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Can a Multivitamin Reduce Breast Cancer Recurrence?
There is a great deal of controversy regarding the value of multivitamin supplements in cancer prevention. However, with respect to preventing breast cancer recurrence, an important study was published in the Journal of Breast Cancer Research and Treatment in 2011 by Kwan ML, et al.
All Fiber Is Not Created Equal
Sometimes the best place to start is at the end. So, the conclusion of this article is that all fiber is good ... but some fiber is better. Let's break it down. There are two main types of fiber: soluble fiber and insoluble fiber.
Branding: Set Your Practice Apart
Dr. Brad started his practice seven years ago on a shoestring budget. He created his generic logo in five minutes using a website because he didn't have the time to figure out how to make something special.
What We Can Learn From Spine Surgery
Patients with lumbar stenosis presumably present for conservative care to improve their quality of life and avoid surgery. However, providing clear guidance to these patients can be difficult for a number of reasons.
A Simple Protocol for Holiday Stress
It's winter, a time when we should be deep in reflection, eating warming foods and sleeping long hours. Following nature's rhythms, we restore our bodies and minds in preparation for the renewal of spring.
Dedicated to Defending Chiropractic
Whether you're a veteran DC or a first-trimester student, the name George McAndrews should be part and parcel of your professional vernacular, as familiar as the word chiropractic.
News in Brief
New President / CEO Takes Office at Yo San University. Electroacupuncture for Constipation?
Southwest Acupuncture College Brings It to Division 1 Athletes
When Michael Phelps' photograph with the distinctive round marks left by cupping went viral, the Division 1 student athletes treated through the Dal Ward Athletic Center at the University of Colorado (CU) could relate.
End of an Era Looms at NYCC
New York Chiropractic College recently announced that Dr. Frank Nicchi will retire in August 2017 after 36 years with the college, the past 17 as president.
Molecular Motors: Tiny Machines Behind the Rhythm of Life
In the clinic, we aim to restore healthy patterns of movement for qi that has gotten trapped or misdirected, or may have even collapsed. We may be focused on freeing stagnation, releasing heat or redirecting counterflow qi, but it often comes down to helping re-establish a flow of sorts.
6 Steps to Make 2017 Your Best Year Yet
People often ask me what defines success. Success, for me, is simple: doing exactly what you want to do in life. Whether it's the kind of practice you run, your life at home, your hobbies or something else, it's achieving anything you put your mind to.
A Q & A About Updated Codes
Yes, indeed there was an update to ICD-10 on Oct.1, 2016. This is a regular update to the diagnosis coding system and this type of update will occur every Oct. 1, just as it did when the ICD-9 system was in place.
Herbs for Digestion: The Power of Bitter
Many cultures (and indeed herbal clinicians) around the world have long respected the role of bitter herbs and foods for promoting digestion. For example, aperitifs – drinks consumed before a meal to stimulate appetite and digestion – were originally derived from bitter herbs.
Meshing TCM With Environmental Pediatrics: Where's the Overlap?
Pediatrics has a long history within Chinese medicine dating back to the late Han dynasty (i.e., the late 200s CE), with the two primary areas of emphasis being herbal medicine and xiao er tui na (pediatric massage).
Little Sticker, Big Impact
It's the end of an election year. Hilary Clinton and Donald Trump were the subject of conversation for everyone, everywhere for the entire 2016 calendar year. I don't think any of us can deny that this election affected us all very deeply on a personal level.
Overuse Injuries in Young Athletes (Pt. 2)
Most overuse injuries are benign, but there are some high-risk injuries that, if unrecognized or inappropriately treated, can result in significant loss in time from the sport or even require leaving the sport.
DVT: Know the Signs and You Could Save a Life
I lost a friend several months ago. He died from a pulmonary embolism (PE) secondary to a deep-vein thrombosis (DVT) that originated in his lower leg. Bobby was in his mid-60s, soft-spoken and had a big heart.
2016: A Year in the Life of Acupuncture
Happy Holidays, may you, your family and friends have peace, joy and blessings throughout this special time of year. As 2016 comes to a close, we can look back and celebrate the many events and accomplishments for the profession of acupuncture.
A First for the Profession: CCE Accredits First Chiropractic Residencies
The Council on Chiropractic Education (CCE) has awarded accreditation to all five chiropractic residency programs currently administered at Veterans Administration facilities, "the first residency programs in the nation ever to be awarded this distinction, a significant advancement in the evolution of chiropractic education," according to a VA press release announcing the milestone.
