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Volume 2, Issue 3 of Topics in Integrative Health Care is Now Available



Published on October 7, 2011

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Topics in Integrative Health CareVolume 2, Issue 3 of Topics in Integrative Health Care is Now Available.

Topics in Integrative Health Care (TIHC) is a peer-reviewed, open-access quarterly online journal.  TIHC can be located on the web at http://www.tihcij.com.

TIHC is dedicated to advancing the integration of multiple disciplines, both complementary and mainstream, into diverse health care settings in order to provide optimal patient care. It presents themed issues on topics of current relevance to health care providers interested in integrative, conservative care, health promotion and disease prevention. It includes international, interdisciplinary Grand Rounds in order to facilitate communication and patient comanagement among various health professions, for the good of patients everywhere.

The current issue’s table of contents:

Editorial


Topics in Integrative Health Care
Cheryl Hawk, DC, PhD, CHES 
Topics in Integrative Health Care 2011,Vol. 2(3)  ID: 2.3001


Each issue of TIHC focuses on a particular theme. Although many of the articles are invited, we also welcome unsolicited manuscripts with original research, Grand Rounds, clinical briefs and “fast facts” collections. All submissions are peer-reviewed.

The following themes are tentatively scheduled:
  • Winter 2011: Interdisciplinary education and training
  • Spring 2012: Integrative Approaches to Chronic Disease Prevention and Management

Commentary

Can Healthcare Providers Contribute to the Prevention of Dependent Adult Abuse?  Recognizing and Intervening for Caregiver Stress
Cheryl Hawk, DC, PhD, CHES
Topics in Integrative Health Care 2011, Vol. 2(3)  ID:  2.3002


As Dr. Salsbury describes in her article, dependent adult abuse is an under-recognized issue in the U.S. However, it is one which must be addressed, not only because it currently affects many of our most vulnerable citizens—but also because it is likely to grow. Currently 1 in 7 Americans suffers a disability, and this number is expected to increase.1 For the disabled who require personal assistance, at least 75% of their caregivers are “informal,” being unpaid family members or friends living either inside or outside the disabled person’s home. Approximately 12% of middle-aged Americans currently are involved in caregiving for a family member,2,3 and this number is likely to increase as the number of disabled increases.

Research

Opportunities to Integrate Prevention Into the Chiropractic Clinical Encounter: A Practice-based Research Project By the Integrated Chiropractic Outcomes Network (ICON)
Cheryl Hawk, DC, PhD, CHES ; Marion Willard Evans, Jr., DC, PhD, MCHES, CWP ; Dr. Ronald L. Rupert ; Harrison Ndetan, MSc, MPH, DrPH
Topics in Integrative Health Care 2011, Vol. 2(3) ID: 2.3003

Purpose:
to collect exploratory data on the characteristics of chiropractic practices participating in a practice-based research network (PBRN), particularly with respect to important health promotion and disease prevention activities, to lay the groundwork for future longitudinal studies.

Methods: This was a cross-sectional descriptive study conducted by the methods of practice-based research in the offices of participating U.S. chiropractors. Data were collected by self-report from practitioners and from all patients presenting for treatment in the participating offices for one week in March 2011.

Results: Data were collected on 1891 patients of 38 Doctors of Chiropractic (DCs) in 30 practices in 17 U.S. states. Forty-seven percent of DCs reported that they routinely gave advice on diet; 26% on weight management; and 21% on tobacco use. Of the 1891 patients, 24.9% were presenting for wellness/maintenance care only. Forty percent of patients’ health concern’s duration was > 1 year. The mean number of annual visits reported by patients was 14. Of the 12.4% of patients who reported using tobacco currently, 29.1% reported that their practitioner discussed quitting with them. About 40% of patients reported being overweight; 19.5% reported that they received information from their DC on weight management. Only 9.2% of patients reported being obese; 31.6% reported receiving information on weight management from their DC.

Conclusion: Chiropractic patients in this sample presented with risk factors amenable to physician counseling. Their DCs reported routinely providing advice on some risk factors, and a substantial proportion of patients with risk factors reported receiving advice from their DC. Chiropractic practices, in which patients with chronic pain have frequent follow-up visits, present an opportunity to advise patients on health risks, which could contribute to improved health outcomes.


A Survey of Alabama Chiropractors Regarding Health Promotion, Primary Prevention, and Primary Care
Ronald Ivie, DC, DABCO, MA ; Michael A. Perko, PhD, CHES, FAAHE ; Marion Willard Evans, Jr., DC, PhD, MCHES, CWP ; Harrison Ndetan, MSc, MPH, DrPH
Topics in Integrative Health Care 2011, Vol. 2(3) ID: 2.3004

Doctors of Chiropractic (DCs) perform health promotion as part of routine practice. In addition, the regulating body for chiropractic educational institutions has a standard in place on the teaching of this subject matter in all accredited colleges. The largest chiropractic professional organization in the U.S. (the American Chiropractic Association) and the Association of Chiropractic Colleges also have position statements supportive of prevention and health promotion as part of practice. However, very little is known as to whether practicing chiropractors have the aptitude, willingness, competence or the infrastructure to appropriately address primary preventive issues with patients. Additionally, little is known regarding attitudes and beliefs among DC’s in different regions of the country and whether demographic and cultural norms will affect the ability to meet the accrediting agency’s charge.

