have brief screening tools for depression. The o...

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

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......OBJECTIVE: The musculoskeletal system is a common but often overlooked cause of chest pain. The purpose of the present study is to evaluate the relative effectiveness of 2 treatment approaches for acute musculoskeletal chest pain: (1) chiropractic treatment that included spinal manipulation and (2......) self-management as an example of minimal intervention. METHODS: In a nonblinded, randomized, controlled trial set at an emergency cardiology department and 4 outpatient chiropractic clinics, 115 consecutive patients with acute chest pain and no clear medical diagnosis at initial presentation were...

Perceived stress and fatigue among students in a doctor of chiropractic training program.

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Kizhakkeveettil, Anupama; Vosko, Andrew M; Brash, Marissa; Ph, Dr; Philips, Michael A

2017-03-01

High levels of stress and fatigue are associated with decreased academic success, well-being, and quality of life. The objective of this research was to quantify levels of perceived stress and fatigue among chiropractic students to identify sources of and student coping mechanisms for perceived stress and fatigue and to identify the relationship between students' perceived stress and fatigue. A survey comprised of the Perceived Stress Scale, the Undergraduate Sources of Stress Survey, and the Piper Fatigue Scale was administered to chiropractic students in their 2nd, 5th, and 8th trimesters of doctoral study. Data were analyzed by descriptive statistics, 1-way analysis of variance, and linear correlation tests. Students reported having moderate to high levels of stress and fatigue, with higher levels of stress and fatigue seen in women than in men. A nonsignificant difference among stress scores and a significant difference among fatigue scores were observed based on program term. Levels of stress predicted levels of fatigue, and stress was strongly correlated with psychological health, relationships with family members, mood, and need for learning accommodations. Fatigue was strongly correlated with psychological health, academic demands, and conflicts between studies and other activities. There are differences in the reporting of perceived stress and fatigue levels in this chiropractic student population based on gender. The correlation between fatigue and stress also suggests that measures that may alleviate one may likely affect the other.

A prospective survey of chiropractic student experiences with pediatric care and variability of case mix while on clinical placement in Rarotonga.

Science.gov (United States)

Todd, Angela J; Carroll, Matthew T; Russell, David G; Mitchell, Eleanor K L

2017-03-01

To compare chiropractic students' perceptions of preparedness for practice before and after a clinical placement in Rarotonga and to report demographics from these experiences. The students completed deidentified pre- and postplacement surveys assessing pediatric practice preparedness. Students tallied the patient numbers, age, and chiropractic techniques used per visit for each day of clinic placement. On completion of the program, participating students (27/34, or 79% of the student cohort) did a postplacement survey on their perception of practice preparedness. Data were analyzed with the Spearman rho correlation, the Mann-Whitney U test, and regression analysis. There was an increase in perceived preparedness for pediatric practice, ranging from 24.1% of the student cohort at the start of the study to 82.1% following clinical placement in Rarotonga. The change in student preparedness to practice with children was positively correlated with the total number of children managed (r s = .05, p = .01) and the number of children managed who were under 10 years of age (r s = .60, p = .001). Multiple regression analysis demonstrated a medium positive effect for postprogram preparedness (F [4, 20] = 3.567, p = .024). Clinical outreach to Rarotonga provided a broad case mix of patients and a change in student perceptions of preparedness to practice with children, which was positively affected by the total number of children managed and the number of children managed who were under 10 years of age.

Learning and Study Strategies Inventory subtests and factors as predictors of National Board of Chiropractic Examiners Part 1 examination performance.

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Schutz, Christine M; Dalton, Leanne; Tepe, Rodger E

2013-01-01

This study was designed to extend research on the relationship between chiropractic students' learning and study strategies and national board examination performance. Sixty-nine first trimester chiropractic students self-administered the Learning and Study Strategies Inventory (LASSI). Linear trends tests (for continuous variables) and Mantel-Haenszel trend tests (for categorical variables) were utilized to determine if the 10 LASSI subtests and 3 factors predicted low, medium and high levels of National Board of Chiropractic Examiners (NBCE) Part 1 scores. Multiple regression was performed to predict overall mean NBCE examination scores using the 3 LASSI factors as predictor variables. Four LASSI subtests (Anxiety, Concentration, Selecting Main Ideas, Test Strategies) and one factor (Goal Orientation) were significantly associated with NBCE examination levels. One factor (Goal Orientation) was a significant predictor of overall mean NBCE examination performance. Learning and study strategies are predictive of NBCE Part 1 examination performance in chiropractic students. The current study found LASSI subtests Anxiety, Concentration, Selecting Main Ideas, and Test Strategies, and the Goal-Orientation factor to be significant predictors of NBCE scores. The LASSI may be useful to educators in preparing students for academic success. Further research is warranted to explore the effects of learning and study strategies training on GPA and NBCE performance.

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

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Schlappi Mark

2005-08-01

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

Recruitment methods and costs for a randomized, placebo-controlled trial of chiropractic care for lumbar spinal stenosis: a single-site pilot study.

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Cambron, Jerrilyn A; Dexheimer, Jennifer M; Chang, Mabel; Cramer, Gregory D

2010-01-01

The purpose of this article is to describe the methods for recruitment in a clinical trial on chiropractic care for lumbar spinal stenosis. This randomized, placebo-controlled pilot study investigated the efficacy of different amounts of total treatment dosage over 6 weeks in 60 volunteer subjects with lumbar spinal stenosis. Subjects were recruited for this study through several media venues, focusing on successful and cost-effective strategies. Included in our efforts were radio advertising, newspaper advertising, direct mail, and various other low-cost initiatives. Of the 1211 telephone screens, 60 responders (5.0%) were randomized into the study. The most successful recruitment method was radio advertising, generating more than 64% of the calls (776 subjects). Newspaper and magazine advertising generated approximately 9% of all calls (108 subjects), and direct mail generated less than 7% (79 subjects). The total direct cost for recruitment was $40 740 or $679 per randomized patient. The costs per randomization were highest for direct mail ($995 per randomization) and lowest for newspaper/magazine advertising ($558 per randomization). Success of recruitment methods may vary based on target population and location. Planning of recruitment efforts is essential to the success of any clinical trial. Copyright 2010 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.

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

DEFF Research Database (Denmark)

Lyons, K. J.; Salsbury, S. A.; Hondras, M. A.

2013-01-01

Background: While older adults may seek care for low back pain (LBP) from both medical doctors (MDs) and doctors of chiropractic (DCs), co-management between these providers is uncommon. The purposes of this study were to describe the preferences of older adults for LBP co-management by MDs and DCs...... 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...

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

Science.gov (United States)

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

2014-01-01

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

Maintenance care in chiropractic - what do we know?

DEFF Research Database (Denmark)

Leboeuf-Yde, Charlotte; Hestbæk, Lise

2008-01-01

of maintenance care are considered controversial. It is therefore relevant to investigate the scientific evidence forming the basis for its use. OBJECTIVES: A review of the literature was performed in order to obtain answers to the following questions: What is the exact definition of maintenance care, what...... any of the questions. CONCLUSION: There is no evidence-based definition of maintenance care and the indications for and nature of its use remains to be clearly stated. It is likely that many chiropractors believe in the usefulness of maintenance care but it seems to be less well accepted...

Gimme that old time religion: the influence of the healthcare belief system of chiropractic's early leaders on the development of x-ray imaging in the profession.

Science.gov (United States)

Young, Kenneth John

2014-01-01

Chiropractic technique systems have been historically documented to advocate overutilization of radiography. Various rationales for this have been explored in the literature. However, little consideration has been given to the possibility that the healthcare belief system of prominent early chiropractors may have influenced the use of the diagnostic modality through the years. The original rationale was the visualisation of chiropractic subluxations, defined as bones slightly out of place, pressing on nerves, and ultimately causing disease. This paradigm of radiography has survived in parts of the chiropractic profession, despite lacking evidence of clinical validity. The purpose of this paper is to compare the characteristics of the chiropractic technique systems that have utilised radiography for subluxation detection with the characteristics of religion, and to discover potential historical links that may have facilitated the development of those characteristics. Twenty-three currently or previously existing technique systems requiring radiography for subluxation analysis were found using a search of the internet, books and consultation with experts. Evidence of religiosity from the early founders' writings was compared with textbooks, published papers, and websites of subsequently developed systems. Six criteria denoting religious thinking were developed using definitions from various sources. They are: supernatural concepts, claims of supremacy, rules and rituals, sacred artefacts, sacred stories, and special language. All of these were found to a greater or lesser degree in the publicly available documents of all the subluxation-based chiropractic x-ray systems. The founders and early pioneers of chiropractic did not benefit from the current understanding of science and research, and therefore substituted deductive and inductive reasoning to arrive at conclusions about health and disease in the human body. Some of this thinking and rationalisation

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African Journals Online (AJOL)

Items 151 - 200 of 1020 ... Issue, Title ... Vol 48, No 2 (2006), Barriers to HIV Care and Treatment by Doctors: A review of the literature. ... Vol 48, No 5 (2006), Breast cancer – early detection and screening in South African women from the ...

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

Reduction of progressive thoracolumbar adolescent idiopathic scoliosis by chiropractic biophysics® (CBP®) mirror image® methods following failed traditional chiropractic treatment: a case report

OpenAIRE

Haggard, Joshua S.; Haggard, Jennifer B.; Oakley, Paul A.; Harrison, Deed E.

2017-01-01

[Purpose] To present a case demonstrating the reduction of progressive thoracolumbar scoliosis by incorporating Chiropractic BioPhysics® (CBP®) technique’s mirror image® exercises, traction and blocking procedures based on the ‘non-commutative properties of finite rotation angles under addition’ engineering law. [Subject and Methods] A 15-year-old female presented with a right thoracolumbar scoliosis having a Cobb angle from T5–L3 of 27° and suffering from headaches and lower back pains. Her ...

75 FR 36099 - Legislative Changes to Primary Care Loan Program Authorized Under Title VII of the Public Health...

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2010-06-24

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Legislative Changes to Primary Care Loan Program Authorized Under Title VII of the Public Health Service Act AGENCY... changes Section 723 of the Public Health Service Act (PHSA) regarding administration of the PCL program...

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

Directory of Open Access Journals (Sweden)

Walker Bruce F

2005-04-01

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

Standard deviation analysis of the mastoid fossa temperature differential reading: a potential model for objective chiropractic assessment.

Science.gov (United States)

Hart, John

2011-03-01

This study describes a model for statistically analyzing follow-up numeric-based chiropractic spinal assessments for an individual patient based on his or her own baseline. Ten mastoid fossa temperature differential readings (MFTD) obtained from a chiropractic patient were used in the study. The first eight readings served as baseline and were compared to post-adjustment readings. One of the two post-adjustment MFTD readings fell outside two standard deviations of the baseline mean and therefore theoretically represents improvement according to pattern analysis theory. This study showed how standard deviation analysis may be used to identify future outliers for an individual patient based on his or her own baseline data. Copyright © 2011 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.

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

Science.gov (United States)

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

2016-01-01

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

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

Directory of Open Access Journals (Sweden)

William B Stason

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

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

Science.gov (United States)

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

2016-01-01

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

EFFECTIVENESS OF CHIROPRACTIC ADJUSTMENT IN LUMBAR PAIN IN CROSSFIT PRACTITIONERS

OpenAIRE

MOEHLECKE, DESIREE; FORGIARINI JUNIOR, LUIZ ALBERTO

2017-01-01

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 ...

Browse Title Index

African Journals Online (AJOL)

Items 1 - 50 of 217 ... Browse Title Index. Journal Home > Advanced ... Vol 13, No 1 (2016), Access to specialized surgical care, Abstract PDF. H Saidi ... Vol 9, No 2 (2012), Clinical Assessment of the Palmaris Longus – Accuracy of common tests, Abstract PDF ... Vol 11, No 2 (2014), Clinical trials in Surgery, Abstract PDF.

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…

Restructuring of the jurisprudence course taught at the Canadian Memorial Chiropractic College

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Gleberzon, Brian J.

2010-01-01

Introduction: The process by which the jurisprudence course was restructured at the Canadian Memorial Chiropractic College is chronicled. Method: A Delphi process used to restructure the course is described, and the results of a student satisfaction survey are presented. Results: When asked “I think this material was clinically relevant,” over 81% of the 76 students who respondents strongly agreed or agreed with this statement; 100% of students agreed or strongly agreed that scope of practice; marketing, advertising and internal office promotion; record keeping; fee schedules; malpractice issues and; professional malpractice issues and negligence was clinically relevant. When asked “I think this material was taught well,” a minimum of 89% of students agreed or strongly agreed with this statement. Discussion: This is the first article published that described the process by which a jurisprudence course was developed and assessed by student survey. Summary: Based on a survey of student perceptions, restructuring of the jurisprudence course was successful in providing students with clinically relevant information in an appropriate manner. This course may serve as an important first step in development a ‘model curriculum’ for chiropractic practice and the law courses in terms of content, format and assessment strategies. PMID:20195427

Chiropractic curriculum mapping and congruence of the evidence for workplace interventions in work-related neck pain.

Science.gov (United States)

Frutiger, Martin; Tuchin, Peter Jeffery

2017-10-01

The purpose of this study was to provide a best-synthesis summary of the literature for effective workplace health promotion interventions (WHPI) for work-related mechanical neck pain (MNP) and to determine the congruence between knowledge of WHPI for work-related MNP and coverage of MNP in the chiropractic postgraduate program at Macquarie University. A literature review was undertaken to determine effective WHPI for work-related MNP. We searched Cochrane Library, PubMed, EMBASE, CINAHL, and PEDro (from 1991 to 2016) for systematic reviews and meta-analyses. The PRISMA (2009) 27-item checklist was used to critically appraise included articles. Lectures, tutorials, and assessment tasks within the chiropractic postgraduate program were mapped to the literature review findings and analyzed. There was moderate-quality evidence for multidimensional WHPI, including aspects of mental and physical functioning, activity performance and modifications, and environmental modifications, to reduce MNP and disability in workers, particularly in the long term. Education on coverage of MNP and effective WHPI for MNP was inadequately covered although congruent with synthesis of current literature. Education on body functions and structures and personal factors were the most commonly covered components. Multidimensional WHPI, focusing on physical, mental, and environmental modifications, appear to reduce self-reported MNP primarily in office workers. There is adequate congruence between the chiropractic postgraduate program at Macquarie University and the published literature on some WHPI. However, there is inadequate coverage on aspects of MNP and effective WHPI for MNP, particularly those focusing on activity and participation and environmental factors.

Do chiropractic college faculty understand informed consent: a pilot study

Directory of Open Access Journals (Sweden)

Hondras Maria A

2006-12-01

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

The use of diagnostic coding in chiropractic practice

DEFF Research Database (Denmark)

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

2015-01-01

BACKGROUND: Diagnostic coding has several potential benefits, including improving the feasibility of data collection for research and clinical audits and providing a common language to improve interdisciplinary collaboration. The primary aim of this study was to determine the views and perspectives......-2 PLUS) provided the 14 chiropractors with some experience in diagnostic coding, followed by an interview on the topic. The interviews were analysed thematically. The participating chiropractors and an independent coder applied ICPC-2 PLUS terms to the diagnoses of 10 patients. Then the level...... of agreement between the chiropractors and the coder was determined and Cohen's Kappa was used to determine the agreement beyond that expected by chance. RESULTS: From the interviews the three emerging themes were: 1) Advantages and disadvantages of using a clinical coding system in chiropractic practice, 2...

Statin induced myopathy presenting as mechanical musculoskeletal pain observed in two chiropractic patients

OpenAIRE

Rodine, Robert J; Tibbles, Anthony C; Kim, Peter SY; Alikhan, Neetan

2010-01-01

Lipid lowering drugs, such as statins, are commonly used to treat approximately 10 million Canadians affected by hypercholesterolemia. The most commonly experienced side-effect of statin medication is muscle pain. Statin induced myopathy consists of a spectrum of myopathic disorders ranging from mild myalgia to fatal rhabdomyolysis. The following is a presentation of 2 cases of statin induced myopathy in patients presenting in a chiropractic setting. In addition, discussion will surround the ...

Assessment of Chiropractic Treatment for Low Back Pain, Military Readiness and Smoking Cessation in Military Active Duty Personnel

Science.gov (United States)

2016-03-01

Chiropractic services are part of the Sports Medicine and Rehabilitative Therapy Clinic and have been avail- able since September 2003. A single DC...manual ma- nipulation of upper and lower extremity joints and other spinal regions, interferential current therapy, ultrasound therapy, cryotherapy

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

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

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

2008-01-01

Background There have been no published national studies on the use in Australia of the manipulative therapies, acupuncture, chiropractic or osteopathy, or on matters including the purposes for which these therapies are used, treatment outcomes and the socio-demographic characteristics of users. Methods This study on the three manipulative therapies was a component of a broader investigation on the use of complementary and alternative therapies. For this we conducted a cross-sectional, population survey on a representative sample of 1,067 adults from the six states and two territories of Australia in 2005 by computer-assisted telephone interviews. The sample was recruited by random digit dialling. Results Over a 12-month period, approximately one in four adult Australians used either acupuncture (9.2%), chiropractic (16.1%) or osteopathy (4.6%) at least once. It is estimated that, adult Australians made 32.3 million visits to acupuncturists, chiropractors and osteopaths, incurring personal expenditure estimated to be A$1.58 billion in total. The most common conditions treated were back pain and related problems and over 90% of the users of each therapy considered their treatment to be very or somewhat helpful. Adverse events are reported. Nearly one fifth of users were referred to manipulative therapy practitioners by medical practitioners. Conclusion There is substantial use of manipulative therapies by adult Australians, especially for back-related problems. Treatments incur considerable personal expenditure. In general, patient experience is positive. Referral by medical practitioners is a major determinant of use of these manipulative therapies. PMID:18377663

Differences of Cutaneous Two-Point Discrimination Thresholds Among Students in Different Years of a Chiropractic Program.

Science.gov (United States)

Dane, Andrew B; Teh, Elaine; Reckelhoff, Kenneth E; Ying, Pee Kui

2017-09-01

The aim of this study was to investigate if there were differences in the two-point discrimination (2-PD) of fingers among students at different stages of a chiropractic program. This study measured 2-PD thresholds for the dominant and nondominant index finger and dominant and nondominant forearm in groups of students in a 4-year chiropractic program at the International Medical University in Kuala Lumpur, Malaysia. Measurements were made using digital calipers mounted on a modified weighing scale. Group comparisons were made among students for each year of the program (years 1, 2, 3, and 4). Analysis of the 2-PD threshold for differences among the year groups was performed with analysis of variance. The mean 2-PD threshold of the index finger was higher in the students who were in the higher year groups. Dominant-hand mean values for year 1 were 2.93 ± 0.04 mm and 1.69 ± 0.02 mm in year 4. There were significant differences at finger sites (P < .05) among all year groups compared with year 1. There were no significant differences measured at the dominant forearm between any year groups (P = .08). The nondominant fingers of the year groups 1, 2, and 4 showed better 2-PD compared with the dominant finger. There was a significant difference (P = .005) between the nondominant (1.93 ± 1.15) and dominant (2.27 ± 1.14) fingers when all groups were combined (n = 104). The results of this study demonstrated that the finger 2-PD of the chiropractic students later in the program was more precise than that of students in the earlier program. Copyright © 2017. Published by Elsevier Inc.

Testing the feasibility of a knowledge translation intervention designed to improve chiropractic care for adults with neck pain disorders: study protocol for a pilot cluster-randomized controlled trial.

Science.gov (United States)

Dhopte, Prakash; Ahmed, Sara; Mayo, Nancy; French, Simon; Quon, Jeffrey A; Bussières, André

2016-01-01

Neck pain in adults is common and a leading cause of physical disability. Recently, a guideline was developed for the management of non-specific neck pain (NSNP) with an aim to improve the quality of the delivery of chiropractic care. One key guideline recommendation is to undertake multimodal care for patients with NSNP. The aim of this pilot study is to determine the feasibility of implementing a multifaceted knowledge translation intervention by promoting the use of multimodal care by chiropractors managing patients with NSNP. The design is a cluster-randomized controlled pilot and feasibility trial. Chiropractors in private practice in Canada will be approached to participate in the study. Thirty consenting chiropractors will be randomized to receive either a theory-based educational intervention in the experimental group or simply a printed copy of the guideline in the control group. Each chiropractor will recruit five neck pain patients (a total of 150 patients) into the study. Development of the multifaceted intervention was informed by the results of a related qualitative study based on the Theoretical Domains Framework and consists of a series of three webinars, two online case scenarios, a self-management video on Brief Action Planning, and a printed copy of the practice guideline. Primary feasibility outcomes for both chiropractors and patients include rates of (1) recruitment, (2) retention, and (3) adherence to the intervention. A checklist of proxy measures embedded within patient encounter forms will be used to assess chiropractors' compliance with guideline recommendations (e.g. exercise and self-care prescriptions) at study onset and at 3 months. Secondary outcomes include scores of behavioural constructs (level of knowledge and self-efficacy) for recommended multimodal care. Clinical outcomes include pain intensity and neck pain-specific disability. Analyses from this study will focus on generating point estimates and corresponding 95�

A Comprehensive Child Development Program; Title XX, Final Report.

Science.gov (United States)

Whatley, Juanita T.

This booklet describes the Comprehensive Child Day Care Program for the Atlanta Public School System, a Title XX Program. This program provided day care services for children of clients in various categories. The program goals for 1975-76 were geared toward providing comprehensive day care to encompass social services to the family and…

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

Nature versus nurture segues to choice versus circumstance in the new millennium: one consideration for an integrative biopsychosocial philosophy, art, and science of chiropractic.

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Smith, Monica

2009-12-01

This commentary discusses the evolving sociocultural roles and sociocultural authority of chiropractic. The complex interconnectivity of the biological, psychological, and social aspects of our individual and collective well-being has occupied centuries of "nature versus nurture" philosophical debate, creative art, and scientific work. What has emerged is a better understanding of how our human development is affected by the circumstances of what we are born with (ie, nature) and how we are shaped by the circumstances that we are born into (ie, nurture). In the new millennium, a cumulative challenge to the emerging integrative biopsychosocial health care disciplines is one of reconciling "circumstance versus choice"; that is, advancing individually and collectively the fullest actualization of human potential through the philosophy, art, and science of autonomy and empowerment.

The Impact of the Medicare-Eligible Retiree Health Care Fund on Navy Military Treatment Facilities’ Demand-to-Capacity Solution

Science.gov (United States)

2012-03-01

Physical Therapy, Optometry, Audiology, Tele-Dermatology and Eyes, Nose & Throat (ENT); (3) Dental Care, i.e., General Dentistry , Oral Surgery...Physical Therapy, Chiropractic, Optometry, Audiology, Public Health and Eyes, Nose & Throat (ENT); (3) Dental Care, including General Dentistry ...guidelines. Version 3.2. Unified biostatistical utility. Retrieved September 14, 2010, from http://www.dtic.mil/whs/directives/corres/pdf/601517p.pdf

Knowledge and application of correct car seat head restraint usage among chiropractic college interns: a cross-sectional study.

Science.gov (United States)

Taylor, John Am; Burke, Jeanmarie; Gavencak, John; Panwar, Pervinder

2005-03-01

Cervical spine injuries sustained in rear-end crashes cost at least $7 billion in insurance claims annually in the United States alone. When positioned correctly, head restraint systems have been proven effective in reducing the risk of whiplash associated disorders. Chiropractors should be knowledgeable about the correct use of head restraint systems to educate their patients and thereby prevent or minimize such injuries. The primary objective of this study was to determine the prevalence of correct positioning of car seat head restraints among the interns at our institution. The secondary objective was to determine the same chiropractic interns' knowledge of the correct positioning of car seat head restraints. It was hypothesized that 100 percent of interns would have their head restraint correctly positioned within an acceptable range and that all interns would possess the knowledge to instruct patients in the correct positioning of head restraints. Cross-sectional study of a convenient sample of 30 chiropractic interns from one institution. Interns driving into the parking lot of our health center were asked to volunteer to have measurements taken and to complete a survey. Vertical and horizontal positions of the head restraint were measured using a beam compass. A survey was administered to determine knowledge of correct head restraint position. The results were recorded, entered into a spreadsheet, and analyzed. 13.3 percent of subjects knew the recommended vertical distance and only 20 percent of subjects knew the recommended horizontal distance. Chi Square analyses substantiated that the majority of subjects were unaware of guidelines set forth by the National Highway Traffic Safety Administration (NHTSA) for the correct positioning of the head restraint (chi(2) (vertical) = 16.13, chi(2) (horizontal) = 10.80, p .05). Interestingly, the 13.3 percent of the subjects who were aware of the vertical plane recommendations did not correctly position their own

Taking care of Care

NARCIS (Netherlands)

Evelien Eggink; Debbie Oudijk; Isolde Woittiez

2010-01-01

Original title: Zorgen voor Zorg. The Dutch population will become increasingly older over the coming decades. This will have consequences for the use of care and consequently the demand for staff, especially in the nursing and care sectors (home care, nursing homes and residential care

Engagement as predictors of performance in a single cohort of undergraduate chiropractic students.

