1,435 research outputs found
The appropriate use of radiography in clinical practice: a report of two cases of biomechanical versus malignant spine pain
BACKGROUND: To describe the evaluation, treatment, management and referral of two patients with back pain with an eventual malignant etiology, who were first thought to have a non-organic biomechanical disorder. CLINICAL FEATURES: The study was a retrospective review of the clinical course of two patients seen by a chiropractor in a multi-disciplinary outpatient facility, who presented with what was thought to be non-organic biomechanical spine pain. Clinical examination by both medical and chiropractic physicians did not indicate the need for radiography in the early course of management of either patient. Upon subsequent re-evaluation, it was decided that certain clinical factors required investigation with advanced imaging. In one instance, the patient responded to conservative care of low back pain for nine weeks, after which she developed severe pain in the pelvis. In the second case, the patient presented with signs and symptoms consistent with uncomplicated musculoskeletal pain that failed to respond to a course of conservative care. He was referred for medical therapy which also failed to relieve his pain. In both patients, malignancy was eventually discovered with magnetic resonance imaging and both patients are now deceased, resulting in an inability to obtain informed consent for the publication of this manuscript. CONCLUSION: In these two cases, the prudent use of diagnostic plain film radiography did not significantly alter the appropriate long-term management of patients with neuromusculoskeletal signs and symptoms. The judicious use of magnetic resonance imaging was an effective procedure when investigating recalcitrant neuromusculoskeletal pain in these two patients
An Epidemiological Examination of the Subluxation Construct Using Hillās Criteria of Causation
Background
Chiropractors claim to locate, analyze and diagnose a putative spinal lesion known as subluxation and apply the mode of spinal manipulation (adjustment) for the correction of this lesion.
Aim
The purpose of this examination is to review the current evidence on the epidemiology of the subluxation construct and to evaluate the subluxation by applying epidemiologic criteria for it's significance as a causal factor.
Methods
The databases of PubMed, Cinahl, and Mantis were searched for studies using the keywords subluxation, epidemiology, manipulation, dose-response, temporality, odds ratio, relative risk, biological plausibility, coherence, and analogy.
Results
The criteria for causation in epidemiology are strength (strength of association), consistency, specificity, temporality (temporal sequence), dose response, experimental evidence, biological plausibility, coherence, and analogy. Applied to the subluxation all of these criteria remain for the most part unfulfilled.
Conclusion
There is a significant lack of evidence to fulfill the basic criteria of causation. This lack of crucial supportive epidemiologic evidence prohibits the accurate promulgation of the chiropractic subluxation
Attitudes of non-practicing chiropractors: a pilot survey concerning factors related to attrition
Background
Research into attitudes about chiropractors who are no longer engaged in active clinical practice is non-existent. Yet non-practicing chiropractors (NPCs) represent a valid sub-group worthy of study.
Aim
The purpose of this research was to assess attrition attitudes of NPCs about the chiropractic profession and develop a scale to assess such attitudes.
Methods
A 48 item survey was developed using the PsychData software. This survey included 35 Likert-style items assessing various aspects of the profession namely financial, educational, psychosocial and political. An internet discussion site where NPCs may be members was accessed for recruitment purposes.
Results
A total of 70 valid responses were received for analysis. A majority of respondents were male with 66% being in non-practice status for 3 to 5 years and less with 43% indicating that they had graduated since the year 2000. Most respondents were employed either in other healthcare professions and non-chiropractic education. A majority of NPCs believed that business ethics in chiropractic were questionable and that overhead expense and student loans were factors in practice success. A majority of NPCs were in associate practice at one time with many believing that associates were encouraged to prolong the care of patients and that associate salaries were not fair. Most NPCs surveyed believed that chiropractic was not a good career choice and would not recommend someone to become a chiropractor. From this survey, a 12 item scale was developed called the "chiropractor attrition attitude scale" for future research. Reliability analysis of this novel scale demonstrated a coefficient alpha of 0.90.
