Sample records for osteopathy

  1. Macroscopic Biological Characteristics of Individualized Therapy in Chinese Mongolian Osteopathy

    NASA Astrophysics Data System (ADS)

    Namula, Zhao; Mei, Wang; Li, Xue-en

    Objective: Chinese Mongolian osteopathy has been passed down from ancient times and includes unique practices and favorable efficacy. In this study, we investigate the macroscopic biological characteristics of individualized Chinese Mongolian osteopathy, in order to provide new principle and methods for the treatment of bone fracture. Method: With a view to provide a vital link between nature and humans, the four stages of Chinese Mongolian osteopathy focus on the unity of the mind and body, the limbs and body organs, the body and its functions, and humans and nature. Results: We discuss the merits of individualized osteopathy in terms of the underlying concepts, and evaluate the approaches and principles of traditional medicine, as well as biomechanics. Conclusions: Individualized Mongolian osteopathy targets macroscopic biological components including dynamic reduction, natural fixation, and functional healing. Chinese Mongolian osteopathy is a natural, ecological and non-invasive osteopathy that values the link between nature and humans, including the unity of mind and body. The biological components not only serve as a foundation for Chinese Mongolian osteopathy but are also important for the future development of modern osteopathy, focusing on individualization, actualization and integration.

  2. Complex segregation analysis of craniomandibular osteopathy in Deutsch Drahthaar dogs.

    PubMed

    Vagt, J; Distl, O

    2018-01-01

    This study investigated familial relationships among Deutsch Drahthaar dogs with craniomandibular osteopathy and examined the most likely mode of inheritance. Sixteen Deutsch Drahthaar dogs with craniomandibular osteopathy were diagnosed using clinical findings, radiography or computed tomography. All 16 dogs with craniomandibular osteopathy had one common ancestor. Complex segregation analyses rejected models explaining the segregation of craniomandibular osteopathy through random environmental variation, monogenic inheritance or an additive sex effect. Polygenic and mixed major gene models sufficiently explained the segregation of craniomandibular osteopathy in the pedigree analysis and offered the most likely hypotheses. The SLC37A2:c.1332C>T variant was not found in a sample of Deutsch Drahthaar dogs with craniomandibular osteopathy, nor in healthy controls. Craniomandibular osteopathy is an inherited condition in Deutsch Drahthaar dogs and the inheritance seems to be more complex than a simple Mendelian model. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. 42 CFR 62.2 - Definitions.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... means those programs of graduate training in medicine, osteopathy, dentistry or other health professions..., osteopathy, dentistry or an equivalent credential for a particular health profession who is enrolled for a... the Secretary. School means a school of medicine, osteopathy, dentistry, or other health profession...

  4. 42 CFR 417.1 - Definitions.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... part. Health professionals means physicians (doctors of medicine and doctors of osteopathy), dentists... majority of whom are licensed to practice medicine or osteopathy. The written services arrangement must... group: (1) That is composed of health professionals licensed to practice medicine or osteopathy and of...

  5. 42 CFR 413.75 - Direct GME payments: General requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...-based providers for the costs of approved residency programs in medicine, osteopathy, dentistry, and... participates in an approved medical residency program, including programs in osteopathy, dentistry, and... programs in osteopathy, dentistry, and podiatry, as required in order to become certified by the...

  6. 32 CFR 74.2 - Policy.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... DOCTORS OF OSTEOPATHY AS MEDICAL OFFICERS § 74.2 Policy. In the interest of obtaining maximum uniformity, the following criteria are established for the appointment of doctors of osteopathy as medical... as medical officers in the Air Force, a doctor of osteopathy must: (1) Be a citizen of the United...

  7. 42 CFR 476.98 - Reviewer qualifications and participation.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... services furnished or proposed to be furnished by a licensed doctor of medicine or osteopathy or by a doctor of dentistry must be respectively another licensed doctor of medicine or osteopathy or of... that peers are not available to make initial denial determinations, a doctor of medicine or osteopathy...

  8. A workforce survey of Australian osteopathy: analysis of a nationally-representative sample of osteopaths from the Osteopathy Research and Innovation Network (ORION) project.

    PubMed

    Adams, Jon; Sibbritt, David; Steel, Amie; Peng, Wenbo

    2018-05-10

    Limited information is available regarding the profile and clinical practice characteristics of the osteopathy workforce in Australia. This paper reports such information by analysing data from a nationally-representative sample of Australian osteopaths. Data was obtained from a workforce survey of Australian osteopathy, investigating the characteristics of the practitioner, their practice, clinical management features and perceptions regarding research. The survey questionnaire was distributed to all registered osteopaths across Australia in 2016 as part of the Osteopathy Research and Innovation Network (ORION) project. A total of 992 Australian osteopaths participated in this study representing a response rate of 49.1%. The average age of the participants was 38.0 years with 58.1% being female and the majority holding a Bachelor or higher degree qualification related to the osteopathy professional. Approximately 80.0% of the osteopaths were practicing in an urban area, with most osteopaths working in multi-practitioner locations, having referral relationships with a range of health care practitioners, managing patients a number of musculoskeletal disorders, and providing multi-model treatment options. A total of 3.9 million patients were estimated to consult with osteopaths every year and an average of approximate 3.0 million hours were spent delivering osteopathy services per year. Further research is required to provide rich, in-depth examination regarding a range of osteopathy workforce issues which will help ensure safe, effective patient care to all receiving and providing treatments as part of the broader Australian health system.

  9. 42 CFR 62.4 - To whom will scholarship program awards be available in addition to those individuals pursuing...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ..., osteopathy, or dentistry? 62.4 Section 62.4 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND... medicine, osteopathy, or dentistry? The Secretary will, from time-to-time, publish in the Federal Register a list of those health professions in addition to medicine, osteopathy, and dentistry for which the...

  10. Exploring the measurement properties of the osteopathy clinical teaching questionnaire using Rasch analysis.

    PubMed

    Vaughan, Brett

    2018-01-01

    Clinical teaching evaluations are common in health profession education programs to ensure students are receiving a quality clinical education experience. Questionnaires students use to evaluate their clinical teachers have been developed in professions such as medicine and nursing. The development of a questionnaire that is specifically for the osteopathy on-campus, student-led clinic environment is warranted. Previous work developed the 30-item Osteopathy Clinical Teaching Questionnaire. The current study utilised Rasch analysis to investigate the construct validity of the Osteopathy Clinical Teaching Questionnaire and provide evidence for the validity argument through fit to the Rasch model. Senior osteopathy students at four institutions in Australia, New Zealand and the United Kingdom rated their clinical teachers using the Osteopathy Clinical Teaching Questionnaire. Three hundred and ninety-nine valid responses were received and the data were evaluated for fit to the Rasch model. Reliability estimations (Cronbach's alpha and McDonald's omega) were also evaluated for the final model. The initial analysis demonstrated the data did not fit the Rasch model. Accordingly, modifications to the questionnaire were made including removing items, removing person responses, and rescoring one item. The final model contained 12 items and fit to the Rasch model was adequate. Support for unidimensionality was demonstrated through both the Principal Components Analysis/t-test, and the Cronbach's alpha and McDonald's omega reliability estimates. Analysis of the questionnaire using McDonald's omega hierarchical supported a general factor (quality of clinical teaching in osteopathy). The evidence for unidimensionality and the presence of a general factor support the calculation of a total score for the questionnaire as a sufficient statistic. Further work is now required to investigate the reliability of the 12-item Osteopathy Clinical Teaching Questionnaire to provide evidence for the validity argument.

  11. Ideas, properties, and standards of fracture repositioning with osteopathy in traditional Mongolian medicine in China.

    PubMed

    Wang, Mei; Wang, Hongxia; Zhao, Namula

    2015-02-01

    To explore the unique ideas, properties, and standards of fracture repositioning with osteopathy in traditional Mongolian medicine in China. Based on the natural life concept of "integration of universe and man", osteopathy in traditional Mongolian medicine in China uses the modern principles and methods of physiology, psychology, and biomechanics. Against this background, we explored the unique ideas, properties, and stan- dards of fracture repositioning in traditional Mongolian medicine. Fracture treatment with osteopathy in traditional Mongolian medicine in China is based on (a) the ideas of natural, sealed, self and dynamic repositioning of fractures; (b) the properties of structural continuity and functional completeness; (c) the standards of "integration of movement and stillness" and "force to force". The unique ideas, properties, and standards of fracture repositioning with osteopathy in traditional Mongolian medicine in China have resulted in the widespread use of such techniques and represents the future direction of the development of fracture repositioning.

  12. Effectiveness of osteopathic manipulative treatment versus osteopathy in the cranial field in temporomandibular disorders - a pilot study.

    PubMed

    Gesslbauer, Christina; Vavti, Nadja; Keilani, Mohammad; Mickel, Michael; Crevenna, Richard

    2018-03-01

    Temporomandibular disorders are a common musculoskeletal condition causing severe pain, physical and psychological disability. The effect and evidence of osteopathic manipulative treatment and osteopathy in the cranial field is scarce and their use are controversial. The purpose of this pilot study was to evaluate the effectiveness of osteopathic manipulative treatment and osteopathy in the cranial field in temporomandibular disorders. A randomized clinical trial in patients with temporomandibular disorders was performed. Forty female subjects with long-term temporomandibular disorders (>3 months) were included. At enrollment, subjects were randomly assigned into two groups: (1) osteopathic manipulative treatment group (20 female patients) and (2) osteopathy in the cranial field group (20 female patients). Examination was performed at baseline (E0) and at the end of the last treatment (E1), consisting of subjective pain intensity with the Visual Analog Scale, Helkimo Index and SF-36 Health Survey. Subjects had five treatments, once a week. 36 subjects completed the study (33.7 ± 10.3 y). Patients in both groups showed significant reduction in Visual Analog Scale score (osteopathic manipulative treatment group: p = 0.001; osteopathy in the cranial field group: p< 0.001), Helkimo Index (osteopathic manipulative treatment group: p = 0.02; osteopathy in the cranial field group: p = 0.003) and a significant improvement in the SF-36 Health Survey - subscale "Bodily Pain" (osteopathic manipulative treatment group: p = 0.04; osteopathy in the cranial field group: p = 0.007) after five treatments (E1). All subjects (n = 36) also showed significant improvements in the above named parameters after five treatments (E1): Visual Analog Scale score (p< 0.001), Helkimo Index (p< 0.001), SF-36 Health Survey - subscale "Bodily Pain" (p = 0.001). The differences between the two groups were not statistically significant for any of the three target parameters. Both therapeutic modalities had similar clinical results. The findings of this pilot trial support the use of osteopathic manipulative treatment and osteopathy in the cranial field as an effective treatment modality in patients with temporomandibular disorders. The positive results in both treatment groups should encourage further research on osteopathic manipulative treatment and osteopathy in the cranial field and support the importance of an interdisciplinary collaboration in patients with temporomandibular disorders. Implications for rehabilitation Temporomandibular disorders are the second most prevalent musculoskeletal condition with a negative impact on physical and psychological factors. There are a variety of options to treat temporomandibular disorders. This pilot study demonstrates the reduction of pain, the improvement of temporomandibular joint dysfunction and the positive impact on quality of life after osteopathic manipulative treatment and osteopathy in the cranial field. Our findings support the use of osteopathic manipulative treatment and osteopathy in the cranial field and should encourage further research on osteopathic manipulative treatment and osteopathy in the cranial field in patients with temporomandibular disorders. Rehabilitation experts should consider osteopathic manipulative treatment and osteopathy in the cranial field as a beneficial treatment option for temporomandibular disorders.

  13. 42 CFR 417.1 - Definitions.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... osteopathy), dentists, nurses, podiatrists, optometrists, physicians' assistants, clinical psychologists... osteopathy and of such other licensed health professionals (including dentists, optometrists, and podiatrists...

  14. 42 CFR 417.1 - Definitions.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... osteopathy), dentists, nurses, podiatrists, optometrists, physicians' assistants, clinical psychologists... osteopathy and of such other licensed health professionals (including dentists, optometrists, and podiatrists...

  15. 42 CFR 57.1503 - Eligibility.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... this subpart, the applicant shall: (1) Be a nonprofit private school of medicine, dentistry, osteopathy... approved by the school of medicine, osteopathy or dentistry with which the hospital or outpatient facility...

  16. 42 CFR 57.1503 - Eligibility.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... this subpart, the applicant shall: (1) Be a nonprofit private school of medicine, dentistry, osteopathy... approved by the school of medicine, osteopathy or dentistry with which the hospital or outpatient facility...

  17. Metaphyseal osteopathy in a British Shorthair cat.

    PubMed

    Adagra, Carl; Spielman, Derek; Adagra, Angela; Foster, Darren J

    2015-04-01

    Metaphyseal osteopathy, otherwise known as hypertrophic osteodystrophy, is a disease that causes pyrexia and lethargy accompanied by pain in the thoracic and pelvic limbs of rapidly growing large-breed dogs. While metaphyseal osteopathy has been descibed in association with slipped capital femoral epiphysis in cats, it has not previously been reported as a cause of limb pain and pyrexia in this species. A 7-month-old British Shorthair cat presented with a 1 month history of pyrexia, lethargy and pain in all limbs. Investigation included radiographs of the limbs and chest, abdominal ultrasound, serum biochemical analysis, haematology, bone biopsy, joint fluid aspiration and cytology. Findings were consistent with a diagnosis of metaphyseal osteopathy. The cat's clinical signs resolved following the administration of prednisolone. Symptoms recurred 1 month after the cessation of prednisolone therapy, but resolved when administration was resumed. © ISFM and AAFP 2014.