Science.gov (United States)

Rix, Jacqueline; Dewhurst, Philip; Cooke, Caroline; Newell, David

2017-03-01

To investigate the potential association of novel academic and nonacademic factors with chiropractic student academic performance. Students enrolled into year 1 of a chiropractic master's degree (MChiro) at our college were selected for this study. Data collected included demographics, attendance, virtual learning environment use, additional learning needs, previous degree qualifications, and summative marks. Differences between students who had to take an examination more than once (resit) and nonresit students were explored using t test and χ 2 analysis. Relationships between attendance and end-of-year marks were explored using regression analysis. Male students outperformed female students in four of the six units and as the total year average. Students who attended risk [ RR] = 2.6; 95% confidence interval [CI], 1.4-4.9). Students who performed poorly (<70%) in the semester 1 unit of a course on human structure and failed the semester 1 practical assessment of a course on clinical management were significantly more likely to have one or more resit assessments in semester 2 units ( RR = 3.5 [95% CI, 2.2-5.7]; RR = 3.2 [95% CI, 2.0-4.9]). Attendance and unit 105 were independent predictors of one or more resits at the end-of-year ( R 2 = 0.86, p < .001). Attendance and first semester summative marks were associated with end-of-year performance. As such, these markers of performance may be used to flag struggling students in the program.

Nutrition and youth soccer for childhood overweight: a pilot novel chiropractic health education intervention.

Science.gov (United States)

Leach, Robert A; Yates, Joyce M

2008-01-01

The purpose of this pilot novel chiropractic health education intervention was to gather preliminary evidence regarding possible benefits from recreational youth soccer and nutrition education in overweight women. A secondary purpose was to determine whether some nutrition knowledge is an independent predictor of changes in body mass index (BMI). A quiz developed and validated on separate age and sex appropriate blinded cohorts was used on study participants-22 volunteers of 57 eligible fourth-grade, overweight female Mississippi public school students. At the beginning of a 5-month study period, a 15-minute baseline nutrition intervention, grounded in Social Cognitive Theory and based on the United States Department of Agriculture's "My Tips for Families" information, was applied in a chiropractic clinic. Subjects were then randomized to 2 months of recreational soccer (n = 14) or waiting list control (n = 8). No preintervention differences were found in height, weight, BMI, or age. Higher follow-up BMI scores were found in both groups, and no significant differences between groups were found, possibly because of the small sample sizes and the short 8-week soccer intervention period. Gains in nutrition knowledge were sustained (P nutrition knowledge and follow-up BMI (r = -.185; P nutrition education alone may be an ineffective intervention for overweight children. The study provides an example of how youth soccer may benefit overweight children.

Guidance for implementing the long-term surveillance program for UMTRA Project Title I Disposal Sites

International Nuclear Information System (INIS)

1996-02-01

This guidance document has two purposes: it provides guidance for writing site-specific long-term surveillance plans (LTSP) and it describes site surveillance, monitoring, and long-term care techniques for Title I disposal sites of the Uranium Mill Tailings Radiation Control Act (UMTRCA) (42 USC Section 7901 et seq.). Long-term care includes monitoring, maintenance, and emergency measures needed to protect public health and safety and the environment after remedial action is completed. This document applies to the UMTRCA-designated Title I disposal sites. The requirements for long-term care of the Title I sites and the contents of the LTSPs are provided in U.S. Nuclear Regulatory Commission (NRC) regulations (10 CFR Section 40.27) provided in Attachment 1

Long-term trajectories of patients with neck pain and low back pain presenting to chiropractic care: A latent class growth analysis.

Science.gov (United States)

Ailliet, L; Rubinstein, S M; Hoekstra, T; van Tulder, M W; de Vet, H C W

2018-01-01

Information on the course of neck pain (NP) and low back pain (LBP) typically relies on data collected at few time intervals during a period of up to 1 year. In this prospective, multicentre practice-based cohort study, patients consulting a chiropractor responded weekly for 52 weeks to text messages on their cell phones. Data from 448 patients (153 NP, 295 LBP) who had returned at least one set of answers in the first 26 weeks were used. Outcome measures were pain intensity (VAS) and functional outcome, assessed using four different questions: pain intensity, limitation in activities of daily living (ADL), number of days with pain in the previous week and number of days limited in ADL. Distinct patterns of pain were analysed with quadratic latent class growth analysis. The final model was a 4-class model for NP and LBP. The 'recovering from mild baseline pain' is most common (76.3% of NP patients/58.3% of LBP patients) followed by the 'recovering from severe baseline pain' class (16.3% NP/29.8% LBP). They follow similar trajectories when considered over a period of 6 months. Pain at baseline, duration of complaints, functional status, limitations in ADL and the score on psychosocial scales were the variables that most contributed to distinguish between groups. Most patients with NP or LBP presenting in chiropractic care show a trajectory of symptoms characterized by persistent or fluctuating pain of low or medium intensity. Only a minority either experience a rapid complete recovery or develop chronic severe pain. Ninety percentage of patients with neck pain or low back pain presenting to chiropractors have a 30% improvement within 6 weeks and then show a trajectory of symptoms characterized by persistent or fluctuating pain of low or medium intensity. Only a minority either experience a rapid complete recovery or develop chronic severe pain. © 2017 European Pain Federation - EFIC®.

Award-winning articles and posters from the World Federation of Chiropractic's 12th Biennial Congress 2013.

Science.gov (United States)

Haldeman, Scott; Chapman-Smith, David

2014-01-01

This editorial reviews the original research submissions to the World Federation of Chiropractic's 12th Biennial Congress held in Durban, South Africa from April 10 - 13, 2013, and the four award-winning scientific articles in the NCMIC Louis Sportelli Research Awards competition at the Congress which are published in this issue of the Journal of Manipulative and Physiological Therapeutics. Copyright © 2014 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.

Chiropractic treatment including instrument-assisted manipulation for non-specific dizziness and neck pain in community-dwelling older people: a feasibility randomised sham-controlled trial.

Science.gov (United States)

Kendall, Julie C; French, Simon D; Hartvigsen, Jan; Azari, Michael F

2018-01-01

Dizziness in older people is a risk factor for falls. Neck pain is associated with dizziness and responds favourably to neck manipulation. However, it is unknown if chiropractic intervention including instrument-assisted manipulation of the neck in older people with neck pain can also improve dizziness. This parallel two-arm pilot trial was conducted in Melbourne, Australia over nine months (October 2015 to June 2016). Participants aged 65-85 years, with self-reported chronic neck pain and dizziness, were recruited from the general public through advertisements in local community newspapers and via Facebook. Participants were randomised using a permuted block method to one of two groups: 1) Activator II™-instrument-assisted cervical and thoracic spine manipulation plus a combination of: light massage; mobilisation; range of motion exercises; and home advice about the application of heat, or 2) Sham-Activator II™-instrument-assisted manipulation (set to zero impulse) plus gentle touch of cervical and thoracic spinal regions. Participants were blinded to group allocation. The interventions were delivered weekly for four weeks. Assessments were conducted one week pre- and post-intervention. Clinical outcomes were assessed blindly and included: dizziness (dizziness handicap inventory [DHI]); neck pain (neck disability index [NDI]); self-reported concerns of falling; mood; physical function; and treatment satisfaction. Feasibility outcomes included recruitment rates, compliance with intervention and outcome assessment, study location, success of blinding, costs and harms. Out of 162 enquiries, 24 participants were screened as eligible and randomised to either the chiropractic ( n  = 13) or sham ( n  = 11) intervention group. Compliance was satisfactory with only two participants lost to follow up; thus, post-intervention data for 12 chiropractic intervention and 10 sham intervention participants were analysed. Blinding was similar between groups. Mild harms

Comparing the characteristics of highly cited titles and highly alted titles

Energy Technology Data Exchange (ETDEWEB)

Didegah, F.; Bowman, T.D.; Bowman, S.; Hartley, J.

2016-07-01

This study examines differences in the types of titles for articles that show high altmetric activity (highly alted articles) versus highly cited articles. This work expands on previous research on document titles in combination with a grounded theory approach to develop a codebook in which articles were manually coded based on 11 characteristics. The results show that there are differences and similarities in titles across many of the examined characteristics; highly cited titles and highly mentioned titles on Wikipedia have some similar characteristics such as they have the the highest percentage of substantive words; in addition, there are no or very few titles referencing outside or with humor/lightness on both platforms. Twitter and Facebook also showed some similarities having the highest percentage of humorous/light titles and lowest percentage of substantive words in their titles. (Author)

Patient-centered professional practice models for managing low back pain in older adults: a pilot randomized controlled trial.

Science.gov (United States)

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

2017-10-13

Low back pain is a debilitating condition for older adults, who may seek healthcare from multiple providers. Few studies have evaluated impacts of different healthcare delivery models on back pain outcomes in this population. The purpose of this study was to compare clinical outcomes of older adults receiving back pain treatment under 3 professional practice models that included primary medical care with or without chiropractic care. We conducted a pilot randomized controlled trial with 131 community-dwelling, ambulatory older adults with subacute or chronic low back pain. Participants were randomly allocated to 12 weeks of individualized primary medical care (Medical Care), concurrent medical and chiropractic care (Dual Care), or medical and chiropractic care with enhanced interprofessional collaboration (Shared Care). Primary outcomes were low back pain intensity rated on the numerical rating scale and back-related disability measured with the Roland-Morris Disability Questionnaire. Secondary outcomes included clinical measures, adverse events, and patient satisfaction. Statistical analyses included mixed-effects regression models and general estimating equations. At 12 weeks, participants in all three treatment groups reported improvements in mean average low back pain intensity [Shared Care: 1.8; 95% confidence interval (CI) 1.0 to 2.6; Dual Care: 3.0; 95% CI 2.3 to 3.8; Medical Care: 2.3; 95% CI 1.5 to 3.2)] and back-related disability (Shared Care: 2.8; 95% CI 1.6 to 4.0; Dual Care: 2.5; 95% CI 1.3 to 3.7; Medical Care: 1.5; 95% CI 0.2 to 2.8). No statistically significant differences were noted between the three groups on the primary measures. Participants in both models that included chiropractic reported significantly better perceived low back pain improvement, overall health and quality of life, and greater satisfaction with healthcare services than patients who received medical care alone. Professional practice models that included primary care and

A survey in the West Midlands on the use of the courtesy title 'Dr' by UK dental practitioners.

Science.gov (United States)

Thomas, D J; Allsopp, J

1997-10-25

To assess the 1995 General Dental Council's decision to remove restrictions on GDPs using the courtesy title 'Dr'. In 1996 this survey undertook a qualitative analysis of the views of four groups involved in primary dental care: 72 GDPs, 25 medical practitioners, 46 vocational dental practitioners, 89 patients. These indicated that some respondents thought that there would possibly be better quality of patient care due to improved medical history taking, that the public's image of the dental profession might be enhanced and that 87% of newly qualified dentists were in favour of the use of the title 'Dr'. Use of the title appears to be on the increase and if use of the title does become widespread, then all practitioners will need to re-evaluate their choice of personal titles. GDPs need to consider if using the title 'Dr' will encourage patients to give more detailed medical histories.

Carpal tunnel syndrome and the "double crush" hypothesis: a review and implications for chiropractic

Directory of Open Access Journals (Sweden)

Russell Brent S

2008-04-01

Full Text Available Abstract Upton and McComas claimed that most patients with carpal tunnel syndrome not only have compressive lesions at the wrist, but also show evidence of damage to cervical nerve roots. This "double crush" hypothesis has gained some popularity among chiropractors because it seems to provide a rationale for adjusting the cervical spine in treating carpal tunnel syndrome. Here I examine use of the concept by chiropractors, summarize findings from the literature, and critique several studies aimed at supporting or refuting the hypothesis. Although the hypothesis also has been applied to nerve compressions other than those leading to carpal tunnel syndrome, this discussion mainly examines the original application – "double crush" involving both cervical spinal nerve roots and the carpal tunnel. I consider several categories: experiments to create double crush syndrome in animals, case reports, literature reviews, and alternatives to the original hypothesis. A significant percentage of patients with carpal tunnel syndrome also have neck pain or cervical nerve root compression, but the relationship has not been definitively explained. The original hypothesis remains controversial and is probably not valid, at least for sensory disturbances, in carpal tunnel syndrome. However, even if the original hypothesis is importantly flawed, evaluation of multiple sites still may be valuable. The chiropractic profession should develop theoretical models to relate cervical dysfunction to carpal tunnel syndrome, and might incorporate some alternatives to the original hypothesis. I intend this review as a starting point for practitioners, educators, and students wishing to advance chiropractic concepts in this area.

The Trouble with Title XX: A Review of Child Daycare Policy.

Science.gov (United States)

Morgan, Gwen G.

This discussion of government policy concerning child day care calls for a shift from provider-oriented to consumer-oriented services funded under Title XX of the Social Security Amendments. Three general views of child day care are described: the social services view, the school-oriented view, and a newer, parent-supportive, consumer-oriented…

Variations in Patterns of Utilization and Charges for the Care of Headache in North Carolina, 2000-2009: A Statewide Claims' Data Analysis.

Science.gov (United States)

Hurwitz, Eric L; Vassilaki, Maria; Li, Dongmei; Schneider, Michael J; Stevans, Joel M; Phillips, Reed B; Phelan, Shawn P; Lewis, Eugene A; Armstrong, Richard C

2016-05-01

The purpose of the study was to compare patterns of utilization and charges generated by medical doctors (MDs), doctors of chiropractic (DCs), and physical therapists (PTs) for the treatment of headache in North Carolina. Retrospective analysis of claims data from the North Carolina State Health Plan for Teachers and State Employees from 2000 to 2009. Data were extracted from Blue Cross Blue Shield of North Carolina for the North Carolina State Health Plan using International Classification of Diseases, Ninth Revision, diagnostic codes for headache. The claims were separated by individual provider type, combination of provider types, and referral patterns. The majority of patients and claims were in the MD-only or MD plus referral patterns. Chiropractic patterns represented less than 10% of patients. Care patterns with single-provider types and no referrals incurred the least charges on average for headache. When care did not include referral providers or services, MD with DC care was generally less expensive than MD care with PT. However, when combined with referral care, MD care with PT was generally less expensive. Compared with MD-only care, risk-adjusted charges (available 2006-2009) for patients in the middle risk quintile were significantly less for DC-only care. Utilization and expenditures for headache treatment increased from 2000 to 2009 across all provider groups. MD care represented the majority of total allowed charges in this study. MD care and DC care, alone or in combination, were overall the least expensive patterns of headache care. Risk-adjusted charges were significantly less for DC-only care. Copyright © 2016 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.

The Nordic Maintenance Care Program - Time intervals between treatments of patients with low back pain: how close and who decides?

Directory of Open Access Journals (Sweden)

Leboeuf-Yde Charlotte

2010-03-01

Full Text Available Abstract Background The management of chiropractic patients with acute and chronic/persistent conditions probably differs. However, little is known on this subject. There is, for example, a dearth of information on maintenance care (MC. Thus it is not known if patients on MC are coerced to partake in a program of frequent treatments over a long period of time, or if they are actively involved in designing their own individualized treatment program. Objectives It was the purpose of this study to investigate how chiropractic patients with low back pain were scheduled for treatment, with special emphasis on MC. The specific research questions were: 1. How many patients are on maintenance care? 2 Are there specific patterns of intervals between treatments for patients and, if so, do they differ between MC patients and non-MC patients? 3. Who decides on the next treatment, the patient, the chiropractor or both, and are there any differences between MC patients and non-MC patients? Methods Chiropractic students, who during their summer holidays were observers in chiropractic clinics in Norway and Denmark, recorded whether patients were classified by the treating chiropractor as a MC-patient or not, dates for last and subsequent visits, and made a judgement on whether the patient or the chiropractor decided on the next appointment. Results Observers in the study were 16 out of 30 available students. They collected data on 868 patients from 15 Danish and 13 Norwegian chiropractors. Twenty-two percent and 26%, respectively, were classified as MC patients. Non-MC patients were most frequently seen within 1 week. For MC patients, the previous visit was most often 2-4 weeks prior to the actual visit, and the next appointment between 1 and 3 months. This indicates a gradual increase in intervals. The decision of the next visit was mainly made by the chiropractor, also for MC patients. However, the study samples of chiropractors appear not to be

The efficacy of chiropractic adjustments and PAIN®GONE therapy in the treatment of trapezius myofascial pain syndrome

OpenAIRE

2014-01-01

M.Tech. (Chiropractic) Myofascial trigger points are very common and can become a painful part of most people’s life at one time or another. According to Travell and Simons (1999), active upper trapezius myofascial trigger points are common in patients presenting with neck pain. Myofascial pain syndrome is a regional muscle disorder that is one of the most common causes of persistent pain in the head, face and neck regions (Rachlin, 2002). The PAIN®GONE pen is a device that produces a high...

42 CFR 476.86 - Correlation of Title XI functions with Title XVIII functions.

Science.gov (United States)

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Correlation of Title XI functions with Title XVIII functions. 476.86 Section 476.86 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF...) Qio Review Functions § 476.86 Correlation of Title XI functions with Title XVIII functions. (a...

Correlation of preadmission organic chemistry courses and academic performance in biochemistry at a midwest chiropractic doctoral program.

Science.gov (United States)

McRae, Marc P

2010-01-01

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

Test anxiety and academic performance in chiropractic students.

Science.gov (United States)

Zhang, Niu; Henderson, Charles N R

2014-01-01

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

20 CFR 404.535 - How much will we withhold from your title VIII and title XVI benefits to recover a title II...

Science.gov (United States)

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false How much will we withhold from your title... Officer § 404.535 How much will we withhold from your title VIII and title XVI benefits to recover a title II overpayment? (a) If past-due benefits are payable to you, we will withhold the lesser of the...

Degree of vertical integration between the undergraduate program and clinical internship with respect to cervical and cranial diagnostic and therapeutic procedures taught at the canadian memorial chiropractic college.

Science.gov (United States)

Leppington, Charmody; Gleberzon, Brian; Fortunato, Lisa; Doucet, Nicolea; Vandervalk, Kyle

2012-01-01

The purpose of this study was to determine if diagnostic and therapeutic procedures for the cervical and cranial spine taught to students during the undergraduate program at Canadian Memorial Chiropractic College are required to be used during their internship by their supervising clinicians and, if so, to what extent these procedures are used. Course manuals and course syllabi from the Applied Chiropractic and Clinical Diagnosis faculty of the undergraduate chiropractic program for the academic year 2009-2010 were consulted and a list of all diagnostic and therapeutic procedures for the cranial and cervical spine was compiled. This survey asked clinicians to indicate if they themselves used or if they required the students they were supervising to use each procedure listed and, if so, to what extent each procedure was used. Demographic information of each clinician was also obtained. In general, most diagnostic procedures of the head and neck were seldom used, with the exception of postural observation and palpation. By contrast, most cervical orthopaedic tests were often used, with the exception of tests for vertigo. Most therapeutic procedures were used frequently with the exception of prone cervical and "muscle" adjustments. There was a low degree of vertical integration for cranial procedures as compared to a much higher degree of vertical integration for cervical procedures between the undergraduate and clinical internship programs taught. Vertical integration is an important element of curricular planning and these results may be helpful to aid educators to more appropriately allocate classroom instruction.

Sexual harassment of female chiropractors by their patients: a pilot survey of faculty at the Canadian Memorial Chiropractic College

Science.gov (United States)

Gleberzon, Brian; Statz, Rachel; Pym, Matthew

2015-01-01

Background: The purpose of this study was to survey a group of female chiropractors and inquire as to whether or not they had been sexually harassed by their patients. Methods: An online questionnaire was emailed via Survey Monkey to 47 female faculty members at the Canadian Memorial Chiropractic College (CMCC). Respondents were asked if they had been sexual harassed and, if so, the characteristics of the incident(s), their response to it, how serious they perceived the problem to be and whether or not they felt prepared to deal with it. Results: Nineteen of 47 questionnaires were completed and returned. Of these 19, eight respondents reported being sexually harassed by a patient (all male), most commonly within the first 5 years of practice and most commonly involving a ‘new’ patient. It was rarely anticipated. The nature of the harassment varied and respondents often ignored the incident. Most respondents perceive this to be a problem facing female chiropractors. Discussion: Although this is the first survey of its kind, this is a significant problem facing other healthcare professionals. Conclusions: Among this group of respondents, sexual harassment by patients was a common occurrence. More training on how to handle it, during either a student’s chiropractic education or offered as a continuing education program, may be warranted. PMID:26136603

Intentions of Chiropractic Interns Regarding use of Health Promotion in Practice: Applying Theory of Reasoned Action to Identify Attitudes, Beliefs, and Influencing Factors.

Science.gov (United States)

Evans, Marion W; Ndetan, Harrison; Williams, Ronald D

2009-01-01

The theory of reasoned action is a health behavioral theory that has been used to predict personal health behaviors and intentions as well as those of providers delivering health care. The purpose of this study was to determine interns' future practices regarding the use of health promotion using this model to develop survey questions and to determine attitudes and perceived influences on their prospective behaviors in general, toward the use of health promotion once in practice. Across the course of one year, all graduating interns at a chiropractic college were queried with a 20 question survey designed using the theory of reasoned action. Frequencies and inferential statistics were performed including prediction modeling using logistic regression. A majority (>85%) of interns indicated they would use health promotion in practice. Differences were noted based on perceived skill levels, perception of educational emphasis, various normative beliefs, and gender. Most interns will use some form of health promotion in practice. Normative influences including those seen as key influencers are as powerful a predictor as perceived education or skill levels on future practice of health promotion.

The Nordic maintenance care program--time intervals between treatments of patients with low back pain: how close and who decides?

DEFF Research Database (Denmark)

Sandnes, Kjerstin F; Bjørnstad, Charlotte; Leboeuf-Yde, Charlotte

2010-01-01

The management of chiropractic patients with acute and chronic/persistent conditions probably differs. However, little is known on this subject. There is, for example, a dearth of information on maintenance care (MC). Thus it is not known if patients on MC are coerced to partake in a program...... of frequent treatments over a long period of time, or if they are actively involved in designing their own individualized treatment program....

History of Chiropractic Care

Science.gov (United States)

... 2706 of PPACA CPT and RUC Advisor Fellowship Appeals Verification of Benefits Medicare Medicare News MACRA Advance ... JMPT Annual Reports Archives: ACA News Digital Edition Advertising Opportunities Social Media ACA Blogs Podcasts Newsroom Letters ...

Work-related acute physical injuries, chronic overuse complaints, and the psychosocial work environment in Danish primary care chiropractic practice - a cross-sectional study.

Science.gov (United States)

Hansen, Mille Charlotte; Aagaard, Tine; Christensen, Henrik Wulff; Hartvigsen, Jan

2018-01-01

Little is known about the physical and psychosocial work environment of chiropractors and their work-related health complaints, and this has never been described for Danish chiropractors. The aim of this study was, therefore, to describe work-related acute physical injuries, overuse complaints, and psychosocial stress in Danish chiropractic work settings. We developed a questionnaire specifically for this study and distributed it electronically in August 2016 using SurveyXact to all 575 members of the Danish Chiropractors' Association working in primary care clinics. Chiropractors were asked about their work-related acute physical injuries and overuse complaints as well as any psychosocial stress they experienced at work during the previous year. We described our sample and variables using means, medians, ranges, and confidence intervals where appropriate. Statistically significant differences between genders, types of complaints and injuries, and between clinic owners and associates were examined using Chi-square and Fischer's exact tests, where appropriate, or by examining confidence intervals for non-overlap. 355 (65.2%) chiropractors answered the survey. Of these, 216 (61%, 95% CI 56-66) had experienced a work-related acute physical injury and/or overuse complaint during the previous year. Work-related overuse complaints were most commonly reported in the low back, wrist, thumb, and shoulder, and were more common among women (63%, 95% CI 56-70) than men (51%, 95% CI 43-59). Chiropractors with more than five years in practice (59%, 95% CI 52-64) reported significantly fewer work-related acute injuries and overuse complaints during the previous year compared with chiropractors with less than five years in practice (83%, 95% CI 73-91). In general, these practicing Danish chiropractors reported having a good psychosocial work environment, and 90% of chiropractors "always" or "often" felt that they were motivated and committed to their work. This sample of Danish

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

Science.gov (United States)

McRae, Marc P.

2010-01-01

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

Browse Title Index

African Journals Online (AJOL)

2004): Special Issue 2004, Differential production of immune parameters by mouse strains ... agglutination and complement fixation tests in the field diagnosis ... List All Titles · Free To Read Titles This Journal is Open Access.