Conclusion
The low response rate indicates that findings cannot be generalized to the NPC population. This study nonetheless demonstrates that NPCs attrition attitudes can be assessed. The lack of a central database of NPCs is a challenge to future research. Appropriate investigation of attrition within the chiropractic profession would be helpful in the analysis of attitudes regarding both chiropractic education and practice. Further research is needed in this area
Design, characterization, and control of the NASA three degree of freedom reaction compensation platform
Increasing research is being done into industrial uses for the microgravity environment aboard orbiting space vehicles. However, there is some concern over the effects of reaction forces produced by moving objects, especially motors, robotic actuators, and astronauts. Reaction forces produced by the movement of these objects may manifest themselves as undesirable accelerations in the space vehicle making the vehicle unusable for microgravity applications. It is desirable to provide compensation for such forces using active means. This paper presents the design and experimental evaluation of the NASA three degree of freedom reaction compensation platform, a system designed to be a testbed for the feasibility of active attenuation of reaction forces caused by moving objects in a microgravity environment. Unique 'linear motors,' which convert electrical current directly into rectilinear force, are used in the platform design. The linear motors induce accelerations of the displacer inertias. These accelerations create reaction forces that may be controlled to counteract disturbance forces introduced to the platform. The stated project goal is to reduce reaction forces by 90 percent, or -20 dB. Description of the system hardware, characterization of the actuators and the composite system, and design of the software safety system and control software are included
An epidemiological examination of the subluxation construct using Hill's criteria of causation
<p>Abstract</p> <p>Background</p> <p>Chiropractors claim to locate, analyze and diagnose a putative spinal lesion known as subluxation and apply the mode of spinal manipulation (adjustment) for the correction of this lesion.</p> <p>Aim</p> <p>The purpose of this examination is to review the current evidence on the epidemiology of the subluxation construct and to evaluate the subluxation by applying epidemiologic criteria for it's significance as a causal factor.</p> <p>Methods</p> <p>The databases of PubMed, Cinahl, and Mantis were searched for studies using the keywords subluxation, epidemiology, manipulation, dose-response, temporality, odds ratio, relative risk, biological plausibility, coherence, and analogy.</p> <p>Results</p> <p>The criteria for causation in epidemiology are strength (strength of association), consistency, specificity, temporality (temporal sequence), dose response, experimental evidence, biological plausibility, coherence, and analogy. Applied to the subluxation all of these criteria remain for the most part unfulfilled.</p> <p>Conclusion</p> <p>There is a significant lack of evidence to fulfill the basic criteria of causation. This lack of crucial supportive epidemiologic evidence prohibits the accurate promulgation of the chiropractic subluxation.</p
Sources of Spring and Fall Hop Aphid, Phorodon humuli (Schrank), (Homoptera: Aphididae) Migrants in South Central Washington
The hop aphid, Phorodon humuli (Schrank), flies from hop, Humulus lupulus L., to its overwintering Prunus spp. hosts in the fall. The sources of these aphids were not known because much of the aphid flight occurs after hop plants are removed from fields during harvest. We found that the bottoms of hop plants remaining alive in harvested hop yards averaged 1.7 to 5.8 hop aphids per leaf in three years of sampling. Unharvested hop plants remaining after harvest averaged 32.8 to 127.1 aphids per leaf in two years. Feral hops were also infested with hop aphids in late summer and early fall. Sources for the spring aphid flight from Prunus spp. to hop included Prunus cerasifera Ehrhart, which averaged 44.0 to 105.1 aphids per shoot in two years of sampling. Fruit-type Prunus spp. trees growing on residential properties averaged 0.9 and 11.3 aphids per shoot in the same years but few of these trees were found. Plum and prune orchards averaged 0 to 5.5 aphids per shoot in two years and estimates indicate that orchard trees are much more numerous than other hop aphid host trees. Potential alternative management strategies for hop aphid control are discussed
The necessary future of chiropractic education: a North American perspective
The chiropractic educational system in North America is currently in a state of flux. The attempted conversion of some chiropractic schools into "universities" and the want of university affiliation for chiropractic schools suggests that we are searching for a better alternative to the present system. In the early 20(th )century, the Flexner Report helped transform modern medical education into a discipline that relies on scientific and clinical knowledge. Some have wondered if it is time for a Flexner-type report regarding the education of doctors of chiropractic. This article outlines the current challenges within the chiropractic educational system and proposes positive changes for that system
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