  18. 32 CFR 74.1 - Purpose.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... DOCTORS OF OSTEOPATHY AS MEDICAL OFFICERS § 74.1 Purpose. The purpose of this part is to implement the provisions of Pub. L. 763, 84th Congress (70 Stat. 608), relating to the appointment of doctors of osteopathy...

  19. Understanding clinical reasoning in osteopathy: a qualitative research approach.

    PubMed

    Grace, Sandra; Orrock, Paul; Vaughan, Brett; Blaich, Raymond; Coutts, Rosanne

    2016-01-01

    Clinical reasoning has been described as a process that draws heavily on the knowledge, skills and attributes that are particular to each health profession. However, the clinical reasoning processes of practitioners of different disciplines demonstrate many similarities, including hypothesis generation and reflective practice. The aim of this study was to understand clinical reasoning in osteopathy from the perspective of osteopathic clinical educators and the extent to which it was similar or different from clinical reasoning in other health professions. This study was informed by constructivist grounded theory. Participants were clinical educators in osteopathic teaching institutions in Australia, New Zealand and the UK. Focus groups and written critical reflections provided a rich data set. Data were analysed using constant comparison to develop inductive categories. According to participants, clinical reasoning in osteopathy is different from clinical reasoning in other health professions. Osteopaths use a two-phase approach: an initial biomedical screen for serious pathology, followed by use of osteopathic reasoning models that are based on the relationship between structure and function in the human body. Clinical reasoning in osteopathy was also described as occurring in a number of contexts (e.g. patient, practitioner and community) and drawing on a range of metaskills (e.g. hypothesis generation and reflexivity) that have been described in other health professions. The use of diagnostic reasoning models that are based on the relationship between structure and function in the human body differentiated clinical reasoning in osteopathy. These models were not used to name a medical condition but rather to guide the selection of treatment approaches. If confirmed by further research that clinical reasoning in osteopathy is distinct from clinical reasoning in other health professions, then osteopaths may have a unique perspective to bring to multidisciplinary decision-making and potentially enhance the quality of patient care. Where commonalities exist in the clinical reasoning processes of osteopathy and other health professions, shared learning opportunities may be available, including the exchange of scaffolded clinical reasoning exercises and assessment practices among health disciplines.

  20. Increasing Diversity.

    ERIC Educational Resources Information Center

    Weaver, Richard D.; Wood, Douglas

    1996-01-01

    Educators in dentistry and osteopathy discuss efforts within their fields to diversify clinical education. Dental school changes focus on curriculum reform, closer education-care delivery relationship, patient centeredness, comprehensive care experiences, and patient care as a distinct mission of dental education. Efforts in osteopathy emphasize…

  1. 42 CFR 62.9 - Under what circumstances can the period of obligated service be deferred to complete approved...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... from a school of medicine, osteopathy, or dentistry, veterinary medicine, optometry, podiatry or... for any participant receiving a degree from a school of medicine, osteopathy or dentistry, or (2) one...

  2. Patients' appraisals of public and private healthcare: a qualitative study of physiotherapy and osteopathy.

    PubMed

    Bradbury, Katherine J; Bishop, Felicity L; Yardley, Lucy; Lewith, George

    2013-10-01

    Patients have previously reported differences in their experiences of treatments received in the public and private sectors; it remains unclear whether such perceived differences are particular to or shared across different interventions. This study explored whether patients' appraisals of public and private treatments are similar when appraising a complementary therapy (osteopathy) compared to a mainstream therapy (physiotherapy). Thirty-five qualitative interviews were analysed thematically. Patients' appraisals varied by health-care sector and therapy type: physiotherapy was appraised more negatively in the National Health Service than the private sector but osteopathy was appraised similarly within both health-care sectors. Potential reasons for this are discussed.

  3. Steroid osteopathy

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Conway, J.J.; Weiss, S.C.

    1984-01-01

    Patients receiving steroids or having disease processes which increase natural steroid production often demonstrate ''the classic x-ray changes'' of avascular necrosis of bone. Bone scintigraphy in these patients most frequently demonstrates an increased radionuclide localization. The literature suggests that the increased activity is related to healing of the avascular process. In a recent study of Legg-Calve-Perthes Disease (LCPD), 37 of the children had multiple studies and increased activity within the epiphysis during revascularization was extremely rare. Not only are the scintigraphic findings in steroid osteopathy dissimilar to that in healing LCPD, but the time interval for healing is much tomore » short for that of a vascular necrosis and no patients demonstrated an avascular phase on bone scintigraphy. Of 15 children with renal transplants on steroid therapy, 9 demonstrated x-ray and clinical findings of osteopathy. In 8 of 9 instances, bone scintigraphy showed increased localization of radionuclide in the affected bone. Improvement or a return to normal occurred in those patients in whom steroids were discontinued. The following is a proposed mechanism for steroid osteopathy. Steroids affect the osteoblastic and osteoclastic activity of bone and weaken its internal structure. Ordinary stress produces microtrabecular fractures. Fractures characteristically stimulate reactive hyperemia and increase bone metabolism. The result is increased bone radiopharmaceutical localization. The importance of recognizing this concept is that steroid osteopathy is preventable by reducing the administered steroid dose. As opposed to avascular necrosis, bone changes are reversible.« less

  4. 42 CFR 485.618 - Condition of participation: Emergency services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... supervision of a pathologist or other qualified doctor of medicine or osteopathy. If blood banking services...) Except as specified in paragraph (d)(3) of this section, there must be a doctor of medicine or osteopathy... is justified because other available alternatives would increase the time needed to stabilize a...

  5. 42 CFR 485.618 - Condition of participation: Emergency services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... supervision of a pathologist or other qualified doctor of medicine or osteopathy. If blood banking services...) Except as specified in paragraph (d)(3) of this section, there must be a doctor of medicine or osteopathy... is justified because other available alternatives would increase the time needed to stabilize a...

  6. 42 CFR 485.618 - Condition of participation: Emergency services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... supervision of a pathologist or other qualified doctor of medicine or osteopathy. If blood banking services...) Except as specified in paragraph (d)(3) of this section, there must be a doctor of medicine or osteopathy... is justified because other available alternatives would increase the time needed to stabilize a...

  7. 42 CFR 485.618 - Condition of participation: Emergency services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... supervision of a pathologist or other qualified doctor of medicine or osteopathy. If blood banking services...) Except as specified in paragraph (d)(3) of this section, there must be a doctor of medicine or osteopathy... is justified because other available alternatives would increase the time needed to stabilize a...

  8. 42 CFR 485.618 - Condition of participation: Emergency services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... supervision of a pathologist or other qualified doctor of medicine or osteopathy. If blood banking services...) Except as specified in paragraph (d)(3) of this section, there must be a doctor of medicine or osteopathy... is justified because other available alternatives would increase the time needed to stabilize a...

  9. Hypertrophic osteopathy secondary to metastatic ovarian adenocarcinoma in a mare.

    PubMed

    Browne, Nimet S; Scarratt, William K; Robertson, John

    2016-12-01

    A 10-year-old Andalusian mare was presented for evaluation of weight loss, increasing periods of recumbency, and swelling of the lower limbs. Radiographs revealed severe palisading to solid periosteal new bone formation in numerous locations. Necropsy revealed a metastatic malignant adenocarcinoma of ovarian origin with secondary hypertrophic osteopathy.

  10. 42 CFR 493.1455 - Standard; Clinical consultant qualifications.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... clients concerning the diagnosis, treatment and management of patient care. The clinical consultant must... subspecialty of oral pathology, § 493.1443(b)(6); or (b) Be a doctor of medicine, doctor of osteopathy, doctor of podiatric medicine licensed to practice medicine, osteopathy, or podiatry in the State in which...

  11. 42 CFR 493.1417 - Standard; Clinical consultant qualifications.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... clients concerning the diagnosis, treatment and management of patient care. The clinical consultant must... of medicine, doctor of osteopathy or doctor of podiatric medicine and possess a license to practice medicine, osteopathy or podiatry in the State in which the laboratory is located. [57 FR 7172, Feb. 28...

  12. 42 CFR 57.2202 - Definitions.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... school of medicine or osteopathy which provides a course of study, or a portion thereof, which leads... means a student who is enrolled, or accepted for enrollment, in a school and pursuing a course of study... of study leading to the degree of doctor of medicine or doctor of osteopathy, plus a period, not to...

  13. 42 CFR 57.2202 - Definitions.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... school of medicine or osteopathy which provides a course of study, or a portion thereof, which leads... means a student who is enrolled, or accepted for enrollment, in a school and pursuing a course of study... of study leading to the degree of doctor of medicine or doctor of osteopathy, plus a period, not to...

  14. 42 CFR 57.2202 - Definitions.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... school of medicine or osteopathy which provides a course of study, or a portion thereof, which leads... means a student who is enrolled, or accepted for enrollment, in a school and pursuing a course of study... of study leading to the degree of doctor of medicine or doctor of osteopathy, plus a period, not to...

  15. 42 CFR 57.2202 - Definitions.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... school of medicine or osteopathy which provides a course of study, or a portion thereof, which leads... means a student who is enrolled, or accepted for enrollment, in a school and pursuing a course of study... of study leading to the degree of doctor of medicine or doctor of osteopathy, plus a period, not to...

  16. 42 CFR 57.2202 - Definitions.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... school of medicine or osteopathy which provides a course of study, or a portion thereof, which leads... means a student who is enrolled, or accepted for enrollment, in a school and pursuing a course of study... of study leading to the degree of doctor of medicine or doctor of osteopathy, plus a period, not to...

  17. 49 CFR 398.3 - Qualifications of drivers or operators.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ..., nervous, organic, or functional disease, likely to interfere with safe driving. (3) No loss of fingers... (b)(8) of this section by a licensed doctor of medicine or osteopathy as meeting the requirements of... licensed doctor of medicine or osteopathy based on a physical examination as required by paragraph (b)(7...

  18. 49 CFR 398.3 - Qualifications of drivers or operators.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ..., nervous, organic, or functional disease, likely to interfere with safe driving. (3) No loss of fingers... (b)(8) of this section by a licensed doctor of medicine or osteopathy as meeting the requirements of... licensed doctor of medicine or osteopathy based on a physical examination as required by paragraph (b)(7...

  19. 49 CFR 398.3 - Qualifications of drivers or operators.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ..., nervous, organic, or functional disease, likely to interfere with safe driving. (3) No loss of fingers... (b)(8) of this section by a licensed doctor of medicine or osteopathy as meeting the requirements of... licensed doctor of medicine or osteopathy based on a physical examination as required by paragraph (b)(7...

  20. 49 CFR 398.3 - Qualifications of drivers or operators.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ..., nervous, organic, or functional disease, likely to interfere with safe driving. (3) No loss of fingers... (b)(8) of this section by a licensed doctor of medicine or osteopathy as meeting the requirements of... licensed doctor of medicine or osteopathy based on a physical examination as required by paragraph (b)(7...

  1. Metaphyseal osteopathy-like disease in two sibling kittens.

    PubMed

    Pantaleo, Valeria; D'Ettorre, Paolo; Caldin, Marco; Vezzoni, Aldo

    2016-01-01

    This report describes the diagnosis and treatment of a growth plate disturbance resembling canine metaphyseal osteopathy in two, two-month-old, sibling, intact, female Domestic Shorthair cats. Clinical signs and radiographic lesions resolved spontaneously after three months. Follow-up examination at six months of age showed complete recovery and no radiographic abnormalities.

  2. 42 CFR 482.12 - Condition of participation: Governing body.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...) Every Medicare patient is under the care of: (i) A doctor of medicine or osteopathy (This provision is not to be construed to limit the authority of a doctor of medicine or osteopathy to delegate tasks to... mechanism.); (ii) A doctor of dental surgery or dental medicine who is legally authorized to practice...

  3. 42 CFR 410.68 - Antigens: Scope and conditions.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... months that is— (1) Prepared for a patient by a doctor of medicine or osteopathy who has examined the patient and developed a plan of treatment including dosage levels; and (2) Administered— (i) In accord with the plan of treatment developed by the doctor of medicine or osteopathy who prepared the antigen...

  4. Descriptive study of interprofessional collaboration between physicians and osteopaths for the pediatric population in Quebec, Canada.