Special informal care

NARCIS (Netherlands)

Y. Wittenberg; M.H. Kwekkeboom; A.H. de Boer

2012-01-01

Original title: Bijzondere mantelzorg The notion of informal care generally conjures up a picture of care provided to older persons by relatives and friends. However, people with psychiatric problems or intellectual disabilities also receive a great deal of care from those close to them. As

Chiropractic manipulative therapy of the thoracic spine in combination with stretch and strengthening exercises, in improving postural kyphosis in woman

Directory of Open Access Journals (Sweden)

Kim C. Branco

2016-10-01

Method: A randomised study design with thirty female participants between the ages of twenty and  thirty nine was selected. Group 1 (n = 10 received chiropractic spinal manipulative therapy to the thoracic spine. Group 2 (n = 10 received chiropractic spinal manipulative therapy to the thoracic spine as well as stretch and strengthening exercises i.e. stretching the pectoralis major muscles and strengthening the rhomboid, middle and inferior trapezius muscles. Group 3 (n = 10 received stretch and strengthening exercises. The stretch and strengthening exercises were performed in the consultation rooms to ensure that the participants were complying with the treatment and doing the exercises properly. The study consisted of seven consultations for Group 1 (they received treatment once a week for six weeks and for Groups 2 and 3 there were nineteen consultations (they received three treatments a week for six weeks. Objective data was recorded at the beginning of the first, fourth and seventh consultations for Group 1, and the first, tenth and nineteenth consultations for Groups 2 and 3. On the seventh consultation (for Group 1 and nineteenth consultation for Groups 2 and 3, only data collection was done. Objective data were obtained by using the Flexicurve® Ruler measurements for the angle of kyphosis. Visual analysis was done by taking lateral (sagittal view photographs at the beginning of the initial and final consultations. Results: Statistical analysis revealed significant statistical changes for the intragroup results for all three groups. No significant statistical difference was found between the groups for the inter-group analysis. Conclusion: The study showed that all three treatment protocols for Groups 1, 2, and 3 were effective. However, Group 1 had not shown a great improvement in their postural kyphosis, Group 3 had shown a relatively good improvement in their posture, while Group 2 had shown the best results with regards to improvement of the

INIS: Authority List for Journal Titles

International Nuclear Information System (INIS)

1992-01-01

This is the nineteenth revision of the INIS: Authority List for Journal Titles (IAEA-INIS-11). It lists 10,797 journal titles which have contained articles within the scope of INIS. The purpose of this Authority List is to provide descriptive cataloguers with a standard abbreviation for journal titles and to assist users of INIS products with a tool for verifying the full title of a journal. A journal, or periodical, is generally published within a defined, fixed interval between issues, which usually has more than one issue a year, and which usually includes a mixture of articles, letters, summaries, etc. Within this definition, annuals such as Annual Review of Nuclear Science are included. Series titles as, for example the McGraw-Hill Series in Nuclear Engineering, are not included in this Authority. Entries: Each entry consists of: - the full journal title (highlighted); - the abbreviated title; - ISSN, if available; - CODEN, if available; - additional information related to the journal title. Arrangement: In Part I, the full journal titles are grouped by country or international organization name and ordered alphabetically, followed by the ISSN, the CODEN in square brackets if available, and then the abbreviated title. The abbreviated title is based on the rules of ISO 4: Documentation - International Code for the Abbreviation of Titles of Periodicals. The abbreviations of the words are taken from the ISDS List of Periodical Title Word Abbreviation. In Part II, the order of the citations is reversed: the abbreviated journal titles are arranged alphabetically, followed by country code. Then the full journal titles are followed by the country of publication, and if available, ISSN and CODEN. Additional Information: There is important information related to the journal titles which are fundamental for tracing the history of the title and the present status. They are listed below and are entered whenever applicable: - Ceased publication; - Superseded by

Title IX Resource Guide

Science.gov (United States)

Office for Civil Rights, US Department of Education, 2015

2015-01-01

Title IX of the Education Amendments of 1972 (Title IX) prohibits discrimination based on sex in education programs and activities in federally funded schools at all levels. If any part of a school district or college receives any Federal funds for any purpose, all of the operations of the district or college are covered by Title IX. The essence…

Getting to one from title 10 + title 32 unity of effort in the homeland

OpenAIRE

Prosch, Caroline Ross.

2011-01-01

CHDS State/Local Approved for public release; distribution is unlimited This thesis bridges the knowledge gap between Title 10 Active Duty and Title 32 National Guard in order to breakdown cultural barriers and reach unity of effort for response operations in the homeland. Regrettably, a unified response was missing among Title 10 Active Duty and Title 32 National Guard members following Hurricane Katrina. Since then, initiatives based in doctrine, statutes and formal recommendations...

Browse Title Index

African Journals Online (AJOL)

Items 601 - 650 of 788 ... Browse Title Index ... Issue, Title ... Vol 14, No 1 (2006), Social science research: a critique of quantitative and qualitative methods ... Vol 18, No 1 (2010), Stress among part-time business students: a study in a Ghanaian ...

20 CFR 408.931 - How much will we withhold from your title II and title XVI benefits to recover a title VIII...

Science.gov (United States)

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false How much will we withhold from your title II... and Overpayments Adjustment of Title II Benefits § 408.931 How much will we withhold from your title...-due benefits. (b)(1) We will collect the overpayment from current monthly benefits due in a month...

Browse Title Index

African Journals Online (AJOL)

Items 151 - 200 of 229 ... Browse Title Index ... Issue, Title. Vol 14, No 2 ... Vol 15, No 1 (2017), Qualitative and quantitative methods of suicide research in old age, Abstract PDF ... Vol 11, No 2 (2013), Simple Algorithm in the Management of Fetal ...

Changes in the use practitioner-based complementary and alternative medicine over time in Canada: Cohort and period effects.

Directory of Open Access Journals (Sweden)

Mayilee Canizares

Full Text Available The use of complementary and alternative medicine (CAM is growing. However the factors contributing to changes over time and to birth cohort differences in CAM use are not well understood.We used data from 10186 participants, who were aged 20-69 years at the first cycle of data collection in the longitudinal component of the Canadian National Population Health Survey (1994/95-2010/11. We examined chiropractic and other practitioner-based CAM use with a focus on five birth cohorts: pre-World War II (born 1925-1934; World War II (born 1935-1944; older baby boomers (born 1945-1954; younger baby boomers (born 1955-1964; and Gen Xers (born 1965-1974. The survey collected data every two years on predisposing (e.g., sex, education, enabling (e.g., income, behavior-related factors (e.g., obesity, need (e.g., chronic conditions, and use of conventional care (primary care and specialists.The findings suggest that, at corresponding ages, more recent cohorts reported greater CAM (OR = 25.9, 95% CI: 20.0; 33.6 for Gen Xers vs. pre-World War and chiropractic use than their predecessors (OR = 2.2, 95% CI: 1.7; 2.8 for Gen Xers vs. pre-World War. There was also a secular trend of increasing CAM use, but not chiropractic use, over time (period effect across all ages. Factors associated with cohort differences were different for CAM and chiropractic use. Cohort differences in CAM use were partially related to a period effect of increasing CAM use over time across all ages while cohort differences in chiropractic use were related to the higher prevalence of chronic conditions among recent cohorts. The use of conventional care was positively related to greater CAM use (OR = 1.8, 95% CI: 1.6; 2.0 and chiropractic use (OR = 1.2, 95% CI: 1.1; 1.4 but did not contribute to changes over time or to cohort differences in CAM and chiropractic use.The higher CAM use over time and in recent cohorts could reflect how recent generations are approaching their healthcare needs

INIS: Authority list for journal titles

Energy Technology Data Exchange (ETDEWEB)

NONE

2003-03-01

This is the twenty-ninth revision of the INIS: Authority List for Journal Titles (IAEA-INIS-11). It lists the titles of 12 990 journals which have contained articles within the scope of INIS. The purpose of this report is to provide descriptive cataloguers with a standard entry for the full title of a journal. In addition to the full journal title, the ISSN (International Standard Serial Number), administered by the ISSN International Centre, Paris, France, and/or CODEN, assigned by Chemical Abstracts Service, USA, are given in this manual. In order to help the reader to find titles easily, the list is divided into two parts. In Part I, the full journal titles are grouped by country or international organization responsible for coverage and ordered alphabetically. In Part II, the full journal titles of all countries or international organizations are arranged alphabetically. The country name or the international organization name responsible for coverage of the journal title to INIS is entered in parentheses. Journal titles marked with an asterisk are regularly scanned by INIS. Titles that have been identified by INIS Centres as 'Key Journals' are marked with the hash sign.

INIS: Authority list for journal titles

International Nuclear Information System (INIS)

2003-01-01

This is the twenty-ninth revision of the INIS: Authority List for Journal Titles (IAEA-INIS-11). It lists the titles of 12 990 journals which have contained articles within the scope of INIS. The purpose of this report is to provide descriptive cataloguers with a standard entry for the full title of a journal. In addition to the full journal title, the ISSN (International Standard Serial Number), administered by the ISSN International Centre, Paris, France, and/or CODEN, assigned by Chemical Abstracts Service, USA, are given in this manual. In order to help the reader to find titles easily, the list is divided into two parts. In Part I, the full journal titles are grouped by country or international organization responsible for coverage and ordered alphabetically. In Part II, the full journal titles of all countries or international organizations are arranged alphabetically. The country name or the international organization name responsible for coverage of the journal title to INIS is entered in parentheses. Journal titles marked with an asterisk are regularly scanned by INIS. Titles that have been identified by INIS Centres as 'Key Journals' are marked with the hash sign

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.

Browse Title Index

African Journals Online (AJOL)

Items 201 - 250 of 488 ... African Journal of Paediatric Surgery. ... Ileocecal valve atresia: Introduction of a new surgical approach ... Vol 4, No 1 (2007), Isolated Bilateral Macrostomia: Case Series and ... Vol 9, No 2 (2012), Laparoscopic inguinal hernia repair in ... List All Titles · Free To Read Titles This Journal is Open Access.

Title V Workforce Development in the Era of Health Transformation.

Science.gov (United States)

Margolis, Lewis; Mullenix, Amy; Apostolico, Alexsandra A; Fehrenbach, Lacy M; Cilenti, Dorothy

2017-11-01

Purpose The National Maternal and Child Health Workforce Development Center at UNC Chapel Hill (the Center), funded by the Maternal and Child Health Bureau, provides Title V state/jurisdiction leaders and staff and partners from other sectors with opportunities to develop skills in quality improvement, systems mapping and analysis, change management, and strategies to enhance access to care to leverage and implement health transformation opportunities to improve the health of women and children. Description Since 2013, the Center has utilized a variety of learning platforms to reach state and jurisdiction Title V leaders. In the intensive training program, new skills and knowledge are applied to a state-driven health transformation project and include distance-based learning opportunities, multi-day, in-person training and/or onsite consultation, as well as individualized coaching to develop workforce skills. Assessment The first intensive cohort of eight states reported enhanced skills in the core areas of quality improvement, systems mapping and analysis, change management, and strategies to enhance access to care which guided changes at state system and policy levels. In addition, teams reported new and/or enhanced partnerships with many sectors, thereby leveraging Title V resources to increase its impact. Conclusion The Center's provision of core workforce skills and application to state-defined goals has enabled states to undertake projects and challenges that not only have a positive impact on population health, but also encourage collaborative, productive partnerships that were once found to be challenging-creating a workforce capable of advancing the health and wellbeing of women and children.

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

Directory of Open Access Journals (Sweden)

Riksman Janine S

2011-02-01

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

Intentions of Chiropractic Interns Regarding use of Health Promotion in Practice: Applying Theory of Reasoned Action to Identify Attitudes, Beliefs, and Influencing Factors

Science.gov (United States)

Evans, Marion W.; Ndetan, Harrison; Williams, Ronald D.

2009-01-01

Purpose: The theory of reasoned action is a health behavioral theory that has been used to predict personal health behaviors and intentions as well as those of providers delivering health care. The purpose of this study was to determine interns' future practices regarding the use of health promotion using this model to develop survey questions and to determine attitudes and perceived influences on their prospective behaviors in general, toward the use of health promotion once in practice. Methods: Across the course of one year, all graduating interns at a chiropractic college were queried with a 20 question survey designed using the theory of reasoned action. Frequencies and inferential statistics were performed including prediction modeling using logistic regression. Results: A majority (>85%) of interns indicated they would use health promotion in practice. Differences were noted based on perceived skill levels, perception of educational emphasis, various normative beliefs, and gender. Conclusion: Most interns will use some form of health promotion in practice. Normative influences including those seen as key influencers are as powerful a predictor as perceived education or skill levels on future practice of health promotion. PMID:19390679

Commentary on a framework for multicultural education.

Science.gov (United States)

Hammerich, Karin F

2014-09-01

Today's changing demographics require that multicultural factors be considered in the delivery of quality patient-centred health care in chiropractic. Yet minimal training in cultural competency in chiropractic education leaves graduates ill-equipped to treat a diverse population. This commentary examines cultural competency training in current literature, demonstrates frameworks for curriculum integration, and suggests how cultural competency might be included in a chiropractic college curriculum. A database search yielded little evidence that cultural competency is integrated into curricula of chiropractic schools. Some journal articles note that promoting multicultural education and cultural sensitivity is an important goal. However, they provide no mechanisms as to how this can be achieved within training programs. Thus, although an undeniable need exists for all healthcare practitioners to develop cultural competency in the face of an increasingly diverse population, cultural competency education has not kept pace. Chiropractic schools must review their curricula to develop the cultural competencies of their graduates and a basic framework is suggested.

Prevalence of nursing diagnoses in an intensive care unit

Directory of Open Access Journals (Sweden)

Vinicia de Holanda Cabral

2017-01-01

Full Text Available To identify the main nursing diagnostic titles used in the care of critically ill patients hospitalized in an Intensive Care Unit, verifying the presence thereof in the diagnoses of NANDA International’s Taxonomy II. Methods: descriptive and documental study, in which 69 medical records of patients aged over 18 years were consulted. Results: 22 nursing diagnostic titles were found; the most frequent was risk for infection (99.0%, risk for skin integrity (75.0% and risk for aspiration (61.0%. Most diagnoses were in the domains safety/ protection (43.0% and activity/rest (26.5%. Conclusions: authors identified the main nursing diagnostic titles used in the care of critically ill patients admitted to the Intensive Care Unit and the presence thereof in the diagnoses of NANDA International’s Taxonomy II.

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

Science.gov (United States)

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

2016-04-01

A reporting and learning system is a method of monitoring the occurrence of incidents that affect patient safety. This cross-sectional survey asked pediatric chiropractors about factors that may limit their participation in such a system. The list of potential barriers for participation was developed using a systematic approach. All members of the 2 pediatric councils associated with US national chiropractic organizations were invited to complete the survey (N = 400). The cross-sectional survey was created using an online survey tool (REDCap) and sent directly to member emails addressed by the respective executive committees. Of the 400 potential respondents, 81 responded (20.3%). The most common limitations to participating were identified as time pressure (96%) and patient concerns (81%). Reporting and learning systems have been utilized to increase safety awareness in many high-risk industries. To be successful, future patient safety studies with pediatric chiropractors need to ensure these barriers are understood and addressed. © The Author(s) 2015.

CAM therapies among primary care patients using opioid therapy for chronic pain

Directory of Open Access Journals (Sweden)

Mundt Marlon P

2007-05-01

Full Text Available Abstract Background Complementary and alternative medicine (CAM is an increasingly common therapy used to treat chronic pain syndromes. However; there is limited information on the utilization and efficacy of CAM therapy in primary care patients receiving long-term opioid therapy. Method A survey of CAM therapy was conducted with a systematic sample of 908 primary care patients receiving opioids as a primary treatment method for chronic pain. Subjects completed a questionnaire designed to assess utilization, efficacy and costs of CAM therapies in this population. Results Patients were treated for a variety of pain problems including low back pain (38.4%, headaches (9.9%, and knee pain (6.5%; the average duration of pain was 16 years. The median morphine equivalent opioid dose was 41 mg/day, and the mean dose was 92 mg/day. Forty-four percent of the sample reported CAM therapy use in the past 12 months. Therapies utilized included massage therapy (27.3%, n = 248, chiropractic treatment (17.8%, n = 162, acupuncture (7.6%, n = 69, yoga (6.1%, n = 55, herbs and supplements (6.8%, n = 62, and prolotherapy (5.9%, n = 54. CAM utilization was significantly related to age female gender, pain severity income pain diagnosis of neck and upper back pain, and illicit drug use. Medical insurance covered chiropractic treatment (81.8% and prolotherapy (87.7%, whereas patients primarily paid for other CAM therapies. Over half the sample reported that one or more of the CAM therapies were helpful. Conclusion This study suggests CAM therapy is widely used by patients receiving opioids for chronic pain. Whether opioids can be reduced by introducing such therapies remains to be studied.

CAM therapies among primary care patients using opioid therapy for chronic pain.

Science.gov (United States)

Fleming, Sara; Rabago, David P; Mundt, Marlon P; Fleming, Michael F

2007-05-16

Complementary and alternative medicine (CAM) is an increasingly common therapy used to treat chronic pain syndromes. However; there is limited information on the utilization and efficacy of CAM therapy in primary care patients receiving long-term opioid therapy. A survey of CAM therapy was conducted with a systematic sample of 908 primary care patients receiving opioids as a primary treatment method for chronic pain. Subjects completed a questionnaire designed to assess utilization, efficacy and costs of CAM therapies in this population. Patients were treated for a variety of pain problems including low back pain (38.4%), headaches (9.9%), and knee pain (6.5%); the average duration of pain was 16 years. The median morphine equivalent opioid dose was 41 mg/day, and the mean dose was 92 mg/day. Forty-four percent of the sample reported CAM therapy use in the past 12 months. Therapies utilized included massage therapy (27.3%, n = 248), chiropractic treatment (17.8%, n = 162), acupuncture (7.6%, n = 69), yoga (6.1%, n = 55), herbs and supplements (6.8%, n = 62), and prolotherapy (5.9%, n = 54). CAM utilization was significantly related to age female gender, pain severity income pain diagnosis of neck and upper back pain, and illicit drug use. Medical insurance covered chiropractic treatment (81.8%) and prolotherapy (87.7%), whereas patients primarily paid for other CAM therapies. Over half the sample reported that one or more of the CAM therapies were helpful. This study suggests CAM therapy is widely used by patients receiving opioids for chronic pain. Whether opioids can be reduced by introducing such therapies remains to be studied.

32 CFR 644.62 - Title evidence.

Science.gov (United States)

2010-07-01

... HANDBOOK Acquisition Procurement of Title Evidence, Title Clearance, and Closings § 644.62 Title evidence... and their charter to issue the same. They must also be financially sound and be willing and able to...

Title to mining properties

International Nuclear Information System (INIS)

Crouch, K.M.

1976-01-01

The requirements of the law which must be met in order to create title to an unpatented mining claim and the procedures which should be followed when an attempt is made to determine the title to the claim is acceptable are reviewed

Post-traumatic upper cervical subluxation visualized by MRI: a case report

Directory of Open Access Journals (Sweden)

Demetrious James

2007-12-01

Full Text Available Abstract Background This paper describes MRI findings of upper cervical subluxation due to alar ligament disruption following a vehicular collision. Incidental findings included the presence of a myodural bridge and a spinal cord syrinx. Chiropractic management of the patient is discussed. Case presentation A 21-year old female presented with complaints of acute, debilitating upper neck pain with unremitting sub-occipital headache and dizziness following a vehicular collision. Initial emergency department and neurologic investigations included x-ray and CT evaluation of the head and neck. Due to persistent pain, the patient sought chiropractic care. MRI of the upper cervical spine revealed previously unrecognized clinical entities. Conclusion This case highlights the identification of upper cervical ligamentous injury that produced vertebral subluxation following a traumatic incident. MRI evaluation provided visualization of previously undetected injury. The patient experienced improvement through chiropractic care.

Primary Medical Care in Chile

DEFF Research Database (Denmark)

Scarpaci, Joseph L.

Primary medical care in Chile: accessibility under military rule [Front Cover] [Front Matter] [Title Page] Contents Tables Figures Preface Chapter 1: Introduction Chapter 2: The Restructuring of Medical Care Financing in Chile Chapter 3: Inflation and Medical Care Accessibility Chapter 4: Help......-Seeking Behavior of the Urban Poor Chapter 5: Spatial Organization and Medical Care Accessibility Chapter 6: Conclusion...

INIS: Authority list for journal titles

International Nuclear Information System (INIS)

2005-01-01

This is the 31st revision of the INIS: Authority List for Journal Titles (IAEA-INIS-11). This list is published annually and includes the titles of all journals which have contained articles submitted to INIS at the time of publication. The current list contains 13,104 journal titles, 2,078 regularly scanned journals and 561 key journals. It was last updated in February 2005. The purpose of this report is to provide descriptive cataloguers with a standard entry for the full title of a journal. In addition to the full journal title, the ISSN (International Standard Serial Number), administered by the ISSN International Centre, Paris, France, and/or CODEN, assigned by Chemical Abstracts Service, USA, are given in this manual. In order to help the user find titles easily, the list is arranged in six parts, followed by summary statistics: In Part I, all key journals are grouped under the name of the country or international organization responsible for their input in INIS, then sorted alphabetically under their title. In Part II, all key journals are sorted alphabetically under their title. The name of the country or international organization responsible for their input in INIS is entered in parentheses within the body of the entry. In Part III, all journals that are regularly scanned by INIS Centers are grouped under the name of the country or international organization responsible for their input in INIS, then sorted alphabetically under their title. In Part IV, all journals that are regularly scanned by INIS Centers are sorted alphabetically under their title. The name of the country or international organization responsible for their input in INIS is entered in parentheses within the body of the entry. In Part V, all journals are grouped under the name of the country or international organization responsible for their input in INIS, then sorted alphabetically under their title. In Part VI, all journals are sorted alphabetically under their title. The name of the

INIS: Authority list for journal titles

Energy Technology Data Exchange (ETDEWEB)

NONE

2005-03-01

This is the 31st revision of the INIS: Authority List for Journal Titles (IAEA-INIS-11). This list is published annually and includes the titles of all journals which have contained articles submitted to INIS at the time of publication. The current list contains 13,104 journal titles, 2,078 regularly scanned journals and 561 key journals. It was last updated in February 2005. The purpose of this report is to provide descriptive cataloguers with a standard entry for the full title of a journal. In addition to the full journal title, the ISSN (International Standard Serial Number), administered by the ISSN International Centre, Paris, France, and/or CODEN, assigned by Chemical Abstracts Service, USA, are given in this manual. In order to help the user find titles easily, the list is arranged in six parts, followed by summary statistics: In Part I, all key journals are grouped under the name of the country or international organization responsible for their input in INIS, then sorted alphabetically under their title. In Part II, all key journals are sorted alphabetically under their title. The name of the country or international organization responsible for their input in INIS is entered in parentheses within the body of the entry. In Part III, all journals that are regularly scanned by INIS Centers are grouped under the name of the country or international organization responsible for their input in INIS, then sorted alphabetically under their title. In Part IV, all journals that are regularly scanned by INIS Centers are sorted alphabetically under their title. The name of the country or international organization responsible for their input in INIS is entered in parentheses within the body of the entry. In Part V, all journals are grouped under the name of the country or international organization responsible for their input in INIS, then sorted alphabetically under their title. In Part VI, all journals are sorted alphabetically under their title. The name of the

INIS: Authority list for journal titles

International Nuclear Information System (INIS)

2006-01-01

This is the 32nd revision of the INIS: Authority List for Journal Titles (IAEA-INIS-11). This list is published annually and includes the titles of all journals which have contained articles submitted to INIS at the time of publication. The current list contains 13,231 journal titles, 2,125 regularly scanned journals and 555 key journals. It was last updated in February 2006. The purpose of this report is to provide descriptive cataloguers with a standard entry for the full title of a journal. In addition to the full journal title, the ISSN (International Standard Serial Number), administered by the ISSN International Centre, Paris, France, and/or CODEN, assigned by Chemical Abstracts Service, USA, are given in this manual. In order to help the user find titles easily, the list is arranged in six parts, followed by summary statistics: In Part I, all key journals are grouped under the name of the country or international organization responsible for their input in INIS, then sorted alphabetically under their title. In Part II, all key journals are sorted alphabetically under their title. The name of the country or international organization responsible for their input in INIS is entered in parentheses within the body of the entry. In Part III, all journals that are regularly scanned by INIS Centres are grouped under the name of the country or international organization responsible for their input in INIS, then sorted alphabetically under their title. In Part IV, all journals that are regularly scanned by INIS Centres are sorted alphabetically under their title. The name of the country or international organization responsible for their input in INIS is entered in parentheses within the body of the entry. In Part V, all journals are grouped under the name of the country or international organization responsible for their input in INIS, then sorted alphabetically under their title. In Part VI, all journals are sorted alphabetically under their title. The name of the

Chiropractic manipulative therapy of the thoracic spine in combination with stretch and strengthening exercises, in improving postural kyphosis in woman

Directory of Open Access Journals (Sweden)

Kim Castello Branco

2016-12-01

Conclusion: The study showed that all three treatment protocols for Groups 1, 2, and 3 were effective. However, Group 1 had not shown a great improvement in their postural kyphosis, Group 3 had shown a relatively good improvement in their posture, while Group 2 had shown the best results with regards to improvement of the participants' posture. Therefore, in conclusion, Groups 2 and 3 treatment protocols can be used effectively to treat postural kyphosis but Group 2's treatment protocol, consisting of chiropractic spinal manipulative therapy to the thoracic spine in combination with stretch and strengthening exercises, will yield the best results.

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......-pelvic spine were included. DATA EXTRACTION: Data quality were assessed independently by the two reviewers, with a quality score based on predefined methodologic criteria. Results of the studies were then evaluated in relation to quality. DATA SYNTHESIS: None of the tests studied had been sufficiently...... evaluated in relation to reliability and validity. Only tests for palpation for pain had consistently acceptable results. Motion palpation of the lumbar spine might be valid but showed poor reliability, whereas motion palpation of the sacroiliac joints seemed to be slightly reliable but was not shown...

