resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
A Conversation With Dr. Betty Edmond
This month's column is an exclusive interview with Betty Edmond MD, newly elected CEO/President of the AOMA Graduate School of Integrative Medicine in Austin, Texas.
True Practice Mobility for the Chiropractic Profession
When natural disasters occur, chiropractors can literally travel to the other side of the world to offer humanitarian relief in less than a day. The chiropractor's license to legally practice, however, can't make it past the state line.
Five Branches University Has First Hospital TCM Residency
Established in 1984, Five Branches University (FBU) has campuses in Santa Cruz and San Jose, Calif., which serve the communities of Santa Cruz, the Monterey Bay, and Silicon Valley.
Let's Clear Up the Collection Confusion
This is an often-misunderstood practice swirling with misinformation. First, a few basics: Insurance is a contract between the patient and the insurance company. The insurance company is simply making a payment for services or care on behalf of the patient.
Acupuncture Points: Broadening Our Scope and Diagnostic Work
As every practitioner knows, the correct diagnosis is everything. Most healing disciplines rely on the use of symptomatology for their treatment implementation. Beyond symptomatology, we have clinical tests to provide more objective findings.
A New Year and Vision for the ACA
Inadequate pain management coupled with the epidemic of prescription opioid overuse and abuse has taken a severe toll on the lives of millions of people in the United States. Every day, more than 1,000 people are treated in the ER for misusing prescription opioids.
News in Brief
Updated Neck Pain & Whiplash Guideline; Attention, IHS DCs; New VP of Institutional Advancement At Palmer; N.J. DC Interns At U.S. Olympic Training Center; Chiropractic Society Of R.I. On The Front Lines.
Shoulder Rehab: Start With the Scapula
The scapula is an incredible display of elegance and movement within the biomechanics of human motion. It's evolved for mobility and stability in the scapulo-thoracic region, giving us the ability to do things that are uniquely human, such as throwing with accuracy.
The Case Report: A Valuable Tool
Case reports are a valuable form of descriptive research. The most basic form of practice-based research, a case report is a detailed account of the history, presenting symptoms, assessment, observations, treatment and follow-up of an individual patient, discussed in the context of prior and potential future research.
Low Back Pain in Running Athletes
After 7 million years of adapting to upright postures, the lumbar spine and pelvis have become remarkably adept at managing ground-reactive forces associated with running.
Another Step Forward for Chiropractic
Chiropractic is now available to 86,000-plus Latter-Day Saints missionaries and you are invited to become a provider. LDS membership in not required; our only concern is that our missionaries get the best quality care available.
The winter season is upon us and offers unique challenges for the clinician and patient alike. To effectively navigate through the winter season there are two main TCM medicinals, Huang Qi and Gan Jiang, to consider, as well as two important formulas which feature these two TCM treasures.
The Acupuncture Channel System (Part 1)
The earliest Chinese reference to channels is in the Mawangdui Medical Manuscripts,1 which are dated to the Warring States period of the Zhou Dynasty (475 BC-221 AD). The text presents 11 channels. There are no acupuncture points listed in those channels.
An Education in Gluten Sensitivity
A relatively new syndrome officially documented as non-celiac gluten sensitivity (NCGS) or gluten sensitivity (GS) was officially recognized and published in the new list of gluten-related disorders in 2012.
We Get Letters & Email
Our Country Needs Us Between Elections, Too; Continuing Care: We Aren't There Yet; Our Associations Need to Do More.
An Opportunity & a Responsibility
Nearly 80 Americans die from an opioid-related overdose every day, and spine-related pain is one of the principle drivers of opioid use. This unfortunate situation creates both an opportunity and a responsibility.
Flirting With Alternative Therapies
There are about as many adjunct therapies being marketed to acupuncturists as there are acupuncturists. While some may remain purist in their application of traditional Chinese medicine, others choose to explore new horizons of treatment.
Qigong for Substance Abuse
It is commonly believed that substance abuse, in addition to harming one’s physiological state, hurts the spirit. There is also a belief that one’s spirit does not weaken due to substance abuse, but rather, the person finds solace in addiction due to an already weak spirit.
Scar Reduction With Acupuncture & Microneedling (Part 2)
Protocols & treatment Timing
Crow Like the Rooster
As we welcome in the Year of the Rooster, we look at some of its major characteristics: confidence and communication, which suits the image we have of the Rooster...strutting in the farmyard, crowing to the others that it's time to wake up.
Anti-Aging With Dr. Ping Zhang
Jennifer Waters, TCM practitioner and writer of the Acupuncture Today column, "Talking With the Masters" sat down with Dr. Ping Zhang to discuss aniti-aging with acupuncture.
Prepare for the End, From the Beginning: Wealth Building and Retirement with the Tao
Yin and yang flow into and out from one another continually. Beginnings become endings and endings become beginnings again. Wholeness and cycles are the nature of Tao.
Nutrition for Menopause: Front-Line Therapy for All Phases
Of all the changes women experience during their reproductive life, there is no doubt the most dreaded are the three phases of menopause. This is not surprising since all of the symptoms associated with menopause are replete with unpleasantness.
March, 2016, Vol. 16, Issue 03
Becoming an Informed Consumer of Research: Basic Considerations
By Martha Brown Menard, PhD, LMT
Research is a fundamental aspect of every health care discipline. It supports the theoretical foundation of any discipline and helps to distinguish useful treatments and practices from those that offer no benefit or prove harmful. In addition, integrative health care therapies such as massage therapy, chiropractic and acupuncture have developed a sizable body of research to support their use. Research on the effectiveness of these therapies has helped facilitate their acceptance by conventional health care and the general public, and is a cornerstone of the shift towards evidence-informed practice across health care more generally.