    PubMed

    Morin, Chantal; Desrosiers, Johanne; Gaboury, Isabelle

    2017-11-14

    Osteopathy is an increasingly popular healthcare approach that uses a wide variety of therapeutic manual techniques to address pain and somatic dysfunction. In Quebec, Canada, osteopathy is the complementary medicine most often recommended by family physicians. However, factors fostering the development of interprofessional collaboration (IPC) between physicians and osteopaths are unknown. This study aimed to describe the current situation in terms of IPC among practitioners working with pediatric patients. A self-administered questionnaire was sent to osteopaths, family physicians, and pediatricians involved with pediatric patients in the province of Quebec. The postal questionnaire captured general knowledge about osteopathy and its practice parameters and role, sources of information, communication aspects including having a professional relationship and referrals, and influence of the upcoming government regulation. Quantitative data from the questionnaires were analyzed using descriptive statistics. Logistic regression model for factors associated with osteopathic referrals and multiple linear regression analyses for the number of correct answers about general osteopathic practice parameters were performed. A total of 274 physicians (155 family physicians (response rate 13%) and 119 pediatricians (17%)) and 297 osteopaths (42%) completed the survey. According to physicians, osteopathy was most appropriate for musculoskeletal pain (241; 91%) and plagiocephaly (235; 88%). Osteopathic referral was positively associated with having a professional relationship (odds ratio [OR] 4.10 (95% confidence interval [CI] 2.12; 7.95), p < 0.001), personal consultation (OR 2.58 (95% CI 1.35; 4.93), p = 0.004), community-based practice (OR 1.89 (95% CI 1.03; 3.47), p = 0.040), and belief in the active role of osteopathy for pediatric conditions (OR 1.22 (95% CI 1.01; 1.47), p = 0.042). The majority of physicians (72%) and osteopaths (62%) considered the upcoming government regulation of osteopathy a positive factor for collaboration. Some collaboration already exists among these practitioners, including mutual referrals, but optimizing this collaboration still poses some challenges.

  5. 34 CFR 668.7 - Gainful employment in a recognized occupation.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... to hold a degree as a doctor of medicine or osteopathy, or a doctor of dental science; (2) Leads to a... medicine or osteopathy, or a doctor of dental science; (2) Leads to a degree or certificate awarded by an... of the institution's submission, the institution is not subject to the requirements arising from the...

  6. 34 CFR 668.7 - Gainful employment in a recognized occupation.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... to hold a degree as a doctor of medicine or osteopathy, or a doctor of dental science; (2) Leads to a... medicine or osteopathy, or a doctor of dental science; (2) Leads to a degree or certificate awarded by an... of the institution's submission, the institution is not subject to the requirements arising from the...

  7. 34 CFR 668.7 - Gainful employment in a recognized occupation.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... to hold a degree as a doctor of medicine or osteopathy, or a doctor of dental science; (2) Leads to a... medicine or osteopathy, or a doctor of dental science; (2) Leads to a degree or certificate awarded by an... of the institution's submission, the institution is not subject to the requirements arising from the...

  8. 34 CFR 668.7 - Gainful employment in a recognized occupation.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... to hold a degree as a doctor of medicine or osteopathy, or a doctor of dental science; (2) Leads to a... medicine or osteopathy, or a doctor of dental science; (2) Leads to a degree or certificate awarded by an... of the institution's submission, the institution is not subject to the requirements arising from the...

  9. 78 FR 64603 - Medicare Program: Conditions of Participation (CoPs) for Community Mental Health Centers

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-29

    ... 1861(r)(1), which lists a doctor of medicine or osteopathy. The commenter believes that this will help ensure that clients in a CMHC receive quality care from appropriately trained doctors of medicine or osteopathy legally authorized to practice medicine and surgery by the State. Response: We thank the...

  10. Applying the Department of Health and Human Services Underserved Area Criteria to Army Dental Facilities

    DTIC Science & Technology

    1993-01-01

    The Act also applied to students in schools of medicine, osteopathy , or optometry, and was based on county practitioner-population ratios. By 1971...primatry cam physician (Ui) Othier tourists (non-residtnt) may osteopathy (D.O.) providing direct ratio of less than 2.50:1I but greater be included

  11. An Analysis of Factors Affecting the Retention of Medical Officers in the United States Navy

    DTIC Science & Technology

    1986-12-01

    Others, such as the Berry Plan <BP) and the Medi cal / Osteopathi c Scholarship Program (MOSP) were terminated in 1973 and 1977, respectively CRef. 15...Length-of -Servi ce Doctor of Osteopathy (OSTEO) Marital Status Age Medical School Eligible to Retire 66 VARIABLE SOURCE OF ENTRY PHYSICIAN SPECIALTY

  12. 42 CFR 62.4 - To whom will scholarship program awards be available in addition to those individuals pursuing...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... available in addition to those individuals pursuing courses of study leading to degrees in medicine... medicine, osteopathy, or dentistry? The Secretary will, from time-to-time, publish in the Federal Register a list of those health professions in addition to medicine, osteopathy, and dentistry for which the...

  13. 42 CFR 62.4 - To whom will scholarship program awards be available in addition to those individuals pursuing...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... available in addition to those individuals pursuing courses of study leading to degrees in medicine... medicine, osteopathy, or dentistry? The Secretary will, from time-to-time, publish in the Federal Register a list of those health professions in addition to medicine, osteopathy, and dentistry for which the...

  14. 42 CFR 62.4 - To whom will scholarship program awards be available in addition to those individuals pursuing...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... available in addition to those individuals pursuing courses of study leading to degrees in medicine... medicine, osteopathy, or dentistry? The Secretary will, from time-to-time, publish in the Federal Register a list of those health professions in addition to medicine, osteopathy, and dentistry for which the...

  15. 42 CFR 62.4 - To whom will scholarship program awards be available in addition to those individuals pursuing...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... available in addition to those individuals pursuing courses of study leading to degrees in medicine... medicine, osteopathy, or dentistry? The Secretary will, from time-to-time, publish in the Federal Register a list of those health professions in addition to medicine, osteopathy, and dentistry for which the...

  16. Hypertrophic osteopathy associated with renal pelvis transitional cell carcinoma in a dog

    PubMed Central

    Grillo, Thais P.; Brandão, Cláudia V.S.; Mamprim, Maria J.; de Jesus, Carlos M.N.; Santos, Taizha C.; Minto, Bruno W.

    2007-01-01

    A 6-year-old male, Belgian shepherd dog was presented with lethargy, oliguria, hematuria, and reluctance to move. The dog developed hypertrophic osteopathy secondary to renal pelvis transitional cell carcinoma. A nephrectomy was performed and after a year, the dog was completely asymptomatic, and no evidence of metastatic disease was present. PMID:17824162

  17. Medicare and Graduate Medical Education.

    DTIC Science & Technology

    1995-09-01

    research. The physician counts reported here are based on American Medical Association counts of doctors of medicine (M.D.s). Schools of osteopathy ...whose graduates receive a doctor of osteopathy degree, produce about 5 percent of a more broadly defined physician workforce. Even critics who have...provided insurance, and federal subsi- dies directed toward the supply of physicians. Con- ventional economic analysis would stress that in the

  18. Competition within the physicians' services industry: osteopaths and allopaths.

    PubMed

    Blackstone, E A

    1982-01-01

    Within the physicians' services industry, doctors of osteopathy are the only "full line" competitors of medical doctors. Given the current interest in merger of the two schools of practice, this Article examines the benefits of having an independent osteopathic school. These benefits include: (1) reduction of the monopoly power of medical doctors in malpractice litigation, fee negotiations with third party payors and the formulation of health policy; (2) greater satisfaction of consumer desires; and (3) diversity and innovation in physicians' training and methods of practice. The Article concludes that society has an interest in discouraging merger of the two groups; osteopathy should be maintained as an independent school of practice. To this end, society should carefully consider the impact of legislation and regulatory policies that may have the unintended effect of eliminating osteopathy as an independent competitor.

  19. Arterial hypertension and hypertrophic pulmonary osteopathy associated with aortic valvular endocarditis in a dog.

    PubMed

    Vulgamott, J C; Clark, R G

    1980-08-01

    A 5-year-old spayed female Doberman Pinscher was referred for clinical evaluation following two acute episodes of lameness, lethargy, and respiratory dyspnea. The femoral pulse had a bounding "water-hammer" quality. Arterial blood pressures were 280 mm of Hg to greater than 300 mm of Hg during systole and approximately 40 mm of Hg during diastole. Systolic blood pressure was lowered to 210 mm of Hg, using prazosin. Radiography revealed extensive pulmonary interstitial markings and smooth subperiosteal expansions of the long bones indicative of hypertrophic pulmonary osteopathy. Despite symptomatic treatment, the dog's health gradually deteriorated, and it died 9 days after referral. Necropsy revealed vegetative endocarditis of the aortic valve. Insufficiency of the aortic valve was believed to be responsible for the systolic hypertension and the hypertrophic pulmonary osteopathy.

  20. Using Data Mining to Determine the Impact Continuity of Care Has on the Air Force’s Healthcare System

    DTIC Science & Technology

    2014-12-26

    continuity of care by requiring compliance with the standards and guidelines of the Patient Centered Medical Home 3 (PCMH) model requiring the continuity...back  Rheumatism – Pain associated with joints and connective tissues (back pain, neck pain and osteoarthritis )  Osteopathies, chondropathies, and...pain, neck pain and osteoarthritis )  Osteopathies, chondropathies, and acquired musculoskeletal deformities – Diseases associated with bones or

  1. Reliability of diagnosis and clinical efficacy of visceral osteopathy: a systematic review.

    PubMed

    Guillaud, Albin; Darbois, Nelly; Monvoisin, Richard; Pinsault, Nicolas

    2018-02-17

    In 2010, the World Health Organization published benchmarks for training in osteopathy in which osteopathic visceral techniques are included. The purpose of this study was to identify and critically appraise the scientific literature concerning the reliability of diagnosis and the clinical efficacy of techniques used in visceral osteopathy. Databases MEDLINE, OSTMED.DR, the Cochrane Library, Osteopathic Research Web, Google Scholar, Journal of American Osteopathic Association (JAOA) website, International Journal of Osteopathic Medicine (IJOM) website, and the catalog of Académie d'ostéopathie de France website were searched through December 2017. Only inter-rater reliability studies including at least two raters or the intra-rater reliability studies including at least two assessments by the same rater were included. For efficacy studies, only randomized-controlled-trials (RCT) or crossover studies on unhealthy subjects (any condition, duration and outcome) were included. Risk of bias was determined using a modified version of the quality appraisal tool for studies of diagnostic reliability (QAREL) in reliability studies. For the efficacy studies, the Cochrane risk of bias tool was used to assess their methodological design. Two authors performed data extraction and analysis. Eight reliability studies and six efficacy studies were included. The analysis of reliability studies shows that the diagnostic techniques used in visceral osteopathy are unreliable. Regarding efficacy studies, the least biased study shows no significant difference for the main outcome. The main risks of bias found in the included studies were due to the absence of blinding of the examiners, an unsuitable statistical method or an absence of primary study outcome. The results of the systematic review lead us to conclude that well-conducted and sound evidence on the reliability and the efficacy of techniques in visceral osteopathy is absent. The review is registered PROSPERO 12th of December 2016. Registration number is CRD4201605286 .

  2. Possible therapeutic potential of berberine in diabetic osteopathy.

    PubMed

    Rahigude, A B; Kaulaskar, S V; Bhutada, P S

    2012-10-01

    Diabetic osteopathy is a complication that leads to decreased bone mineral density, bone formation and having high risk of fractures that heals slowly. Diabetic osteopathy is a result of increase in osteoclastogenesis and decrease in osteoblastogenesis. Various factors viz., oxidative stress, increased inflammatory markers, PPAR-γ activation in osteoblast, activation of apoptotic pathway, increased glucose levels and inhibitory effect on parathyroid hormone etc. are mainly responsible for decreased bone mineral density. Berberine is an isoquinoline alkaloid widely used in Asian countries as a traditional medicine. Berberine is extensively reported to be an antioxidant, anti-inflammatory, antidiabetic, and having potential to treat diabetic complications and glucocorticoid induced osteoporosis. The osteoclastogenesis decreasing property of berberine can be hypothesized for inhibiting diabetic osteopathy. In addition, chronic treatment of berberine will be helpful for increasing the osteoblastic activity and expression of the modulators that affect osteoblastic differentiation. The apoptotic pathways stimulated due to increased inflammatory markers and nucleic acid damages could be reduced due to berberine. Another important consideration that berberine is having stimulatory effect on glucagon like peptide release and insulin sensitization that will be helpful for decreasing glucose levels and therefore, may exerts osteogenesis. Thiazolidinediones show bone loss due to activation of PPAR-γ in osteoblasts, whereas berberine stimulates PPAR-γ only in adipocytes and not in osteoblasts, and therefore the decreased bone loss due to use of thiazolidinediones may not be observed in berberine treatment conditions. Berberine decreases the advanced glycation end-products (AGE) formation in diabetic condition which will be ultimately helpful to decrease the stiffness of collagen fibers due to AGE-induced cross linking. Lastly, it is also reported that berberine has inhibitory effect on parathyroid hormone and enhances marker genes like osteocalcin, which are responsible for the osteoblastic activity. From these evidences, we hypothesized that berberine may have potential in the treatment of diabetic osteopathy. Copyright © 2012 Elsevier Ltd. All rights reserved.

  3. [Antiepileptic drug-induced osteopathy. Subtypes, pathogenesis, prevention, early diagnosis and treatment].