A better understanding of care

NARCIS (Netherlands)

Isolde Woittiez; Lisa Putman; Evelien Eggink; Michiel Ras

2014-01-01

Original title: Zorg beter begrepen Dutch government spending on care for people with an intellectual disability has been rising steeply for many years. This increase is due not so much to rising costs, but mainly to growth in demand for care. The profile of those applying for care has changed.

7 CFR 1927.55 - Title clearance services.

Science.gov (United States)

2010-01-01

... REGULATIONS TITLE CLEARANCE AND LOAN CLOSING Real Estate Title Clearance and Loan Closing § 1927.55 Title clearance services. (a) Responsibilities of closing agents. Services to be provided to the agency and the borrower by a closing agent in connection with the transaction vary depending on whether a title insurance...

Chiropractic care for back pain

Science.gov (United States)

... The chiropractor may also do other treatments, like massage and other work on soft tissues. Some people ... tumors Severe arthritis Bone or joint infections Severe osteoporosis (thinning bones) Severely pinched nerves Very rarely, manipulation ...

National Ignition Facility Title II Design Plan

International Nuclear Information System (INIS)

Kumpan, S

1997-01-01

This National Ignition Facility (NIF) Title II Design Plan defines the work to be performed by the NIF Project Team between November 1996, when the U.S. Department of Energy (DOE) reviewed Title I design and authorized the initiation of Title H design and specific long-lead procurements, and September 1998, when Title 11 design will be completed

24 CFR 202.12 - Title II.

Science.gov (United States)

2010-04-01

... INSTITUTIONS AND MORTGAGEES Title I and Title II Specific Requirements § 202.12 Title II. (a) Tiered pricing—(1... rate up to two percentage points under the mortgagee's customary lending practices must be based on... after accounting for the value of servicing rights generated by making the loan and other income to the...

INIS: Authority list for journal titles

International Nuclear Information System (INIS)

2007-01-01

This is the 33rd revision of the INIS: Authority List for Journal Titles (IAEA-INIS-11). This list is published annually and includes the titles of all journals which have contained articles submitted to INIS at the time of publication. The current list contains 13 396 journal titles, 2 170 regularly scanned journals and 578 key journals. It was last updated in February 2007. A journal - or periodical - is a continuing publication issued in a succession of discrete parts, usually bearing numbering and/or chronological designations and intended to be continued indefinitely. It is generally published within a defined, fixed interval between issues and normally appears more than once per year. It includes a mixture of articles, letters, summaries, etc. Within this definition, annuals such as the Annual Review of Nuclear Science are included, but series titles such as the McGraw-Hill Series in Nuclear Engineering are not. The purpose of this document is to provide descriptive cataloguers with standard elements to include in bibliographic level 'S' of the INIS record. These elements include field (tag) 229 (Full Journal Title), 320 (ISSN) and 321 (CODEN). The full journal title is mandatory, and either the ISSN or the CODEN must be included (both may appear). Instructions on how to use this and other elements of the INIS record format are found in INIS: Guide to Bibliographic Description (IAEA-INIS-1). In order to help the user find titles easily, the list is arranged in six parts, followed by summary statistics: - In Part I, all key journals are grouped under the name of the country or international organization responsible for their input in INIS, then sorted alphabetically under their title. - In Part II, all key journals are sorted alphabetically under their title. The name of the country or international organization responsible for their input in INIS is entered in parentheses within the body of the entry. - In Part III, all journals that are regularly scanned by

20 CFR 416.573 - How much will we withhold from your title II and title VIII benefits to recover a title XVI...

Science.gov (United States)

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false How much will we withhold from your title II... Payment of Benefits, Overpayments, and Underpayments § 416.573 How much will we withhold from your title...-due benefits. (b)(1) We will collect the overpayment from current monthly benefits due in a month by...

Long Term Care

Science.gov (United States)

... can help! CLICK HERE TO FIND YOUR LOCAL SOCIAL WORKER. Futher Reading ARTICLE TITLE AUTHOR HDSA PUBLICATION DATE Choosing Home Healthcare Assistance The Marker Fall 2001 Palliative Care in Huntington’s Disease Richard ...

INIS: Authority list for journal titles

International Nuclear Information System (INIS)

2008-01-01

This is the 34th revision of the INIS: Authority List for Journal Titles (IAEA-INIS-11). This list is published annually and includes the titles of all journals which have contained articles submitted to INIS at the time of publication. The current list contains 13 538 journal titles, 2 106 regularly scanned journals and 613 key journals. It was last updated in February 2008. A journal - or periodical - is a continuing publication issued in a succession of discrete parts, usually bearing numbering and/or chronological designations and intended to be continued indefinitely. It is generally published within a defined, fixed interval between issues and normally appears more than once per year. It includes a mixture of articles, letters, summaries, etc. Within this definition, annuals such as the Annual Review of Nuclear Science are included, but series titles such as the McGraw-Hill Series in Nuclear Engineering are not. The purpose of this document is to provide descriptive cataloguers with standard elements to include in bibliographic level 'S' of the INIS record. These elements include field (tag) 229 (Full Journal Title), 320 (ISSN) and 321 (CODEN). The full journal title is mandatory, and either the ISSN or the CODEN must be included (both may appear). Instructions on how to use this and other elements of the INIS record format are found in INIS: Guide to Bibliographic Description (IAEA-INIS-1). In order to help the user find titles easily, the list is arranged in six parts, followed by summary statistics: - In Part I, all key journals are grouped under the name of the country or international organization responsible for their input in INIS, then sorted alphabetically under their title. - In Part II, all key journals are sorted alphabetically under their title. The name of the country or international organization responsible for their input in INIS is entered in parentheses within the body of the entry. - In Part III, all journals that are regularly scanned by

75 FR 32480 - Funding Opportunity: Affordable Care Act Medicare Beneficiary Outreach and Assistance Program...

Science.gov (United States)

2010-06-08

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Administration on Aging Funding Opportunity: Affordable Care Act Medicare Beneficiary Outreach and Assistance Program Funding for Title VI Native American Programs Purpose of Notice: Availability of funding opportunity announcement. Funding Opportunity Title/Program Name: Affordable Care Act Medicare...

45 CFR 1356.71 - Federal review of the eligibility of children in foster care and the eligibility of foster care...

Science.gov (United States)

2010-10-01

..., DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION ON CHILDREN, YOUTH AND FAMILIES, FOSTER CARE... foster care and the eligibility of foster care providers in title IV-E programs. 1356.71 Section 1356.71... § 1356.71 Federal review of the eligibility of children in foster care and the eligibility of foster care...

Land Titles and Rice Production in Vietnam

DEFF Research Database (Denmark)

Van Den Broeck, Katleen; Newman, Carol; Tarp, Finn

In most of the empirical literature on land titling, the household is regarded as unitary, and land rights are found to have ambiguous effects on land allocation, investment and productivity. Using data from 12 provinces in Vietnam, we diversify land titles, and show in a household fixed effects...... analysis of plot level rice yields that land titles are indeed important. Only exclusively held titles have the expected positive effects, and the positive effect on yields is found in male headed households. Furthermore, a household level rice yield function reveals that exclusive user rights...... are inefficiency decreasing, while jointly held user rights have no efficiency effects. Finally, once the gender of the head of household is controlled for, exclusively held female titles have a greater positive effect on the efficiency of the household than that of male held titles...

Functional disability in patients with low back pain: the mediator role of suffering and beliefs about pain control in patients receiving physical and chiropractic treatment.

Science.gov (United States)

Pereira, M Graça; Roios, Edite; Pereira, Marta

Low back pain is the leading cause of disability worldwide. There is evidence that depression, anxiety, and external locus of control are negative predictors of functional disability in low back patients. This study focused on the mediator role of suffering and beliefs about pain control in the relationship between psychological morbidity and functional disability in patients receiving physical therapy and chiropractic treatment for chronic low back pain. The sample included 213 patients receiving chiropractic treatment and 125 receiving physical therapy, who answered the following instruments: Beliefs about Pain Control Questionnaire; Inventory of Subjective Experiences of Suffering in Illness; Oswestry Low Back Pain Disability Questionnaire; and the Hospital Anxiety and Depression Scales. Suffering was a mediator in the relationship between depression and functional disability in both treatment groups. Only beliefs related to external chance events mediated the relationship between depression and functional disability in the physical therapy group, but not in the chiropratic teratment group. Intervention should focus on suffering regardless of the type of treatment and target beliefs about pain control, in patients receiving physical therapy treatment since they seem to play a key role in functional disability in patients with low back pain. Copyright © 2017 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. Publicado por Elsevier Editora Ltda. All rights reserved.

Quarterly title list for the period ending June 1980

International Nuclear Information System (INIS)

1980-01-01

The title list contains: a) 17 titles and abstracts of laboratory reports, b) 36 titles of publications (32 with abstracts), c) 13 titles of articles submitted for publication (12 with abstracts), and d) 72 titles of lectures (52 with abstracts.) (GG) [de

Title of the paper goes here second line

Indian Academy of Sciences (India)

%%Please download if these packages are not included %%in your local TeX distribution %%txfonts,balance,textcase,float %% \\begin{document} %%paper title %%For line breaks, \\\\ can be used within title \\title{Title of the paper goes here\\\\ second line} %%author names are separated by comma (,) %%use \\and before ...

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.

Beyond the spine

DEFF Research Database (Denmark)

Donovan, James; Cassidy, J David; Cancelliere, Carol

2015-01-01

Over the past two decades, clinical research within the chiropractic profession has focused on the spine and spinal conditions, specifically neck and low back pain. However, there is now a small group of chiropractors with clinical research training that are shifting their focus away from...... highlight recent research in these new areas and discuss how clinical research efforts in musculoskeletal areas beyond the spine can benefit patient care and the future of the chiropractic profession....

INIS: Authority list for journal titles

International Nuclear Information System (INIS)

2009-01-01

This is the 35th revision of the INIS: Authority List for Journal Titles (IAEA-INIS-11). This list is published annually and includes the titles of all journals which have contained articles submitted to INIS at the time of publication. The current list contains 13 750 journal titles, 1 965 regularly scanned journals and 593 key journals. It was last updated in March 2009. A journal - or periodical - is a continuing publication issued in a succession of discrete parts, usually bearing numbering and/or chronological designations and intended to be continued indefinitely. It is generally published within a defined, fixed interval between issues and normally appears more than once per year. It includes a mixture of articles, letters, summaries, etc. Within this definition, annuals such as the Annual Review of Nuclear Science are included, but series titles such as the McGraw-Hill Series in Nuclear Engineering are not. The purpose of this document is to provide descriptive cataloguers with standard elements to include in bibliographic level 'S' of the INIS record. These elements include field (tag) 229 (Full Journal Title), 320 (ISSN) and 321 (CODEN). The full journal title is mandatory, and either the ISSN or the CODEN must be included (both may appear). Instructions on how to use this and other elements of the INIS record format are found in INIS: Guide to Bibliographic Description (IAEA-INIS-1). In order to help the user find titles easily, the list is arranged in six parts, followed by summary statistics: - In Part I, all key journals are grouped under the name of the country or international organization responsible for their input in INIS, then sorted alphabetically under their title. - In Part II, all key journals are sorted alphabetically under their title. The name of the country or international organization responsible for their input in INIS is entered in parentheses within the body of the entry. - In Part III, all journals that are regularly scanned by the

Are chiropractors in the uk primary healthcare or primary contact practitioners?: a mixed methods study

Directory of Open Access Journals (Sweden)

Jones-Harris Amanda R

2010-10-01

Full Text Available Abstract Background One of the debates regarding the role of chiropractors is whether or not they should be considered as primary healthcare practitioners. Primary care is often used to describe chiropractic but without any definition of what is meant by the term. Primary healthcare itself has many definitions and this adds to the problem. Existing research literature, based mostly in the USA, suggests that the use of the title "primary healthcare professional" by chiropractors is central to the identity of the profession. It has also been suggested that the concept of primary care is misused by chiropractors because they have not examined the concept in detail and thus do not understand it. For the sake of quality of patient care and for the legitimacy of the profession, chiropractors in the UK need to agree on their healthcare role. This study aimed to examine the opinions of chiropractors towards the use of the term primary healthcare when applied to chiropractic practice within the UK. Methods A sequential study of exploratory design was used; this model is characterised by an initial phase of qualitative data collection and analysis that precedes and informs the quantitative phase of data collection and analysis. In this study, interviews with members of chiropractic teaching faculty were used to inform the development of a questionnaire used to survey the opinions of chiropractors in the UK. Results There was a general consensus of opinion that chiropractors are primary contact practitioners, who work in a primary healthcare setting and that to be able to fulfil this healthcare role, chiropractors must be able to diagnose patients and refer when required. Participants did not feel that chiropractors are able to treat all of the most common medical conditions that present in a primary healthcare setting. Conclusions The findings of this study suggest that chiropractors in the UK view their role as one of a primary contact healthcare

24 CFR 203.385 - Types of satisfactory title evidence.

Science.gov (United States)

2010-04-01

... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Types of satisfactory title... Title Waivers § 203.385 Types of satisfactory title evidence. The following types of title evidence shall be satisfactory to the Commissioner: (a) Fee or owner's title policy. A fee or owner's policy of...

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

Directory of Open Access Journals (Sweden)

Huber Laura L

2006-08-01

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

A picture of care use

NARCIS (Netherlands)

Inger Plaisier; Mirjam de Klerk

2015-01-01

Original title: Zicht op zorggebruik The number of older people in the Netherlands is increasing, and people with chronic illnesses are living longer. This is likely to lead to a concomitant increase in care use. In order to control the costs of long-term care, Dutch government policy in this

Interprofessional education through shadowing experiences in multi-disciplinary clinical settings

Directory of Open Access Journals (Sweden)

Moore Ainsley E

2010-12-01

Full Text Available Abstract The World Health Organization has recently added Interprofessional Education (IPE to its global health agenda recognizing it as a necessary component of all health professionals' education. We suggest mandatory interprofessional shadowing experiences as a mechanism to be used by chiropractic institutions to address this agenda. IPE initiatives of other professions (pharmacy and medicine are described along with chiropractic. This relative comparison of professions local to our jurisdiction in Ontario, Canada is made so that the chiropractic profession may take note that they are behind other health care providers in implementing IPE. Interprofessional shadowing experiences would likely take place in a multi-disciplinary clinical setting. We offer an example of how two separate professions within a Family Health Team (FHT can work together in such a setting to enhance both student learning and patient care. For adult learners, using interprofessional shadowing experiences with learner-derived and active objectives across diverse health professional groups may help to improve the educational experience. Mandatory interprofessional shadowing experiences for chiropractors during their training can enhance future collaborative practice and provide success in reaching a goal common to each profession - improved patient care.

Formulating the Right Title for a Research Article.

Science.gov (United States)

Bavdekar, Sandeep B

2016-02-01

Title is an important part of the article. It condenses article content in a few words and captures readers' attention. A good title for a research article is the one which, on its own, is able to introduce the research work to the fullest extent, but in a concise manner. Writing scientific titles that are informative and attractive is a challenging task. This communication describes the importance of titles and the methods of creating appropriate titles for research papers. © Journal of the Association of Physicians of India 2011.

Quarterly title list for the period ending September 1976

International Nuclear Information System (INIS)

1976-01-01

The title list of the Max-Planck-Institut fuer Plasmaphysik and the Projektgruppe fuer Laserforschung of the MPG is concerned with the period from July until September 1976, and it contains: a) 12 titles and abstracts of laboratory reports, b) 37 titles of publications (30 abstracts), c) 20 titles of articles submitted for publication (16 abstracts), and d) 25 titles of lectures (12 abstracts). (GG) [de

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

Science.gov (United States)

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

2015-12-01

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

24 CFR 202.11 - Title I.

Science.gov (United States)

2010-04-01

... in 24 CFR 25.5. Civil money penalties may be imposed against Title I lenders and mortgagees pursuant... unacceptable risk to the Department; or (iv) Transfer of a Title I loan to a party that does not have a valid...

Chiropractors in Finland – a demographic survey

Directory of Open Access Journals (Sweden)

Malmqvist Stefan

2008-08-01

Full Text Available Abstract Background The Finnish chiropractic profession is young and not fully accepted by Finnish healthcare authorities. The demographic profile and style of practice has not been described to date. However, as the profession seems to be under rapid development, it would be of interest to stakeholders, both chiropractic and political, to obtain a baseline description of this profession with a view to the development of future goals and strategies for the profession. The purpose of this study was to describe the chiropractic profession in Finland in relation to its demographic background, the demographics of their clinics, practice patterns, interactions with other health care practitioners and some of the professions' plans for the future. Methods A structured questionnaire survey was conducted in 2005, in which all 50 members of the Finnish Chiropractic Union were invited to participate. Results In all, 44 questionnaires were returned (response rate 88%. Eighty percent of the respondents were men, and 77% were aged 30 to 44 years old, most of whom graduated after 1990 with either a university-based bachelors' or masters' degree in chiropractic. Solo practice was their main practice pattern. The vast majority described their scope of practice to be based on a musculoskeletal approach, using the Diversified Technique, performing Soft Tissue Therapy and about two-thirds also used an Activator Instrument (mechanical adjusting instrument. The mean number of patient visits reported to have been seen weekly was 59 of which nine were new patients. Most practitioners found this number of patients satisfactory. At the initial consultation, 80% of respondents spent 30–45 minutes with their patients, 75% spent 20–30 minutes with "new old" patients and on subsequent visits 80% of respondents spent 15–30 minutes. Interactions with other health care professions were reasonably good and most of chiropractors intended to remain within the profession

How property title impacts urban consolidation

DEFF Research Database (Denmark)

Easthope, Hazel; Warnken, Jan; Sherry, Cathy

2014-01-01

Continuing urbanisation is triggering an increase in multi-titled housing internationally. This trend has given rise to a substantial research interest in the social consequences of higher density living. Little enquiry, however, has been directed to examining how property title subdivisions gene...

The ties that bind: what's in a title?

Science.gov (United States)

Neuhaus, Susan J

2018-03-01

Many Australian and New Zealand surgeons use the title 'Mister' rather than 'Doctor', a practice dating back to traditions established over 600 years ago. The Royal Australasian College of Surgeons is currently undergoing a period of critical self-reflection, embodied by its 'Respect' campaign. Active measures to embrace diversity and encourage women into surgery are underway. This paper reviews the historical basis to the use of gendered titles and their current use amongst fellows. De-identified demographic data from the college register of active fellows was searched by self-identified title, country or state, and gender. Data were further reviewed by surgical sub-specialty and year of fellowship. The college dataset suggests that there is significant variance in the preference for gendered titles, determined predominantly by geography rather than specialty. The highest use of gendered titles (by male and female surgeons) was in Victoria/Tasmania (58% male, 22% female) and New Zealand (81% male, 17% female). By contrast, only 2% of female surgeons in other states elected a gendered title (Miss/Mrs/Ms). Surgery is the only profession that continues to use gendered titles. As the College of Surgeons moves towards greater equity and diversity, consideration should be given to phasing out the use of gendered titles, which serve to divide rather than unite our profession. © 2017 Royal Australasian College of Surgeons.

Songwriting in music-caring

DEFF Research Database (Denmark)

Jonsdottir, Valgerdur

2009-01-01

This paper introduces songwriting as a music therapeutic approach used in a research study in progress.  The title of the research is:  The lived experience of a group of mothers having young children with special-needs, participating ina music therapy group defined as music-caring within the fra......-up session.  The last interveiw was conducted the 4th of January 2007.  Baker, F., & Wigram, T. (Eds,), (2005). Songwriting: Methods, Techniques and Clinical Applications for Music Therapy Clinicians, Educators and Students.  London: Jessica Kingsley Publishers.......This paper introduces songwriting as a music therapeutic approach used in a research study in progress.  The title of the research is:  The lived experience of a group of mothers having young children with special-needs, participating ina music therapy group defined as music-caring within...... the framework of early intervention.  The paper discusses the rationale for choosing songwriting for providing music-caring, describes its progression, presents few songs, and some perspectives about its meaning. This paper presentation introduces songwriting as a central music therapeutic approach used...

Interprofessional collaboration and turf wars how prevalent are hidden attitudes?

Science.gov (United States)

Chung, Chadwick L R; Manga, Jasmin; McGregor, Marion; Michailidis, Christos; Stavros, Demetrios; Woodhouse, Linda J

2012-01-01

Interprofessional collaboration in health care is believed to enhance patient outcomes. However, where professions have overlapping scopes of practice (eg, chiropractors and physical therapists), "turf wars" can hinder effective collaboration. Deep-rooted beliefs, identified as implicit attitudes, provide a potential explanation. Even with positive explicit attitudes toward a social group, negative stereotypes may be influential. Previous studies on interprofessional attitudes have mostly used qualitative research methodologies. This study used quantitative methods to evaluate explicit and implicit attitudes of physical therapy students toward chiropractic. A paper-and-pencil instrument was developed and administered to 49 individuals (students and faculty) associated with a Canadian University master's entry-level physical therapy program after approval by the Research Ethics Board. The instrument evaluated explicit and implicit attitudes toward the chiropractic profession. Implicit attitudes were determined by comparing response times of chiropractic paired with positive versus negative descriptors. Mean time to complete a word association task was significantly longer (t = 4.75, p =.00) when chiropractic was associated with positive rather than negative words. Explicit and implicit attitudes were not correlated (r = 0.13, p =.38). While little explicit bias existed, individuals associated with a master's entry-level physical therapy program appeared to have a significant negative implicit bias toward chiropractic.

Interprofessional Collaboration and Turf Wars How Prevalent Are Hidden Attitudes?*

Science.gov (United States)

Chung, Chadwick L. R.; Manga, Jasmin; McGregor, Marion; Michailidis, Christos; Stavros, Demetrios; Woodhouse, Linda J.

2012-01-01

Purpose: Interprofessional collaboration in health care is believed to enhance patient outcomes. However, where professions have overlapping scopes of practice (eg, chiropractors and physical therapists), "turf wars" can hinder effective collaboration. Deep-rooted beliefs, identified as implicit attitudes, provide a potential explanation. Even with positive explicit attitudes toward a social group, negative stereotypes may be influential. Previous studies on interprofessional attitudes have mostly used qualitative research methodologies. This study used quantitative methods to evaluate explicit and implicit attitudes of physical therapy students toward chiropractic. Methods: A paper-and-pencil instrument was developed and administered to 49 individuals (students and faculty) associated with a Canadian University master's entry-level physical therapy program after approval by the Research Ethics Board. The instrument evaluated explicit and implicit attitudes toward the chiropractic profession. Implicit attitudes were determined by comparing response times of chiropractic paired with positive versus negative descriptors. Results: Mean time to complete a word association task was significantly longer (t = 4.75, p =.00) when chiropractic was associated with positive rather than negative words. Explicit and implicit attitudes were not correlated (r = 0.13, p =.38). Conclusions: While little explicit bias existed, individuals associated with a master's entry-level physical therapy program appeared to have a significant negative implicit bias toward chiropractic PMID:22778528

40 CFR 300.220 - Related Title III issues.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 27 2010-07-01 2010-07-01 false Related Title III issues. 300.220 Section 300.220 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SUPERFUND, EMERGENCY... PLAN Planning and Preparedness § 300.220 Related Title III issues. Other related Title III requirements...

Browse Title Index

African Journals Online (AJOL)

Items 151 - 200 of 437 ... Journal Home > Advanced Search > Browse Title Index ... prospects and realistic strategies to its implementation in Nigeria\\'s Institute of ... and Communication Technology (ICT) in information dissemination, Abstract.

Browse Title Index

African Journals Online (AJOL)

1986), University Engineering Education and Training in Nigeria: Development, ... Vol 29, No 1 (2010), Use of Energy Method to Simulate the ... of Optimal Rational Composition of Titles Producible from Nigerian Clays ...

Roadmap Through Title XX. Financing Services for Children Through Title XX and Other Programs: Manual 5.

Science.gov (United States)

Copeland, William C.; Iversen, Iver A.

This manual, part of a Hecht Institute four-manual series entitled Financing Children's Services Through Title XX and Related Programs, teaches what Title XX regulations are, what they mean, and what actions and procedures are commanded by them. The first section covers the necessity of rule systems, the characteristics of a good rule system and…

Title X may get 10% funding increase despite cutbacks for deficit.

