Mapping evidence of spinal manipulation therapy for headaches in South Africa: a scoping review of grey literature

Objective Spinal manipulative therapy (SMT) has been demonstrated to be an effective management approach for primary headaches; however, current literature often excludes data from South Africa (SA). The use of grey literature provides a viable mechanism to address knowledge gaps. Understanding that Master’s dissertations are a source of grey literature, this review’s primary objective was to address the following question: What is the range of evidence, particularly regarding subjective and objective outcome measures, for the application of SMT in managing headache patients at chiropractic training facilities in SA? Methods A scoping review methodology was adopted in compliance with the Joana-Briggs-Institute and the Arksey and O’Malley frameworks and reported following the preferred reporting items for systematic reviews and meta-analysis extended for scoping reviews checklist. The search was performed using the Durban University of Technology and University of Johannesburg Research Databases. All studies conducted from 1995 to May 2023 were retrieved. Trials conducted with SMT for the management of headaches were included and subjective (i.e., numerical rating scale, headache disability index, neck disability index) and objective (i.e., range of motions, pressure algometry) outcomes were extracted. Results In total 25 dissertations with 921 headache patients were reviewed. Across most of the dissertations, combining SMT with additional modalities versus SMT alone or another modality alone yielded greater improvement in subjective outcome measures, although there were occasional exceptions where no clear pattern emerged. In terms of objective measures, there were both increases and decreases across the different interventions. Discussion The findings align with existing literature, indicating that primary headache patients in SA who receive SMT in conjunction with other non-pharmacological treatments respond favourably. This study underscores the potential value of grey literature, particularly in regions where high-quality data is scarce. It highlights the significance of SMT for policymakers, funders, and other stakeholders involved in managing headache patients in SA. Although limitations related to the quality of the dataset are acknowledged, the standardization and robust design of clinical trial protocols at SA institutions reveal numerous strengths. Despite ongoing discussions in the literature regarding the use of SMT for headache management, there is a strong case for existing literature to be used in the SA context

The Effect of Intermittent Fasting Combined with Ad Libitum Days on Adults' Elevated Blood Pressure: A Systematic Review of Human Studies

AbstractBackground:Diets utilizing intermittent fasting as an alternative method to promote weight loss have grown in popularity. However, the efficacy of intermittent among elevated blood pressure remains unclear. This review sys-tematically analyses studies investigating the effects of intermittent variations among elevated blood pressure on changes in systolic blood pressure and diastolic blood pressure. Changes in body weight, body mass index, waist cir-cumference, and energy intake were assessed as a secondary objective. Methods:The American Search Elite, CINAHL, Cochrane, MEDLINE, ProQuest, PubMed, Scopus, and grey liter-ature databases were searched for articles investigating intermittent fasting with ad libitum among adults with elevated blood pressure from Jan 2010 to Jun 2022. Results:Twelve studies met the eligibility criteria. Systolic and diastolic blood pressure generally decreased, between -2.0 to -0.04 mmHg and -3 to -0.01 mmHg, respectively. The body weight and body mass index reduced significantly (-2.85 to -0.09 kg and -1.05 to -0.03 kg/m2, respectively). The review found a waist circumference reduction of -0.67 to -0.21 cm and an energy intake reduction of -263.89 to -2.58 kcal. Conclusion:Intermittent fasting reduces systolic and diastolic blood pressure in 2-24 wk while decreasing body weight, body mass index, and energy intake. However, needs 48 wk to reduce waist circumference. This implies that it is critical to perform intermittent fasting on elevated blood pressure before the development of high blood pressure as part of a program to prevent hypertension in adults

A national survey of osteopaths' conceptions of practice in France: structural validity of the Osteo-TAQfr and the tendency toward technical rationality