    PubMed

    Bartl, R

    2007-07-29

    Published reports of studies on the long-term effects of anti-epileptic drugs (AED) on bone--its density, thickness, vitamin D metabolism and risk of fracture--have shown considerable methodological inadequacies (34). Despite these problems it has been clearly shown that patients with epilepsy who are on anti-epileptic drugs have a greater than normal risk of bone loss, abnormal mineralization and fractures. A patient on long-term treatment with AED has a two- to three-fold risk of sustaining a fracture. On average 50% of patients (ranging from 4-70% in different studies [18]) have an osteopathy (34). Type, dosage and duration of AED treatment determine the exact picture of the osteopathy--regardless of whether or not they are enzyme-inducing. Among the enzyme-inducing drugs, especially phenytoin, primidone, phenobarbital and carbamezapine have been investigated for their influence on vitamin D metabolism. Bone loss has also been noted even without evidence of vitamin D deficiency. Mixed forms of osteoporosis and osteomalacia occur particularly often and must be taken into account in any differentiated form of treatment. But the question remains unanswered whether current AEDs, such as lamotrigine, gabapentin or levetiracetam will cause little or no osteopathy. Comparable to the situation during long-term systemic administration of glucocorticoids, initial diagnosis, including the inexpensive dual-energy X-ray absorptiometry (DXA) and the serum concentration of 25-hydroxyvitamin D, must be obtained to determine whether initially there are any bone changes. In addition to a differentiated and clearly defined treatment of osteopathy in a patient with epilepsy, the aim must be to minimize the tendency towards seizures and their severity. The annual cost of adequate vitamin D substitution is about EUR 50, while biphosphonate treatment costs about EUR 500; the costs of vertebral or forearm fractures are about EUR 1000 and those of hip fracture about EUR 15,000. These figures exclude the costs of rehabilitation, nursing care and loss of earnings. Looked at in this way, the problem of AED-induced osteopathy has been underestimated. Yet it is actually preventable and--if already present--can be efficaciously and inexpensively treated when the new guidelines of the (German) Joint Organization of Osteology are followed. The prerequisite of rational treatment is a diagnostically clear distinction of osteoporosis and osteomalacia, but mixed forms are common. ("osteoporomalacia"). Further investigations of more recently developed AEDs (e.g. gabapentin, lamotrigine or levetiracetam) regarding their damaging action on bone during their long-term administration is essential. Systematic control of the state of bones in all patients on long-term treatment with AEDs is nowadays recommended without qualification, even though some study data are unsatisfactory or even lacking.

  4. Hypertrophic osteopathy associated with mycotic pneumonia in two juvenile elk (Cervus elaphus).

    PubMed

    Ferguson, Nicole M; Lévy, Michel; Ramos-Vara, José A; Baird, Debra K; Wu, Ching Ching

    2008-11-01

    Two yearling bull elk (cervus claphus) from the same farm developed anorexia, weight loss, and lameness. On physical examination, both elk were thin and showed diffuse swelling of all lower limbs. Radiographs of the lower limbs showed periosteal thickening of the distal extremities, consistent with hypertrophic osteopathy. Thoracic radiographs indicated the presence of pulmonary nodules. Cytologic evaluations of tracheal washes on both elk were consistent with inflammation. Acid-fast stains on both samples were negative. Because of the poor prognosis, both elk were euthanized. At necropsy, the carpal, metacarpal, tarsal, and metatarsal bones, as well as the radius, ulna, and tibia had thickening of cortical bone. There were multiple encapsulated nodules throughout the lungs, lymph nodes, and kidney, and smaller nodules in the myocardium. On microscopic examination, these nodules contained myriads of hyphae, and immunohistochemistry for Aspergillus sp. was strongly positive. Aspergillus fumigatus was isolated from affected tissue in 1 elk. Necropsy findings in both elk were consistent with disseminated fungal granulomas and periosteal hyperostosis. This case presents the first description of hypertrophic osteopathy in elk. The source of infection was undetermined, but inhalation of spores from contaminated feed or bedding was suspected.

  5. IMAGING DIAGNOSIS-MAGNETIC RESONANCE IMAGING FEATURES OF CRANIOMANDIBULAR OSTEOPATHY IN AN AIREDALE TERRIER.

    PubMed

    Matiasovic, Matej; Caine, Abby; Scarpante, Elena; Cherubini, Giunio Bruto

    2016-05-01

    An Airedale Terrier was presented for evaluation of depression and reluctance to be touched on the head. Magnetic resonance (MR) imaging of the head was performed. The images revealed bone lesions affecting the calvarium at the level of the coronal suture and left mandibular ramus, with focal cortical destruction, expansion, and reactive new bone formation. Skull lesions were hypointense on T1-weighted sequences, hyperintense on T2-weighted sequences, and showed an intense and homogeneous enhancement after gadolinium administration. Reactive new bone formation and periosteal proliferation were confirmed histopathologically. The clinical signs, imaging findings, and histopathological examination were consistent with craniomandibular osteopathy. © 2015 American College of Veterinary Radiology.

  6. Oxytocin as a novel therapeutic option for type I diabetes and diabetic osteopathy.

    PubMed

    Elabd, S K; Sabry, I; Mohasseb, M; Algendy, A

    2014-04-01

    The aim of the present study was to highlight the newly discovered metabolic role of oxytocin (OT) in the type I diabetic rats. Previous studies have demonstrated that OT has a beneficial role on bone physiology and therefore, the OT effect on the diabetic osteopathy will be assessed as well. Induction of the type I diabetes was carried out by an intraperitoneal injection of 60 mg/kg body weight of streptozotocin. The metabolic role of OT on diabetic rats after OT treatment with intramuscular injection of 40 µIU/kg body weight for 6 weeks was assessed. Histological and ultrastructural studies of rat pancreas samples, before and after the OT injection, were performed and compared with the obtained physiological results. Oxytocin treatment had positive metabolic effects in diabetic rats. This is based on the change in glucose metabolism, lipid profile, and insulin sensitivity in experimental animals. In addition, OT treatment showed histological regenerative changes of pancreatic islet cells of diabetic rats. Moreover, OT administration showed that it has an anabolic effect on the bone biology. The results suggest that activation of the oxytocin receptor (OTR) pathway by infusion of OT, OT analogs, or OT agonists may represent a promising approach for the treatment of diabetes and some of its complications, including diabetic osteopathy.

  7. 42 CFR 57.1502 - Definitions.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... medicine, dentistry, osteopathy, pharmacy, optometry, podiatry, veterinary medicine, or public health which..., or dentistry eligible for assistance under subpart B of this part, providing for effective control by...

  8. 42 CFR 57.1502 - Definitions.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... medicine, dentistry, osteopathy, pharmacy, optometry, podiatry, veterinary medicine, or public health which... equivalent degree, doctor of podiatry or an equivalent degree, bachelor of science in pharmacy or an...

  9. 42 CFR 57.1502 - Definitions.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... medicine, dentistry, osteopathy, pharmacy, optometry, podiatry, veterinary medicine, or public health which... equivalent degree, doctor of podiatry or an equivalent degree, bachelor of science in pharmacy or an...

  10. 42 CFR 57.1502 - Definitions.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... medicine, dentistry, osteopathy, pharmacy, optometry, podiatry, veterinary medicine, or public health which... equivalent degree, doctor of podiatry or an equivalent degree, bachelor of science in pharmacy or an...

  11. 42 CFR 57.1502 - Definitions.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... medicine, dentistry, osteopathy, pharmacy, optometry, podiatry, veterinary medicine, or public health which... equivalent degree, doctor of podiatry or an equivalent degree, bachelor of science in pharmacy or an...

  12. 42 CFR 415.152 - Definitions.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... participates in an approved GME program, including programs in osteopathy, dentistry, and podiatry. (2) A..., dentistry, or podiatry. Teaching physician means a physician (other than another resident) who involves...

  13. The DREEM, part 1: measurement of the educational environment in an osteopathy teaching program.

    PubMed

    Vaughan, Brett; Carter, Annie; Macfarlane, Chris; Morrison, Tracy

    2014-05-20

    Measurement of the educational environment has become more common in health professional education programs. Information gained from these investigations can be used to implement and measure changes to the curricula, educational delivery and the physical environment. A number of questionnaires exist to measure the educational environment, and the most commonly utilised of these is the Dundee Ready Educational Environment Measure (DREEM). The DREEM was administered to students in all year levels of the osteopathy program at Victoria University (VU), Melbourne, Australia. Students also completed a demographic survey. Inferential and correlational statistics were employed to investigate the educational environment based on the scores obtained from the DREEM. A response rate of 90% was achieved. The mean total DREEM score was 135.37 (+/- 19.33) with the scores ranging from 72 to 179. Some subscales and items demonstrated differences for gender, clinical phase, age and whether the student was in receipt of a government allowance. There are a number of areas in the program that are performing well, and some aspects that could be improved. Overall students rated the VU osteopathy program as more positive than negative. The information obtained in the present study has identified areas for improvement and will enable the program leaders to facilitate changes. It will also provide other educational institutions with data on which they can make comparisons with their own programs.

  14. 42 CFR 66.102 - Definitions.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... level in a program leading to the award of a doctor of philosophy of science, or equivalent degree. For... individuals holding a doctor of philosophy, science, medicine, dentistry, osteopathy, optometry, podiatry...

  15. 42 CFR 66.102 - Definitions.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... level in a program leading to the award of a doctor of philosophy of science, or equivalent degree. For... individuals holding a doctor of philosophy, science, medicine, dentistry, osteopathy, optometry, podiatry...

  16. 42 CFR 66.102 - Definitions.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... level in a program leading to the award of a doctor of philosophy of science, or equivalent degree. For... individuals holding a doctor of philosophy, science, medicine, dentistry, osteopathy, optometry, podiatry...

  17. 42 CFR 482.26 - Condition of participation: Radiologic services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... have available, diagnostic radiologic services. If therapeutic services are also provided, they, as... osteopathy who is qualified by education and experience in radiology. (2) Only personnel designated as...

  18. 42 CFR 424.101 - Definitions.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... primarily engaged in providing, by or under the supervision of doctors of medicine or osteopathy, inpatient services for the diagnosis, treatment, and care or rehabilitation of persons who are sick, injured, or...

  19. 49 CFR 242.7 - Definitions.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... means a person licensed as a doctor of medicine or doctor of osteopathy. A medical examiner can be a... metropolitan areas, without regard to whether those systems use new technologies not associated with...

  20. 49 CFR 242.7 - Definitions.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... means a person licensed as a doctor of medicine or doctor of osteopathy. A medical examiner can be a... metropolitan areas, without regard to whether those systems use new technologies not associated with...

  1. 49 CFR 242.7 - Definitions.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... means a person licensed as a doctor of medicine or doctor of osteopathy. A medical examiner can be a... metropolitan areas, without regard to whether those systems use new technologies not associated with...

  2. 10 CFR 712.32 - Designated Physician.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... designation, of a physical, mental/personality disorder, or health condition that might affect his or her... school of medicine or osteopathy; (2) Have a valid, unrestricted state license to practice medicine in...

  3. Perception of peer physical examination in two Australian osteopathy programs.

    PubMed

    Vaughan, Brett; Grace, Sandra

    2016-01-01

    Peer physical examination (PPE) is an efficient and practical educational approach whereby students can practise their examination skills on each other before commencing clinical practice with actual patients. Little is known about the use of PPE in osteopathy education. Students in Year 1 of the osteopathy programs at Victoria University (Melbourne, Australia) and Southern Cross University (Lismore, Australia) completed the Examining Fellow Students and the Peer Physical Examination questionnaires prior to, and at the completion of, their first 12-week teaching session. Descriptive statistics were generated for each questionnaire. The McNemar and sign tests were used to evaluate differences between each questionnaire administration. Logistic regression was used to evaluate the influence of demographics on responses to both questionnaires. Results showed that students in both programs were generally willing to examine non-sensitive areas both before and after the 12-week teaching session. Students' were less apprehensive about PPE at the end of the teaching session, and this was reinforced by results for previous exposure to PPE in other courses. Consistent with previous studies, unwillingness to participate in PPE was associated with being female, being born outside Australia, holding religious beliefs, and being older. This is the first study to explore students' perceptions of PPE in this cohort and provides a basis for further work, including evaluating longer term changes in student perception of PPE, and whether these perceptions extend to practising manual therapy techniques. This study demonstrates that perceptions about PPE reported in medicine and other disciplines, namely that unwillingness to participate in PPE is associated with being female, being born outside Australia, holding religious beliefs, and being older, also apply to osteopathy. These findings are significant for all manual therapy students who spend a substantial portion of their course developing skills in PPE and practising manual therapy techniques. They highlight the need for curriculum development that acknowledges the importance of good practice in PPE, including discussions about body image, feedback skills training for educators, and providing detailed information to students about what to expect in practical skills classes before they commence their course.

  4. 42 CFR 410.59 - Outpatient occupational therapy services: Conditions.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... is under the care of a physician who is a doctor of medicine, osteopathy, or podiatric medicine. (2... submitted for furnished services contain prescribed information on patient functional limitations. (b...

  5. 42 CFR 410.59 - Outpatient occupational therapy services: Conditions.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... is under the care of a physician who is a doctor of medicine, osteopathy, or podiatric medicine. (2... submitted for furnished services contain prescribed information on patient functional limitations. (b...

  6. 42 CFR 418.202 - Covered services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... must be performed by a doctor of medicine or osteopathy. (d) Counseling services provided to the... control or to enable the patient to maintain activities of daily living and basic functional skills. (i...

  7. 42 CFR 418.202 - Covered services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... must be performed by a doctor of medicine or osteopathy. (d) Counseling services provided to the... control or to enable the patient to maintain activities of daily living and basic functional skills. (i...

  8. 42 CFR 418.202 - Covered services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... must be performed by a doctor of medicine or osteopathy. (d) Counseling services provided to the... control or to enable the patient to maintain activities of daily living and basic functional skills. (i...

  9. 42 CFR 418.202 - Covered services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... must be performed by a doctor of medicine or osteopathy. (d) Counseling services provided to the... control or to enable the patient to maintain activities of daily living and basic functional skills. (i...