Science.gov (United States)

Kaeser, L

1994-04-01

The politics of the US budget deficit and President's Clinton proposed health budget are described. The proposed health budget included the following items and expenditure levels: Title X planning with a 10% increase to 199 million; abstinence-based programs deleted and funding directed to the Office of Adolescent Health for $6.8 million; Community Health Centers with a 1% increase to $604 million; WIC with a 12% increase to $3.7 billion; Title IIIb of the Ryan White CARE Act on AIDS prevention with a 40% increase to $67 million; National Institute of Child Heath and Human Development, including contraceptive research, with a 5% increase to $581 million; Sexually Transmitted Disease Prevention for $100 million; Breast and Cervical Cancer Screening for $78 million; and Maternal and Child Health Block Grant with a 1% increase to $679 million. Abortion funding for poor women was an item deleted from the appropriations budget for the next fiscal year, because of its inclusion in health care reform. Final funding levels may diverge greatly from Clinton's proposed budget outlined above. Appropriations subcommittees will consider funding for each of the departments. There is no certainty on how the administration will support the proposed budget, or what actions on health care reform will impact on appropriations. If the cost of health care reform is enough, it may be that other health funding will be cut. The president's budget was sent to Congress on February 7, 1994, and included mandatory entitlement programs, which are 66% of the entire federal budget, and discretionary spending, such as for family planning. The prior Bush and Reagan administrations reduced discretionary funding, and Clinton is in the awkward position of having politically supported both increased health funding and federal budget reduction. The agreement between Congress and President Clinton in 1993 to cut federal spending over the next 5 years has reduced the ability to include new spending.

Browse Title Index

African Journals Online (AJOL)

Items 51 - 100 of 346 ... Journal Home > Advanced Search > Browse Title Index ... and hygiene promotion services in Rungwe district, Tanzania, Abstract .... as seen in NIgerian teaching hospital: pattern and a simple classification, Abstract.

33 CFR 401.1 - Short title.

Science.gov (United States)

2010-07-01

... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Short title. 401.1 Section 401.1 Navigation and Navigable Waters SAINT LAWRENCE SEAWAY DEVELOPMENT CORPORATION, DEPARTMENT OF TRANSPORTATION SEAWAY REGULATIONS AND RULES Regulations § 401.1 Short title. These regulations may be cited as the...

Browse Title Index

African Journals Online (AJOL)

Items 51 - 100 of 153 ... Issue, Title. Vol 9, No 2 (2006):, Effects of efficient water utilisation on water resources development in Swaziland under climate change, Abstract .... Ethical, Indigenous and Socio-Economic Perspectives, Abstract.

Inscribing Authority: Female Title Bearers in Jewish Inscriptions

Directory of Open Access Journals (Sweden)

Carrie Duncan

2012-02-01

Full Text Available This paper investigates representations of gender in the material culture of the ancient synagogue. The pertinent data are numerous dedicatory and funerary inscriptions linking individual Jews, men and women, with titles seemingly associated with leadership in Late Antique synagogues (ca. 200–600 CE. Bernadette Brooten’s influential 1982 monograph argued against the prevailing tendency to characterize these titles as indications of power, authority, and responsibility when associated with men but as meaningless flattery when applied to women. She suggests that synagogue titles denote power, authority and responsibility on all title bearers equally, both men and women. I question the continued utility of proffering female title-holders as enumerable examples of powerful women rescued from their forgotten place in history. Using theoretical insights developed by historians Elizabeth Clark and Gabrielle Spiegel, this paper will engage a comparative analysis with the work of Riet van Bremen and Saba Mahmood to develop new methods of conceptualizing women’s authority in early Jewish communities. I propose that viewing women’s synagogue titles as culturally constructed representations allows for a fruitful inquiry into how women’s titles were used by male-dominated synagogue communities in their self-articulation and public presentation of Judaism.

31 CFR 505.01 - Short title.

Science.gov (United States)

2010-07-01

... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Short title. 505.01 Section 505.01 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN... CERTAIN MERCHANDISE BETWEEN FOREIGN COUNTRIES § 505.01 Short title. The regulations in this part may be...

18 CFR 415.1 - Short title.

Science.gov (United States)

2010-04-01

... 18 Conservation of Power and Water Resources 2 2010-04-01 2010-04-01 false Short title. 415.1 Section 415.1 Conservation of Power and Water Resources DELAWARE RIVER BASIN COMMISSION ADMINISTRATIVE MANUAL BASIN REGULATIONS-FLOOD PLAIN REGULATIONS Generally § 415.1 Short title. This part shall be known...

Student Achievement in Title I Schools

Science.gov (United States)

Diaz, Abby T.

2017-01-01

This researcher seeks to answer the following question: How did two elementary Title I schools, identified as "high performing" on the first Smarter Balanced assessment, address elements of Maslow's hierarchy of needs when developing school-wide initiatives to enhance student achievement? Many students in Title I schools face barriers to…

Browse Title Index

African Journals Online (AJOL)

Items 101 - 150 of 183 ... Journal Home > Advanced Search > Browse Title Index ... Vol 61 (2017), New interventions and sustainable solutions: .... Vol 35 (2011), Resurgence of tribal levies: Double taxation for the rural poor, Abstract PDF.

Browse Title Index

African Journals Online (AJOL)

Items 901 - 950 of 1355 ... Journal of Applied Sciences and Environmental Management. ... Journal Home > Advanced Search > Browse Title Index .... Vol 22, No 2 (2018), Performance evaluation of a locally fabricated sawdust fired oven for ...

Browse Title Index

African Journals Online (AJOL)

Items 101 - 150 of 465 ... Journal Home > Advanced Search > Browse Title Index ... and twinning data of an igbo kindred during the Nigerian Civil War, Abstract ... on laboratory estimations with special reference to clinical chemistry, Abstract.

Browse Title Index

African Journals Online (AJOL)

Items 101 - 150 of 533 ... Southern African Linguistics and Applied Language Studies. ... Issue, Title ... Vol 34, No 1 (2016), Book Review: Qualitative-Quantitative Analyses of .... The complex consonants of simple CV-syllables in Zezuru, Abstract.

Browse Title Index

African Journals Online (AJOL)

Items 1 - 50 of 644 ... Journal Home > Advanced Search > Browse Title Index. Log in or ... Ethics review n international health research: quality assurance or bureaucratic nightmare? Details ... Audit of Management of Open Fractures, Details PDF.

Browse Title Index

African Journals Online (AJOL)

Items 1 - 50 of 165 ... Journal Home > Advanced Search > Browse Title Index ... Vol 43 (2011), Assessment of the Learning Commons takeoff at the University of ... the archive of South Africa's Truth and Reconciliation Commission, Abstract.

Neck pain in children: a retrospective case series.

Science.gov (United States)

Cox, Jocelyn; Davidian, Christine; Mior, Silvano

2016-09-01

Spinal pain in the paediatric population is a significant health issue, with an increasing prevalence as they age. Paediatric patients attend for chiropractor care for spinal pain, yet, there is a paucity of quality evidence to guide the practitioner with respect to appropriate care planning. A retrospective chart review was used to describe chiropractic management of paediatric neck pain. Two researchers abstracted data from 50 clinical files that met inclusion criteria from a general practice chiropractic office in the Greater Toronto Area, Canada. Data were entered into SPSS 15 and descriptively analyzed. Fifty paediatric neck pain patient files were analysed. Patients' age ranged between 6 and 18 years (mean 13 years). Most (98%) were diagnosed with Grade I-II mechanical neck pain. Treatment frequency averaged 5 visits over 19 days; with spinal manipulative therapy used in 96% of patients. Significant improvement was recorded in 96% of the files. No adverse events were documented. Paediatric mechanical neck pain appears to be successfully managed by chiropractic care. Spinal manipulative therapy appears to benefit paediatric mechanical neck pain resulting from day-today activities with no reported serious adverse events. Results can be used to inform clinical trials assessing effectiveness of manual therapy in managing paediatric mechanical neck pain.

Browse Title Index

African Journals Online (AJOL)

Items 101 - 150 of 414 ... Journal Home > Advanced Search > Browse Title Index. Log in or ... of an algebraic function for the permutation of truth table columns, Abstract ... appraisal and productivity levels in selected Nigerian universities, Abstract.

25 CFR 151.13 - Title examination.

Science.gov (United States)

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false Title examination. 151.13 Section 151.13 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND AND WATER LAND ACQUISITIONS § 151.13 Title examination. If the Secretary determines that he will approve a request for the acquisition of land from...

Title IX: With New Opportunities, Girls' Interest Rises

Science.gov (United States)

Toporek, Bryan

2012-01-01

On June 23, 1972, President Richard M. Nixon signed into law Title IX of the Education Amendments of 1972, which prohibits gender discrimination in any federally financed education program or activity. Title IX is far-reaching, but the law is most often associated with school and college athletics. Title IX allows schools to prove their athletic…

Unravelling functional neurology: a scoping review of theories and clinical applications in a context of chiropractic manual therapy.

Science.gov (United States)

Meyer, Anne-Laure; Meyer, Amanda; Etherington, Sarah; Leboeuf-Yde, Charlotte

2017-01-01

Functional Neurology (FN), a seemingly attractive treatment approach used by some chiropractors, proposes to have an effect on a multitude of conditions but some of its concepts are controversial. A scoping review was performed to describe, in the context of chiropractic manual therapy, 1) the FN theories, and 2) its clinical applications (i.e. its indications, examination procedures, treatment modalities, treatment plans, and clinical outcomes) using four sources: i) one key textbook, ii) the scientific peer-reviewed literature, iii) websites from chiropractors using FN, and iv) semi-structured interviews of chiropractors using FN. The scientific literature was searched in PubMed, PsycINFO, and SPORTDiscus, completed by a hand search in the journal Functional Neurology, Rehabilitation and Ergonomics (November 2016 and March 2017, respectively). The only textbook on the topic we found was included and articles were chosen if they had an element of manual therapy. There was no restriction for study design but discussion papers were excluded. Websites were found in Google using the search term "Functional Neurology". Chiropractors, known to use FN, were invited based on their geographical location. Theories were mainly uncovered in the textbook as were all aspects of the clinical applications except treatment plans. The other three sources were used for the five aspects of clinical applications. Results were summarized and reported extensively in tables. Eleven articles were included, five websites scrutinized, and four semi-structured interviews performed. FN is based on the belief that reversible lesions in the nervous system are the cause of a multitude of conditions and that specific clusters of neurons can be positively affected by manipulative therapy, but also by many other stimuli. Diagnostic procedures include both conventional and unusual tests, with an interpretation specific to FN. Initial treatment is intense and clinical outcomes reported as positive

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African Journals Online (AJOL)

Items 151 - 200 of 879 ... South African Journal of Higher Education. ... Browse Title Index ... in a USA school setting: Merging transition theory with a narrative approach, Abstract ... Citation analysis of theses and dissertations submitted at the ...

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African Journals Online (AJOL)

Items 1 - 50 of 130 ... Journal Home > Advanced Search > Browse Title Index. Log in or ... using the technological pedagogical content knowledge(TPACK) framework, Abstract PDF ... Tamara N. Hrin, Dušica D. Milenković, Mirjana D. Segedinac.

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African Journals Online (AJOL)

Items 101 - 150 of 278 ... Journal Home > Advanced Search > Browse Title Index ... drie paradigmas beskou: 'n eenheid, of 'n veelheid van perspektiewe? ... Vol 45, No 1 (2011), Genre pedagogy in the mediation of socially-situated literacies ...

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African Journals Online (AJOL)

Items 251 - 300 of 1260 ... Journal Home > Advanced Search > Browse Title Index ... Consumption of ammonia-nitrogen by aob in immobilized batch culture, Abstract PDF .... Vol 9, No 3S (2017): Special Issue, Design an automatic temperature ...

Browse Title Index

African Journals Online (AJOL)

Items 1 - 50 of 147 ... Journal Home > Advanced Search > Browse Title Index .... Library (TEEAL) Database among faculty members in Federal University, ... Vol 5, No 2 (2014), Effects of corporate culture on the implementation of automation in ...

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African Journals Online (AJOL)

Items 201 - 250 of 531 ... Journal Home > Advanced Search > Browse Title Index ... thermal conductivity and viscosity in a flat plate solar collector, Abstract PDF .... similarity method in unsteady two-dimensional MHD boundary layer on the body ...

78 FR 48941 - Advisory Committee on Prosthetics and Special-Disabilities Programs, Notice of Meeting

Science.gov (United States)

2013-08-12

... receive briefings on the Blind Rehabilitation Program, Chiropractic Care, Audiology and Speech Pathology... briefing on Telemedicine. No time will be allocated for receiving oral presentations from the public...

Competition between informal care and paid work

NARCIS (Netherlands)

Edith Josten; Alice de Boer

2015-01-01

Oringinal title: Concurrentie tussen mantelzorg en betaald werk The Dutch government would like citizens to provide more care to loved ones who need it – perhaps caring for an elderly parent or looking after a partner with a long-term illness. At the same time, the government wishes to raise

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African Journals Online (AJOL)

Items 601 - 650 of 879 ... South African Journal of Higher Education. ... Browse Title Index .... The challenge of thesis supervision in an art university, Abstract ... No 2 (2004), Robert Sternberg's mental self-government theory and its contribution to ...

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African Journals Online (AJOL)

Items 1 - 50 of 736 ... Journal Home > Advanced Search > Browse Title Index ... Vol 5 (2008), A Contagious Malady: The Human Quest for Truth through Religion, Abstract ... A Study of Politeness Strategies Used by the National University of ...

Browse Title Index

African Journals Online (AJOL)

Items 101 - 150 of 879 ... Journal Home > Advanced Search > Browse Title Index ... Vol 20, No 4 (2006), Assessing academic potential for university admission: ... Vol 16, No 2 (2002), Book Review: Rethinking truth by Higgs, P & Smith, J, Details.

Browse Title Index

African Journals Online (AJOL)

Items 651 - 700 of 1199 ... Issue, Title ... Vol 5, No 1 (2011), Motivation, an Essential Ingredient for Optimal Performance in Emerging Markets, Abstract PDF ... Vol 3, No 5 (2009), Multinational transfer pricing and international taxation: what, why, ...

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African Journals Online (AJOL)

Items 451 - 500 of 533 ... Journal Home > Advanced Search > Browse Title Index .... for past tense forms in Northern Sotho: verb stems with final 'm' and 'n', Abstract ... in an academic writing class: Implications for a dialogic pedagogy, Abstract.

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African Journals Online (AJOL)

Items 701 - 750 of 808 ... Issue, Title ... Vol 58, No 2 (2010), Short Communicaton: The socio-economic impact of helminth infections and the ... Vol 62 (2014): Special Edition, Special edition summarizing the scientific discourse which took place ...

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African Journals Online (AJOL)

Items 301 - 350 of 788 ... Journal Home > Advanced Search > Browse Title Index ... Vol 26, No 1 (2018), Gender differentials in the perception of .... Vol 25, No 1 (2017), Impact of total quality management on students' academic performance in ...

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African Journals Online (AJOL)

Items 1 - 50 of 194 ... Journal Home > Advanced Search > Browse Title Index ... Vol 14, No 1 (2000), A functional categoriality of adjectives in ... Vol 1, No 1 (1987), Alienation and affirmation: The humanistic vision of Bessie Head, Abstract PDF.

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African Journals Online (AJOL)

Items 101 - 150 of 1117 ... Journal Home > Advanced Search > Browse Title Index ... Vol 13, No 3 (2007):, an edu-ethical perspecitve on the nature of truth: case studies in elite ... 2009: September: Supplement, An empirical study of university ...

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African Journals Online (AJOL)

Items 101 - 150 of 294 ... Journal Home > Advanced Search > Browse Title Index. Log in or .... S Edwards, M Hlongwane, J Thwala, N Robinson ... Vol 16, No 1 (2017), Infancy of internet cafe: The substitute of ubuntu-padare pedagogy, Abstract.

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African Journals Online (AJOL)

Items 1 - 50 of 98 ... Journal Home > Advanced Search > Browse Title Index ... model for the continued professionalisation of student affairs in Africa, Abstract PDF ... Vol 2, No 2 (2014), Book Review: How College Affects Students, A Third decade ...

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African Journals Online (AJOL)

Items 1 - 50 of 76 ... Journal Home > Advanced Search > Browse Title Index ... Vol 4, No 1 (2011), Automation of AutoCAD for Detailing of Reinforced .... Vol 10, No 1 (2017), Housing data base for sustainable housing provision, Abstract PDF.

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African Journals Online (AJOL)

Items 51 - 100 of 103 ... Issue, Title ... SE Edusah, E Osei-Tutu ... Vol 6, No 2 (2016), Interrelationships among unemployment, inflation and economic growth in Nigeria, Abstract .... Vol 4, No 3 (2014): Special Edition, Socio-cultural Issues for ...

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African Journals Online (AJOL)

Items 1 - 41 of 41 ... Issue, Title ... Vol 1, No 3 (2004): Special Edition, Assessment of the quality and reserves of Bat ... Vol 1, No 1 (1997), Bovine dermatophilosis in Zambia: epidemiology, socio-economic impacts and future perspectives, Abstract.

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African Journals Online (AJOL)

Items 351 - 391 of 391 ... Issue, Title ... Vol 2, No 3 (1999): Special Edition, The efficacy of low volume application of roundup ... Vol 1, No 1 (1998), The relationships among National Socio-Economic Indicators and Child Health Statistics, Abstract.

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

DEFF Research Database (Denmark)

Eirikstoft, Heidi; Kongsted, Alice

2014-01-01

reducible disc syndromes followed by facet joint pain, dysfunction and sacroiliac (SI)-joint pain. Classification was inconclusive in 5% of the patients. Differences in pain, activity limitation, and psychological factors were small across subgroups. Within 10 days, 82% were reported to belong to the same......Sub-grouping of low back pain (LBP) is believed to improve prediction of prognosis and treatment effects. The objectives of this study were: (1) to examine whether chiropractic patients could be sub-grouped according to an existing pathoanatomically-based classification system, (2) to describe...... patient characteristics within each subgroup, and (3) to determine the proportion of patients in whom clinicians considered the classification to be unchanged after approximately 10 days. A cohort of 923 LBP patients was included during their first consultation. Patients completed an extensive...

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African Journals Online (AJOL)

Items 151 - 167 of 167 ... Issue, Title ... Vol 2, No 2 (2013), Women and the Leadership Paradigm: Bridging the Workplace Gender-Gap in Nigeria, Abstract PDF ... Vol 5, No 2 (2016), Women's participation and gender issues in local governance ...

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African Journals Online (AJOL)

Items 51 - 73 of 73 ... Journal Home > Advanced Search > Browse Title Index ... Vol 13 (2006), The ageing eye” functional changes from cradle to gray: A ... Vol 12 (2005), The evaluation of vision in children using monocular vision acuity and ...

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African Journals Online (AJOL)

Items 51 - 100 of 391 ... Journal Home > Advanced Search > Browse Title Index ... Efficacy of four Rodenticides on the Ghanaian Market, Abstract ... Vol 2, No 1 (2000):, Determination of some wear elements in used car engine oil and oil filter ...

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African Journals Online (AJOL)

Items 251 - 300 of 652 ... Journal Home > Advanced Search > Browse Title Index ... Vol 18, No 7 (2015), Introduction to virtual property: Lex virtualis ipsa ... Vol 17, No 1 (2014), Legal challenges relating to the commercial use of outer space, with ...

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African Journals Online (AJOL)

Items 551 - 600 of 879 ... Journal Home > Advanced Search > Browse Title Index ... A James, E Ralfe, L van Laren, N Ngcobo ... 1 (2011), Recognition of prior learning in promoting lifelong learning: A pedagogy of hope or a shattering of dreams?

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African Journals Online (AJOL)

Items 1 - 50 of 89 ... Issue, Title ... of two-phased approaches to load balancing in cloud computing, Abstract ... Vol 19, No 1 (2012), Assessing Network Services and Security in ... Vol 23, No 1 (2016), Cloud model construct for transaction-based ...

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African Journals Online (AJOL)

Items 51 - 100 of 198 ... Issue, Title ... Vol 13, No 1 (2015), Biometric Enhancement of Home and Office Security to Reduce Assassinations in Nigeria, Abstract PDF ... Vol 9, No 1 (2013), Cloud Computing: Key to IT Development in West Africa ...

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African Journals Online (AJOL)

Items 151 - 198 of 198 ... Issue, Title ... scheme for QoS and energy conservation in cloud computing, Abstract PDF ... Vol 9, No 1 (2013), Performance and Security Evaluation of ... Vol 18, No 1 (2017), Reducing capital flight through local cloud ...

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African Journals Online (AJOL)

Items 51 - 97 of 97 ... Journal Home > Advanced Search > Browse Title Index ... Vol 20, No 2 (2008), Research Note: Anthropometric data of the foot of ... Vol 26, No 1 (2014), Validation of the Automation Attitude Questionnaire for Airline Pilots ...

Titles of Midas

Directory of Open Access Journals (Sweden)

G. L. Huxley

2001-09-01

Full Text Available The Phrygian inscription on the tomb at Yazılıkaya (8th century gives Midas the titles wanax and lawagtas, paralled in Mycenaean, and there were strong connections between his dynasty and Greek Aeolis.

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African Journals Online (AJOL)

Items 51 - 100 of 412 ... Issue, Title. Vol 30, No 3 (2011) ... Transferring the principle of double effect from war to business, Abstract. G. J. Rossouw ... Vol 22, No 2 (2003), Can more business ethics teaching halt corruption in companies? Abstract.

Relationships between nutrition-related knowledge, self-efficacy, and behavior for fifth grade students attending Title I and non-Title I schools.

Science.gov (United States)

Hall, Elisha; Chai, Weiwen; Albrecht, Julie A

2016-01-01

The Social Cognitive Theory (SCT) is a widely used theory for nutrition education programming. Better understanding the relationships between knowledge, self-efficacy, and behavior among children of various income levels can help to form and improve nutrition programs, particularly for socioeconomically disadvantaged youth. The purpose of this study was to determine the relationships between knowledge, self-efficacy, and behavior among fifth grade students attending Title I (≥40% of students receiving free or reduced school meals) and non-Title I schools (students receiving free or reduced school meals). A validated survey was completed by 55 fifth grade students from Title I and 122 from non-Title I schools. Differences in knowledge, self-efficacy, and behavior scores between groups were assessed using t test and adjusted for variations between participating schools. Regression analysis was used to determine the relationships between knowledge, self-efficacy, and behavior. In adjusted models, the Title I group had significantly lower scores on several knowledge items and summary knowledge (P = 0.04). The Title I group had significantly lower scores on several behavior variables including intakes of fruits (P = 0.02), vegetables (P = 0.0005), whole grains (P = 0.0003), and lean protein (P = 0.047), physical activity (P = 0.002) and summary behavior (P = 0.001). However the Title I group scored higher on self-efficacy for meal planning (P = 0.04) and choosing healthy snacks (P = 0.036). Both self-efficacy (β = 0.70, P knowledge (β = 0.35, P = 0.002) strongly predicted behavior; however, only self-efficacy remained significant in the Title I group (self-efficacy, β = 0.82, P = 0.0003; knowledge, β = 0.11, P = 0.59). Results demonstrate disparities in nutrition knowledge and behavior outcomes between students surveyed from Title I and non-Title I schools, suggesting more resources may be necessary for lower income populations

Is there a chilly climate? An educational environmental mixed method study in a chiropractic training institution.

Science.gov (United States)

Palmgren, Per J; Chandratilake, Madawa; Nilsson, Gunnar H; Laksov, Klara Bolander

2013-01-01

The attitude towards gender in an educational environment has a significant impact on a student's behavior, sense of well-being, and academic performance. Our study aimed to explore the presence and extent of gender-related issues in a chiropractic undergraduate learning environment, which has been a scarcely researched topic in the literature. The Perceived Chilly Climate Scale (PCCS) was used as the initial tool for screening the gender issues among undergraduates. The issues identified were explored further with a series of focus group interviews. The PCCS had an 83% response rate. The PCCS score (105/196) indicated the nonexistence of alarming gender-related issues. However, the PCCS score was significantly higher among female than male subjects, immigrants than nonimmigrants, and minorities than majority ethnic groups. Despite high ratings on the questionnaire quantitative findings, the focus groups indicated a good sense of equality, oppression-free environment, and no obvious signs of discrimination. The educational environment of the institution concerned was conducive to equality. However, subtle but important gender-, ethnic-, and minority-related issues could be addressed to provide an enhanced educational environment to learners.

Picture of informal care

NARCIS (Netherlands)

Alice de Boer

2005-01-01

Original title: Kijk op informele zorg. Many people assume that the giving of informal care to the sick and disabled is in decline. This is blamed among other things on the growing labour participation of women. In reality, however, this assumption is incorrect: the percentage of people

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African Journals Online (AJOL)

Items 101 - 150 of 1732 ... Journal Home > Advanced Search > Browse Title Index ... Vol 10, No 3 (2007), An Audit Of Perioperative Cardiac Arrest At ... Vol 11, No 4 (2008), An Audit Of Rejected Repeated X-ray Films As A Quality Assurance ...

Land Titles and Rice Production in Vietnam

DEFF Research Database (Denmark)

Van Den Broeck, Katleen; Newman, Carol; Tarp, Finn

analysis of plot level rice yields that land titles are indeed important. Only exclusively held titles have the expected positive effects, and the positive effect on yields is found in male headed households. Furthermore, a household level rice yield function reveals that exclusive user rights...

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African Journals Online (AJOL)

Items 151 - 200 of 221 ... Issue, Title ... Vol 38 (2010), Soft drink consumption of Grade 4 and Grade 7 learners in the Wynberg area, City of Cape Town, South .... Vol 42 (2014), The meaning of food for obese men: a qualitative study, Abstract PDF.

Exploring New Directions: Title I in the Year 2000.

Science.gov (United States)

Puma, Michael J.; Drury, Darrel W.