Background:Despite the growing popularity of osteopathy in France, little is known about how French osteopaths conceptualise key aspects of their practice, including skills, knowledge, and decision-making. This study aimed to adapt and validate the Osteopaths' Therapeutic Approaches Questionnaire (Osteo-TAQ) for use in a French osteopathic population (Osteo-TAQfr) and to examine the professional profile and core elements of clinical practice among French osteopaths. The first objective was to establish the psychometric properties of the Osteo-TAQfr within a French osteopathic population. The second aim was to explore French osteopaths’ conceptions of practice and their approach to patient care, thereby contributing to a broader understanding of the profession in France and its relevance within the discourse on allied health professions (AHPs). Methods:A cross-sectional study was conducted to (1) adapt and validate the French version of the Osteopaths' Therapeutic Approaches Questionnaire (Osteo-TAQfr) and (2) explore osteopaths’ conceptions of practice in France. The translation and cultural adaptation process was informed by cognitive interviews to ensure linguistic and contextual appropriateness. Exploratory Factor Analysis (EFA) was performed to assess the factor structure in the French osteopathic context and Confirmatory Factor Analysis (CFA) was used to test the validity of previously established constructs—Professional Artistry (PA) and Technical Rationality (TR). Internal consistency was evaluated using McDonald’s omega (ω). Results:The survey yielded 1,703 complete responses. Analysis supported a two-factor model with PA andTR subscales, both showing strong reliability estimations (PA ω = 0.882; TR ω = 0.873). Minor theory-informed adjustments improved model fit. A moderate negative correlation was observed between the PA and TR subscales (r=-0.407). Respondents with additional health professions qualifications scored lower on the PA subscale and higher on the TR subscale

Relationships Between Muscle Activation and Thoraco-Lumbar Kinematics in Direction-Specific Low Back Pain Subgroups During Everyday Tasks

Background/Objectives: The assessment of relationships between trunk muscle activity and thoraco-lumbar movements during sagittal bending has demonstrated that low back pain (LBP) subgroups (flexion pattern and active extension pattern motor control impairment) reveal distinct relationships that differentiate these subgroups from control groups. The study objective was to establish whether such relationships exist during various daily activities. Methods: Fifty participants with non-specific chronic low back pain (NSCLBP) (27 flexion pattern (FP), 23 active extension pattern (AEP)) and 28 healthy controls were recruited. Spinal kinematics were analysed using 3D motion analysis (Vicon™,Oxford, UK) and the muscle activity recorded via surface electromyography during a range of activities (box lift, box replace, reach up, step up, step down, stand-to-sit, and sit-tostand). The mean sagittal angles for upper and lower thoracic and lumbar regions were correlated with normalised mean amplitude electromyography of bilateral transversus abdominis/internal oblique (IO), external oblique (EO), superficial lumbar multifidus (LM), and erector spinae (ES). Relationships were assessed via Pearson correlations (significance p < 0.01). Results: In the AEP group, increased spinal extension was associated with altered LM activity during box-replace, reach-up, step-up, and step-down tasks. In the FP group, increased lower lumbar spinal flexion was associated with reduced muscle activation, while increased lower thoracic flexion was associated with increased muscle activation. The control group elicited no significant associations. Correlations ranged between −0.812 and 0.754. Conclusions: Differential relationships between muscle activity and spinal kinematics exist in AEP, FP, and pain-free control groups, reinforcing previous observations that flexion or extension-related LBP involves distinct motor control strategies during different activities. These insights could inform targeted intervention approaches, such as movement-based interventions and wearable technologies, for these groups

Relationship between trait mindfulness and physical activity among emerging adults: The mediating roles of exercise-related cognitive errors and trait self-control

Exercise-related cognitive errors (ECEs) is a significant factor that can negatively influence physical activity (PA) engagement among emerging adults, whereas mindfulness interventions may be beneficial for promoting PA. Against this background, we investigated the potential association between trait mindfulness and PA levels among emerging adults and determined whether trait self-control and ECEs serve as mediators

AI-assisted abnormal CXR findings and correlation with behavioral risk factors: A Public Health Radiography approach to formulating policies and effective interventions

