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HEALTHBEAT SHOW NOTES .... Episode #78 - Recorded January 5, 2007Hello
and welcome to this week’s edition of HealthBeat, Chiropractic OnLine Today’s
Health, News and informational Podcast. In
this week’s news:
We’ll Look At –
For
HealthBeat, This is Dr. Todd Eglow. Happy
New Year and Welcome to HealthBeat
Podcast #78, recorded January 5, 2007. HealthBeat
is Chiropractic OnLine Today’s radio program, providing current news and
commentary about Chiropractic and Health. This
week’s Episode is sponsored by DaVinci
Laboratories.
Please surf to our web site at www.ChiropracticRadio.com
and click on the DaVinci link for your Health and Nutritional needs. If
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or Skype us by typing in “healthbeat”,
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Chiropractic OnLine Today has always provided our news and education content for
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thank everyone for their continued support. And
Now for some news …. Interdisciplinary
Rehabilitation in Fibromyalgia and Chronic Back Pain: A Prospective Outcome
Study A
study in the November 2006 issue of the Journal of Pain aimed to examine
short-term and mid-term course of health, biopsychosocial functional ability,
and coping performance of patients with fibromyalgia (FM) or chronic back pain
(BP) after participation in a standardized 4-week inpatient, interdisciplinary
pain rehabilitation program. In
a prospective cohort study, assessments were made by using a set of
standardized, well-tested self-rating instruments and other parameters before
and after the intervention up to the 6-month follow-up with standardized effect
sizes (ES) and comparison to population norms. The
effects of improvements in health and coping domains on pain reduction were
examined by linear regression modeling. The health of the 65 fibromyalgia and
the 60 chronic back pain patients at baseline was far worse than expected from
the norms. Improvements included standardized effect sizes up to 1.09 for pain, physical role performance, and mental/affective health dimensions and 0.50 in coping at discharge from the clinic. Physical and social function, mood, and coping were significantly associated with pain reduction. For
more information, surf to our Show Notes for a link to this study - http://www.jpain.org/article/PIIS1526590006006961/abstract?browse_volume=7&issue_key=TOC%40%40JOURNALS%40YJPAI%400007%400011&issue_preview=no&select1=no&select1=no&vol= New
Law Requires Report of Fraud http://library.findlaw.com/2000/Nov/1/130252.html Osteoporosis
and Vertebral Fractures According
to a study published in the December 2006 issue of the European Spine Journal,
the etiology of osteoporotic vertebral fractures is multi-factorial, and cannot
be explained solely by low bone mass. After sustaining an initial vertebral
fracture, the risk of subsequent fracture increases greatly. Examination
of physiologic loads imposed on vertebral bodies may help to explain a mechanism
underlying this fracture cascade. Osteoporosis,
which means "porous bones," is a condition that causes formerly strong
bones to gradually thin and weaken, leaving them susceptible to fractures. About
1.5 million fractures occur each year due to osteoporosis. This
study tested the hypothesis that model-derived segmental vertebral loading is
greater in individuals who have sustained an osteoporotic vertebral fracture
compared to those with osteoporosis and no history of fracture. Flexion
moments, and compression and shear loads were calculated from T2 to L5 in 12
participants with fractures and 19 without fractures while standing.
The results of the study found that the fracture group had significantly
greater normalized compression and shear force profiles and a trend for a
greater flexion moment profile. The
differences observed in multi-level spinal loading between the groups may
explain a mechanism for increased risk of subsequent vertebral fractures.
Interventions aimed at restoring vertebral morphology or reduce thoracic
curvature may assist in normalizing spine load profiles. If
you have questions about Osteoporosis, contact your Doctor of Chiropractic. For
more information, surf to our Show Notes for links to this study - http://www.springerlink.com/content/a122524213k822h7/ http://www.medscape.com/viewarticle/465001 Dr.
Janse Biography Recently
released is a biography of one of the pioneers in the history of Chiropractic,
Dr. Joseph Janse. From the book's author, Dr. Reed B. Phillips, D.C.,
Ph.D., President of Southern California University of Health Sciences, says the
following: "In
each of our lives, there are a few individuals who have the power and influence
to change our direction. Dr. Joseph Janse was one such person for me. I am
acquainted with the brightest, the most famous, and the most eloquent, yet no
other person has had an impact for the ultimate good of the chiropractic
profession and its educational development like Dr. Joseph Janse. Thus the
appropriate title of this book, Joseph Janse: The Apostle of Chiropractic
Education." Further,
Dr. James F. Winterstein, D.C., D.A.C.B.R., President, National University of
Health Sciences, Lombard, Illinois, writes: "This
biography will bring to life the person most of us came to know as an adult,
though it will trace his roots from his parents to his last years on this earth.