This report takes stock of the present Title I program, identifies the most promising approaches to educating the nation's disadvantaged children, and offers guidance to policymakers seeking to improve Title I's effectiveness. The report draws upon hundreds of studies, evaluations, and other documents, and details the evolution of the Title I…

Citation Oil and Gas Corporation... Title V Applicability Determination

Science.gov (United States)

This document may be of assistance in applying the Title V air operating permit regulations. This document is part of the Title V Policy and Guidance Database available at www2.epa.gov/title-v-operating-permits/title-v-operating-permit-policy-and-guidance-document-index. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

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African Journals Online (AJOL)

Items 201 - 250 of 577 ... Issue, Title. Vol 20, No 2 (2003), Emergency Contraception: A Global Overview of Knowledge, Attitudes and Practices Among Providers, Abstract PDF. Deborah Haggai. Vol 23 (2006):, Emergency laparotomy for peripartum haemorrhage in Bida North Central Nigeria, Abstract PDF. Sunny Abiodun O ...

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African Journals Online (AJOL)

Items 101 - 150 of 155 ... Issue, Title. Vol 12 (2012), Political Dissent and Autonomy in Wum Local Government, Southern (West) Cameroons, 1957 – 1968, Abstract. TP Mbeum. Vol 9 (2009), Post-Emancipation Slave Commerce: Increasing Child Slave Trafficking and Women's Agency in Late Nineteenth-century Ghana ...

24 CFR 203.386 - Coverage of title evidence.

Science.gov (United States)

2010-04-01

... SINGLE FAMILY MORTGAGE INSURANCE Contract Rights and Obligations Property Title Transfers and Title... the public records, there are not, at such date, any outstanding prior liens, including any past-due...

24 CFR 234.65 - Nature of title.

Science.gov (United States)

2010-04-01

... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Nature of title. 234.65 Section 234.65 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued... OWNERSHIP MORTGAGE INSURANCE Eligibility Requirements-Individually Owned Units § 234.65 Nature of title. A...

75 FR 2595 - Proposed Information Collection (Application for Furnishing Long-Term Care Services to...

Science.gov (United States)

2010-01-15

... (Application for Furnishing Long- Term Care Services to Beneficiaries of Veterans Affairs, and Residential Care... comments for information needed to determine non-Federal nursing home or residential care home... information technology. Titles: a. Application for Furnishing Long-Term Care Services to Beneficiaries of...

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African Journals Online (AJOL)

Items 51 - 98 of 98 ... Issue, Title. Vol 4, No 1 (2016), First-year seminar intervention: Enhancing firstyear mathematics performance at the University of Johannesburg, Abstract PDF. Melanie Jacobs, Estherna Pretorius. Vol 5, No 2 (2017), From Inky Pinky Ponky to Improving Student Understanding in Assessment: Exploring the ...

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African Journals Online (AJOL)

Items 551 - 600 of 1463 ... Issue, Title. Vol 15, No 2 (2015), Evaluation of the diagnostic performance and operational characteristics of four rapid immunochromatographic syphilis tests in Burkina Faso, Abstract PDF. FY Bocoum, H Ouedraogo, G Tarnagda, A Kiba, S Tiendrebeogo, F Bationo, B Liestman, S Diagbouga, ...

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African Journals Online (AJOL)

Items 9951 - 10000 of 11090 ... Issue, Title. Vol 10, No 36 (2011), Study of heavy metals bioaccumulation in the process of vermicomposting, Abstract PDF. MM Aleagha, G Ebadi. Vol 10, No 45 (2011), Study of malondialdehyde (MDA) content, superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) activities in ...

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African Journals Online (AJOL)

Items 101 - 150 of 985 ... Journal Home > Advanced Search > Browse Title Index ... Vol 17 (2010), Alternating Direction Implicit Finite Difference Time Domain Acoustic Wave Algorithm, Abstract. E Ikata .... Vol 17 (2010), Analytic derivation of the wave profile and phase speed of sixth order Stokes waves in deep water, Abstract.

Browse Title Index

African Journals Online (AJOL)

Items 451 - 500 of 581 ... Issue, Title. Vol 30, No 1 (2016), Risky sexual behaviour and associated factors among students of Debre Tabor University, Northwest Ethiopia: a cross-sectional study, Abstract PDF. Awoke Derbie, Mekonnen Assefa, Daniel Mekonnen, Fantahun Biadglegne. Vol 28, No 1 (2014), Road traffic accident: ...

14 CFR 1245.109 - Assignment of title to NASA.

Science.gov (United States)

2010-01-01

... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Assignment of title to NASA. 1245.109... INTELLECTUAL PROPERTY RIGHTS Patent Waiver Regulations § 1245.109 Assignment of title to NASA. (a) The instrument of waiver set forth in § 1245.115(c) shall be voided by NASA with respect to the domestic title to...

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African Journals Online (AJOL)

Items 101 - 108 of 108 ... Issue, Title. Vol 8, No 2 (2016), The status and challenges of clinical informatics development in South Africa, Abstract PDF. Abayomi Kehinde Owolabi, Thokozani Patrick Mhlongo, Neil Evans. Vol 4, No 1 (2012), The stuttering implementation of language policies in the South African education system ...

Browse Title Index

African Journals Online (AJOL)

Items 751 - 800 of 846 ... Journal Home > Advanced Search > Browse Title Index ... Vol 9, No 3S (2017): Special Issue, The effect of torrefaction on oil palm ... core competency skills of IRBM tax auditors towards their performance, Abstract PDF ... of exchange rates behavior in Malaysia by using NATREX model, Abstract PDF.

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African Journals Online (AJOL)

Items 51 - 76 of 76 ... Issue, Title. Vol 6, No 1 (2013), Integrating Sustainability into the Real Estate Valuation Process: A Nigerian Perspective, Abstract PDF. G K Babawale, B A Oyalowo. Vol 5, No 1 (2012), Internalising internationa valuation standards: Relevance and applicability issues in the Nigerian context, Abstract PDF.

Browse Title Index

African Journals Online (AJOL)

Items 51 - 100 of 201 ... Issue, Title. Vol 12, No 1 (2006), Conservative management of cervical ectopic pregnancy: case report, Abstract PDF. TD Naidoo, MR Ramogale, J Moodley. Vol 18, No 2 (2012), Contraceptive use and associated factors among South African youth (18 - 24 years): A population-based survey, Abstract ...

Browse Title Index

African Journals Online (AJOL)

Items 1 - 50 of 76 ... Issue, Title. Vol 16, No 2 (2006), A profile of the theatre procedures in paediatrict ophthalmic practice, Abstract. E O Onwasigwe. Vol 15, No 2 (2005), Abdominal cocoon, Abstract. Abdulrasheed K Adesunkanmi, Tajudeen A Badmus, Olukayode Ogundoyin, Akinwumi B Ogunrombi. Vol 18, No 1 (2008) ...

Browse Title Index

African Journals Online (AJOL)

Items 1 - 50 of 93 ... Issue, Title. Vol 5 (2013), A cost-effective Geographic Information Systems for Transportation (GIS-T) application for traffic congestion analyses in the Developing World, Abstract PDF. E Agyemang. Vol 3 (2011), A Historical and Gendered Perspective on HIV / AIDS in Botswana, Abstract PDF. J Hesselberg ...

Browse Title Index

African Journals Online (AJOL)

Items 301 - 350 of 577 ... Issue, Title. Vol 32, No 2 (2015), Late arrival in hospital during labour: any correlation with materno-foetal outcome? The state specialist hospital, Asubiaro, Osogbo Experience. Abstract PDF. OO Awolola. Vol 30, No 2 (2013), Late Reproductive Effects of Cancer Treatment in Young People, Abstract ...

Browse Title Index

African Journals Online (AJOL)

Items 1 - 50 of 251 ... Issue, Title. Vol 55 (2014), 20 Years of democracy: Transforming the public service, Abstract. A Ruiters. Vol 63 (2016), Zemk' iinkomo magwala ndini! Wake up! The cows are being stolen! Abstract. Sipho Pityana. Vol 56 (2014), A layperson's guide to Nene's budget statement, Abstract. B Turok.

Browse Title Index

African Journals Online (AJOL)

Items 1 - 50 of 1007 ... Issue, Title. Vol 11, No 1 (1997), (+)-Floribundone 3 from the pods of Senna septemtrionalis, Details PDF. Gizachew Alemayehu, Bekuretsion Woldeyesus, Berhanu M Abegaz. Vol 14, No 1 (2000), 11α-Hydroxy muzigadiolide, a novel drimane sesquiterpene from the stem bark of warburgia ugandensis ...

Browse Title Index

African Journals Online (AJOL)

Items 151 - 170 of 170 ... Issue, Title. Vol 20, No 2 (2004), The Impact of Mine Closures on Rural Population Dynamics: The Case of Zhombe in Kwekwe District, Midlands Province, Zimbabwe, Abstract. Crescentia Madebwe. Vol 29, No 1 (2013), The Influence of Organisational Culture and Job Satisfaction on Intentions to ...

Browse Title Index

African Journals Online (AJOL)

Items 151 - 200 of 633 ... Issue, Title. Vol 19, No 1 (2009), Delays in Tuberculosis Treatment and Associated Factors in Jimma Zone, Southwest Ethiopia, Abstract PDF. Ayalew Tegegn, Meseret Yazachew. Vol 26, No 1 (2016), Delivery Site Preferences and Associated Factors among Married Women of Child Bearing Age in ...

Browse Title Index

African Journals Online (AJOL)

Items 251 - 300 of 367 ... Issue, Title. Vol 43 (2014), Some interlingual communicative challenges for foreign African interpreters in South African courtrooms, Abstract PDF. SE Usadolo, E Kotze. Vol 29 (1996), South Africa's new language policy in the context of the organisation for African unity's language plan of action for ...

Browse Title Index

African Journals Online (AJOL)

Items 51 - 100 of 110 ... Issue, Title. Vol 10, No 1 (2003), Incidence and Determinants of Child Labour in Nigeria: Implications for Poverty Alleviation, Abstract. Benjamin Chiedozie Okpukpara, Ngozi Odurukwu. Vol 20, No 1 (2013), Inflation and capacity utilisation in Nigeria's manufacturing sector, Abstract. OA Ishola. Vol 19, No ...

Browse Title Index

African Journals Online (AJOL)

Items 151 - 200 of 643 ... Issue, Title. Vol 18, No 2 (2015), Contraceptive Knowledge and Compliance with Guidelines for Providing Contraceptive Services by Patent Medicine Vendors In Ibadan North Local Government Area, Nigeria, Abstract PDF. OO Ajayi, AJ Ajuwon. Vol 16, No 2 (2013), Coping Strategy for Food Security ...

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African Journals Online (AJOL)

Issue, Title. Vol 8, No 2 (2016): Supplement, Using operative models (ICF and CBR) within an interprofessional context to address community needs, Abstract PDF. A Rhoda, F Waggie, G.C. Filies, J.M. Frantz. Vol 2, No 1 (2010), Using portfolios to assess professional competence and development in medical laboratory ...

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African Journals Online (AJOL)

Issue, Title. Vol 43, No 2 (2006), Review: "'n Wonderlike geweld. Jeugherinneringe", By Elsa Joubert (2005), Abstract PDF. Henriette Roos. Vol 53, No 1 (2016), Review: Breyten Breytenbach, A Monologue in Two Voices, Abstract PDF. Andy Carolin. Vol 53, No 1 (2016), Review: The Shadow of the Hummingbird, Abstract ...

78 FR 38810 - Proposed Information Collection (Application for Furnishing Long-Term Care Service to...

Science.gov (United States)

2013-06-27

... (Application for Furnishing Long- Term Care Service to Beneficiaries of Veterans Affairs, and Residential Care.... 2900-0616.'' SUPPLEMENTARY INFORMATION: Title: Residential Care Home Program--Sponsor Application, VA... collection. Abstract: VA Form 10-2407 is an application used by a residential care facility or home that...

What is the title of a Web page? A study of Webography practice

Directory of Open Access Journals (Sweden)

Timothy C. Craven

2002-01-01

Full Text Available Few style guides recommend a specific source for citing the title of a Web page that is not a duplicate of a printed format. Sixteen Web bibliographies were analyzed for uses of two different recommended sources: (1 the tagged title; (2 the title as it would appear to be from viewing the beginning of the page in the browser (apparent title. In all sixteen, the proportion of tagged titles was much less than that of apparent titles, and only rarely did the bibliography title match the tagged title and not the apparent title. Convenience of copying may partly explain the preference for the apparent title. Contrary to expectation, correlation between proportion of valid links in a bibliography and proportion of accurately reproduced apparent titles was slightly negative.

Caring about the young

NARCIS (Netherlands)

John Stevens; Evert Pommer; Hetty van Kempen; Elke Zeijl; Isolde Woittiez; Klarita Sadiraj; Rob Gilsing; Saskia Keuzenkamp

2009-01-01

Original title: De jeugd een zorg. Youth care services are going through major changes. This has created a need for a better insight into the demand that is likely to be placed on these services in the future at both national and regional level. This report suggests that the use of ambulant

Browse Title Index

African Journals Online (AJOL)

Items 1 - 20 of 20 ... Issue, Title. Vol 9, No 2 (2000), Age dependent changes in the hypothalamic amino acid neurotransmitters in response to nicotine, Abstract. NM Radwan, NA Ahmed, YAM Aly. Vol 9, No 2 (2000), Autoantibodies, ocular and auditory changes in patients with vitiligo, Abstract. AE Fathia, EA Nagwa, ...

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African Journals Online (AJOL)

Items 151 - 183 of 183 ... Issue, Title. Vol 9, No 1 (2004), Socio-economic constraints affecting youths involvement in national economic development, Abstract. Josephine U Nwagwu. Vol 12, No 2 (2007), Stabilizing Potential Of Cement-Fly Ash Mixture On Expansive Clay Soil, Abstract. OO Amu, AB Fajobi, SO Afekhuai. Vol 11 ...

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African Journals Online (AJOL)

Items 101 - 150 of 670 ... Issue, Title. Vol 9, No 2 (2012), Business Planning and the Economic Growth of Small and Medium Scale Enterprises in Nigeria, Abstract. Egbe Aneozeng A, Ejoh Ndifon Ojong, Obo Ekpenyong Bassey. Vol 11, No 2 (2014), Calabar Humaphors: An Analysis of Selected Jokes in Nigerian Stand Up ...

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African Journals Online (AJOL)

Issue, Title. Vol 25, No 2 (2005), Yam-based farm practices and nematode problems in stored yams (Dioscorea spp.) in Ghana, Abstract PDF. CK Kwoseh, RA Plowright, J Bridge, R Asiedu. Vol 27, No 2 (2007), Yield, irrigation production efficiency and economic returns of broccoli under variable drip irrigation and lateral ...

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African Journals Online (AJOL)

Items 201 - 250 of 11090 ... Issue, Title. Vol 12, No 49 (2013), In vitro regeneration of selected Kenyan papaya (Carica papaya L.) lines through shoot tip culture, Abstract PDF. Naomi Nzilani Mumo, Fredah Karambu Rimberia, George Edward Mamati, Agnes Wanjiru Kihurani. Vol 7, No 12 (2008), In vitro regeneration of Turkish ...

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African Journals Online (AJOL)

Items 151 - 200 of 232 ... Issue, Title. Vol 5 (2003), Pre-School Education for a Democratic Society: Identifying Views of Stakeholders in Tanzania, Abstract. Willy LM Komba, Satoki T Mahenge, Gadi Koda. Vol 13, No 2 (2012), Process of Assuring Quality in Counselling at the National Open University of Nigeria: A Critique ...

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African Journals Online (AJOL)

Items 501 - 550 of 670 ... Issue, Title. Vol 11, No 4 (2014), Strategies for Fostering Creativity Among Business Education Graduates in Nigeria, Abstract. BO Nwosu, KE Ojo. Vol 13, No 1 (2015) ... Vol 10, No 1 (2013), The Challenges Facing Accounting Education: The Nigerian Experience, Abstract. OR Okolie. Vol 5 (2008), The ...

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African Journals Online (AJOL)

Items 1 - 50 of 183 ... Issue, Title. Vol 62 (2017), #SchoolsOnFire: Criminal justice responses to protests that impede the right to basic education, Abstract PDF. Ann Skelton, Martin Nsibirwa. Vol 45 (2013), 'Pale Face'/'Pointy Face: SA Criminology in Denial, Abstract PDF. S Henkeman. Vol 59 (2017), Aluta continua: Police ...

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Issue, Title. Vol 38, No 1 (2004), Book Review: Unexpected Voices – Theory, Practice and Identity in the Writing Classroom. Abstract. Charly Dyers. Vol 38, No 1 (2004), Book Review: Shelley Angelil-Carter: Stolen Language? Plagiarism in Writing. Abstract. Elizabeth de Kadt. Vol 37, No 1 (2003), Book Review: The Green ...

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Issue, Title. Vol 23, No 2 (2011), Dynamique foliaire et croissance du maïs: Application du modèle «STICS» en conditions tropicales en RD-Congo, Abstract PDF. MM Lufuluabo, RV Kizungu, KK Nkongolo. Vol 18, No 1 (2006), Dynamique spatio-temporelle des populations d\\'Altises Podagrica spp. (Coleoptera ...

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African Journals Online (AJOL)

Items 201 - 250 of 661 ... Journal Home > Advanced Search > Browse Title Index. Log in or Register to get access to full text downloads. .... A El-Mahdy, B Bolduc, J Upadhyay, R Shoukr, A Khoury. Vol 19, No 1 (2013), Factors affecting lower calyceal stone clearance after Extracorporeal shock wave lithotripsy, Abstract PDF.

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African Journals Online (AJOL)

Items 201 - 250 of 367 ... Issue, Title. Vol 42 (2013), Nursing the Cure: A Phonetic Analysis of /ʊə/ in South African English, Abstract PDF. I Bekker. Vol 1 (1980), Nuwe ontwikkelings binne chomsky se teorle van kerngrammatika, Abstract PDF. J Maartens. Vol 42 (2013), Obligatory Reflexivity in a Minimalist Grammar of ...

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Items 651 - 700 of 1007 ... Issue, Title. Vol 4, No 1 (1990), Kinetics of oxidation of β-diimihe macrocyclic complexes and accessibility of six-coordinate copper(III) complexes generated by electrochemical oxidation of copper(II) complexes, Abstract PDF. Mohamed A. Khalifa. Vol 14, No 2 (2000), Kinetics of periodate oxidation of ...

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Issue, Title. Vol 22, No 2 (2008), Voltammetric determination of heparin based on its interaction with malachite green, Abstract PDF. Xueliang Niu, Weili Zhang, Na Zhao, Wei Sun. Vol 22, No 2 (2008), Voltammetric determination of l-cysteic acid on a 1-[4-(ferrocenyl-ethynyl)phenyl]-1-ethanone modified carbon paste ...

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Items 51 - 100 of 265 ... Issue, Title. Vol 35, No 2 (2008), Choice of place for childbirth: prevalence and correlates of utilization of health facilities in Chongwe district, Zambia, Abstract PDF. AN Hazemba, S Siziya. Vol 43, No 1 (2016), Clinical and Radiological Features of Multiple Myeloma Patients at the University Teaching ...

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Issue, Title. Vol 88, No 8 (1998), New birth and death registration forms - a foundation for the future, a challenge for health workers? Abstract PDF. Debbie Bradshaw, Danuta Kielkowski, Freddy Sitas. Vol 83, No 3 (1993), New estimates of infant and child mortality for blacks in South Africa, 1968-1979, Abstract PDF.

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African Journals Online (AJOL)

Items 851 - 900 of 1006 ... Issue, Title. Vol 54, No 2 (2012), The effect of the introduction of a standard monitoring protocol on the investigations performed on the metabolic control of type 2 diabetes at Addington Hospital Medical Outpatients Department, Durban, South Africa, Abstract PDF. JM Gill, A Ross, F Pirie, ...

Walking (Gait), Balance, and Coordination Problems

Science.gov (United States)

... FES) d Complementary & Alternative Medicines Chiropractic Therapy Marijuana Massage and Bodywork Acupuncture d For Clinicians d Resources & ... Advocate Program d Advanced Care Needs Pressure Sores Osteoporosis Seeking Services: Questions to Ask d Resources for ...

Secondary-Progressive MS (SPMS)

Science.gov (United States)

... FES) d Complementary & Alternative Medicines Chiropractic Therapy Marijuana Massage and Bodywork Acupuncture d For Clinicians d Resources & ... Advocate Program d Advanced Care Needs Pressure Sores Osteoporosis Seeking Services: Questions to Ask d Resources for ...

Diagnosing MS

Science.gov (United States)

... FES) d Complementary & Alternative Medicines Chiropractic Therapy Marijuana Massage and Bodywork Acupuncture d For Clinicians d Resources & ... Advocate Program d Advanced Care Needs Pressure Sores Osteoporosis Seeking Services: Questions to Ask d Resources for ...

Staying Well

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... FES) d Complementary & Alternative Medicines Chiropractic Therapy Marijuana Massage and Bodywork Acupuncture d For Clinicians d Resources & ... Advocate Program d Advanced Care Needs Pressure Sores Osteoporosis Seeking Services: Questions to Ask d Resources for ...

Health and Wellness

Science.gov (United States)

... FES) d Complementary & Alternative Medicines Chiropractic Therapy Marijuana Massage and Bodywork Acupuncture d For Clinicians d Resources & ... Advocate Program d Advanced Care Needs Pressure Sores Osteoporosis Seeking Services: Questions to Ask d Resources for ...

T Cells

Science.gov (United States)

... FES) d Complementary & Alternative Medicines Chiropractic Therapy Marijuana Massage and Bodywork Acupuncture d For Clinicians d Resources & ... Advocate Program d Advanced Care Needs Pressure Sores Osteoporosis Seeking Services: Questions to Ask d Resources for ...

Primary-Progressive MS (PPMS)

Science.gov (United States)

... FES) d Complementary & Alternative Medicines Chiropractic Therapy Marijuana Massage and Bodywork Acupuncture d For Clinicians d Resources & ... Advocate Program d Advanced Care Needs Pressure Sores Osteoporosis Seeking Services: Questions to Ask d Resources for ...

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African Journals Online (AJOL)

Items 51 - 100 of 100 ... Issue, Title. Vol 28 (2013): Special Issue, Occurrence of Cryptosporidium and Giardia in domestic animals in peri-urban communities of Kafue district, Zambia, Abstract. J Siwila, IGK Phiri, HI Enemark, M Nchito, A Olsen. Vol 26, No 1 (2009), Occurrence of foot and mouth disease serotypes in Tanzania: A ...

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Items 1 - 15 of 15 ... Issue, Title. Vol 1, No 1 (2008), Assessment Of Ophthalmic Patients' Satisfaction In Owo, Abstract. CO Omolase, CO Fadamiro, BO Omolase, AS Aina, EO Omolade. Vol 3, No 1 (2010), Case Report: Strongyloides stercoralis coinfection in a Nigerian with HIV. Abstract. A.A Oyekunle, R.A.A Bolarinwa, O.A ...

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African Journals Online (AJOL)

Items 1 - 15 of 15 ... Issue, Title. Vol 1, No 1 (2007), An Action Five Strategy For Bridging The Gender Gap In Academic Research Activities In African Universities. The Case of Nigeria, Abstract PDF. DN Okorie, OG Agabi, CM Uche. Vol 1, No 1 (2007), Book Review: Confronting sexual harassment in Ghanaian Universities ...

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African Journals Online (AJOL)

Items 201 - 240 of 240 ... Issue, Title. Vol 8, No 4 (2005), Status equipment in primary health centres of Tafa Lga, North Central Nigeria, Abstract. MN Sambo, I Lewis, K Sabitu. Vol 10, No 1 (2007), Stroke at a tertiary medical institution in Northern Nigeria: Patients\\' profile and predictors of outcome, Abstract. KW Wahab, MU ...

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Items 101 - 107 of 107 ... Issue, Title. Vol 6, No 1 (2017), The Ophthalmic status manifestations of nutritional and lifestyle disorders of men in a peri urban community in Ghana, Abstract PDF. F. Vuvor, M. Steiner-Asiedu, F.K. Saalia. Vol 2, No 1 (2013), Thyroid Disorders in Accra, Ghana: A Retrospective Histopathological Study ...

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African Journals Online (AJOL)

Items 51 - 100 of 165 ... Issue, Title. Vol 30 (2005), Digitisation projects at the University of Cape Town Libraries, Abstract. Janine Dunlop, Lesley Hart. Vol 24 (2002), DISA: an African Perspective on Digital Technology, Abstract. Michele Pickover, Dale Peters. Vol 30 (2005), Doing it right – or are we? Basic principles in the ...

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African Journals Online (AJOL)

Items 1 - 50 of 66 ... Issue, Title. Vol 48, No 1-2 (2015), A hierarchical modeling of information seeking behavior of school teachers in rural areas of Nigeria, Abstract. Manir Abdullahi Kamba. Vol 49, No 1-2 (2016), Access to electronic information resources by students of federal college of education in south east Nigeria ...

