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Insomnia Treatment Based on the Yu Theory
In recent years, acupuncture has risen in popularity as a form of alternative or supplemental medicine for the treatment of many different types of disorders.
What's Bugging You? Probiotics and Your Health
An estimated 100 trillion microorganisms representing more than 500 different species inhabit every normal, healthy bowel. Gut-dwelling bacteria keep pathogens in check, aid digestion and nutrient absorption, and contribute to immune function.
Scope of Chiropractic Practice: Why Now Is the Time to Expand
In my January article, "Scope of Chiropractic Practice: Is It Time for Change?" I discussed the use of the term primary spine care practitioner, the loss of privileges to diagnose in Texas, and the fact that the definition of "chiropractic" varied from state to state.
5 Ways to Enhance Your Family Practice
Every practice has a personality style. A practice that caters to athletes, PI cases or adults, for example, projects differently to patients than a family wellness practice.
The Qi Focus: A Guide to Managing Stress
Stress, are you experiencing heightened stress levels? Your own, and your clients? Is Trumpitis getting to you? I recently polled a cluster of acupuncturists, Asian Bodywork Therapists (ABT) and psychotherapy colleagues on the issue.
The First (Only) Choice for Spinal Pain
The study on NSAIDs for spinal pain summarized on the front page of this issue is intriguing on a number of levels, the most obvious being the conclusion that "compared with placebo, NSAIDs do not provide a clinically important effect on spinal pain, and six patients must be treated with NSAIDs for one patient to achieve a clinically important benefit in the short-term."
Integrative Cardiology: The Heart of TCM & Western Medicine
Patient centered therapy is a growing trend in hospitals that are expanding to boutique services.
Treating LBP the Right Way: Think Natural
An updated clinical practice guideline from the American College of Physicians (ACP) recommends spinal manipulation and other non-invasive, non-drug therapies as first options for acute, subacute and chronic low back pain, rather than pain medications, as stipulated in the original 2007 guideline.
Toxicity & Kids: The Importance of Environmental Intake
The old adage is true that children are not little adults. Traditional Chinese medicine (TCM) has long known that the physiology of children is unique, as are the diseases that plague them.
Chiropractic: A Great Fit for the White House
Dr. Eric Kaplan is a New York Chiropractic College alumnus; a No. 1 best-selling author whose books include Awaken the Wellness Within and The 5 Minute Motivator; a chiropractor for professional sports teams and elite athletes; and even served as an advisor under the Clinton Administration to the President's Council on Sports & Physical Fitness.
The Chiropractor's Guide to CRISPR
Science magazine's "Breakthrough of the Year" award for 2015 was described as "the gene-editing tool called CRISPR." CRISPR stands for "clustered regularly interspaced short palindromic repeats."
NSAIDs No Better Than Placebo for Spine Pain
A meta-analysis of randomized, placebo-controlled trials comparing the efficacy and safety of NSAIDs with placebo for spinal pain concludes that among 6,065 spine pain patients, "NSAIDs reduced pain and disability, but provided clinically unimportant effects over placebo."
How to Correct a Cuboid Subluxation
Cuboid subluxation is a poorly recognized condition, even though it is not uncommon. It has been described in the literature under various names: cuboid subluxation, cuboid syndrome, locked cuboid, dropped cuboid, cuboid fault syndrome or peroneal cuboid syndrome.
Treating the Terrain of Chronic Sinus Infections
Chronic sinus infections can be stubborn to treat, but the therapeutic path forward can be simplified when utilizing three distinct treatment principles which take into account the terrain of the body, and the way in which microbes grow.
Give Your Patients the Ergonomic Advantage
Prolonged sitting contributes to low back pain and is a health risk. When I discuss my POLITE technique practice recommendations with patients, ergonomics may be last, but not least!
Shedding Light on the Benefits of Heliotherapy
I can't imagine anyone not feeling good strolling in the sun on a beautiful spring day. The sun is responsible for all life on earth and is best illustrated along the equator touting the richest biodiversity on the planet, in stark contrast to the Arctic Circle and South Pole.
Making Sense of Liver Regulation
In Chinese medicine, the liver has the function of moving and storing qi and blood. In its moving function, the liver smoothly distributes qi and blood to the tendons, muscles and flesh through microcirculation.
Waist Circumference: A Conversation Starter (Part 2)
Now let's discuss the clinical approach to reducing WC and implementation in today's chiropractic practice. The primary intervention centers around dietary modification and lifestyle habits aimed to reduce adiposity, improve insulin sensitivity and ultimately, diminish systemic metabolic dysfunction.
Help Save an Important Chiropractic Landmark
The chiropractic profession has a splendid and varied history. Sadly, many landmarks have been lost to bulldozers and wrecking crews, such as the Ryan Building, Little-Bit-O-Heaven, Spears Chiropractic Hospital, and Clearview Sanitarium.
News In Brief
A "Modern" Business Model. Acupuncturists may have a new professional atmosphere to consider, as a new concept is on the horizon - at least for one business.
Good Works at the Canandaigua VA
Faculty and students of the Finger Lakes School of Acupuncture and Oriental Medicine (FLSAOM) of the New York Chiropractic College have provided acupuncture to veterans at the Veterans' Administration Medical Center (VAMC) in Canandaigua, New York since September of 2007.
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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