Another Chance to Make a Difference
Just a few months ago, "the worst natural disaster to strike the United States since Hurricane Sandy" hit Louisiana. During this storm, one area experienced 31 inches of rain in 15 hours as almost 7 trillion gallons of water rained down in just one week across the state.
A Letter to the Profession from the New President at AAAOM
Volunteering for a national, nonprofit organization brings with it such highs, lows, and accomplishments, as well as a steep learning curve.
Chiro School Reunion: Whatever Happened to...?
I opened the door to the closet slowly, carefully, since I knew it contained a large number of precariously stacked file boxes. It also held numerous outdated gizmos with electrical cords of various lengths that could trip or strangle a person.
April, 2005, Vol. 05, Issue 04
How Should We Teach Assessment?
By Whitney Lowe, LMT
Musculoskeletal disorders (MSDs) are some of the most commonly occurring causes of pain and disability in this country. They are treated by a wide variety of practitioners, and many people with them seek the care of someone other than a physician.Consequently, massage therapy is frequently used to address this wide array of pain and injury problems.
Proper treatment of any MSD begins with identifying the underlying problem. It is only then that we can determine if we should even be working on this client. If the practitioner has determined that a MSD exists for which massage treatment would be helpful, s/he must then determine which techniques or approaches to use with the client that should be helpful. The way to make this determination is through proper and accurate assessment.
Information may be gathered in many different forms, systems or structures yet they all have several elements in common. A thorough assessment includes detailed information from the client history, observable characteristics of the client and his/her condition, as well as specific methods of physical examination.
Some practitioners shy away from any organized framework for their assessment process, stating instead that intuition guides them. Others may state they do assessment solely through what they feel in their hands. While these are very important skills and may work well for basic relaxation massage approaches, they don't provide information necessary to make appropriate clinical decisions about treating MSDs. If I had an illness or injury and went to see a physician, I wouldn't want that doctor to evaluate me based on intuition or palpation alone. Likewise, many MSDs are complex and we must engage in a more comprehensive process when evaluating them.
There are some misconceptions about what assessment entails. Some feel it is just evaluating a client's range of motion. Evaluating range of motion is important, but you must know more than your client has a limitation in a certain motion, such as abduction of the shoulder. You must do what you can to find out why that limitation exists. Others state that assessment is mainly the use of special orthopedic tests like the Phalen's test for evaluating carpal tunnel syndrome. Memorization and use of various orthopedic tests is helpful, but only when used in their proper contexts. Simply memorizing these tests does not make you effective at assessment any more than memorizing the alphabet makes you a writer.
Assessment and Learning Theory
Learning theorists have developed classifications of how we learn that describe increasing levels of complexity. One of the most common classifications still used today is Bloom's Taxonomy of Educational Objectives, first published in the mid-1950s. In this classification, Bloom and his colleagues described six levels of increasing cognitive complexity: knowledge, comprehension, application, analysis, synthesis and evaluation.
The lowest levels, knowledge and comprehension, involve rote memorization. While memorization has its usefulness, it should not be the primary goal of our educational objectives. Unfortunately, most educational environments do not go past this level and assume that "learning" has occurred because an individual is able to achieve a specific score on a test that emphasizes rote memorization and, too often, little else.
The problem with this approach is that it doesn't reflect clinical reality at all. In the clinic room, the practitioner is faced with situations where memorization of facts still leaves you pondering as to what your client's primary complaint really is. In order to get past this point you must use the higher levels of the taxonomy - analysis, synthesis and evaluation. These abilities are developed through practical application of clinical reasoning activities in the learning process. Assessment is a complex procedure of clinical reasoning that has to use these higher cognitive functions in order to be even minimally effective.
Consequently, if we want to teach assessment skills in the way they will be eventually used in practice, we have to radically alter the way they are initially presented. In order to do this we have to get away from trying to have students find the "right" answer all the time. In many cases there isn't one "right" answer. There are several different paths and they each take us in different directions that may produce a good clinical reasoning process. Therefore, to accomplish this goal we must create educational activities that encourage a degree of cognitive uncertainty and encourage the practitioner to go through the reasoning process to figure a problem out. It is only through this kind of practice that these skills are developed.
So, when learning assessment, don't get stuck on trying to memorize a large group of special orthopedic tests or performing range-of-motion evaluations and call that your assessment. You must look at the entire picture of gathering information from the client's story and physical examination, process the importance of what you have found out, and construct a model for explaining your findings. When you can do this, you have moved into the higher levels of cognitive complexity, used advanced assessment strategies, and performed a much more thorough service in seeking care for your clients.
Click here for more information about Whitney Lowe, LMT.
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