Introduction: cardiovascular, respiratory and related diseases (CVRDs) constitute over 40 % cause of death worldwide, mostly reported in low-and-middle-income countries. The catastrophic effect of this spans across poor health outcomes, severe economic loss and significant societal consequences. Responding to this situation necessitates collective strategy to prevent further deterioration as these conditions are closely related, share common risk factors as well as control measures at the clinical, population and policy levels. Thus, this study is aimed at understanding the distribution of AI-assisted abnormal adult chest X-ray (CXR) and examine relationship with behavioral factors; to lay foundation for planned interventions. Method: prospective mixed-methods research, cross-sectional in nature, conducted across six top-rated hospitals in Nigeria, representing the six geopolitical zones of the country via purposive sampling technique. Quantitative aspect involved data collection on demographics and abnormal findings from AI-assisted technology, while Qualitative aspect explored individual’s behavioral choices in relation to risk factors. Informed consent and ethical approval were obtained; SPSS software utilized for descriptive and correlation analysis. Results: cardiomegaly (15,35 %), pleural effusion (14,03 %), fibrous opacities (10,43 %), pleural capping (8,51 %), pulmonary mass (7,91 %), apical opacities (7,55 %), consolidation (6,59 %), infiltration (5,88 %) among the sixteen abnormal findings in decreasing order of magnitude. An early onset of these anomalies at 30 years was noted, hitting peak values at 40-44 years. A significant percentage of the population engages in unhealthy lifestyle, found to positively correlate with these anomalies in varying degrees; low education levels, health education gaps, poor income and environmental challenges clearly seen. Conclusions: a Public Health Radiography approach- AI assisted, engaging with empirical evidence provides a novel and valuable strategy in designing effective interventions and policy making to address CVRDs burden

Development of a national osteopathic Practice-Based Research Network (PBRN): the NCOR Research Network

This original research details the development of the UK’s first osteopathic Practice-Based Research Network (PBRN), the NCOR Research Network, which represents a significant advancement in research capacity. This intellectually coherent framework provides essential baseline data on practitioners, their clinical activities, and patient demographics, with significant potential to influence professional development, education, and healthcare policy. Data were collected through a crosssectional online survey study conducted between September 2023 and December 2023. The study included 570 osteopaths registered with the General Osteopathic Council who consented to participate in the NCOR Research Network. We examined demographic characteristics of osteopaths, details of their clinical practice, patient demographics, common presenting complaints, treatment approaches, and attitudes towards evidence-based practice. The median age bracket of participants was 50–59 years, with 55% identifying as women. Participants had a median of 17 years of clinical experience. Most worked in private practice (71% as principals, 32% as associates), seeing 20–39 h of patients per week. The majority (87%) regularly treated adults aged 65 or older. Low back pain was the most common complaint seen daily (56%). Spinal articulation/mobilization (79%) and soft tissue massage (78%) were the most frequently used techniques. Participants reported positive views towards evidence-based practice but cited lack of research skills and time as barriers to engagement. The NCOR Research Network provides a foundation for future osteopathic research in the UK. While the sample was not fully representative of UK osteopaths, it offers insights into current osteopathic practice. The network aims to foster collaboration between clinicians and academics, potentially bridging the gap between research and practice in osteopathy. Protocol registration: https://doi.org/10.17605/OSF.IO/HPWG

Global status of chiropractic education research and scholarly publications: a scoping review