  10. 42 CFR 484.18 - Condition of participation: Acceptance of patients, plan of care, and medical supervision.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... a doctor of medicine, osteopathy, or podiatric medicine. (a) Standard: Plan of care. The plan of... potential, functional limitations, activities permitted, nutritional requirements, medications and...

  11. 42 CFR 484.18 - Condition of participation: Acceptance of patients, plan of care, and medical supervision.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... a doctor of medicine, osteopathy, or podiatric medicine. (a) Standard: Plan of care. The plan of... potential, functional limitations, activities permitted, nutritional requirements, medications and...

  12. 42 CFR 484.18 - Condition of participation: Acceptance of patients, plan of care, and medical supervision.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... a doctor of medicine, osteopathy, or podiatric medicine. (a) Standard: Plan of care. The plan of... potential, functional limitations, activities permitted, nutritional requirements, medications and...

  13. 42 CFR 484.18 - Condition of participation: Acceptance of patients, plan of care, and medical supervision.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... a doctor of medicine, osteopathy, or podiatric medicine. (a) Standard: Plan of care. The plan of... potential, functional limitations, activities permitted, nutritional requirements, medications and...

  14. 42 CFR 424.20 - Requirements for posthospital SNF care.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... process whereby a physician extender works with a doctor of medicine or osteopathy to deliver health care... indicates whether utilization review is used as an alternative to the second and subsequent recertifications...

  15. 42 CFR 424.20 - Requirements for posthospital SNF care.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... process whereby a physician extender works with a doctor of medicine or osteopathy to deliver health care... indicates whether utilization review is used as an alternative to the second and subsequent recertifications...

  16. 42 CFR 424.20 - Requirements for posthospital SNF care.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... process whereby a physician extender works with a doctor of medicine or osteopathy to deliver health care... indicates whether utilization review is used as an alternative to the second and subsequent recertifications...

  17. 42 CFR 424.20 - Requirements for posthospital SNF care.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... process whereby a physician extender works with a doctor of medicine or osteopathy to deliver health care... indicates whether utilization review is used as an alternative to the second and subsequent recertifications...

  18. 5 CFR 339.104 - Definitions.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... the condition, specifically as a result of the normal aging process, or in response to the work... Doctor of Medicine or Doctor of Osteopathy, or a physician who is serving on active duty in the uniformed...

  19. 42 CFR 482.60 - Special provisions applying to psychiatric hospitals.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... medicine or osteopathy, psychiatric services for the diagnosis and treatment of mentally ill persons; (b... determine the degree and intensity of treatment furnished to Medicare beneficiaries, as specified in § 482...

  20. 42 CFR 415.208 - Services of moonlighting residents.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... not related to their approved GME programs and are performed in an outpatient department or emergency... providers in § 415.102(a). (ii) The resident is fully licensed to practice medicine, osteopathy, dentistry...

  1. Dermatology Internet Yellow Page advertising.

    PubMed

    Francis, Shayla; Kozak, Katarzyna Z; Heilig, Lauren; Lundahl, Kristy; Bowland, Terri; Hester, Eric; Best, Arthur; Dellavalle, Robert P

    2006-07-01

    Patients may use Internet Yellow Pages to help select a physician. We sought to describe dermatology Internet Yellow Page advertising. Dermatology advertisements in Colorado, California, New York, and Texas at 3 Yellow Page World Wide Web sites were systematically examined. Most advertisements (76%; 223/292) listed only one provider, 56 listed more than one provider, and 13 listed no practitioner names. Five advertisements listed provider names without any credentialing letters, 265 listed at least one doctor of medicine or osteopathy, and 9 listed only providers with other credentials (6 doctors of podiatric medicine and 3 registered nurses). Most advertisements (61%; 179/292) listed a doctor of medicine or osteopathy claiming board certification, 78% (139/179) in dermatology and 22% (40/179) in other medical specialties. Four (1%; 4/292) claims of board certification could not be verified (one each in dermatology, family practice, dermatologic/cosmetologic surgery, and laser surgery). Board certification could be verified for most doctors of medicine and osteopathy not advertising claims of board certification (68%; 41/60; 32 dermatology, 9 other specialties). A total of 50 advertisements (17%) contained unverifiable or no board certification information, and 47 (16%) listed a physician with verifiable board certification in a field other than dermatology. All Internet Yellow Page World Wide Web sites and all US states were not examined. Nonphysicians, physicians board certified in medical specialties other than dermatology, and individuals without verifiable board certification in any medical specialty are advertising in dermatology Internet Yellow Pages. Many board-certified dermatologists are not advertising this certification.

  2. Acupuncture, chiropractic and osteopathy use in Australia: a national population survey

    PubMed Central

    Xue, Charlie CL; Zhang, Anthony L; Lin, Vivian; Myers, Ray; Polus, Barbara; Story, David F

    2008-01-01

    Background There have been no published national studies on the use in Australia of the manipulative therapies, acupuncture, chiropractic or osteopathy, or on matters including the purposes for which these therapies are used, treatment outcomes and the socio-demographic characteristics of users. Methods This study on the three manipulative therapies was a component of a broader investigation on the use of complementary and alternative therapies. For this we conducted a cross-sectional, population survey on a representative sample of 1,067 adults from the six states and two territories of Australia in 2005 by computer-assisted telephone interviews. The sample was recruited by random digit dialling. Results Over a 12-month period, approximately one in four adult Australians used either acupuncture (9.2%), chiropractic (16.1%) or osteopathy (4.6%) at least once. It is estimated that, adult Australians made 32.3 million visits to acupuncturists, chiropractors and osteopaths, incurring personal expenditure estimated to be A$1.58 billion in total. The most common conditions treated were back pain and related problems and over 90% of the users of each therapy considered their treatment to be very or somewhat helpful. Adverse events are reported. Nearly one fifth of users were referred to manipulative therapy practitioners by medical practitioners. Conclusion There is substantial use of manipulative therapies by adult Australians, especially for back-related problems. Treatments incur considerable personal expenditure. In general, patient experience is positive. Referral by medical practitioners is a major determinant of use of these manipulative therapies. PMID:18377663

  3. 42 CFR 413.70 - Payment for services of a CAH.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... receives an incentive payment for the reasonable costs of purchasing certified EHR technology in a cost... call” means a doctor of medicine or osteopathy, a physician assistant, a nurse practitioner, or a...

  4. 42 CFR 413.70 - Payment for services of a CAH.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... receives an incentive payment for the reasonable costs of purchasing certified EHR technology in a cost... call” means a doctor of medicine or osteopathy, a physician assistant, a nurse practitioner, or a...

  5. 42 CFR 410.62 - Outpatient speech-language pathology services: Conditions and exclusions.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... physician who is a doctor of medicine or osteopathy. (2) They are furnished under a written plan of... prescribed information on patient functional limitations. (b) Condition for coverage of outpatient speech...

  6. 42 CFR 410.62 - Outpatient speech-language pathology services: Conditions and exclusions.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... physician who is a doctor of medicine or osteopathy. (2) They are furnished under a written plan of... prescribed information on patient functional limitations. (b) Condition for coverage of outpatient speech...

  7. 42 CFR 411.12 - Charges imposed by an immediate relative or member of the beneficiary's household.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...) Natural or adoptive parent, child, or sibling. (3) Stepparent, stepchild, stepbrother, or stepsister. (4... of conducting the practice of medicine, osteopathy dentistry, podiatry, optometry, or chiropractic...

  8. 42 CFR 415.208 - Services of moonlighting residents.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... emergency department of a hospital in which they have their training program are covered as physician... beneficiaries in providers in § 415.102(a). (ii) The resident is fully licensed to practice medicine, osteopathy...

  9. 42 CFR 415.208 - Services of moonlighting residents.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... emergency department of a hospital in which they have their training program are covered as physician... beneficiaries in providers in § 415.102(a). (ii) The resident is fully licensed to practice medicine, osteopathy...

  10. 42 CFR 415.208 - Services of moonlighting residents.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... emergency department of a hospital in which they have their training program are covered as physician... beneficiaries in providers in § 415.102(a). (ii) The resident is fully licensed to practice medicine, osteopathy...

  11. 42 CFR 476.98 - Reviewer qualifications and participation.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... doctor of dentistry must be respectively another licensed doctor of medicine or osteopathy or of dentistry with active staff privileges in one or more hospitals in the QIO area. (2) If a QIO determines...

  12. Metaphyseal osteopathy in three Australian Kelpie siblings.

    PubMed

    Greenwell, C M; Brain, P H; Dunn, A L

    2014-04-01

    Metaphyseal osteopathy (MO) was diagnosed in three Australian Kelpie puppies that were presented for veterinary assessment of lameness. The three puppies were siblings. Each was from a different litter by the same breeding pair. The puppy in case one was seen by the authors, and the puppies in cases two and three were patients at other veterinary hospitals. However, the medical records and radiographs were examined and reviewed for this report. Radiographic investigation of the lameness revealed pathognomonic appearance of MO affecting the metaphyseal region of the long bones in all three puppies. The diagnosis was confirmed on histopathology in one patient. MO is considered a disease of large and giant-breed dogs, being rarely reported in non-large-breed dogs, and has not been reported in the Australian Kelpie, which is considered a medium-breed dog. This case series suggests a previously unreported breed predisposition to MO in the Australian Kelpie. © 2014 Australian Veterinary Association.

  13. Osteopathic educators' attitudes towards osteopathic principles and their application in clinical practice: A qualitative inquiry.

    PubMed

    Kasiri-Martino, Hannah; Bright, Philip

    2016-02-01

    The implicit use of overarching osteopathic principles (OP) in clinical practice is a regulatory requirement; agreed definition of what constitutes such principles remains elusive. The profession currently faces questions of identity and relevance in the face of evidence-informed healthcare. This study sought to investigate the opinions and experiences of practising osteopathic educators as to how OP are relevant to clinical practice in isolation and to the profession as a whole. A qualitative approach employing grounded theory to explore the views of current practitioners involved in osteopathic education. Nine practising osteopaths were selected for the study using initially purposive then theoretical sampling. Semi-structured interviews were used to gather data, audio-recorded, transcribed verbatim and anonymised. Data was analysed and interpreted using a thematic framework approach and conceptually modelled. Triangulation was completed; peer corroboration for high-level themes and participant confirmation for transcript authenticity was obtained. Two polarised concepts emerged: (1) OP benefit the profession and (2) OP limit or jeopardize the profession. These emanated from different perceptions of the identity of osteopathy: (1) osteopathy as a philosophy or (2) osteopathy as a manual therapy with a philosophical background. The osteopathic profession faces the danger of being divided on the basis of ideological differences from within. The increasing criticality applied to UK healthcare behoves the osteopathic profession to clarify its aims, guiding 'principles' and underlying values. This could be problematic in light of the divergence of views, leading to a situation of either settling these differences or irrevocably fracturing the profession. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Health Manpower in Missouri.

    ERIC Educational Resources Information Center

    Harmon, Loyd M., Ed.

    This supplementary report begins with general information on licensing boards, associations, societies, reliability of data, and similar items. The second, and main, section deals with the following disciplines: administrators, doctors of medicine, doctors of osteopathy, dentists, dental hygienists, dieticians, inhalation therapists, medical…

  15. 42 CFR 410.59 - Outpatient occupational therapy services: Conditions.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... is under the care of a physician who is a doctor of medicine, osteopathy, or podiatric medicine. (2) They are furnished under a written plan of treatment that meets the requirements of § 410.61. (3) They...

  16. Talking about Complementary and Alternative Medicine with Your Health Care Providers: A Workbook and Tips

    MedlinePlus

    ... therapy Omega-3 fatty acids Osteopathy Probiotics Pulsed electromagnetic fields Qigong Reflexology Reiki Relaxation therapy Selenium Soy ... types of energy therapies are biofield therapies and electromagnetic-based therapies. Biofield therapy: A type of energy ...

  17. 42 CFR 51c.102 - Definitions.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... of primary care physicians in general or family practice, internal medicine, pediatrics, or... individual. (g) Physician means a licensed doctor of medicine or doctor of osteopathy. (h) Primary health..., preventive health education, children's eye and ear examinations, prenatal and post-partum care, prenatal...

  18. 42 CFR 495.100 - Definitions.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... AND CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements... professionals: (1) A doctor of medicine or osteopathy. (2) A doctor of dental surgery or medicine. (3) A doctor of podiatric medicine. (4) A doctor of optometry. (5) A chiropractor. Geographic health professional...

  19. 42 CFR 495.100 - Definitions.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... AND CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements... professionals: (1) A doctor of medicine or osteopathy. (2) A doctor of dental surgery or medicine. (3) A doctor of podiatric medicine. (4) A doctor of optometry. (5) A chiropractor. Geographic health professional...

  20. 42 CFR 495.100 - Definitions.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... AND CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements... professionals: (1) A doctor of medicine or osteopathy. (2) A doctor of dental surgery or medicine. (3) A doctor of podiatric medicine. (4) A doctor of optometry. (5) A chiropractor. Geographic health professional...

  1. 42 CFR 495.100 - Definitions.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... AND CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements... professionals: (1) A doctor of medicine or osteopathy. (2) A doctor of dental surgery or medicine. (3) A doctor of podiatric medicine. (4) A doctor of optometry. (5) A chiropractor. Geographic health professional...

