Chiropractic treatment of older adults with neck pain with or without headache or dizziness: Analysis of 288 Australian chiropractors' self-reported views

© 2019 The Author(s). Background: Neck pain is a leading cause of individual and societal burden worldwide, affecting an estimated 1 in 5 people aged 70 years and older. The nature and outcomes of chiropractic care for older adults with neck pain, particularly those with co-morbid headaches, remains poorly understood. Therefore, we sought to ascertain: What proportion of Australian chiropractors' caseload comprises older adults with neck pain (with or without headache); How are these conditions treated; What are the reported outcomes? Methods: An online survey examining practitioner and practice characteristics, clinical patient presentations, chiropractic treatment methods and outcomes, and other health service use, was distributed to a random nationally representative sample of 800 Australian chiropractors. Quantitative methods were used to analyze the data. Results: Two hundred eighty-eight chiropractors (response rate = 36%) completed the survey between August and November 2017. Approximately one-third (M 28.5%, SD 14.2) of the chiropractors' patients were older adults (i.e. aged ≥65 years), of which 45.5% (SD 20.6) presented with neck pain and 31.3% (SD 20.3) had co-morbid headache. Chiropractors reported to combine a range of physical and manual therapy treatments, exercises and self-management practices in their care of these patients particularly: manipulation of the thoracic spine (82.0%); activator adjustment of the neck (77.3%); and massage of the neck (76.5%). The average number of visits required to resolve headache symptoms was reported to be highest among those with migraine (M 11.2, SD 8.8). The majority of chiropractors (57.3%) reported a moderate response to treatment in reported dizziness amongst older adults with neck pain. Approximately 82% of older adult patients were estimated to use at least one other health service concurrently to chiropractic care to manage their neck pain. Conclusion: This is the first known study to investigate chiropractic care of older adults living with neck pain. Chiropractors report using well-established conservative techniques to manage neck pain in older adults. Our findings also indicate that this target group of patients may frequently integrate chiropractic care with other health services in order to manage their neck pain. Further research should provide in-depth investigation of older patients' experience and other patient-reported outcomes of chiropractic treatment

Character and environmental lability of cyanobacteria-derived dissolved organic matter

Autotrophic dissolved organic matter (DOM) is central to the carbon biogeochemistry of aquatic systems, and the full complexity of autotrophic DOM has not been extensively studied, particularly by high-resolution mass spectrometry (HRMS). Terrestrial DOM tends to dominate HRMS studies in freshwaters due to the propensity of such compounds to ionize by negative mode electrospray, and possibly also because ionizable DOM produced by autotrophy is decreased to low steady-state concentrations by heterotrophic bacteria. In this study, we investigated the character of DOM produced by the widespread cyanobacteriaMicrocystis aeruginosausing high-pressure liquid chromatography-electrospray ionization-high-resolution mass spectrometry.M. aeruginosaproduced thousands of detectable compounds in axenic culture. These compounds were chromatographically resolved and the majority were assigned to aliphatic formulas with a broad polarity range. We found that the DOM produced byM. aeruginosawas highly susceptible to removal by heterotrophic freshwater bacteria, supporting the hypothesis that this autotroph-derived organic material is highly labile and accordingly only seen at low concentrations in natural settings

Eutrophication and acidification: Do they induce changes in the dissolvedorganic matter dynamics in the coastal Mediterranean Sea?

Original research paperTwo mesocosms experiments were conducted in winter 2010 and summer 2011 to examine how increased pCO2and/or nutrient concentrations potentially perturbate dissolved organic matter dynamics in natural microbialassemblages. Thefluorescence signals of protein- and humic-like compounds were used as a proxy for labileand non-labile material, respectively, while the evolution of bacterial populations, chlorophylla(Chla) anddissolved organic carbon (DOC) concentrations were used as a proxy for biological activity. For both seasons,the presence of elevated pCO2did not cause any significant change in the DOC dynamics (p-valueb0.05). Theconditions that showed the greatest changes in prokaryote abundances and Chlacontent were those amendedwith nutrients, regardless of the change in pH. The temporal evolution offluorophores and optical indices re-vealed that the degree of humification of the organic molecules and their molecular weight changed significantlyin the nutrient-amended treatment. The generation of protein-like compounds was paired to increases in theprokaryote abundance, being higher in the nutrient-amended tanks than in the control. Different patterns inthe magnitude and direction of the generation of humic-like molecules suggested that these changes dependedon initial microbial populations and the availability of extra nutrient inputs. Based on our results, it is expected that in the future projected coastal scenarios the eutrophication processes will favor the transformations of labile and recalcitrant carbon regardless of changes in pCO2.MINECO, European Union, Generalitat de Catalunya, CSICVersión del editor3,25