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Items 351 - 400 of 400 ... Issue, Title. Vol 9, No 1 (2010), Soft tissue sarcoma of the thigh: Need for angiography in the developing, Abstract PDF. IA Adigun, GA Rahman, KO Ogundipe. Vol 3, No 1 (2004), Spectrum of rheumatic heart disease in Zaria, Northern Nigeria, Abstract. SS Danbauchi, MA Alhassan, SO David, ...

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African Journals Online (AJOL)

Items 51 - 68 of 68 ... Issue, Title. Vol 12, No 1-2 (2009), Sécurité et ordre politique au Cameroun : entre dynamiques internes et connexions internationales, Abstract PDF. BEP Chantal. Vol 6, No 1-2 (2003), Self-Determination, Nationalism, Development and Pan-Africanism Stuck on the Runway: Are Intellectuals to be Blamed ...

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African Journals Online (AJOL)

Items 251 - 300 of 328 ... Issue, Title. Vol 7, No 1 (2003), Sexual Harassment in Academia in Nigeria: How Real? Details PDF. Olugbenga Jelil Ladebo. Vol 8, No 2 (2004), Shaping the internet for match-making/dating: a challenge for the contemporary Nigerian family institution, Abstract PDF. Wale Adesina. Vol 6, No 1 (2002) ...

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African Journals Online (AJOL)

Items 101 - 150 of 198 ... Issue, Title ... Vol 7, No 1 (2013), Enterprise Cloud Adoption: Leveraging on the Business ... Load Balancing And Job Scheduling In Cloud Computing ... Vol 13, No 1 (2015), ICT-Based Framework for Improved Food Security in Nigeria ... Vol 5, No 1 (2012), IT-Based Solutions to the Electoral System in ...

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African Journals Online (AJOL)

Issue, Title. Vol 20, No 1 (2015), Assessment of iron status among preschool children (6 to 59 months) with and without malaria in Western Province, Kenya, Abstract. I Kisiangani, C Mbakaya, A Makokha, D Magu. Vol 20, No 1 (2015), Assessment of iron status among preschool children (6 to 59 months) with and without ...

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African Journals Online (AJOL)

Items 201 - 250 of 1006 ... Issue, Title. Vol 49, No 8 (2007), Clinical approach to a patient with abnormal uterine bleeding, Abstract PDF. B G Lindeque. Vol 57, No 5 (2015), Clinical evidence in the management of swimmer's ear, Abstract PDF. Andre Marais. Vol 50, No 1 (2008), Clinical features of Systemic Lupus ...

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Items 251 - 300 of 2005 ... Issue, Title. Vol 92, No 4 (2015), Blood Pressure and Obesity Index Assessment in a Typical Urban Slum in Enugu, Nigeria, Abstract. GI Ahaneku, CU Osuji, OC Oguejiofor, BC Anisiuba, VO Ikeh, JE Ahaneku. Vol 80, No 10 (2003):, Blood pressure control in a population where antihypertensives are ...

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Items 51 - 100 of 644 ... Issue, Title. Vol 19, No 2 (2007), A qualitative study of medical student socialization in Malawi\\'s College of Medicine: Clincal crisis and beyond, Abstract PDF. C Wendland, C Bandawe. Vol 19, No 2 (2007), A qualitative study of medical student socialization in Malawi\\'s College of Medicine: Preclinical ...

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Items 1 - 50 of 101 ... Issue, Title. Vol 3, No 4 (2014), Chlamydia trachomatis IgG antibodies seroprevalence among students in two tertiary institutions in Anambra state, Nigeria: a comparative study, Abstract PDF. CB Duru, FE Emele, ED Adinma, CO Ifeadike, KA Uwakwe, AO Oluboyo, BO Oluboyo, C Abejegah. Vol 2, No 1 ...

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Items 151 - 200 of 1038 ... Issue, Title. Vol 31, No 2 (2009), Assessing the utility of a continuous, underway fish egg sampler (CUFES) for sampling zooplankton, Abstract. S Sono, CL Moloney, CD van der Lingen. Vol 38, No 4 (2016), Assessing trophic adaptability is critical for understanding the response of predatory fishes to ...

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Issue, Title. Vol 17 (2005), A. C. conduction behaviour in amorphous WO3/CEO2 thin film, Abstract. B Yagoubi, C A Hogarth, A Boukorrt. Vol 16 (2003), A lossless image compression algorithm using variable block size segmentation, Abstract. Z Brahimi, K A Saadi, N Baraka. Vol 15 (2003), Analysis method of wavelet ...

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African Journals Online (AJOL)

Items 451 - 500 of 1346 ... Issue, Title. Vol 32, No 1 (2015), Fire and the dynamics of two unpalatable grass species (Cymbopogon pospischilii and Elionurus muticus) in a semi-arid climate, Abstract. Hennie A Snyman. Vol 8, No 1 (1973), Fire as a method of controlling macchia (Fynos) vegetation on the Amathole Mountains of ...

Physical Profiling Performance of Air Force Primary Care Providers

Science.gov (United States)

2017-08-09

AFRL-SA-WP-TR-2017-0014 Physical Profiling Performance of Air Force Primary Care Providers Anthony P. Tvaryanas1; William P...COVERED (From – To) September 2016 – January 2017 4. TITLE AND SUBTITLE Physical Profiling Performance of Air Force Primary Care Providers...encounter with their primary care team. An independent medical standards subject matter expert (SME) reviewed encounters in the electronic health record

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

Directory of Open Access Journals (Sweden)

Pollard Henry

2010-04-01

Full Text Available Abstract Background Hamstring injuries are the most common injury in Australian Rules football. It was the aims to investigate whether a sports chiropractic manual therapy intervention protocol provided in addition to the current best practice management could prevent the occurrence of and weeks missed due to hamstring and other lower-limb injuries at the semi-elite level of Australian football. Methods Sixty male subjects were assessed for eligibility with 59 meeting entry requirements and randomly allocated to an intervention (n = 29 or control group (n = 30, being matched for age and hamstring injury history. Twenty-eight intervention and 29 control group participants completed the trial. Both groups received the current best practice medical and sports science management, which acted as the control. Additionally, the intervention group received a sports chiropractic intervention. Treatment for the intervention group was individually determined and could involve manipulation/mobilization and/or soft tissue therapies to the spine and extremity. Minimum scheduling was: 1 treatment per week for 6 weeks, 1 treatment per fortnight for 3 months, 1 treatment per month for the remainder of the season (3 months. The main outcome measure was an injury surveillance with a missed match injury definition. Results After 24 matches there was no statistical significant difference between the groups for the incidence of hamstring injury (OR:0.116, 95% CI:0.013-1.019, p = 0.051 and primary non-contact knee injury (OR:0.116, 95% CI:0.013-1.019, p = 0.051. The difference for primary lower-limb muscle strains was significant (OR:0.097, 95%CI:0.011-0.839, p = 0.025. There was no significant difference for weeks missed due to hamstring injury (4 v14, χ2:1.12, p = 0.29 and lower-limb muscle strains (4 v 21, χ2:2.66, p = 0.10. A significant difference in weeks missed due to non-contact knee injury was noted (1 v 24, χ2:6.70, p = 0.01. Conclusions This study

Comment on the article titled "Increased Incidence of Amyotrophic Lateral Sclerosis in Polymyositis: A Nationwide Cohort Study".

Science.gov (United States)

Parperis, Konstantinos

2017-10-03

With interest, I read the recent article in Arthritis Care and Research titled "Increased Incidence of Amyotrophic Lateral Sclerosis in Polymyositis: A Nationwide Cohort Study" (1). Tseng at al (1) conducted a retrospective cohort study in Taiwan, exploring a link between amyotrophic lateral sclerosis (ALS) and polymyositis (PM). This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

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African Journals Online (AJOL)

Items 801 - 850 of 11090 ... Issue, Title. Vol 10, No 61 (2011), Analysis of chemical constituents in medicinal plants of selected districts of Pakhtoonkhwa, Pakistan, Abstract PDF. I Hussain, R Ullah, J Khan, N Khan, M Zahoor, N Ullah, MuR Khattak, FA Khan, A Baseer, M Khurram. Vol 10, No 77 (2011), Analysis of chloroplast ...

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African Journals Online (AJOL)

Items 151 - 200 of 387 ... Issue, Title. Vol 15, No 2 (2015), Introduction to Christian philosophy, Abstract. Charles Ogundu Nnaji. Vol 8, No 2 (2006), Is Quantum Mechanics a Complete Theory?: A Philosophical Defense of Einstein's Position, Abstract. U O Egbai. Vol 10, No 1 (2007), Jesus in Africa, Abstract. FF Edet. Vol 10, No ...

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Items 1 - 50 of 647 ... Issue, Title. Vol 13, No 2 (2010), 'N toekomstige perspektief op grondwetlike stabiliteit, Abstract PDF. F.W de Klerk. Vol 18, No 5 (2015), Cloete murray and Another v Firstrand bank ltd t/a Wesbank [2015] ZASCA 39A, Abstract PDF. M Laubscher. Vol 15, No 5 (2012), Cave Pecuniam: Lawyers as ...

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Items 1 - 50 of 814 ... Issue, Title. Vol 21, No 2 (2016), A 10 years trend of peptic ulcer disease and other gastrointestinal disorders in northern Uganda, Abstract PDF. T.R. Okello, D.M. Ogwang, I Pecorella. Vol 21, No 2 (2016), A 2-years description of traumatic brain injury admissions in Tikur Anbessa Specialized Hospital ...

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African Journals Online (AJOL)

Items 1 - 50 of 319 ... Issue, Title. Vol 23, No 2 (2016), Carica papaya juice enhanced in-vitro cell proliferation better than freeze-dried PBS extract using scratch assay, Abstract. A.B. Nafiu, E Abdulaziz, M.T. Rahman. Vol 23, No 2 (2016), A comparative study of the ownership and utilization of insecticide treated nets in ...

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African Journals Online (AJOL)

Items 1 - 50 of 52 ... Issue, Title. Vol 15 (2000), Ammi analysis of maize yield trials in South-Western Nigeria, Abstract. SR Ajibade, BA Ogunbodede. Vol 20 (2006), Association of yield with some agronomic characters in potatoes in a cool mid-altitude location, Abstract. CO Amadi, EE Ene Obong. Vol 20 (2006), Casein (CSN3) ...

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African Journals Online (AJOL)

Items 1 - 50 of 249 ... Issue, Title. Vol 10, No 1 (2010), Ye Shakoch Chilot (the court of the sheikhs): A traditional institution of conflict resolution in Oromiya zone of Amhara regional state, Ethiopia, Abstract PDF. M Zeleke. Vol 15, No 3 (2015), A comparative analysis of the Post- Arab Spring National Dialogues in Tunisia and ...

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Items 101 - 150 of 683 ... Issue, Title. Vol 54, No 1 (2006), Bovine tuberculosis survey in urban and peri urban dairy farms in coastal humid region of Tanga, Tanzania, Abstract. ES Swai, G Shirima, S Bwanga, W Moshy. Vol 60, No 3 (2012), Browsing capacity and nutritive value of indigenous browses in a tropical Coastal ...

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African Journals Online (AJOL)

Items 101 - 150 of 1215 ... Journal Home > Advanced Search > Browse Title Index. Log in or ... Vol 12, No 1 (2018), Analysis of the effects of frequent strikes on academic performance of students in universities in Nigeria: Edo State as a focal point, Abstract PDF ... Vol 6, No 1 (2012), Appraisal as a Determinant for Adequate ...

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Items 251 - 300 of 490 ... Issue, Title. Vol 6, No 2 (2010), Knowledge and patterns of use of highly active antiretroviral therapies in HIV management at Abuja, Nigeria, Abstract. Jill I Okpalugo, US Inyang, K Ibrahim, F Anita, Chinwe V Ukwe, NC Aguwa. Vol 5, No 4 (2009), Knowledge and utilization of the acts in two major ...

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Items 1 - 14 of 14 ... Issue, Title. Vol 2, No 1 (2009), Auditory and Respiratory Health Disorders Among Workers in an Iron and Steel Factory, Abstract. GM Abdel – Rasoul, OAE Mahrous, ME Abou Salem, MA Al-Batanony, HK Allam. Vol 2, No 1 (2009), Effect of An Educational Program About Medical Waste Management on ...

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Items 101 - 150 of 263 ... Issue, Title. Vol 1, No 2 (2002), Effect of Light and Darkness on Packed Cell Volume in the Rat, Abstract. A. A. OSINUBI, F. I. DURU, C. C. NORONHA, A. O. OKANLAWON. Vol 4, No 1 (2005), Effect of Marijuana Smoking on Blood Chemistry and Serum Biogenic Amines Concentrations in Humans ...

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Items 301 - 350 of 745 ... Issue, Title. Vol 9, No 3 (1999), Frequency And Outcome In AIDS Patients In A University Teaching Hospital – A Five Year Review, Abstract. SA Ogun, OO Adelowo, AEA ... Vol 18, No 2 (2008), Good cllinical practice in clinical drug trials - What you need to know, Abstract. K Soyebi, Y Abosede, HAB ...

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Items 151 - 200 of 4119 ... Issue, Title. Vol 86, No 2 (1996), A re-evaluation of isotope screening for skeletal metastases in nodenegative breast cancer, Abstract PDF. C.A. Gudgeon, I.D. Werner, D.M. Dent. Vol 104, No 6 (2014), A reflection on the South African Medical Association – past, present and future, Abstract PDF.

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African Journals Online (AJOL)

Items 351 - 400 of 979 ... Issue, Title. Vol 45, No 9 (2003), Erectile dysfunction: A GP's guide to clinical assessment, Abstract PDF. PJ Harden. Vol 47, No 4 (2005), Ethical Issues in Family Practice: My Culture – Right or Wrong? Abstract PDF. GA Ogunbanjo, D Knapp van Bogaert. Vol 59, No 3 (2017), Ethical issues with ...

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Items 201 - 250 of 333 ... Issue, Title. Vol 15, No 1 (2016), Irrigation potential of Inuakpa in Odukpani local government of Cross river using Kostiakov model, Abstract PDF. B.O. Unuigbe, K.I. Ofem, N.R.B. Antigha. Vol 2, No 2 (2003), LABOUR USE IN SMALL-SCALE YAM PRODUCTION IN QUA'AN PAN LOCAL GOVERNMENT ...

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Items 701 - 750 of 1010 ... Issue, Title. Vol 6, No 2 (1998), Performance et stabilité de rendement des génotypes de patate douce dans divers environnements à l'est du Congo, Abstract. P Phemba, T Mutombo, N B Lutaladio, E E Carey. Vol 22 (2014): Supplement, Performance of Artemia shell-free embryos, Moina micrura and ...

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Issue, Title. Vol 13, No 2 (2013), Using Mindfulness as a Teaching Aid for Phenomenology, Abstract PDF. IR Owen. Vol 8, No 1 (2008), Were Nietzsche's Cardinal Ideas – Delusions? Abstract PDF. Eva M Cybulska. Vol 12, No 1 (2012), What did you learn in school today? Abstract PDF. Carina Henriksson. Vol 5, No 1 (2005) ...

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Items 4351 - 4386 of 4386 ... Issue, Title. Vol 107, No 6 (2017), When students become patients: TB disease among medical undergraduates in Cape Town, South Africa, Abstract PDF. H van der Westhuizen, A Dramowski. Vol 106, No 4 (2016), Where do children die and what are the causes? Under-5 deaths in the Metro West ...

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Issue, Title. Vol 10, No 2 (2014), Sorindeia warneckei Engl. (Anacardiaceae), une espèce multi-usagère de la dépression de la Lama au Togo, Abstract PDF. A Akodewou, S Akpavi, M Dourma, K Batawila, KB Amegnaglo, W Atakpama, K Akpagama. Vol 10, No 1 (2014), Sterculia setigera Del.: influence de quelques ...

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Items 1 - 50 of 126 ... Issue, Title. Vol 8, No 2 (2016), 2010 FIFA World Cup stadium investment: Does the post-event usage justify the expenditure? Abstract PDF. Luke Humphrey, Gavin Fraser. Vol 6, No 1 (2014), 7Implication of mergers and acquisitions on stock returns before and during the 2007–2009 credit crunch: An ...

20 CFR 638.510 - Health care and services.

Science.gov (United States)

2010-04-01

... UNDER TITLE IV-B OF THE JOB TRAINING PARTNERSHIP ACT Center Operations § 638.510 Health care and services. The center operator shall provide a health program, including basic medical, dental, and mental...

48 CFR 32.503-15 - Application of Government title terms.

Science.gov (United States)

2010-10-01

... Application of Government title terms. (a) Property to which the Government obtains title by operation of the... Property; and (2) The termination clauses at 52.249, for termination inventory. (c) The contractor may sell... the scrap disposition. (d) When the title to materials or other inventories is vested in the...

20 CFR 411.552 - What effect will the subsequent entitlement to title II benefits have on EN payments for title...

Science.gov (United States)

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false What effect will the subsequent entitlement to title II benefits have on EN payments for title XVI beneficiaries after they assign their ticket? 411.552 Section 411.552 Employees' Benefits SOCIAL SECURITY ADMINISTRATION THE TICKET TO WORK AND SELF...

Matrix of Title V-Related And Air Grant-Eligible Activities

Science.gov (United States)

This document may be of assistance in applying the Title V air operating permit regulations. This document is part of the Title V Policy and Guidance Database available at www2.epa.gov/title-v-operating-permits/title-v-operating-permit-policy-and-guidance-document-index. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Title XX and CETA. A Coordination Guide for Title XX Administrators.

Science.gov (United States)

Urban Management Consultants of San Francisco, Inc., CA.

Written for the social service (Title XX) administrator at the State or sub-State level, this guide is intended to serve four major purposes: (1) Provide selected insights into what the Comprehensive Employment and Training Act (CETA) is and how it works; (2) point out potential areas for coordination which, from study or field experience, hold…

Browse Title Index

African Journals Online (AJOL)

Items 201 - 250 of 327 ... Issue, Title. Vol 10, No 4 (2016), Omphalocoeles: A decade in review, Abstract PDF. S Singh, A Madaree. Vol 2, No 4 (2008), Ortner syndrome, Abstract PDF. E Meyer, NE Jones, LJ Zühlke. Vol 10, No 3 (2016), Outcome of children admitted to a general highcare unit in a regional hospital in the ...

Browse Title Index

African Journals Online (AJOL)

Items 1 - 50 of 356 ... Issue, Title. Vol 27, No 3 (2014), A desire for weight loss in season increases disordered eating behaviour risk and energy deficiency in athletes, Abstract PDF. HH Wright, R Ford, CR Botha. Vol 29, No 3 (2016), A review of infant and young child feeding practice in hospital and the home in KwaZulu-Natal ...

Browse Title Index

African Journals Online (AJOL)

Items 1 - 50 of 412 ... Issue, Title. Vol 32, No 2 (2013), Seinsverständnis and meaning in Heidegger, Abstract. Rafael Winkler. Vol 21, No 3 (2002), A defense of peace as a human right, Abstract. Patrick Hayden. Vol 26, No 2 (2007), A Kantian stance on teleology in biology, Abstract. AA Cohen. Vol 30, No 1 (2011), A Likely ...

Browse Title Index

African Journals Online (AJOL)

Items 151 - 200 of 286 ... Issue, Title. Vol 2, No 3-4 (2008), Impact of fire wood collection on trees species diversity in Bauchi state, Nigeria, Abstract. A Nura, A Ibrahim, I Mohammed, U Haruna. Vol 5, No 3 (2011), Impact of national special program for food security in Abia State, nigeria, Abstract. CO Emerole. Vol 5, No 1 (2011) ...

24 CFR 200.61 - Title.

Science.gov (United States)

2010-04-01

... Commissioner. (c) Endorsement of the credit instrument for insurance shall evidence the acceptability of title... GENERAL INTRODUCTION TO FHA PROGRAMS Requirements for Application, Commitment, and Endorsement Generally...

Energy Information Data Base: serial titles

International Nuclear Information System (INIS)

1980-06-01

The Department of Energy Technical Information Center (TIC) is responsible for creating bibliographic data bases that are used in the announcement and retrieval of publications dealing with all phases of energy. The TIC interactive information processing system makes use of a number of computerized authorities so that consistency can be maintained and indexes can be produced. One such authority is the Energy Information Data Base: Serial Titles. This authority contains the full and abbreviated journal title, country of publication, CODEN, and certain codes. This revision replaces previous revisions of this document

Complementary and alternative medical therapies for chronic low back pain: What treatments are patients willing to try?

Directory of Open Access Journals (Sweden)

Erro Janet

2004-07-01

Full Text Available Abstract Background Although back pain is the most common reason patients use complementary and alternative medical (CAM therapies, little is known about the willingness of primary care back pain patients to try these therapies. As part of an effort to refine recruitment strategies for clinical trials, we sought to determine if back pain patients are willing to try acupuncture, chiropractic, massage, meditation, and t'ai chi and to learn about their knowledge of, experience with, and perceptions about each of these therapies. Methods We identified English-speaking patients with diagnoses consistent with chronic low back pain using automated visit data from one health care organization in Boston and another in Seattle. We were able to confirm the eligibility status (i.e., current low back pain that had lasted at least 3 months of 70% of the patients with such diagnoses and all eligible respondents were interviewed. Results Except for chiropractic, knowledge about these therapies was low. Chiropractic and massage had been used by the largest fractions of respondents (54% and 38%, respectively, mostly for back pain (45% and 24%, respectively. Among prior users of specific CAM therapies for back pain, massage was rated most helpful. Users of chiropractic reported treatment-related "significant discomfort, pain or harm" more often (23% than users of other therapies (5–16%. Respondents expected massage would be most helpful (median of 7 on a 0 to 10 scale and meditation least helpful (median of 3 in relieving their current pain. Most respondents indicated they would be "very likely" to try acupuncture, massage, or chiropractic for their back pain if they did not have to pay out of pocket and their physician thought it was a reasonable treatment option. Conclusions Most patients with chronic back pain in our sample were interested in trying therapeutic options that lie outside the conventional medical spectrum. This highlights the need for additional

Complementary and alternative medical therapies for chronic low back pain: What treatments are patients willing to try?

Science.gov (United States)

Sherman, Karen J; Cherkin, Daniel C; Connelly, Maureen T; Erro, Janet; Savetsky, Jacqueline B; Davis, Roger B; Eisenberg, David M

2004-07-19

Although back pain is the most common reason patients use complementary and alternative medical (CAM) therapies, little is known about the willingness of primary care back pain patients to try these therapies. As part of an effort to refine recruitment strategies for clinical trials, we sought to determine if back pain patients are willing to try acupuncture, chiropractic, massage, meditation, and t'ai chi and to learn about their knowledge of, experience with, and perceptions about each of these therapies. We identified English-speaking patients with diagnoses consistent with chronic low back pain using automated visit data from one health care organization in Boston and another in Seattle. We were able to confirm the eligibility status (i.e., current low back pain that had lasted at least 3 months) of 70% of the patients with such diagnoses and all eligible respondents were interviewed. Except for chiropractic, knowledge about these therapies was low. Chiropractic and massage had been used by the largest fractions of respondents (54% and 38%, respectively), mostly for back pain (45% and 24%, respectively). Among prior users of specific CAM therapies for back pain, massage was rated most helpful. Users of chiropractic reported treatment-related "significant discomfort, pain or harm" more often (23%) than users of other therapies (5-16%). Respondents expected massage would be most helpful (median of 7 on a 0 to 10 scale) and meditation least helpful (median of 3) in relieving their current pain. Most respondents indicated they would be "very likely" to try acupuncture, massage, or chiropractic for their back pain if they did not have to pay out of pocket and their physician thought it was a reasonable treatment option. Most patients with chronic back pain in our sample were interested in trying therapeutic options that lie outside the conventional medical spectrum. This highlights the need for additional studies evaluating their effectiveness and suggests that

Relapsing-Remitting MS (RRMS)

Medline Plus

Full Text Available ... Electrical Stimulation (FES) d Complementary & Alternative Medicines Chiropractic Therapy Marijuana Massage and Bodywork Acupuncture d For Clinicians ... you and your MS care provider discuss your treatment options and expected outcomes. For example: If you ...

Chiropractors' perception of occupational stress and its influencing factors: a qualitative study using responses to open-ended questions.

Science.gov (United States)

Williams, Shawn

2016-01-01

Job stress and emotional exhaustion have been shown to have a negative impact on the helping professional. The development and causal relations of job stress and emotional exhaustion are rather unclear in the chiropractic profession. The objective of this study is to understand the main sources of occupational stress and emotional exhaustion among doctors of chiropractic. Analysis of the written responses to web-based open-ended questionnaire was performed using an interpretive research methodology. Additionally, cross tabulation and Chi square statistical tests were conducted to match and couple the demographic data with the categorical themes. Fourteen professional stress categories emerged from the 970 completed surveys. "Managed Care Organization regulation", "Managed Care reimbursement" and "Scope of Practice Issues" were the most common stressors that negatively influenced chiropractors' professional and personal lives. The results of the categorical analysis suggests that age, marital status, number of years in practice and location of practice may have an influence on the category of stress reported by chiropractors. The qualitative approach revealed common, conventional and culture-specific job stressors in doctors of chiropractic. Notably, these findings suggest an association between third-party payer influences (increased regulation/decreased reimbursement) with that of increased job stress. Further research will be undertaken to refine the stress and satisfaction parameters and address stress interventions.