  2. 42 CFR 495.100 - Definitions.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... AND CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements... professionals: (1) A doctor of medicine or osteopathy. (2) A doctor of dental surgery or medicine. (3) A doctor of podiatric medicine. (4) A doctor of optometry. (5) A chiropractor. Geographic health professional...

  3. Medicine at Michigan State (III): Conditioning for Innovation

    ERIC Educational Resources Information Center

    Walsh, John

    1972-01-01

    Discusses the reasons why basic science courses are taught in all-university departments'' and the clinical experience is provided in cooperation with community health services, rather than a clinical teaching hospital, in the programs for Doctor of Medicine and Doctor of Osteopathy. (AL)

  4. 42 CFR 476.1 - Definitions.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... not hold a doctor of medicine or doctor of osteopathy degree, who meet all applicable State or Federal... means an informal alternative dispute resolution process used to quickly resolve an oral complaint a.... Major clinical area means medicine, surgery, pediatrics, obstetrics and gynecology, or psychiatry. Major...

  5. 42 CFR 476.1 - Definitions.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... not hold a doctor of medicine or doctor of osteopathy degree, who meet all applicable State or Federal... means an informal alternative dispute resolution process used to quickly resolve an oral complaint a.... Major clinical area means medicine, surgery, pediatrics, obstetrics and gynecology, or psychiatry. Major...

  6. 42 CFR 57.2201 - Applicability.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... TEACHING FACILITIES, EDUCATIONAL IMPROVEMENTS, SCHOLARSHIPS AND STUDENT LOANS Physician Shortage Area... award scholarship grants to students of medicine and osteopathy who agree to engage in the full-time... manner as to assure that of the patients receiving medical care in such practice a substantial portion...

  7. Outpatient Pharmacy Civilian Prescription Pathway Process Improvement

    DTIC Science & Technology

    1998-03-01

    Thompson, MSC, USN provided me throughout the residency phase of the program. He devoted time to give counsel and guidance while continually stressing ...service Surgeon General. The term civilian practitioner includes Pharmacy 2 4 doctors of medicine, osteopathy , dentistry or podiatry who are

  8. Evaluation of tibial osteopathy occurrence in neurofibromatosis type 1 Italian patients.

    PubMed

    Morcaldi, Guido; Clementi, Maurizio; Lama, Giuliana; Gabrielli, Orazio; Vannelli, Silvia; Virdis, Raffaele; Vivarelli, Rossella; Boero, Silvio; Bonioli, Eugenio

    2013-05-01

    Neurofibromatosis Type 1 (NF1) is a common autosomal dominant disorder characterized by high penetrance, widely variable expressivity and occurrence of specific skeletal changes such as tibial osteopathy (TO). We collected data on patients referred to the Italian Neurofibromatosis Study Group in order to compare clinical features between 49 NF1 patients with TO, and 98 age-matched NF1 patients without TO, and to determine whether the presence of TO is associated with a different risk of developing the typical NF1 complications. We assessed both groups for: age at diagnosis of NF1, gender distribution, family history, gender inheritance, presence of scoliosis, sphenoid wing osteopathy, other skeletal abnormalities, macrocrania, hydrocephalus, plexiform neurofibromas, tumors, optic pathway gliomas, T2H (high-signal intensity areas on T2 weighted brain MRI), epilepsy, headache, mental retardation, cardiovascular malformations, and Noonan phenotype. Patients of both groups were subdivided by gender and re-evaluated for these items. Statistical comparison was carried out between the two groups of patients for each feature. We collected data on type of treatment and on the clinical conditions of NF1-TO patients after follow-up. Patient's age at NF1 diagnosis was significantly younger in NF1-TO subjects compared with NF1 subjects without TO, and the incidence of T2H was significantly reduced in NF1-TO males compared with NF1 males without TO. The presence of TO does not imply that there is an increased risk of developing typical complications of NF1 (e.g., optic pathway glioma, plexiform neurofibroma, etc.), however, it does allow us to make an earlier diagnosis of NF1. Copyright © 2012 Wiley Periodicals, Inc.

  9. Learning Environment, Preparedness and Satisfaction in Osteopathy in Europe: The PreSS Study

    PubMed Central

    Luciani, Emanuele; van Dun, Patrick L. S.; Esteves, Jorge Eduardo; Lunghi, Christian; Petracca, Marco; Papa, Liria; Merdy, Olivier; Jäkel, Anne; Cerritelli, Francesco

    2015-01-01

    Objective 1) to assess the preparedness to practice and satisfaction in learning environment amongst new graduates from European osteopathic institutions; 2) to compare the results of preparedness to practice and satisfaction in learning environment between and within countries where osteopathy is regulated and where regulation is still to be achieved; 3) to identify possible correlations between learning environment and preparedness to practice. Method Osteopathic education providers of full-time education located in Europe were enrolled, and their final year students were contacted to complete a survey. Measures used were: Dundee Ready Educational Environment Measure (DREEM), the Association of American Medical Colleges (AAMC) and a demographic questionnaire. Scores were compared across institutions using one-way ANOVA and generalised linear model. Results Nine European osteopathic education institutions participated in the study (4 located in Italy, 2 in the UK, 1 in France, 1 in Belgium and 1 in the Netherlands) and 243 (77%) of their final-year students completed the survey. The DREEM total score mean was 121.4 (SEM: 1.66) whilst the AAMC was 17.58 (SEM:0.35). A generalised linear model found a significant association between not-regulated countries and total score as well as subscales DREEM scores (p<0.001). Learning environment and preparedness to practice were significantly positively correlated (r=0.76; p<0.01). Discussion A perceived higher level of preparedness and satisfaction was found amongst students from osteopathic institutions located in countries without regulation compared to those located in countries where osteopathy is regulated; however, all institutions obtained a ‘more positive than negative’ result. Moreover, in general, cohorts with fewer than 20 students scored significantly higher compared to larger student cohorts. Finally, an overall positive correlation between students’ preparedness and satisfaction were found across all institutions recruited. PMID:26103514

  10. Learning Environment, Preparedness and Satisfaction in Osteopathy in Europe: The PreSS Study.

    PubMed

    Luciani, Emanuele; van Dun, Patrick L S; Esteves, Jorge Eduardo; Lunghi, Christian; Petracca, Marco; Papa, Liria; Merdy, Olivier; Jäkel, Anne; Cerritelli, Francesco

    2015-01-01

    1) to assess the preparedness to practice and satisfaction in learning environment amongst new graduates from European osteopathic institutions; 2) to compare the results of preparedness to practice and satisfaction in learning environment between and within countries where osteopathy is regulated and where regulation is still to be achieved; 3) to identify possible correlations between learning environment and preparedness to practice. Osteopathic education providers of full-time education located in Europe were enrolled, and their final year students were contacted to complete a survey. Measures used were: Dundee Ready Educational Environment Measure (DREEM), the Association of American Medical Colleges (AAMC) and a demographic questionnaire. Scores were compared across institutions using one-way ANOVA and generalised linear model. Nine European osteopathic education institutions participated in the study (4 located in Italy, 2 in the UK, 1 in France, 1 in Belgium and 1 in the Netherlands) and 243 (77%) of their final-year students completed the survey. The DREEM total score mean was 121.4 (SEM: 1.66) whilst the AAMC was 17.58 (SEM:0.35). A generalised linear model found a significant association between not-regulated countries and total score as well as subscales DREEM scores (p<0.001). Learning environment and preparedness to practice were significantly positively correlated (r=0.76; p<0.01). A perceived higher level of preparedness and satisfaction was found amongst students from osteopathic institutions located in countries without regulation compared to those located in countries where osteopathy is regulated; however, all institutions obtained a 'more positive than negative' result. Moreover, in general, cohorts with fewer than 20 students scored significantly higher compared to larger student cohorts. Finally, an overall positive correlation between students' preparedness and satisfaction were found across all institutions recruited.

  11. The Optometric Residency Accreditation Process--Planning for the Future.

    ERIC Educational Resources Information Center

    Suchoff, Irwin B.; And Others

    1995-01-01

    The American Optometric Association's current review of procedures for accrediting optometric residencies is discussed. Reasons for the review (projected growth of programs and revised standards) are discussed, procedures currently in place for accrediting programs in osteopathy, dentistry, pharmacy, podiatry, and optometry are summarized; and…

  12. 42 CFR 482.51 - Condition of participation: Surgical services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... applicable State laws and approved medical staff policies and procedures, LPNs and surgical technologists may... of medicine or osteopathy. (2) Licensed practical nurses (LPNs) and surgical technologists (operating... surgical care must be designed to assure the achievement and maintenance of high standards of medical...

  13. 42 CFR 418.202 - Covered services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... the services of the hospice medical director or the physician member of the interdisciplinary group must be performed by a doctor of medicine or osteopathy. (d) Counseling services provided to the.... Counseling, including dietary counseling, may be provided both for the purpose of training the individual's...

  14. 45 CFR 1310.16 - Driver qualifications.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ..., DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, HEAD START... examination, performed by a licensed doctor of medicine or osteopathy, establishing that the individual...) As provided in 45 CFR 1310.2(a), this section does not apply to transportation services to children...

  15. 42 CFR 485.638 - Conditions of participation: Clinical records.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... clinical laboratory services, and consultative findings; (iii) All orders of doctors of medicine or osteopathy or other practitioners, reports of treatments and medications, nursing notes and documentation of... graphics, progress notes describing the patient's response to treatment; and (iv) Dated signatures of the...

  16. Recertification and Relicensure--Implications for the University

    ERIC Educational Resources Information Center

    Strother, George B.; Swinford, David N.

    1975-01-01

    The study surveyed the extent of the movement to require continuing education in 14 professions: accountancy, architecture, dentistry, dietetics, engineering, law, medicine, nursing, optometry, osteopathy, pharmacy, physical therapy, real estate, social work, and veterinary medicine. The report provides some general conclusions and a summary of…

  17. Limonene protects osteoblasts against methylglyoxal-derived adduct formation by regulating glyoxalase, oxidative stress, and mitochondrial function.

    PubMed

    Suh, Kwang Sik; Chon, Suk; Choi, Eun Mi

    2017-12-25

    Methylglyoxal (MG) is a potent protein glycating agent and an important precursor of advanced glycation end products, which are involved in the pathogenesis of diabetic osteopathy. In this study, we investigated the effects of limonene on MG-induced damage in osteoblastic MC3T3-E1 cells. Pretreating cells with limonene prevented MG-induced protein adduct formation, tumor necrosis factor alpha and interleukin-6 release, mitochondrial superoxide production, and cardiolipin peroxidation. In addition, limonene increased glyoxalase I activity, and glutathione and heme oxygenase-1 levels in the presence of MG. Pretreatment with limonene prior to MG exposure reduced MG-induced mitochondrial dysfunction by preventing mitochondrial membrane potential dissipation and adenosine triphosphate loss, and reduced the levels of adenosine monophosphate-activated protein kinase, peroxisome proliferator activated receptor γ coactivator 1α, and nitric oxide. These results demonstrate that limonene may prevent the development of diabetic osteopathy. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Osteopathy for Endometriosis and Chronic Pelvic Pain - a Pilot Study.

    PubMed

    Sillem, M; Juhasz-Böss, I; Klausmeier, I; Mechsner, S; Siedentopf, F; Solomayer, E

    2016-09-01

    Introduction: Pelvic pain is a common problem in gynaecological practice. It is often unclear whether definite causality exists between reported symptoms and objective clinical findings of the female genital tract, and medical or operative treatments do not always achieve long-term resolution of symptoms. Methods: This pilot study investigated 28 patients (age 20-65, median 36.5 years) from a gynaecology practice whose only clinical finding was painful pelvic floor muscle tightness. Following standardised gynaecological and physiotherapist examination, all patients received osteopathic treatment. Pain had been present for a median of 3 years (range 1 month to 20 years). 14 patients had previously confirmed endometriosis. Treatment success was evaluated on consultation with patients in person or in writing. Results: 22 of the 28 participants completed the treatment according to plan. Overall, 17 reported symptom improvement, while 10 of the 14 patients with endometriosis did. Conclusion: Osteopathy is well received by women with painful pelvic floor muscle tightness and appears to be an effective treatment option.

  19. Metastatic anal sac carcinoma with hypercalcaemia and associated hypertrophic osteopathy in a dog

    PubMed Central

    Giuliano, A.; Salgüero, R.; Dobson, J.

    2015-01-01

    A seven-year-old male neutered Irish setter was treated for a metastatic anal sac adenocarcinoma (ASAC) and hypercalcaemia by complete surgical excision of the primary tumour and partial excision of the sublumbar lymph nodes. Further enlargement of the sublumbar lymph nodes was linked to recurrent hypercalcaemia 3 months after surgical treatment. Medical treatment with Toceranib and Clodronate showed modest results in the treatment of the tumour and the hypercalcaemia. Radiotherapy of the sublumbar lymph nodes and later concurrent carboplatin chemotherapy resulted in partial tumour remission with marked reduction in size of the lymph nodes and normalization of the calcaemia. Unfortunately, concurrently with subsequent relapse of the hypercalaemia, the dog developed hypertrophic osteopathy (HO) and lumbar spinal metastasis and the dog was euthanized. To the authors’ knowledge, this is the second case of metastatic apocrine gland carcinoma of the anal sac associated with HO and the first case that describe the development of HO late in the stage of the disease. PMID:26623365

  20. Paraneoplastic hypertrophic osteopathy in 30 dogs

    PubMed Central

    Withers, S. S.; Johnson, E. G.; Culp, W. T. N.; Rodriguez, C. O.; Skorupski, K. A.; Rebhun, R. B.

