The Council on Chiropractic Education's New Wellness Standard: A call to action for the chiropractic profession

BACKGROUND: The chiropractic profession has long considered itself to be a preventive science. Recently the Council on Chiropractic Education (CCE) has defined a set of standards that must be implemented at all US chiropractic colleges as of January of 2007. These are specific to wellness measures and health promoting efforts that should be performed by chiropractors. This will mandate traditional health promotion and prevention methods be taught to students at accredited colleges and to practicing chiropractors. OBJECTIVE: To present the idea of performing traditional health promotion and wellness-concepts in chiropractic practice as a call to action for clinicians and generate discussion on the topic. DISCUSSION: This manuscript discusses relevant topics of health promotion and prevention for chiropractors and other practicing clinicians that should be made priorities with patients in order to enhance both patient health and community and population health. CONCLUSION: All practicing chiropractors, as well as other clinicians should take these new standards from the CCE as a call to action to begin helping patients address the removable causes of morbidity, disability and premature mortality where they exist, in addition to treating their painful spinal conditions

An educational campaign to increase chiropractic intern advising roles on patient smoking cessation

BACKGROUND: Tobacco use, particularly smoking, is the most preventable cause of death in the United States. More than 400,000 premature deaths are associated with its use and the health care costs are in the billions. All health care provider groups should be concerned with patients who continue to smoke and use tobacco. The US Preventive Services Taskforce and Health People 2010 guidelines encourage providers to counsel smokers on cessation. Current studies, though limited regarding chiropractic advising practices indicate a low engagement rate when it comes to providing cessation information. OBJECTIVE: To test a campaign regarding initial impact aimed at increasing chiropractic interns advising on cessation and delivery of information to smokers on cessation. DISCUSSION: Chiropractic interns do engage patients on smoking status and can be encouraged to provide more cessation messages and information to patients. The initial impact assessment of this campaign increased the provision of information to patients by about 25%. The prevalence of smoking among chiropractic patients, particularly at teaching clinics may be lower than the national averages. CONCLUSION: Chiropractic interns can and should be encouraged to advise smokers about cessation. A systematic method of intake information on smoking status is needed and a standardized education protocol for chiropractic colleges is needed. Chiropractic colleges should assess the adequacy of their advising roles and implement changes to increase cessation messages to their patients as soon as possible

Clinical Wellness Coaching: A Brief Assessment of the Development, Implementation, and 3-year Experiences of Interns in a Graduate Certification Program

Purpose: Mississippi is one of sickest states according to national assessments and ranks 49th for overall health outcomes. In addition, Mississippi is the most overweight and obese state, the least physically active state, and ranks second in adult hypertension. This paper reviews the development and three-year assessment of a novel wellness coaching program developed at one southeastern university in a partnership with a foundation whose primary interest was to see more wellness and lifestyle coaching offered in primary medical clinics in the state. Methodology: A model for training graduate students in wellness coaching was envisioned and interdisciplinary training model developed. The design and implementation of the program is described, as well as the programmatic evaluation of the first 3 cohorts of interns including the types of conditions coached and the overall intern experience. Results: Interns were placed in 9 different Mississippi counties over the first three years. In total, 1,186 patients were coached in the field over the three years by 15 interns. Of those, 74% were new patients and 26% were follow-up patients at the clinics. The top three reasons for wellness coaching were weight management (n=252, 21.3%) followed by diabetes (n=238, 20.1%), and metabolic issues (n=204, 17.2%). Interns were surprised at the level of comorbidities and low health literacy, and overall ratings from medical practitioners and staff were very favorable. Conclusion: Graduate level wellness coaching training can develop coaches to aid clinical healthcare providers in reaching patients in need of setting personal lifestyle-related goals for improving overall health outcomes. Interns must be prepared in states like Mississippi for complications such as low health literacy and low literacy situations as well as the comorbidities that a typical patient will have. Barriers to successful interaction with the wellness coach can be mitigated by having staff fully understand their role