Key to this acceptance is the effort to reduce language barriers between conventional health care and more person-centered, integrative approaches to health. As integrative practitioners are usually still in the minority within the larger health care system, it is particularly important that we be able to explain our work in terms that others can grasp. Understanding research greatly improves our ability to communicate effectively with other health professionals through a shared frame of reference and a common language. In addition to this general trend, there is also an increased tendency for massage therapists, acupuncturists, chiropractors, yoga therapists, and other practitioners to work in conventional health care settings as part of a team, or to become involved in multidisciplinary practices. With the growing trend towards interdisciplinary health care, the ability to communicate across disciplines will continue to assume greater importance.
Being able to locate and critically evaluate research in one's field is essential to providing the best possible care for clients. Evidence-informed practice is here to stay as the new standard across health care, and complementary and integrative therapies are being held to it. Because news about recent research is often reported in the popular media, clients or other health care providers may approach practitioners with questions about what implications a new study might have. It is incumbent upon practitioners to be able to discuss questions that arise from research in their field. Understanding how to evaluate research findings helps one to do this knowledgeably, with ease and confidence.
Research evidence has also assumed a major role in influencing health care policy on a national and international level. Policy decisions regarding what treatments are considered "best practices" and which will be reimbursed are increasingly based on research. Cost and consumer satisfaction have also become important study outcomes of interest. I believe that reading health care research offers every complementary practitioner a valuable tool for improving the quality of care you are able to offer your clients, and for ensuring that you and your loved ones receive the best possible health care. Understanding research is vital to the continued development of complementary therapies. And there is another yet important reason to become an informed consumer of research.
Science as a Social Activity
In evaluating the merit of any particular study, it's important to remember that science takes place via human interaction, through informal communication among colleagues with similar interests, more formal presentations and discussions at conferences, and publication of completed research findings in peer-reviewed journals. Knowledge-building is a social process just as much as it is a scientific one.
Because human beings are fallible, the social norms of science help to minimize the presence and/or influence of personal bias in the processes through which speculation becomes knowledge. These norms include an expectation of integrity in the design, conduct, interpretation, and publication of research studies. Peer review serves as an additional structure to maintain integrity. Journals do however have a tendency to prefer publishing studies with positive results. This tendency has been demonstrated and is known as "publication bias."
At the same time, as the number of university tenure-track jobs and the availability of grant funding decreases, there is increasing pressure for scientists to publish positive results. The blog Retraction Watch with support from the Center for Open Science has chronicled the rise in the number of scientific retractions since 2010 and maintains a database to document these. In the end, though, both honest mistakes and deliberate scientific fraud are eventually uncovered through peer review and the nature of how knowledge-building works. Knowledge-building is always provisional — in science, new information can always displace what we thought we knew previously.
Another example of scientific integrity is the practice among peer-reviewed journals of requiring disclosure of all sources of financial support for a study, so that readers can judge the extent to which the study could be biased because of who funded the research. As an example, a study concluding that smoking poses no substantial health risks in spite of numerous contradictory studies would be viewed even more suspiciously if it were funded by the Tobacco Institute. By the same token, research on herbs and dietary supplements has sometimes been viewed more critically when funded by companies that manufacture these products.
The philosopher of science, Thomas Kuhn, articulated the idea that scientific world views or paradigms define the kinds of research questions that may legitimately be asked. What is thought to be "legitimate" can vary according to the social norms and assumptions of a culture and what is considered within that culture to be useful or important knowledge. Historians of science have detailed the ways in which the practice of science has sometimes been distorted by dominant cultural biases, such as the infamous Tuskegee study.
Ethics in Health Care Research
It is also important to define how research may legitimately be conducted, a subject that has been influenced by social norms and cultural bias as well. Present-day scientists involved in health care research have a code of ethical principles that must be applied to both human and animal research. With respect to human subjects, two of the most basic principles of ethical clinical research are to:
Experimental studies are especially susceptible to ethical concerns because they involve direct intervention by the researcher in the lives or health of the participants. For this reason, the researcher is expected to make every effort to protect the human rights and well-being of the study's participants. Current standards for research ethics have been formalized since World War II. In the U.S., the Nuremberg Code (1947) and the Declaration of Helsinki (1964, revised in 1975) became the foundation for the formation of the National Commission for Protection of Human Subjects and Behavioral Research. This commission produced a document known as the Belmont Report.
The Belmont Report proposes that three core values should underlie all research endeavors: respect for persons, beneficence, and justice. The practical implications of each value are:
An outgrowth of the Belmont Report was the development of U.S. government regulations requiring the establishment of Institutional Review Boards (IRBs), to act as ethics committees to safeguard the rights of study participants. IRBs consider the scientific merit of proposed projects in light of the study's potential risks and benefits, and assess the procedures for selecting and recruiting participants, for ensuring appropriate informed consent, and for maintaining confidentiality of private health care information disclosed during the study. The IRB approves the proposed design of the study only if its benefits outweigh its risks, and then monitors the conduct of the study as it progresses. It is standard practice now for journals to require a statement from authors describing how ethical standards for the study were met when submitting a manuscript for publication.
Understanding the background concepts that underlie how scientific research is developed, carried out and reported can enhance our ability to be informed consumers of research. Just as it's important to not believe everything you read on the Internet, it's important to think critically when we read research.
Martha Brown Menard, PhD, LMT, is the director of the Crocker Institute and a licensed massage therapist in Kiawah Island, SC. She is the author of Making Sense of Research (available here). Martha is also the co-executive director of ACCAHC.
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