Volume 3, Issue 1 of Topics in Integrative Health Care is Now Available
Published on March 27, 2012
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 Volume 3, Issue 1 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 2012,Vol. 3(1) ID: 3.1001
Topics in Integrative Health Care welcomes unsolicited manuscripts with original research, Grand Rounds, clinical briefs and “fast facts” collections. All submissions are peer-reviewed. For the June 2012 issue, we have tentatively scheduled a theme focusing on issues in health professions training and education.
Research
Poor Healthcare Coverage and Management of Low Back Pain: Descriptive Analysis of an African American Cohort
Ekele I. Enyinnaya, DC, MS; Ann Gill Taylor, EdD, RN, FAAN; William A. Knaus, MD
Topics in Integrative Health Care 2012, Vol. 3(1) ID: 3.1002
Purpose: Low back pain is one of the most common musculoskeletal disorders in the developed world and remains a growing and potentially debilitating condition. Management of this condition for individuals with poor healthcare coverage poses an additional burden. The purpose of this study was to characterize management of low back pain in a cohort of African Americans (AA), a majority of who were determined to have poor or no healthcare coverage.
Methods: Data from the general and AA patient populations with low back pain were extracted from the University of Virginia Medical Center Clinical Data Repository (CDR), which contains 15 years of data on approximately one million patients seen at the University of Virginia Medical Center. Patient demographics, healthcare coverage status, comorbidities, low back pain diagnoses, and procedure codes were extracted from the CDR and analyzed for differences between both groups and among healthcare coverage types within the AA cohort with low back pain.
Results: The largest percentage of completely indigent patients, Medicaid recipients, and the uninsured was found within the AA cohort compared to the general cohort (P < .001). AAs with poor healthcare coverage received less healthcare services than AAs with private insurance in management of low back pain.
Conclusion: Differences in the management of low back pain by healthcare coverage type were observed within a cohort of AA with low back pain. Further investigation into the most appropriate low back pain management options for this and other vulnerable communities is warranted.
Patient Characteristics, Screening Use, and Health Education Advice in a Chiropractic Practice-Based Research Network
Marion Willard Evans, Jr., DC, PhD, MCHES, CWP ; Cheryl Hawk, DC, PhD, CHES; Harrison Ndetan, MSc, MPH, DrPH; Ronald L. Rupert, DC, MS
Topics in Integrative Health Care 2012, Vol. 3(1) ID: 3.1003
Objective: to replicate questions from the National Ambulatory Medical Care Survey (NAMCS) in a sample of Doctors of Chiropractic (DCs) in a practice-based research network (PBRN) to assess the feasibility and appropriateness of the survey instrument for a larger study focusing on prevention and health promotion-related practices.
Methods: The study population consisted of volunteer DCs in the Integrative Chiropractic Outcomes Network (ICON) PBRN. DCs recorded data on each patient who presented in their office during one designated day. Data were collected on chief complaints, screening procedures, diagnosis, and health education advice.
Results: 530 patient visits were captured from 27 DCs in 21 practices. The most common complaint was back pain, and over 80% were established patients. Ordering of screenings on the day of the visit was infrequent, including radiography (4%). Most patients paid with private insurance (61%). Nearly half (49%) presented for a new complaint and only 4% for preventive care. 10.5% of the patients were recorded as tobacco users and over 65% were overweight or obese. Advice on physical activity/exercise was suggested to over 60% of patients. While specific advice on weight management was provided to only 11.5% of obese patients, 74% of obese patients received advice on diet, exercise or weight reduction. Only 9.8% of tobacco users were offered cessation advice that day.
Conclusions: Adaptations of the survey may be necessary to reflect chiropractic practice style, in which patients make multiple visits. Methods to encourage DCs to adopt health promotion and disease prevention advising guidelines may be warranted.
Clinical Brief: Classification of Essential and Parkinson’s Tremors
Clinton Daniels, D.C., M.S.
Topics in Integrative Health Care 2012, Vol. 3(1) ID: 3.1004
Essential tremor and Parkinson’s disease are the most common tremors encountered in clinical practice. In addition to the detailed history, the differential diagnosis is mainly clinical and does not typically require use of special tests. In these cases, the role of the chiropractic physician and manual therapist should be to provide early diagnosis, appropriate referral, and provide palliative care aimed at improved patient function and quality of life.
Clinical Brief: Recognition of Benign Joint Hypermobility Syndrome (BJHS)
Michael Ramcharan, DC, MPH, MUA-C; Lyndsay Andrews, R.T. (R) (CT)2
Topics in Integrative Health Care 2012, Vol. 3(1) ID: 3.1005
The first known reference to joint laxity which leads to joint hypermobility is attributed to Hippocrates who, in the 4th century BC, described the Scythians as being "so-loose-limbed that they were unable to draw a bow-string or hurl a javelin."1 The prevalence of generalized joint hypermobility varies from 10 to 30 percent.2-5 This was illustrated in a study of 123 healthy medical students where 22 (18%) had at least one lax joint, and 14 others (11%) had three or more lax joints.6 Joint laxity is more common in the right limb, females, blacks, and in children from families with higher socioeconomic status.7-9
Fast Facts
THIC Staff
Topics in Integrative Health Care 2012, Vol. 3(1) ID: 3.1006
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:
The American Cancer Society (ACS) publishes Nutrition and Physical Activity Guidelines every 5 years to serve as a foundation for its communication, policy, and community strategies. Free full text available at: http://onlinelibrary.wiley.com/doi/10.3322/caac.20140/abstract
Kushi LH, Doyle C, McCullough M, et al. American Cancer Society Guidelines on nutrition and physical activity for cancer prevention: reducing the risk of cancer with healthy food choices and physical activity. CA Cancer J Clin 2012;62(1):30-67.
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