Peroxisome Proliferator-Activated Receptor (PPAR): Balance for Survival in Parasitic Infections

Parasitic infections induce a magnitude of host responses. At the opposite ends of the spectrum are those that ensure the host's needs to eliminate the invaders and to minimize damage to its own tissues. This review analyzes how parasites would manipulate immunity by activating the immunosuppressive nuclear factor, peroxisome proliferator-activated receptors (PPARs) with type 2 cytokines and free fatty acids from arachidonic acid metabolism. PPARs limit the action of type 1 immunity, in which classically activated macrophages act through the production of proinflammatory signals, to spare the parasites. They also favor the development of alternately activated macrophages which control inflammation so the host would not be destroyed. Possibly, the nuclear factors hold a pivotal role in the establishment of chronic infection by delicately balancing the pro- and anti-inflammatory signaling mechanisms and their ligands may be used as combination therapeutics to limit host pathology

Addressing Food Insecurity: A Qualitative Study of Undergraduate Students\u27 Perceptions of Food Access Resources.

Food insecurity has emerged as a leading health care problem in the United States, impacting college students’ health, well-being, and academic performance. The aims of this study were: (1) to assess the prevalence of food insecurity, (2) to identify college students’ perceptions about food access resources, and (3) to explore students’ expressed needs from the university in improving food security status. A mixed-methods approach was used to assess the quantitative and qualitative aspects of the study aims. An online survey to gather demographic information and assess food security status using the 6-item version of the US Household Food Security Scale Module (HFSSM) was administered. Next, qualitative focus groups with subsets of participants was conducted to gain further insight into the perceptions, coping mechanisms, and resource utilization issues related to food insecurity. This study found 34.1% of undergraduate college students to be food insecure and demonstrates that students with a meal plan are less likely to be food insecure (p = 0.012; OR = 0.68; 95% CI = 0.489, 0.918). Qualitative data identified key influencers of food insecurity: (1) personal beliefs, (2) life skills, and (3) the university. The results of this study contribute to the literature focused on food insecurity prevalence in college students and presents insight from the college student perspective. Findings may support the development of relevant interventions that are congruent with students’ needs, enhancing resource utilization to increase food security status among college students

Food Insecurity and Depression Among US Adults: NHANES 2005–2016

A growing body of evidence suggests that food insecurity is associated with adverse mental health outcomes such as depression and anxiety. In this study, the relationship between food insecurity and depression was examined using data from the 2005–2016 National Health and Nutrition Examination Survey (NHANES). Food insecurity was assessed with the 18-item United States Food Security Survey Module with zero affirmative responses indicating high food security, 1 or 2 affirmative responses indicating marginal food security, and ≥3 affirmative responses indicating food insecurity. Depression was assessed with the Patient Health Questionnaire-9 with scores ≥10 indicating depression. Data were analyzed from 28,448 adult participants aged 20 or older. Food insecurity was present in 19.2% of the sample population (n = 5452). Food security status was significantly associated with gender, race, education level, marital status, smoking status, and BMI (Rao-Scott chi-square, p \u3c 0.05). Fully food secure and very low food security adults experienced depression at a rate of 5.1% and 25.8%, respectively (Rao-Scott chi-square, p \u3c 0.0001). Participants with very low food security had a significantly greater odds of depression than food secure adults, OR = 3.50 (95% CI: 2.98, 4.12). These findings suggest that food insecurity is a significant risk factors for depression in US adults over 20 years of age. To address this issue in our citizenry, police initiatives and public health interventions addressing both food access and mental health should be prioritized

Case report of right hamate hook fracture in a patient with previous fracture history of left hamate hook: is it hamate bipartite?