It is completely appropriate that such a book should be written, for it is not
often that one person can affect the lives of so many with such significance as
this man did." Surf
to our Show Notes for a link for more information about this book - https://www.fcerstore.org/sess/utn;jsessionid=15458887f98c8c4/shopdata/index.shopscript?main_url=https%3A%2F%2Fwww.fcerstore.org%2Fsess%2Futn%3Bjsessionid%3D15458887f98c8c4%2Fshopdata%2F0005_New%2BItems%2Fproduct_details.shopscript%3Farticle%3D0032_Joseph%252BJanse%253D3A%252BThe%252BApostle%252Bof%252BChiropractic%252BEducation%253D2C%252Bby%252BReed%252BB%253D252E%252BPhillips%253D2C%252BD%253D252EC%253D252E%253D2C%252BPh%253D252ED%253D252E%252B%253D28JANSE%253D29 CCGPP
Answers Back Continuing
a story COT's HealthBeat has been covering, is the release of the Low Back Draft
from the Council on Chiropractic Guidelines and Practice Parameters - the CCGPP. The
Press Release was published in an FCER - the Foundation for Chiropractic
Education and Research - eNewsletter. In
brief, the Press release stated - The purpose of presenting the initial draft
document on the internet was to generate just such feedback. The CCGPP
Council and Commission members wanted to promote the best practices concept as
an iterative process. We have been monitoring all the responses and thank
everyone who has presented constructive criticism and creative suggestions to
enhance the document. The CCGPP also recently held a spirited forum at the COCSA
annual meeting. The focus of that forum was additional clarification of the
"Compass" process. This additional feedback will also be considered
for use in the final document. However,
the intent of this article is to dispel some confusion that has arisen regarding
the best practices process. Most importantly, the initial low back draft
document that many have reviewed is NOT the "Chiropractic Clinical
Compass" (See Figure 1). What you have seen to date is merely the
evidence stratification for the most common low back conditions seen in the
average chiropractic clinic. The Council understands that this evidence
stratification is a dry, difficult to understand and implement document.
From the outset, the CCGPP has recognized and planned for translating the
science to the field for ease of application in the treatment room with the
patient. This is the nature of the DIER (Dissemination, Implementation,
Evaluation, and Revision) process. It is this process that will ultimately
become the Chiropractic Clinical Compass. Surf
to our Show Notes for the full Press Release. Chiropractic
Clinical Compass: The DIER Facts Many
are now aware that the Council on Chiropractic Guidelines and Practice
Parameters (CCGPP) is creating a chiropractic best practices process entitled
the "Chiropractic Clinical Compass". In May of 2006 the CCGPP
released the initial draft of the Introduction and Low Back evidence
stratification and synthesis. This document has generated considerable
commentary and concern throughout the profession. The
purpose of presenting the initial draft document on the internet was to generate
just such feedback. The CCGPP Council and Commission members wanted to
promote the best practices concept as an iterative process. We have been
monitoring all the responses and thank everyone who has presented constructive
criticism and creative suggestions to enhance the document. The CCGPP also
recently held a spirited forum at the COCSA annual meeting. The focus of that
forum was additional clarification of the "Compass" process. This
additional feedback will also be considered for use in the final document. However,
the intent of this article is to dispel some confusion that has arisen regarding
the best practices process. Most importantly, the initial low back draft
document that many have reviewed is NOT the "Chiropractic Clinical
Compass" (See Figure 1). What you have seen to date is merely the
evidence stratification for the most common low back conditions seen in the
average chiropractic clinic. The Council understands that this evidence
stratification is a dry, difficult to understand and implement document.