The West Family Chiropractic Dynasty: celebrating a century of accomplishment in Canada: Part I: Archibald B. West, DC, Samuel H. West, DC and Stephen E. West, DC: The Founding Father, his Son and Grandson.

Science.gov (United States)

Brown, Douglas M

2010-09-01

This historical treatise documents the unbroken legacy of the West family of chiropractors which has flourished in Canada for over 100 years. Part I, unearths the origins, development and careers of Archibald West, the founder of this dynasty, his son Samuel and grandson Stephen. Part II, not yet ready for publication, will delve into the lives of Archibald's brother Samson and his chiropractic progeny, as well as a nephew of Stephen and another relative of Frederick West.

Title V Permitting Statistics Inventory

Data.gov (United States)

U.S. Environmental Protection Agency — The Title V Permitting Statistics Inventory contains measured and estimated nationwide statistical data, consisting of counts of permitted sources, types of permits...

Establishing contact and gaining trust : an exploratory study of care avoidance

NARCIS (Netherlands)

Schout, Gert; de Jong, Gideon; Zeelen, Jacques

Title. Establishing contact and gaining trust: an exploratory study of care avoidance. Aim. This paper is a report of a study conducted to explore the competencies especially deep-rooted personal qualities - of care providers who succeed in making contact and gaining trust with clients who are

8 ỌZỌ TITLE: THE IGBOMAN'S ARISTOCRATIC INSTITUTION ...

African Journals Online (AJOL)

But money may not be the problem of all the people who are yet to take titles. Some may not like ... Stage One: Payment - In this, the intending ọzọ title holder pays a little sum of money to the alliance group in ..... Orji, M. O. (1999). The History ...

Impact of prenatal care provider on the use of ancillary health services during pregnancy

Science.gov (United States)

2013-01-01

Background Recent declines in the provision of prenatal care by family physicians and the integration of midwives into the Canadian health care system have led to a shift in the pattern of prenatal care provision; however it is unknown if this also impacts use of other health services during pregnancy. This study aimed to assess the impact of the type of prenatal care provider on the self-reported use of ancillary services during pregnancy. Methods Data for this study was obtained from the All Our Babies study, a community-based prospective cohort study of women’s experiences during pregnancy and the post-partum period. Chi-square tests and logistic regression were used to assess the association between type of prenatal care provider and use of ancillary health services in pregnancy. Results During pregnancy, 85.8% of women reported accessing ancillary health services. Compared to women who received prenatal care from a family physician, women who saw a midwife were less likely to call a nurse telephone advice line (OR = 0.30, 95% CI: 0.18-0.50) and visit the emergency department (OR = 0.47, 95% CI: 0.24-0.89), but were more likely receive chiropractic care (OR = 4.07, 95% CI: 2.49-6.67). Women who received their prenatal care from an obstetrician were more likely to visit a walk-in clinic (OR = 1.51, 95% CI: 1.11-2.05) than those who were cared for by a family physician. Conclusions Prenatal care is a complex entity and referral pathways between care providers and services are not always clear. This can lead to the provision of fragmented care and create opportunities for errors and loss of information. All types of care providers have a role in addressing the full range of health needs that pregnant women experience. PMID:23497179

Nursing care of the newborn in a neonatal intensive care unit

Directory of Open Access Journals (Sweden)

Taysa Costa da Silva

2017-06-01

Full Text Available Objective: To verify the main measures of care for the newborn in the neonatal intensive care unit. Method: This is an integrative review, in which, it is possible to identify, analyze and synthesize research results with the inclusion of experimental and non-experimental studies. A total of 133 articles were collected. After reading titles, exclusion criteria and reading resumes, 10 were left, in which the sample was composed. Results: The selected publications were placed in 3 thematic categories: The importance of knowledge in nursing care, to the internal NB in ​​NICU; Nursing evaluation and care used for pain relief in NB; Main factors and adverse events that may lead to the hospitalization of the newborn and the increase of morbidity and mortality in an NICU. Conclusion: The analysis of the aforementioned study exposes the importance and main nursing care that can be administered in newborns in a NICU, so that the reduction of neonatal mortality can be provided. Descriptors: Neonatal Intensive Care Unit; Nursing care; Newborn.

27 CFR 46.205 - Guidelines to determine title to articles in transit.

Science.gov (United States)

2010-04-01

... title to articles in transit. 46.205 Section 46.205 Alcohol, Tobacco Products and Firearms ALCOHOL AND... determine title to articles in transit. The dealer may use the following guidelines to establish who holds title to articles in transit. (a) If State law mandates the change in title, then no agreement or...

75 FR 20999 - Proposed Collection; Comment Request; Survey of Health Care Professionals' Awareness and...

Science.gov (United States)

2010-04-22

... Request; Survey of Health Care Professionals' Awareness and Perceptions of the National Cancer Institute's... approval. Proposed Collection: Title: The Survey of Health Care Professionals' Awareness and Perceptions of... respondents response (minutes/hour) hours Health care professionals who complete the 330 1 5/60 27.5 survey (0...

The Translation of Films: Sub-Titling versus Dubbing

Science.gov (United States)

Voge, Hans

1977-01-01

A study of film translation. Well-documented opinions are given on the advantages and disadvantages of both dubbing and sub-titling. One of the tentative conclusions is that sub-titling is to be preferred because it preserves the original dialogue and allows the audience verying degrees of comprehension. A bibliography is provided. (AMH)

Delay and probability discounting among payday and title loan recipients.

Science.gov (United States)

Mahoney, Colin T; Lawyer, Steven R

2016-04-01

Payday and title loans are short-term loans associated with significant economic impact. Behavioral theories of impulsive choice may provide insight into behavioral processes that underlie the propensity to take out payday and title loans. Adults between the ages of 18 and 30 recruited from the community completed delay and probability discounting tasks for hypothetical money as well as measures of substance use. Patterns of discounting were characterized using a hyperbolic decay model and area under the curve. Participants who took out a payday and/or title loan in the past (n=41) exhibited more impulsive choice patterns on the delay discounting task than did those who did not (n=255). Substance use mediated this relationship between payday and title loan retention and delay discounting. These findings suggest potentially important relationships between payday/title loan borrowing, substance use, and delay discounting. Copyright © 2016 Elsevier B.V. All rights reserved.

Variation in job titles within the nursing workforce.

Science.gov (United States)

Leary, Alison; Maclaine, Katrina; Trevatt, Paul; Radford, Mark; Punshon, Geoffrey

2017-12-01

The work of specialist nursing has been under scrutiny for many years in the UK due to a perception that it is not cost-effective. A common issue is the lack of consistency of job titles, which causes confusion to the public, employing organisations, colleagues and commissioners of services. Lack of consistency has implications for the wider perception of advanced specialist practice in the worldwide community and the workforce more generally. This study aims to understand the variation in job titles in the UK population. A pre-existing data set of accrued studies into the work of nurses working in specialisms was mined for insight (N = 17,960). This study used knowledge discovery through data and descriptive statistics to perform secondary analysis. Mining these data revealed 595 job titles in use in 17,960 specialist posts once the specialism had been removed. The most commonly used titles were Clinical Nurse Specialist, Nurse Specialist/Specialist Nurse, Advanced Nurse Practitioner and Nurse Practitioner. There were three other primary groupings. These were variants with a specialist or technical prefix of suffix, for example Nurse Endoscopist, variants of seniority such as trainee, senior nurse for [specialism] or variants of function such as Nurse Prescriber. The clustering was driven primarily by pay band. A total of 323 posts were recorded as holding titles such as Advanced Nurse Practitioner or Specialist Nurse who were not registered with the Nursing & Midwifery Council. In this data set, there is a large array of titles, which appear to have little relationship with other factors like education. This is confusing to the public, employers and those commissioning services. It also demonstrates that the previous assumptions by Council for Healthcare Regulatory Excellence that advanced practice labels are associated with career progression are unsound and should be addressed by the regulator. © 2017 John Wiley & Sons Ltd.

Aboriginal Determination: Native Title Claims and Barriers to Recognition

Directory of Open Access Journals (Sweden)

Zia Akhtar

2011-09-01

Full Text Available The Australian government has proposed a referendum in 2012 to decide the constitutional status of its indigenous people. There is at present no mechanism to define the indigenous people as a domestic or foreign entity of the Commonwealth. This is an important issue because other settler governments have developed a framework to implement their relationship with the native people. As a result, it is difficult prove title to land that has been abrogated by the deeds of the settlers. In Mabo v Queensland (2,the Commonwealth government was found to have breached its fiduciary duty to the Aboriginal peoples. The judgment led to the Native Title Act 1993 that established the process of asserting native rights that were held to coexist with pastoral ownership. The promulgation of the Native Title Amendment Act 1998 reversed this process and augmented the powers of non-native landlords by providing the device to extinguish native rights. In Western Australia v Ward, a mining lease was held to have precedence over native title that was adjudged to be part of a bundle of rights. In implementing the Native Title Act the issue turns on the determination of the ties to land/ sea that the government allows to the Aboriginal peoples. The judgment in Harrington-Smith on behalf of the Wongatha People v Western Australia indicates that title can be excluded on procedural grounds and that there was an incompatibility between the claims of the Aboriginal peoples and the settlers’ claims. The road map towards a more effective regime of proving title can be achieved if the Aboriginal peoples are granted recognition as a nation in the Constitution and a treaty is signed with them.

24 CFR 1710.209 - Title and land use.

Science.gov (United States)

2010-04-01

... 24 Housing and Urban Development 5 2010-04-01 2010-04-01 false Title and land use. 1710.209... § 1710.209 Title and land use. (a) General information. (1) State whether the developer has reserved the... recording, submit a map which has been prepared to scale and which shows the proposed division of the land...

The Ripple Effect of Title IX on Women's Health Issues: Treating an Increasingly Active Population.

Science.gov (United States)

Mees, Patricia D

2003-04-01

Perhaps no area in sports medicine has changed as dramatically in the last 30 years as women's health. Title IX of the Education Amendments of 1972 prohibited discrimination on the basis of sex in all curricular and extracurricular activities at educational institutions that receive federal funding. Before 1972, many assumed that women were not interested in sports and that there was no need to provide programs for girls and women, and most primary care physicians had little experience in treating female athletes and other active women.

76 FR 35221 - Proposed Collection; Comment Request; NINR End-of-Life and Palliative Care Science Needs...

Science.gov (United States)

2011-06-16

... Request; NINR End-of-Life and Palliative Care Science Needs Assessment: Funding Source Questionnaire... Collection: Title: NINR End-of-Life and Palliative Care Science Needs Assessment: Funding Source... Collection: The NINR End-of-Life Science Palliative Care (EOL PC) Needs Assessment: Funding Source...

Pain: Hope through Research

Science.gov (United States)

... in drugstores. Chiropractic care may ease back pain, neck pain, headaches, and musculoskeletal conditions. It involves "hands-on" ... together. The peripheral nervous system refers to the cervical, thoracic, ... or dysfunction (such as pain) travel from the brain to the spinal cord ...

Pacific Custom Materials, Petition to Object to Title V Operating Permit

Science.gov (United States)

This document may be of assistance in applying the Title V air operating permit regulations. This document is part of the Title V Petition Database available at www2.epa.gov/title-v-operating-permits/title-v-petition-database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

When astrophysics meets lay and specialized audiences: titles in popular and scientific papers

OpenAIRE

Alcaraz Ariza, María Ángeles; Méndez Alcaraz, David Israel

2016-01-01

In this study we carry out a comparative analysis between titles of research papers published in the most authoritative specialized European and US-based astrophysics journals written in English and titles of articles on astrophysics published in Scientific American Magazine, the most prestigious English-written journal in the divulgation of science. We specifically address issues related to three linguistic variables: title length, title lexical density and title type. Our main results show ...

24 CFR 1710.109 - Title to the property and land use.

Science.gov (United States)

2010-04-01

... under the authority of title IV of the Intergovernmental Cooperation Act of 1968.) ... title to property generally has the right to own, use and enjoy the property. A contract to buy a lot... affect your title.” “Here we will discuss the sales contract you will sign and the deed you will receive...

Parents Ask about Title I = Los padres preguntan del Titulo I.

Science.gov (United States)

RMC Research Corp., Portsmouth, NH.

Title I, the largest federal aid program for elementary, middle, and high schools, is introduced in this publication, which includes both English and Spanish versions. Through Title I, the Federal government gives money to school districts around the country based on the number of low-income families in each district. Each district uses Title I…

Title List of documents made publicly available

International Nuclear Information System (INIS)

1982-07-01

The Title List of Documents Made Publicly Available is a monthly publication. It contains descriptions of the information received and generated by the US Nuclear Regulatory Commission (NRC). This information includes: (1) docketed material associated with civilian nuclear power plants and other uses of radioactive materials and (2) nondocketed material received and generated by NRC pertinent to its role as a regulatory agency. As used here, docketed does not refer to Court dockets; it refers to the system by which NRC maintains its regulatory records. This series of documents is indexed by a Personal Author Index, a Corporate Source Index, and a Report Number Index. The docketed information contained in the Title List includes the information formerly issued through the Department of Energy publication Power Reactor Docket Information, last published in January 1979. Microfiche of the docketed information listed in the Title List is available for sale on a subscription basis from the National Technical Information Service (NTIS)

Title List of documents made publicly available

International Nuclear Information System (INIS)

1982-06-01

The Title List of Documents Made Publicly Available is a monthly publication. It contains descriptions of the information received and generated by the US Nuclear Regulatory Commission (NRC). This information includes: (1) docketed material associated with civilian nuclear power plants and other uses of radioactive materials and (2) nondocketed material received and generated by NRC pertinent to its role as a regulatory agency. As used here, docketed does not refer to Court dockets; it refers to the system by which NRC maintains its regulatory records. This series of documents is indexed by a Personal Author Index, a Corporate Source Index, and a Report Number Index. The docketed information contained in the Title List includes the information formerly issued throught the Department of Energy publication Power Reactor Docket Information, last published in January 1979. Microfiche of the docketed information listed in the Title List is available for sale on a subscription basis from the National Technical Information Service (NTIS)

Measuring philosophy: a philosophy index

OpenAIRE

Biggs, Lesley; Mierau, Dale; Hay, David

2002-01-01

Chiropractic philosophy which has been debated since the founding of chiropractic in 1895 has taken on new vigour over the past ten years. Despite a growing body of literature examining chiropractic philosophy, the chiropractic profession continues to be divided over this issue. To date, there has been little research examining the meaning of chiropractic philosophy to rank-and-file practitioners.

Uniform Title in Theory and in Slovenian and Croatian Cataloguing Practice

Directory of Open Access Journals (Sweden)

Marija Petek

2013-09-01

Full Text Available ABSTRACTPurpose:  The paper investigates the importance and development of uniform title that enables collocation in the library catalogue. Research results on use of uniform titles in two union catalogues, the Slovenian COBISS and the Croatian CROLIST are also presented.Methodology/approach:  Theoretical apects of the uniform title are treated: for the first time by Panizzi, then in the Paris Principles being the basis for the Verona's cataloguing code; in the latest International Cataloguing Principles including conceptual models Functional Requirements for Bibliographic Records (FRBR and Functional Requirements for Authority Data (FRAD; and last but not least in the international cataloguing code Resource Description and Access (RDA. To find out whether the uniform titles are used consistently according to the Verona's cataloguing code and to the requirements of the bibliographic formats COMARC and UNIMARC, the frequency of tags 300 and 500 in bibliographic records is explored.Results:  The research results indicate that the use of uniform titles in COBISS and CROLIST is not satisfactory and that the tags 300 and 500 are often missing in bibliographic recods. In online catalogues a special attention should be given to the uniform title as it is considered an efficient linking device in the catalogue and as it enables collocation.Research limitations:  The research is limited to bibliographic records for translations of works of personal authors and of anonymous works; corporate authors are not included.Originality/practical implications:  Presenting development of the uniform title from the very beginning up to now and the first research on the uniform title in COBISS.

Ambulatory care registered nurse performance measurement.

Science.gov (United States)

Swan, Beth Ann; Haas, Sheila A; Chow, Marilyn

2010-01-01

On March 1-2, 2010, a state-of-the-science invitational conference titled "Ambulatory Care Registered Nurse Performance Measurement" was held to focus on measuring quality at the RN provider level in ambulatory care. The conference was devoted to ambulatory care RN performance measurement and quality of health care. The specific emphasis was on formulating a research agenda and developing a strategy to study the testable components of the RN role related to care coordination and care transitions, improving patient outcomes, decreasing health care costs, and promoting sustainable system change. The objectives were achieved through presentations and discussion among expert inter-professional participants from nursing, public health, managed care, research, practice, and policy. Conference speakers identified priority areas for a unified practice, policy, and research agenda. Crucial elements of the strategic dialogue focused on issues and implications for nursing and inter-professional practice, quality, and pay-for-performance.

Browse Title Index - AJOL

African Journals Online (AJOL)

Items 501 - 508 of 508 ... Issue, Title. Vol 33, No 2 (2011), Visuele stereotipering van sportvroue in die sportmedia, Abstract. M Brandt, A Carstens. Vol 30, No 1 (2008), Volunteers\\' perceptions of benefits derived from volunteering: an empirical study, Abstract. J Surujlal, M Dhurup. Vol 33, No 1 (2011), Was the Conconi test ...

ORIGINAL ARTICLES

African Journals Online (AJOL)

alternatives to conventional care (homoeopathy, chiropractic, acupuncture, etc.), and also recognise the groundswell of interest in and support for inclusion of benefits for services provided by traditional healers. The transition from the original, relatively restricted approach which was concerned with established, mainstream.

76 FR 624 - Proposed Information Collection (Patient Satisfaction Survey Michael E. DeBakey Home Care Program...

Science.gov (United States)

2011-01-05

... Collection (Patient Satisfaction Survey Michael E. DeBakey Home Care Program) Activity: Comment Request... satisfaction with the quality of services/care provided by home care program staff. An agency may not conduct... Form 10-0476).'' SUPPLEMENTARY INFORMATION: Title: Patient Satisfaction Survey Michael E. DeBakey Home...

75 FR 70254 - PSD and Title V Permitting Guidance for Greenhouse Gases

Science.gov (United States)

2010-11-17

... Guidance for Greenhouse Gases AGENCY: Environmental Protection Agency (EPA). ACTION: Notice of availability..., ``PSD and Title V Permitting Guidance for Greenhouse Gases'' on its significant guidance Internet Web... guidance titled, ``PSD and Title V Permitting Guidance for Greenhouse Gases.'' This document has been...

Region 7 Title V facilities

Data.gov (United States)

U.S. Environmental Protection Agency — This web map shows the Region 7 Title V facilities (Clean Air Act major sources), any Class I areas within 300 km of R7 States, and any Tribal areas within 50 miles...

Developing a virtual community for health sciences library book selection: Doody's Core Titles.

Science.gov (United States)

Shedlock, James; Walton, Linda J

2006-01-01

The purpose of this article is to describe Doody's Core Titles in the Health Sciences as a new selection guide and a virtual community based on an effective use of online systems and to describe its potential impact on library collection development. The setting is the availability of health sciences selection guides. Participants include Doody Enterprise staff, Doody's Library Board of Advisors, content specialists, and library selectors. Resources include the online system used to create Doody's Core Titles along with references to complementary databases. Doody's Core Titles is described and discussed in relation to the literature of selection guides, especially in comparison to the Brandon/Hill selected lists that were published from 1965 to 2003. Doody's Core Titles seeks to fill the vacuum created when the Brandon/Hill lists ceased publication. Doody's Core Titles is a unique selection guide based on its method of creating an online community of experts to identify and score a core list of titles in 119 health sciences specialties and disciplines. The result is a new selection guide, now available annually, that will aid health sciences librarians in identifying core titles for local collections. Doody's Core Titles organizes the evaluation of core titles that are identified and recommended by content specialists associated with Doody's Book Review Service and library selectors. A scoring mechanism is used to create the selection of core titles, similar to the star rating system employed in other Doody Enterprise products and services.

Evaluating the feasibility of using online software to collect patient information in a chiropractic practice-based research network.

Science.gov (United States)

Kania-Richmond, Ania; Weeks, Laura; Scholten, Jeffrey; Reney, Mikaël

2016-03-01

Practice based research networks (PBRNs) are increasingly used as a tool for evidence based practice. We developed and tested the feasibility of using software to enable online collection of patient data within a chiropractic PBRN to support clinical decision making and research in participating clinics. To assess the feasibility of using online software to collect quality patient information. The study consisted of two phases: 1) Assessment of the quality of information provided, using a standardized form; and 2) Exploration of patients' perspectives and experiences regarding online information provision through semi-structured interviews. Data analysis was descriptive. Forty-five new patients were recruited. Thirty-six completed online forms, which were submitted by an appropriate person 100% of the time, with an error rate of less than 1%, and submitted in a timely manner 83% of the time. Twenty-one participants were interviewed. Overall, online forms were preferred given perceived security, ease of use, and enabling provision of more accurate information. Use of online software is feasible, provides high quality information, and is preferred by most participants. A pen-and-paper format should be available for patients with this preference and in case of technical difficulties.

Tennessee Valley Authority, Paradise Fossil Plant; Petition to Object to Title V Operating Permit

Science.gov (United States)

This document may be of assistance in applying the Title V air operating permit regulations. This document is part of the Title V Petition Database available at www2.epa.gov/title-v-operating-permits/title-v-petition-database.

Use of provider-based complementary and alternative medicine by adult smokers in the United States: Comparison from the 2002 and 2007 NHIS survey.

Science.gov (United States)

Hamm, Eric; Muramoto, Myra L; Howerter, Amy; Floden, Lysbeth; Govindarajan, Lubna

2014-01-01

To provide a snapshot of provider-based complementary and alternative medicine (pbCAM) use among adult smokers and assess the opportunity for these providers to deliver tobacco cessation interventions. Cross-sectional analysis of data from the 2002 and 2007 National Health Interview Surveys. Nationally representative sample. A total of 54,437 (31,044 from 2002; 23,393 from 2007) adults 18 years and older. The analysis focuses on 10 types of pbCAM, including acupuncture, Ayurveda, biofeedback, chelation therapy, chiropractic care, energy therapy, folk medicine, hypnosis, massage, and naturopathy. The proportions of current smokers using any pbCAM as well as specific types of pbCAM in 2002 and 2007 are compared using SAS SURVEYLOGISTIC. Between 2002 and 2007, the percentage of recent users of any pbCAM therapy increased from 12.5% to 15.4% (p = .001). The largest increases occurred in massage, chiropractic, and acupuncture. Despite a decrease in the national average of current smokers (22.0% to 19.4%; p = .001), proportions of smokers within specific pbCAM disciplines remained consistent. Complementary and alternative medicine (CAM) practitioners, particularly those in chiropractic, acupuncture, and massage, represent new cohorts in the health care community to promote tobacco cessation. There is an opportunity to provide brief tobacco intervention training to CAM practitioners and engage them in public health efforts to reduce the burden of tobacco use in the United States.

Une Unite Discursive Restreinte: le Titre (A Restricted Discourse Unit: The Title).

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Vigner, Gerard

1980-01-01

Describes the functions, specific uses, syntactic structure, and typographical characteristics of titles, discussing examples from newspapers, books, films, and scientific journals. Analysis of the semantic relationship between title and text is followed by the description of various instructional techniques for the production of titles and the…

Should title lengths really adhere to the American Psychological Association's twelve word limit?

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Hallock, Robert M; Dillner, Kari M

2016-04-01

The publication manual for the American Psychological Association (APA) suggests that title lengths do not exceed 12 words, yet journals do not prevent longer titles. Here, we examined title lengths in APA journals to see how many exceeded the APA's suggested limit. First, we conducted a systematic analysis of 235 articles in the current issues of 23 APA journals. A total of 52% of titles were more than 12 words long. Second, we examined articles from APA journals that were at least 50 years old to examine whether title lengths have changed over time. Our results suggested that the average title lengths have indeed increased with time. One of 2 courses should be taken. Perhaps science is becoming more complex that longer titles are needed in order to convey the primary message to the reader. If this is the case, then the APA's word limit should be increased. On the other hand, however, maybe editor and reviewers should try to enforce the current word limit to force writers to be succinct. Either way, editors should make their preferences clear so that the trend for longer titles does not continue unchecked. (c) 2016 APA, all rights reserved).

Follow the Money: School Spending from Title I to Adult Earnings

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Rucker C. Johnson

2015-12-01

Full Text Available Title I funding has been the largest federal program of K–12 education for the past fifty years, the objective being to eliminate the educational disadvantage associated with poverty. I provide new evidence on the long-term effects of school spending from Title I on children's educational and adult economic outcomes. To study effects of Title I, I link school district spending and administrative data on Title I funding to nationally representative data on children born between 1950 and 1977 and followed through 2011. Models include controls for birth cohort and school district fixed effects, childhood family–neighborhood characteristics, and other policies. I find that increases in Title I funding are significantly related to increases in educational attainment, high school graduation rates, higher earnings and work hours, reductions in grade repetition, school suspension or expulsion, incarceration, and reductions in the annual incidence of poverty in adulthood; effects on educational outcomes are more pronounced for poor children.