BACKGROUND: Hamate hook fracture is a common fracture in golfers and others who play sports that involve rackets or sticks such as tennis or hockey. This patient had a previous hamate fracture in the opposing wrist along with potential features of hamate bipartite. CASE PRESENTATION: A 19 year old male presented with a complaint of right wrist pain on the ulnar side of the wrist with no apparent mechanism of injury. The pain came on gradually one week before being seen in the office and he reported no prior care for the complaint. His history includes traumatic left hamate hook fracture with surgical excision. CONCLUSION: The patient was found to have marked tenderness over the hamate and with a prior fracture to the other wrist, computed tomography of the wrist was ordered revealing a fracture to the hamate hook in the right wrist. He was referred for surgical evaluation and the hook of the hamate was excised. Post-surgically, the patient was able to return to normal activity within eight weeks. This case is indicative of fracture rather than hamate bipartite. This fracture should be considered in a case of ulnar sided wrist pain where marked tenderness is noted over the hamate, especially after participation in club or racket sports

An ultraviolet-optical flare from the tidal disruption of a helium-rich stellar core

The flare of radiation from the tidal disruption and accretion of a star can be used as a marker for supermassive black holes that otherwise lie dormant and undetected in the centres of distant galaxies. Previous candidate flares have had declining light curves in good agreement with expectations, but with poor constraints on the time of disruption and the type of star disrupted, because the rising emission was not observed. Recently, two `relativistic' candidate tidal disruption events were discovered, each of whose extreme X-ray luminosity and synchrotron radio emission were interpreted as the onset of emission from a relativistic jet. Here we report the discovery of a luminous ultraviolet-optical flare from the nuclear region of an inactive galaxy at a redshift of 0.1696. The observed continuum is cooler than expected for a simple accreting debris disk, but the well-sampled rise and decline of its light curve follows the predicted mass accretion rate, and can be modelled to determine the time of disruption to an accuracy of two days. The black hole has a mass of about 2 million solar masses, modulo a factor dependent on the mass and radius of the star disrupted. On the basis of the spectroscopic signature of ionized helium from the unbound debris, we determine that the disrupted star was a helium-rich stellar core.Comment: To appear in Nature on May 10, 201

Shape memory polymers based on uniform aliphatic urethane networks

Aliphatic urethane polymers have been synthesized and characterized, using monomers with high molecular symmetry, in order to form amorphous networks with very uniform supermolecular structures which can be used as photo-thermally actuable shape memory polymers (SMPs). The monomers used include hexamethylene diisocyanate (HDI), trimethylhexamethylenediamine (TMHDI), N,N,N{prime},N{prime}-tetrakis(hydroxypropyl)ethylenediamine (HPED), triethanolamine (TEA), and 1,3-butanediol (BD). The new polymers were characterized by solvent extraction, NMR, XPS, UV/VIS, DSC, DMTA, and tensile testing. The resulting polymers were found to be single phase amorphous networks with very high gel fraction, excellent optical clarity, and extremely sharp single glass transitions in the range of 34 to 153 C. Thermomechanical testing of these materials confirms their excellent shape memory behavior, high recovery force, and low mechanical hysteresis (especially on multiple cycles), effectively behaving as ideal elastomers above T{sub g}. We believe these materials represent a new and potentially important class of SMPs, and should be especially useful in applications such as biomedical microdevices

Rise and fall of the dust shell of the classical nova V339 Delphini

We present infrared spectroscopy of the classical nova V339 Del, obtained over a ∼ 2 year period. The in- frared emission lines were initially symmetrical, with HWHM velocities of 525 km s−1. In later (t >∼ 77days, where t is the time from outburst) spectra however, the lines displayed a distinct asymmetry, with a much stronger blue wing, possibly due to obscuration of the receding component by dust. Dust formation com- menced at ∼ day 34.75 at a condensation temperature of 1480 ± 20 K, consistent with graphitic carbon. Thereafter the dust temperature declined with time as Td ∝ t−0.346, also consistent with graphitic carbon. The mass of dust initally rose, as a result of an increase in grain size and/or number, peaked at ∼ day 100, and then declined precipitously. This decline was most likely caused by grain shattering due to electrostatic stress after the dust was exposed to X-radiation. An Appendix summarises Planck Means for carbon, and the determination of grain mass and radius for a carbon dust shell