From the outset, the CCGPP has recognized and planned for translating the
science to the field for ease of application in the treatment room with the
patient. This is the nature of the DIER (Dissemination, Implementation,
Evaluation, and Revision) process. It is this process that will ultimately
become the Chiropractic Clinical Compass. Studies
indicate that it takes 17 years for today's research to become common practice
in the treatment room. They also indicate that the body of healthcare
research is doubling every 3.5 years and quickly overwhelming even the most
diligent reader. This is why the Bush administration has made Evidence
Based Medicine/Care and Knowledge Translation national priorities. These
were contributing factors as to why the CCGPP adopted the best practices model. Our
DIER committee has reviewed 41 case studies of the evidence based care
procedures to learn what has and has not worked in order to get doctors to
utilize the latest research in their practices. The common denominator in
virtually every study has been a lack of enthusiasm and confidence in the
information by stakeholder populations, particularly providers. Therefore,
to ensure its credibility the CCGPP adopted the internationally renowned AGREE
instrument as the template for our best practices process. The synthesis
of the aforementioned review indicated that the most promising approach to
changing provider behavior was the use of a variety of interventions including
audit and feedback, reminders, patient mediated intervention and educational
outreach. The
CCGPP intends to utilize those proven knowledge translation strategies to
maximize the successful adoption of the best practices process for the
chiropractic profession. Some of these tools will include:
Best
practices dissemination needs to be planned, active, sustainable and ensure high
accessibility. This is the mission of the CCGPP DIER committee. Best
practices should also target multiple audiences (professionals, patients and
policymakers) and be available in suitable formats for the different groups.
Among existing chiropractic providers the successful introduction of
chiropractic evidence based care needs to be patient-centered, easy to adopt and
validate the doctor's clinical judgment and skills. The best way to introduce
evidence based care is through the training of future chiropractors.
Currently, our chiropractic colleges are adopting best practices curricula in
varying degrees. CCGPP hopes the "Chiropractic Clinical Compass"
will become the resource for that curriculum. Facilitating
the use of the best practices document as a valuable and valid decision-making
tool for healthcare administrators and policymakers will be vital in order to
promote sound healthcare industry decisions, both for the good of the overall
healthcare system and to protect chiropractic providers from inappropriate
punitive external administrative abuse. Chiropractic
patients are the stakeholders who stand to benefit the most from the
chiropractic best practices initiative. As the primary decision makers in
health care, they represent a very important stakeholder population.
Therefore, the best practices document needs to get directly to them such that
they begin to ask their doctors about how evidence based care applies to their
individual cases. After
the full "Chiropractic Clinical Compass" process has been implemented
the CCGPP will evaluate its impact on clinical practice. The literature
will also be reevaluated for relevant enhancements, whether new research on
existing topics and/or topic expansion. This will lead to the revision
portion of the DIER process. CCGPP is committed to review the literature
every two years to ensure its efficacy. It is through this iterative
process that the "Chiropractic Clinical Compass" will improve into the
useful, dynamic database that the CCGPP envisions doctors using every day in
their treatment rooms to the benefit of their patients. At that point the
chiropractic profession as a whole will realize the evidence based care
equation: Science
+ Doctor's Clinical Experience + Patient Values = Chiropractic Best Practices ABOUT
THE AUTHOR: Dr. Mark D. Dehen is a second generation Doctor of Chiropractic
practicing in North Mankato, MN. He does ergonomic consulting and injury
prevention for local industries. Dr. Dehen is a past president of the MN
Chiropractic Association and recipient of the MN Chiropractor of the Year award.
Currently, he serves as Vice Chair of the CCGPP. For
a copy of this release or graphic in a different format, please contact CCGPP at
ccgpp@sc.rr.com. CCCPP
Release. December 9, 2006. http://www.ccgpp.org/archives/Overview%20of%20Best%20Practices%20Project.pdf Health
Corner
–In this edition of HealthBeat’s Health Corner, we present a story recently
published in the New York Times. Science
is not sure yet, but across the country, brain health programs are springing up,
offering the possibility of a cognitive fountain of youth. From
“brain gyms” on the Internet to “brain-healthy” foods and activities at
assisted living centers, the programs are aimed at baby boomers anxious about
entering their golden years and at their parents trying to stave off memory loss
or dementia. You
can surf to our Show Notes for a link to this story – http://www.nytimes.com/2006/12/27/health/27brain.html?_r=1&oref=slogin As
always, please surf to our Podcast Show Notes at ChiropractiRadio.com
for a full listing of web references mentioned in today’s show. And
remember - COT’s Healthbeat always
recommends discussing any
nutritional or exercise lifestyle modifications with a qualified healthcare
professional. Thank
you for listening…. And again, Best Wishes to all our listeners for a Safe,
Healthy & Happy New Year! As
always, We Want to hear from you. Please
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healthbeat@chiropracticradio.com We
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