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Understanding Levels of Evidence
The concept of levels of evidence is a cornerstone of research literacy and a great starting point for understanding basic principles of how research works.
One of the most common trends to see in clinical medical practice and public health is the cycles of health "buzzwords." These come and go depending upon the current cultural zeitgeist. One year, "parasites" are causing all the issues, and the next year it's "candida."
Holistic Skin Care and Modern Technology
Anti-aging is a concept that we hear in reference to skin rejuvenation and growing older on a daily basis. Aging begins as soon as we are born; therefore "pro-aging" is embracing all stages of life gracefully, with vitality, wisdom, joy, and gratitude as the goal.
Keeping Malpractice Allegations at Bay
It has been suggested that in the litigious environment in which we live, the practice of chiropractic should be defensive and practitioners should constantly be watching their backs. An element of defensive practice is a good idea.
Discovery: Finding Insights and Each Other in Different Disciplines
Recently I've been thinking about all sorts of things which are hidden from our daily direct experience. That general category is what links nearly everything that catches my attention and then demands some kind of investigation.
Sleepless nights, anxiety, mood swings, euphoric energy bursts, obsessive thinking, and a strange feeling in his chest. That is what Matt was experiencing when he first entered my practice. Rather than being concerned, he was loving every minute of it.
A Different Way of Looking at It
The way you and your chiropractic colleagues access information has changed over the past decade. According to a recent survey conducted by Dynamic Chiropractic, almost half (48 percent) of DCs read online articles on their personal computer or laptop daily.
With Low-Back Pain, Sometimes Little Things Matter
Typical treatments for low back pain involve large muscles like the quadratus lumborum, iliopsoas, and piriformis. However, there are situations when a very small muscle, the multifidus, can play a significant role in the diagnosis and treatment of low back muscular or spinal injury.
Building Bridges with Discipline
As practitioners of traditional Chinese herbal medicine, our role is to educate patients and medical practitioners about the various safety aspects of our medicine. Medical doctors that embrace Chinese medicine want to collaborate and include Chinese herbal medicine in more aspects of clinical care to support their patients.
Distal Style Treatment of Neurogenic Pain
Treat locally or distally? This question has frequented my thoughts for the treatment of pain throughout my acupuncture career. Each style has strengths and weaknesses, thus the versatile practitioner would do well to forgo dogmatic adherence to any one style in deference to the needs of the individual patient.
Finger (Pad) Pointing: Repetitive-Use Injury Waiting to Happen
"My wrist and hand hurt. I spend all day working on computers and then I come home and spend more time on a computer, usually playing video games."
How to Reach Your World With the Chiropractic Message
My latest effort to share chiropractic occurred in mid-May while I was sitting at an introductory parent information night for high schoolers. The IT instructor informed us that each student would be receiving a computer for all their studies.
Constructing Our Reality, Part 2
My last article discussed perception and its relationship to the primary channels. Before we get to the channels most commonly used to treat sensory disturbances, the small intestine and triple heater, we should first talk about the bladder channel.
Hip Flexor Contractures & LBP in Above-the-Knee Amputations
Patients with above-the-knee amputations (AK or AKA) are particularly prone to developing hip flexor contractures. Not to be confused with muscle tightness, contractures are a permanent shortening of tissues which cause deformity or distortion.
The Need for Standards
ISO-TC-249: You may look at these letters and numbers and wonder what they are and what they might mean. They turn into: International Standards Organization- Technical Committee – 249. There is a global organization called The International Organization for Standardization.
Streamline Your Front Desk
Your front office can be your greatest source of efficiency or it can be a constant bottleneck. Increasing the productivity of this area, while not sacrificing the quality of patient interaction, can be a little tricky. However, with some focused effort and intention, your front desk can keep your practice running smoothly.
Living Well: Lessons From Our Oldest Old
Aging is a significant public health problem, important to chiropractors in practice and important to DCs who teach students training to become chiropractors.
A Whole-Body Approach to Chronic Tension Headaches
Nearly every day in our practices, we see patients with chronic headaches that have not responded to traditional treatment. They present in our offices with a feeble hope that "maybe" a chiropractor can help.
Low Fat vs. Low Carb & the Power of Protein
A science-based website recently posted a nice summary of 23 randomized, controlled trials from peer-reviewed journals pitting low-carb diets against low-fat diets.
Billing Timed Services
Q: I do not always use physical medicine services but in my state I do have a scope of practice that allows me to provide many of these services. I am trying to understand what "direct one-on-one patient contact" means in relation to physical medicine services.
Parker University Embraces New Era
Change is in the air at Parker University, which recently announced the selection of both a new president and a new consultant for its seminar program.