    2016-01-01

    Paraneoplastic hypertrophic osteopathy (pHO) is known to occur in both canine and human cancer patients. While the pathology of pHO is well-described in the dog, very little information exists regarding the true clinical presentation of dogs affected with pHO. The primary objective of this study was to provide a more comprehensive clinical picture of pHO. To this end, we retrospectively identified 30 dogs and recorded data regarding presenting complaints and physical examination (PE) findings on the date of pHO diagnosis. As a secondary objective, any blood test results were also collected from the computerized records. The most common clinical signs included leg swelling, ocular discharge and/or episcleral injection, lameness, and lethargy. The most common haematological and serum biochemical abnormalities included anaemia, neutrophilia and elevated alkaline phosphatase. In addition to presenting a more detailed clinical description of pHO in the dog, these data support the previously described haematological, serum biochemical and PE abnormalities published in individual case reports. PMID:23489591

  1. 42 CFR 413.75 - Direct GME payments: General requirements.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...-based providers for the costs of approved residency programs in medicine, osteopathy, dentistry, and... Council for Graduate Medical Education (ACGME) as a fellowship program in geriatric medicine. (4) Is a... Urban Consumers as compiled by the Bureau of Labor Statistics. Emergency Medicare GME affiliated group...

  2. 42 CFR 413.75 - Direct GME payments: General requirements.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...-based providers for the costs of approved residency programs in medicine, osteopathy, dentistry, and... Council for Graduate Medical Education (ACGME) as a fellowship program in geriatric medicine. (4) Is a... Urban Consumers as compiled by the Bureau of Labor Statistics. Emergency Medicare GME affiliated group...

  3. 42 CFR 413.75 - Direct GME payments: General requirements.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...-based providers for the costs of approved residency programs in medicine, osteopathy, dentistry, and... Council for Graduate Medical Education (ACGME) as a fellowship program in geriatric medicine. (4) Is a... Urban Consumers as compiled by the Bureau of Labor Statistics. Emergency Medicare GME affiliated group...

  4. 34 CFR 685.213 - Total and permanent disability discharge.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Loan based on a total and permanent disability, a borrower must submit a discharge application to the..., who is a doctor of medicine or osteopathy legally authorized to practice in a State, that the borrower... require the borrower to submit additional medical evidence if the Secretary determines that the borrower's...

  5. 42 CFR 410.20 - Physicians' services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... doctor of medicine or osteopathy, including an osteopathic practitioner recognized in section 1101(a)(7) of the Act. (2) A doctor of dental surgery or dental medicine. (3) A doctor of podiatric medicine. (4... based, and a description of any applicable rights under section 1869(a) of the Act. (3) Insufficient...

  6. 42 CFR 410.20 - Physicians' services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... doctor of medicine or osteopathy, including an osteopathic practitioner recognized in section 1101(a)(7) of the Act. (2) A doctor of dental surgery or dental medicine. (3) A doctor of podiatric medicine. (4... based, and a description of any applicable rights under section 1869(a) of the Act. (3) Insufficient...

  7. 34 CFR 685.213 - Total and permanent disability discharge.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Loan based on a total and permanent disability, a borrower must submit a discharge application to the..., who is a doctor of medicine or osteopathy legally authorized to practice in a State, that the borrower... require the borrower to submit additional medical evidence if the Secretary determines that the borrower's...

  8. 42 CFR 410.20 - Physicians' services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... doctor of medicine or osteopathy, including an osteopathic practitioner recognized in section 1101(a)(7) of the Act. (2) A doctor of dental surgery or dental medicine. (3) A doctor of podiatric medicine. (4... based, and a description of any applicable rights under section 1869(a) of the Act. (3) Insufficient...

  9. 42 CFR 424.20 - Requirements for posthospital SNF care.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... knowledge of the case; or (2) A nurse practitioner or clinical nurse specialist, neither of whom has a... physician. For purposes of this section— (i) Collaboration means a process whereby a nurse practitioner or clinical nurse specialist works with a doctor of medicine or osteopathy to deliver health care services...

  10. 5 CFR 339.104 - Definitions.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... risk avoiding value; (f) An explanation of the medical basis for any conclusion which indicates the.... Medical standard is a written description of the medical requirements for a particular occupation based on... Doctor of Medicine or Doctor of Osteopathy, or a physician who is serving on active duty in the uniformed...

  11. 5 CFR 339.104 - Definitions.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... risk avoiding value; (f) An explanation of the medical basis for any conclusion which indicates the.... Medical standard is a written description of the medical requirements for a particular occupation based on... Doctor of Medicine or Doctor of Osteopathy, or a physician who is serving on active duty in the uniformed...

  12. 5 CFR 339.104 - Definitions.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... risk avoiding value; (f) An explanation of the medical basis for any conclusion which indicates the.... Medical standard is a written description of the medical requirements for a particular occupation based on... Doctor of Medicine or Doctor of Osteopathy, or a physician who is serving on active duty in the uniformed...

  13. 5 CFR 339.104 - Definitions.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... risk avoiding value; (f) An explanation of the medical basis for any conclusion which indicates the.... Medical standard is a written description of the medical requirements for a particular occupation based on... Doctor of Medicine or Doctor of Osteopathy, or a physician who is serving on active duty in the uniformed...

  14. 38 CFR 8.22 - Examination of applicants for insurance or reinstatement.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... OF VETERANS AFFAIRS NATIONAL SERVICE LIFE INSURANCE Examinations § 8.22 Examination of applicants for... Service Life Insurance or of an applicant for reinstatement of National Service Life Insurance, such... college of osteopathy and who is listed in the current directory of the American Osteopathic Association...

  15. 38 CFR 8.22 - Examination of applicants for insurance or reinstatement.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... OF VETERANS AFFAIRS NATIONAL SERVICE LIFE INSURANCE Examinations § 8.22 Examination of applicants for... Service Life Insurance or of an applicant for reinstatement of National Service Life Insurance, such... college of osteopathy and who is listed in the current directory of the American Osteopathic Association...

  16. 38 CFR 8.22 - Examination of applicants for insurance or reinstatement.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... OF VETERANS AFFAIRS NATIONAL SERVICE LIFE INSURANCE Examinations § 8.22 Examination of applicants for... Service Life Insurance or of an applicant for reinstatement of National Service Life Insurance, such... college of osteopathy and who is listed in the current directory of the American Osteopathic Association...

  17. 76 FR 35683 - Medicare Program; Conditions of Participation (CoPs) for Community Mental Health Centers

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-17

    ... medicine in the State in which he or she practices. Information contained in The Joint Commission... composed of a doctor of medicine, osteopathy or psychiatry, a psychiatric registered nurse, clinical... medications, herbal remedies, and other alternative treatments or substances that could affect drug therapy...

  18. 42 CFR 410.47 - Pulmonary rehabilitation program: Conditions for coverage.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... means a doctor of medicine or osteopathy as defined in section 1861(r)(1) of the Act. Physician... physician that improves or maintains an individual's pulmonary functional level. Psychosocial assessment... certification including basic life support. (4) Is licensed to practice medicine in the State in which the...

  19. 42 CFR 410.47 - Pulmonary rehabilitation program: Conditions for coverage.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... means a doctor of medicine or osteopathy as defined in section 1861(r)(1) of the Act. Physician... physician that improves or maintains an individual's pulmonary functional level. Psychosocial assessment... certification including basic life support. (4) Is licensed to practice medicine in the State in which the...

  20. 42 CFR 410.47 - Pulmonary rehabilitation program: Conditions for coverage.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... means a doctor of medicine or osteopathy as defined in section 1861(r)(1) of the Act. Physician... physician that improves or maintains an individual's pulmonary functional level. Psychosocial assessment... certification including basic life support. (4) Is licensed to practice medicine in the State in which the...

  1. 42 CFR 410.47 - Pulmonary rehabilitation program: Conditions for coverage.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... means a doctor of medicine or osteopathy as defined in section 1861(r)(1) of the Act. Physician... physician that improves or maintains an individual's pulmonary functional level. Psychosocial assessment... certification including basic life support. (4) Is licensed to practice medicine in the State in which the...

  2. Academic Deans' Views on Curriculum Content in Medical Schools.

    ERIC Educational Resources Information Center

    Graber, David R.; Bellack, Janis P.; Musham, Catherine; O'Neil, Edward H.

    1997-01-01

    A survey of academic deans (n=100) in universities associated with medical and osteopathy schools found that administrators' attitudes about curriculum content are being influenced by changes in health care delivery and an increasingly generalist orientation. There appears to be support for medical school curricula fostering a broader, more…

  3. Teaching the Process of Obtaining Informed Consent to Medical Students.

    ERIC Educational Resources Information Center

    Johnson, Shirley M.; And Others

    1992-01-01

    A unit on informed consent for first-year osteopathy students consists of pre- and posttests, a lecture, readings, small-group discussion, a model videotaped interview, and students' videotaped interviews with a simulated patient. Students were most successful in establishing patient rapport and discussion, least successful in conflict resolution…

  4. Doctors of Osteopathy Licensed in Washington.

    ERIC Educational Resources Information Center

    Senters, Jo

    Based on information gathered by the Health Manpower Project through a survey cosponsored with the Washington Osteopathic Medical Association, this report begins with a statement of philosophy of osteopathic medicine and proceeds to comment on where such professional education is available. Remarks on the type of educational background of the…

  5. 49 CFR 40.121 - Who is qualified to act as an MRO?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... physician (Doctor of Medicine or Osteopathy). If you are a licensed physician in any U.S., Canadian, or... states or provinces without becoming licensed to practice medicine in the other jurisdictions. (b) Basic... clinical experience in controlled substances abuse disorders, including detailed knowledge of alternative...

  6. 49 CFR 40.121 - Who is qualified to act as an MRO?

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... physician (Doctor of Medicine or Osteopathy). If you are a licensed physician in any U.S., Canadian, or... states or provinces without becoming licensed to practice medicine in the other jurisdictions. (b) Basic... clinical experience in controlled substances abuse disorders, including detailed knowledge of alternative...

  7. 49 CFR 40.121 - Who is qualified to act as an MRO?

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... physician (Doctor of Medicine or Osteopathy). If you are a licensed physician in any U.S., Canadian, or... states or provinces without becoming licensed to practice medicine in the other jurisdictions. (b) Basic... clinical experience in controlled substances abuse disorders, including detailed knowledge of alternative...

  8. 49 CFR 40.121 - Who is qualified to act as an MRO?

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... physician (Doctor of Medicine or Osteopathy). If you are a licensed physician in any U.S., Canadian, or... states or provinces without becoming licensed to practice medicine in the other jurisdictions. (b) Basic... clinical experience in controlled substances abuse disorders, including detailed knowledge of alternative...

  9. 49 CFR 40.121 - Who is qualified to act as an MRO?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... physician (Doctor of Medicine or Osteopathy). If you are a licensed physician in any U.S., Canadian, or... states or provinces without becoming licensed to practice medicine in the other jurisdictions. (b) Basic... clinical experience in controlled substances abuse disorders, including detailed knowledge of alternative...

  10. 75 FR 4395 - Proposed Data Collections Submitted for Public Comment and Recommendations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-27

    ... provides funding to PRC grantees that are housed within schools of public health, medicine or osteopathy... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention [60Day-10-0650... Disease Prevention and Health Promotion (NCCDPHP), Centers for Disease Control and Prevention (CDC...

  11. Health Professions Schools. Selected Enrollment Data 1970-71/1977-78.

    ERIC Educational Resources Information Center

    Health Resources Administration (DHEW/PHS), Bethesda, MD. Bureau of Health Manpower.

    Enrollment data are provided for each school of medicine, osteopathy, dentistry, optometry, pharmacy, podiatry, and veterinary medicine for the academic years 1970-71 through 1977-78. In one section, the schools are classified by discipline, and within each discipline the schools are sorted alphabetically by state; discipline totals are also…

  12. Health Professions Schools. Selected Enrollment Data 1970-71/1981-82.

    ERIC Educational Resources Information Center

    Rosenthal, Smauel; And Others

    Enrollment data are presented for each school of medicine, osteopathy, dentistry, optometry, pharmacy, podiatry, and veterinary medicine for the academic years 1970-71 through 1981-82. Projections for future years are made from the length of the academic program for current enrollees. The data are segmented by program type, and include the actual…

  13. An Exploratory Study of Women in the Health Professions Schools. Executive Summary.

    ERIC Educational Resources Information Center

    Urban and Rural Systems Associates, San Francisco, CA.

    The study focused on eight health professions: medicine, osteopathy, dentistry, veterinary medicine, optometry, podiatry, pharmacy, and public health. Its central tasks were to identify and explore the barriers to success that women face as medical/professional school applicants and students and to describe the discrimination process that limits…

  14. Institutional Resource Requirements and Cost Per Student for Contemporary Pharmaceutical Education

    ERIC Educational Resources Information Center

    Swintosky, Joseph V.; And Others

    1976-01-01

    This paper summarizes part of the IOM study that determined the average annual education costs per student, for the first professional degree. Colleges of pharmacy, medicine, dentistry, osteopathy, veterinary medicine, podiatry, optometry, and nursing were included. The data are assessed with particular reference to the University of Kentucky.…

  15. The Comprehensive Health Manpower Training Act of 1971: Legislative History and Analysis of Major Provisions.

    ERIC Educational Resources Information Center

    Kline, Janet

    The Comprehensive Health Manpower Training Act of 1971 significantly amends the Health Professions Educational Assistance Programs contained in the Public Health Service Act. Originally authorized by the Health Professions Education Assistance Act of 1963, the programs provide Federal financial assistance to schools of medicine, osteopathy,…

  16. How Health Professions Students Finance Their Education.

    ERIC Educational Resources Information Center

    Public Health Service (DHEW), Arlington, VA.