Objective: This scoping review aimed to map the volume (number of studies) and nature (topics and designs) of chiropractic education research and scholarly publications on chiropractic learners and programs worldwide. Introduction: Despite the expansion of the chiropractic profession and its recognition by entities such as the World Health Organization, a gap exists in comprehending the international landscape of chiropractic education. No prior studies have systematically mapped the volume and nature of chiropractic education research and scholarly publications. A scoping review of chiropractic education research and scholarly publications is needed to guide future policy development, research agendas, and educational initiatives within the chiropractic profession. Inclusion criteria: Publications in the indexed literature on chiropractic students, graduates, academics, and programs in any chiropractic education setting were included. Studies focused on chiropractic programs and education for chiropractic students or chiropractors worldwide were considered for inclusion. All research designs, literature reviews, descriptive studies, and commentaries were included. Methods: This scoping review was conducted according to JBI methodology for scoping reviews and was reported in line with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). The databases PubMed (NLM), Scopus, CINAHL via EBSCOhost, Index to Chiropractic Literature, Biblioteca Virtual em Saúde, and Educational Resources Information Center were searched from their inception to November 5 and 6, 2023, with no language limits. Data were extracted for primary topics,study designs, and regions of the included documents and entered in Covidence by paired independent reviewers. The findings were organized into figures and tables with a narrative description. Results: The search identified 7494 documents. After deduplication, 5041 were screened for relevance, of which 667 were selected for full-text review. From these, 598 were selected for data extraction. The chiropractic education topics included values/ethical competence (n=3),personal/behavioral competence (n=34), knowledge and cognitive competence (n=49), functional and clinical competence (n=93), and program-relevant research (n=419). Most designs were quantitative (n=391), followed by descriptive reports(n=91), qualitative (n=43), mixed methods(n=40),commentaries (n=22), and literature reviews (n=11). Chiropractic education was most studied in the United States(n=359), Australia (n=116), and Canada (n=106). Conclusions: This scoping review reports the volume and nature of indexed publications relating to chiropractic learners and programs worldwide. This body of literature contains learner competencies in knowledge, skills, and attitudes, as well as studies about chiropractic programs. The increasing number of publications and proportion of study designs over time show that chiropractic scholars and programs are engaged in collecting, analyzing, and distributing data relevant to education and training. The map of professional competencies in the chiropractic education literature shows that the profession possesses the fundamental traits needed to contribute to the global health care workforce

Comparing consecutive third-year Chiropractic Student cohorts: A successful evaluation of the Paired Junior Clinic programme

Introduction: A survey was conducted among third-year chiropractic students to evaluate the substantive effectiveness of junior clinical placements in preparing them for final-year clinical placements. The study aimed to assess the feelings towards perceived readiness and confidence levels of students who participated in the junior clinic program compared to those who did not. Methods: The entire third-year cohort consisting of 166 students, including 42 students involved in junior clinical placements, completed an eight-question survey. Participants in the junior clinic program and non-participants were compared to determine differences in feelings towards perceived clinical preparedness. Results: Students who participated in the junior clinic placements reported significantly higher levels of preparedness and confidence for their final-year clinical placements than non-participants. Conclusion: The survey results showed the importance of junior clinical placements in enhancing the clinical readiness of chiropractic students in preparation for their final-year clinical placement. As indicated by the data collected, the success of these placements suggests that junior clinical placements play a critical role in developing clinical competence. Indexing terms: Chiropractic; Education; Junior Clinic; Student confidence; Student preparedness; Student readiness

Leadership and Capacity Building in International Osteopathic Research: introducing Strengthening Osteopathy Leadership and Research (SOLAR) Program

Research evidence has become the foundation of modern health services. Health professionals rely on sound research to provide safe and effective care for patients, for the development of innovative diagnostic and treatment practices and to develop policies supporting the provision of optimal healthcare. Osteopathy is an established profession with an emerging research evidence base. The Strengthening Osteopathic Leadership and Research (SOLAR) program is a recent international initiative aiming to further build the evidence base and research capacity of the osteopathy profession. The program was developed by The Australian Research Consortium in Complementary and Integrative Medicine (ARCCIM) at the University of Technology Sydney (Sydney, Australia) and funded primarily by Osteopathy Australia, with the support from the Osteopathic Foundation (UK), Osteopaths New Zealand (NZ), Unite Pour l’Osteopathie (France), and Svenska Osteopatförbundet (Sweden). This paper describes the origins, objectives and features of the SOLAR program and outlines the importance of the program for future research and practice in the osteopathy profession. From its beginnings in 2022, to date, the SOLAR program has been highly successful, producing a substantial collection of concrete research and presentations, while enhancing the Fellows’ capacity and confidence as leaders, both in osteopathy and the broader healthcare environment