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
Transforming Las Vegas
On a warm spring day in Las Vegas, Sonia Kim, clinic front desk staff, is busy preparing for a full day of intern shifts at Wongu Health Center. She greets patients, makes sure documents are properly signed, and lets the interns know that their patients have arrived.
Prostate Cancer Risk
A large study published in January 2016 in the American Journal of Clinical Nutrition showed that men who are vegans had a 35% lower risk of developing prostate cancer compared to non-vegan men. The study followed more than 26,346 men who are part of the Adventists Health Study-2.
Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
December, 2008, Vol. 08, Issue 12
Samples From the Research Stream
By Keith Eric Grant, PhD, NCTMB
In monitoring water chemistry and quality, hydrologists often dip into the flow of a river or stream, collecting samples. Similarly, I've been sampling from the stream of recent research in several areas.First, I want to touch on a couple of samples specific to massage and exercise.
A news release from Ohio State University suggests compressive massage has a positive effect on post-exercise tissue recovery.2 The report notes, "The muscles in animals receiving simulated massage had improved function, less swelling and fewer signs of inflammation than did muscles in the animals that received no massage treatment after exercise." Recovery of muscle strength was also greater. The importance of the research is that it starts to reveal a cellular basis for the positive effects of massage, even though the exact mechanism of how the changes occur is not yet known.
On Tuesdays, The New York Times publishes "The Science Times," which spotlights breaking science news. Among the stories they caught from the forefront of research on exercise physiology was one advancing knowledge on how muscles fatigue: "A popular theory, that muscles become tired because they release lactic acid, was discredited not long ago. ... [The report] says the problem is calcium flow inside muscle cells. Ordinarily, ebbs and flows of calcium in cells control muscle contractions. But when muscles grow tired, the investigators report, tiny channels in them start leaking calcium, and that weakens contractions. At the same time, the leaked calcium stimulates an enzyme that eats into muscle fibers, contributing to the muscle exhaustion."1
It's long been thought that delayed-onset muscle soreness (DOMS), the soreness that occurs 24 to 72 hours following strenuous exercise, was due to microfiber damage resulting in leakage of calcium ions from the sarcoplasmic reticulum. Normally, calcium ions are released from the reticulum to initiate muscle fiber contraction and pumped back into it to end contraction. The microdamage would result in leakage, thereby initiating a process of hypertonicity, inflammation and pain-receptor sensitization. The current research pushes this process back in the exercise-recovery cycle as a process of muscle fatigue.
In late October, I attended several days of the annual Science Writers' Conference, jointly put on by the National Association of Science Writers (NASW) and the Council for the Advancement of Science Writing (CASW). The threads of research I want to sample from the conference change the focus to learning and communication. Among the presenters were Clifford Nass, professor of communication and computer science at Stanford University, and Robert Bloomfield, professor of management at the Johnson School of Management at Cornell University. Along with nuances of computer-human interaction, Nass talked about brain neurology. He noted that the upcoming Internet generation are cognitive multi-taskers in a manner never seen before. While hunter-gatherers had to pay attention to multiple signals from their environment, there was a coherence to the different inputs. In contrast, modern multi-taskers pay attention to multiple windows and streams of input that are unrelated to each other. Nass noted that there is no current psychological model for how the young manage multi-tasking, but manage it they do. Moreover, multi-taskers become bored with linear input. It's likely that different neurological use of the brain has physically changed the neurons retained during development. Nass' observations are consistent with observations made by Marc Prensky, who distinguishes between "digital natives" and "digital immigrants."3 There are some profound implications that the learning style of the upcoming generations will be substantially different than for previous generations. To be effective, education and training will have to adapt.
Robert Bloomfield also gave an interesting presentation on the use of the virtual world "Second Life," both for social research and as a place for communicating remotely. As he gave his talk in the "real world," he also was in front of a podium, located on Muse Isle NorthWest in "Second Life," talking to about 15 virtual listeners. Bloomfield characterized "Second Life" as providing "people, time and tools" for research and communication. As an economist, he was interested in the banking failures that occurred in "Second Life," as a means of seeing real people responding to a simpler economic situation than exists in the real world. As a means of communicating remotely, Bloomfield noted that "Second Life" provides a sense of place. The visual view can emulate locations in the real world known to participants. Those attending a virtual conference have access to audio, visual presentations and texting. Via texting, different subgroups of participants can spin off side discussion with little impact to others. While it would be more difficult to teach a kinesthetic "vocabulary" via such means, "Second Life" could provide a rich environment for conceptual learning and for viewing and discussing videos of technique demonstration. While I don't expect virtual massage clients to exist anytime soon, the world of learning and communicating continues to evolve and change.
Click here for previous articles by Keith Eric Grant, PhD, NCTMB.
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