This study applies the Ecological Theory of health promotion to design a survey of attitudes, beliefs and practices of chiropractors in Alabama. Results indicate that although some health promotion practices are performed, many recommended screenings or procedures are not. In addition, though most clinicians agreed that public health measures should be a part of practice, in many cases they reported they did not perform them routinely. Further education and investigation are needed as to how chiropractors can be more involved in prevention and promotion of health as part of routine practice, including removal of actual and perceived barriers to this practice.


Management of Non-cardiac Chest Pain With Chiropractic Care: A Case Report and Brief Review
Stephen R. Cooper, DC ; Mark T. Pfefer, RN, MS, DC
Topics in Integrative Health Care 2011, Vol. 2(3) ID: 2.3005

Objective:
The purpose of this report is to discuss the outcome of a patient with non-cardiac chest pain treated with chiropractic spinal manipulation combined with instrument-assisted soft tissue mobilization.

Introduction: Chest pain is the fourth most common presentation in emergency rooms in the United States. The direct and indirect costs of chest pain are high in terms of disability, medication, repeated hospital admissions and physician visits, and costly diagnostic procedures.

Clinical features: The case of a 45 year-old male presenting to a chiropractic clinic with complaints of chest pain is discussed. Although the source of this chest pain was likely non-cardiac, cardiac risk factors were present and were addressed as well.

Intervention and outcome: The patient was treated with manual thoracic spinal manipulation and instrument-assisted soft tissue mobilization with complete resolution of chest pain at 3 weeks and no chest pain at 1 month and 3 month follow-up visits. Conservative cardiac prevention approaches were encouraged with good outcome.

Conclusion: This case points out the promising role the combination of chiropractic manipulation and instrument-assisted soft tissue mobilization may have in the management of non-cardiac chest pain arising from musculoskeletal dysfunction.


Chiropractic Management of Post-concussion Headache and Neck Pain In a Young Athlete and Implications For Return-To-Play
Mark T. Pfefer, RN, MS, DC ; Stephen R. Cooper, DC ; Angela M. Boyazis
Topics in Integrative Health Care 2011, Vol. 2(3) ID: 2.3006

Objective:
Each year there are an estimated 1.6-3.8 million sports-related brain injuries; 136,000 of which occur in young athletes in the course of high school sports. The purpose of this article is to discuss the management and outcome of a post-concussive headache and neck pain in a young athlete and implications for return to play.

Clinical Features: A 16-year-old male athlete presented to a chiropractic clinic complaining of neck pain and daily headaches from a concussion while playing football 5 weeks previously.

Intervention and Outcome: A short course of diversified-type cervical and thoracic manipulation was applied with significant relief after the second treatment and resolution of symptoms after 5 visits performed over 2 weeks. The athlete was able to participate in a graduated return to play. Three months post-SRC the athlete was able to return to full game play symptom free.

Conclusion: Chiropractors who see athletes in their practices should be aware of SRC and return to play guidelines.


Clinical Brief: Challenges with the Differential Diagnosis of Fibromyalgia
Michael Schneider, DC, PhD
Topics in Integrative Health Care 2011, Vol. 2(3) ID: 2.3007


Fibromyalgia (FM) is a diagnosis of exclusion used to describe patients with a cluster of symptoms that are not attributed to a recognized disease process. The hallmark symptom of FM is chronic widespread pain which is bilateral, above and below the waist, and involving the axial skeleton and/or torso. The symptom cluster also includes unrefreshing sleep, fatigue, cognitive difficulties, and a number of somatic complaints. Unfortunately, FM is often misdiagnosed because these symptoms may also be found associated with latent pathology or disease, metabolic/functional disorders, or chronic musculoskeletal disorders. All clinicians who treat chronic pain patients should learn how to differentiate between FM and other causes of widespread pain and fatigue.


Clinical Brief: Recognizing, Reporting and Responding to Dependent Adult Abuse
Stacie A. Salsbury, PhD RN
Topics in Integrative Health Care 2011, Vol. 2(3) ID: 2.3008


Dependent adult abuse is an under-recognized problem affecting many disabled adults and older persons living in their homes or in institutional settings. Elder abuse, the most common form of dependent adult abuse, may present as physical, emotional/psychological, or sexual abuse; financial exploitation; and neglect, abandonment, or self-neglect. Health care professionals should be aware of the signs and symptoms of dependent adult abuse, and know how to report suspected cases accordingly. Manual therapists may need to modify treatment approaches for patients with a history of dependent adult abuse.

Fast Facts
THIC Staff
Topics in Integrative Health Care 2011, Vol. 2(3) ID: 2.3009

Readers are welcome to contribute to Fast Facts. Please include the original abstract (with citation) that is the source of your contribution. Contributors’ names will be included along with the item.

The following is an excerpt:

This Patient Page in JAMA is free and downloadable. It provides basic information about the issue of elder abuse, as part of the August 3, 2010, JAMA theme issue on violence and human rights.

Hildreth CJ, Burke AE, Golub RM. JAMA patient page. Elder abuse. JAMA 2011;306(5):568.

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