    This report was based on a survey to determine how students in the health professions of medicine osteopathy, dentistry, optometry, pharmacy, podiatry, and veterinary medicine financed their educations during the 1970-71 school year. The purpose of this nationwide survey was to provide information on patterns of student expenses and on the sources…

  17. 49 CFR 240.7 - Definitions.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... examiner means a person licensed as a doctor of medicine or doctor of osteopathy. A medical examiner can be..., braking capacity, and in-train force levels throughout the train; and (4) Is computer enhanced so that it... train; and (4) Is computer enhanced so that it can be programmed for specific train consists and the...

  18. 49 CFR 240.7 - Definitions.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... examiner means a person licensed as a doctor of medicine or doctor of osteopathy. A medical examiner can be..., braking capacity, and in-train force levels throughout the train; and (4) Is computer enhanced so that it... train; and (4) Is computer enhanced so that it can be programmed for specific train consists and the...

  19. Health Professions Education Facilities in the Non-Profit Sector. 1973.

    ERIC Educational Resources Information Center

    Health Resources Administration (DHEW/PHS), Bethesda, MD. Bureau of Health Manpower.

    In this study of the physical facilities of the nation's health professions schools, all schools of dentistry, medicine, optometry, osteopathy, pharmacy, podiatry, public health, and veterinary medicine, and all parent institutions of the schools, were surveyed in May of 1973. The major goals of this pioneering survey were to assess the nature and…

  20. 42 CFR 136.302 - Definitions.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... he or she lives on or near a reservation, is a member of a tribe, band or other organized group... degree of doctor of osteopathy, a degree of bachelor of science in pharmacy or an equivalent degree, a... degree of bachelor of arts, bachelor of science, bachelor of nursing, or to an equivalent degree, or to a...

  1. 42 CFR 136.302 - Definitions.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... he or she lives on or near a reservation, is a member of a tribe, band or other organized group... degree of doctor of osteopathy, a degree of bachelor of science in pharmacy or an equivalent degree, a... degree of bachelor of arts, bachelor of science, bachelor of nursing, or to an equivalent degree, or to a...

  2. 42 CFR 136.302 - Definitions.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... he or she lives on or near a reservation, is a member of a tribe, band or other organized group... degree of doctor of osteopathy, a degree of bachelor of science in pharmacy or an equivalent degree, a... degree of bachelor of arts, bachelor of science, bachelor of nursing, or to an equivalent degree, or to a...

  3. 29 CFR 825.800 - Definitions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... “health care provider” as: (i) A doctor of medicine or osteopathy who is authorized to practice medicine...)(1). Son or daughter means a biological, adopted, or foster child, a stepchild, a legal ward, or a child of a person standing in loco parentis, who is either under age 18, or age 18 or older and...

  4. 42 CFR 136.302 - Definitions.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... he or she lives on or near a reservation, is a member of a tribe, band or other organized group... degree of doctor of osteopathy, a degree of bachelor of science in pharmacy or an equivalent degree, a... degree of bachelor of arts, bachelor of science, bachelor of nursing, or to an equivalent degree, or to a...

  5. 42 CFR 484.18 - Condition of participation: Acceptance of patients, plan of care, and medical supervision.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ..., and medical supervision. Patients are accepted for treatment on the basis of a reasonable expectation... a doctor of medicine, osteopathy, or podiatric medicine. (a) Standard: Plan of care. The plan of... treatments, any safety measures to protect against injury, instructions for timely discharge or referral, and...

  6. 42 CFR 485.631 - Condition of participation: Staffing and staff responsibilities.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Condition of participation: Staffing and staff... participation: Staffing and staff responsibilities. (a) Standard: Staffing—(1) The CAH has a professional health care staff that includes one or more doctors of medicine or osteopathy, and may include one or more...

  7. 42 CFR 485.631 - Condition of participation: Staffing and staff responsibilities.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 5 2011-10-01 2011-10-01 false Condition of participation: Staffing and staff... participation: Staffing and staff responsibilities. (a) Standard: Staffing—(1) The CAH has a professional health care staff that includes one or more doctors of medicine or osteopathy, and may include one or more...

  8. Effects of spinal manipulation and myofascial techniques on heart rate variability: A systematic review.

    PubMed

    Amoroso Borges, Bruno Luis; Bortolazzo, Gustavo Luiz; Neto, Hugo Pasin

    2018-01-01

    The analysis of heart rate variability is important to the investigation of stimuli from the autonomic nervous system. Osteopathy is a form of treatment that can influence this system in healthy individuals as well as those with a disorder or disease. The aim of the present study was to perform a systematic review of the literature regarding the effect of spinal manipulation and myofascial techniques on heart rate variability. Searches were performed of the Pubmed, Scielo, Lilacs, PEDro, Ibesco, Cochrane and Scopus databases for relevant studies. The PEDro scale was used to assess the methodological quality of each study selected. A total of 505 articles were retrieved during the initial search. After an analysis of the abstracts, nine studies were selected for the present review. Based on the findings, osteopathy exerts an influence on the autonomic nervous system depending on the stimulation site and type. A greater parasympathetic response was found when stimulation was performed in the cervical and lumbar regions, whereas a greater sympathetic response was found when stimulation was performed in the thoracic region. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. Hypnosis and Osteopathic Manipulative Treatment for Visual Disorders During Pregnancy: A Case Report.

    PubMed

    Russo, Giancarlo; Remonato, Alessandro; Remonato, Roberto; Zanier, Emiliano

    2017-01-01

    Context • Pregnancy causes physiological alterations to the visual system, particularly in relation to retinal vascularization, with a consequent increase of intraocular pressure, and to the lacrimal fluid, with a consequent ocular dryness, which both can lead to a reduction in visual acuity. Numerous case reports refer to the employment of hypnotic treatment in cases of myopia, but the literature does not report any case of decreased visual acuity postpartum that was treated with hypnosis. Objective • For women with visual disorders that had appeared during pregnancy or were preexisting, the study intended to evaluate the benefits of treatment of the diaphragm by hypnotherapy and osteopathy to modify intracorporeal pressure and restore the women's visual function. Design • The research team performed a case study. Setting • The setting was a private osteopathic clinic. Participant • The participant was a 35-y-old woman lacking visual acuity postpartum. Intervention • The study took place during a period of 1 d. The participant first took part in a hypnotherapy session, the first intervention, and then participated in an osteopathic session, the second intervention. Outcome Measures • For the first evaluation of visual function at baseline, 3 tests were performed: (1) a visual acuity test; (2) a cover test for near and distance vision; and (3) a test for near point convergence. The visual function evaluation (all 3 tests) occurred after the 2 types of treatment (T1, T2). Finally, a visual function evaluation (all 3 tests) occurred at a follow-up session 1 mo after the end of treatment (T3). Results • The intervention produced a significant improvement in visual acuity, due to the multidisciplinary approach of treatment with hypnotherapy and osteopathy, and achieved a result that was maintained in the medium term. Conclusions • Hypnosis and osteopathy produced a significant improvement in visual acuity and the result was maintained in the medium term. Further studies are needed to verify the efficacy of the 2 treatments.

  10. An Exploratory Study of Women in the Health Professions Schools. Volume I: Data Analysis, Findings, Conclusions, Recommendations.

    ERIC Educational Resources Information Center

    Urban and Rural Systems Associates, San Francisco, CA.

    The study focused on women's education in eight health professions: medicine, osteopathy, dentistry, veterinary medicine, optometry, podiatry, pharmacy, and public health. Its central tasks were to identify and explore the barriers to success that women face as school applicants and students. Almost 600 interviews were conducted with…

  11. The Robert Wood Johnson Foundation Annual Report 1978, January 1, 1978 through December 31, 1978.

    ERIC Educational Resources Information Center

    Robert Wood Johnson Foundation, New Brunswick, NJ.

    The nationwide program of financial aid for students enrolled in medicine and osteopathy, sponsored by the Robert Wood Johnson Foundation, is evaluated. The foundation made scholarship and loan funds available to students with minority backgrounds, to women students, and to students from rural areas. The evaluation study sought to determine…

  12. Defense Health Care: 2008 Access to Care Surveys Indicate Some Problems, but Beneficiary Satisfaction Is Similar to Other Health Plans

    DTIC Science & Technology

    2010-03-01

    reported that servicemembers and their families are at risk for mental health problems given the stress of deployment and exposure to combat. A...office-based civilian medical doctors or licensed civilian doctors of osteopathy within the specified locations who were engaged in more than 20

  13. 77 FR 75918 - VA Health Professional Scholarship and Visual Impairment and Orientation and Mobility...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-26

    ...: Written comments may be submitted: By mail or hand-delivery to Director, Regulations Management (02REG... a participant may continue to attend school under the standards and practices of the school at which... Affairs health care facility and a school of medicine or osteopathy.'' We propose to amend this definition...

  14. Costs of Education in the Health Professions: Report of a Study Parts I and II.

    ERIC Educational Resources Information Center

    Health Resources Administration (DHEW/PHS), Bethesda, MD. Bureau of Health Resources Development.

    This report contains aggregate data on costs for all schools of medicine, osteopathy, dentistry, optometry, pharmacy, podiatry, veterinary medicine, and nursing, and the average education costs per student in these fields for a sample of schools during the 1972-73 academic year. Context for the study is provided by an appraisal of the educational…

  15. Health Manpower Source Book. Manpower Supply and Educational Statistics for Selected Health Occupations: 1968. Public Health Service Publication Number 263, Section 20.

    ERIC Educational Resources Information Center

    National Institutes of Health (DHEW), Bethesda, MD. Bureau of Health Professions Education and Manpower Training.

    This publication is a compilation of statistics on supply and education of health manpower in medicine and osteopathy, dentistry, optometry, pharmacy, podiatry, veterinary medicine, nursing, public health, and eight selected allied health occupations. The material is organized by occupations and the following information is presented for each…

  16. 34 CFR 685.218 - Discharge of student loan indebtedness for survivors of victims of the September 11, 2001, attacks.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ..., 2001, documentation of the discharge may be used as an alternative to the documentation in paragraphs... of the discharge may be used as an alternative to the documentation in paragraphs (d)(4) and (d)(5... a doctor of medicine or osteopathy and legally authorized to practice in a state, that the...

  17. 34 CFR 685.218 - Discharge of student loan indebtedness for survivors of victims of the September 11, 2001, attacks.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ..., 2001, documentation of the discharge may be used as an alternative to the documentation in paragraphs... of the discharge may be used as an alternative to the documentation in paragraphs (d)(4) and (d)(5... a doctor of medicine or osteopathy and legally authorized to practice in a state, that the...

  18. 34 CFR 685.218 - Discharge of student loan indebtedness for survivors of victims of the September 11, 2001, attacks.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ..., 2001, documentation of the discharge may be used as an alternative to the documentation in paragraphs... of the discharge may be used as an alternative to the documentation in paragraphs (d)(4) and (d)(5... a doctor of medicine or osteopathy and legally authorized to practice in a state, that the...

  19. 34 CFR 685.218 - Discharge of student loan indebtedness for survivors of victims of the September 11, 2001, attacks.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ..., 2001, documentation of the discharge may be used as an alternative to the documentation in paragraphs... of the discharge may be used as an alternative to the documentation in paragraphs (d)(4) and (d)(5... a doctor of medicine or osteopathy and legally authorized to practice in a state, that the...

  20. 8 CFR 204.12 - How can second-preference immigrant physicians be granted a national interest waiver based on...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false How can second-preference immigrant... REGULATIONS IMMIGRANT PETITIONS Immigrant Visa Petitions § 204.12 How can second-preference immigrant... osteopathy) for whom an immigrant visa petition has been filed pursuant to section 203(b)(2) of the Act shall...

  1. 42 CFR 62.3 - Who is eligible to apply for a scholarship program award?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... enrollment, or be enrolled, as a full-time student in a school located in a State; (2) Be pursuing a course of study or program offered by the school leading to a degree in medicine, osteopathy, dentistry, or... under this part is ineligible for an award unless a written statement satisfactory to the Secretary is...

  2. A Report to the President & Congress on the Status of Health Professions Personnel in the United States. [Advance Issue, August 1978].

    ERIC Educational Resources Information Center

    Health Resources Administration (DHEW/PHS), Bethesda, MD. Bureau of Health Manpower.

    This report, the first of a series of annual reports mandated by the Public Health Service Act as amended by the Health Professions Educational Assistance Act of 1976 (P.L. 94-484), describes and analyzes the status of health professions personnel in the United States. The professions covered are medicine, osteopathy, dentistry, optometry,…

  3. The Role of Aid to Medical, Osteopathic, and Dental Students in a New Health Manpower Education Policy. Staff Working Paper.

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC.

    Current and future financial aid to students of medicine, osteopathy, and dentistry (MODs) is discussed in the context of federal health manpower objectives. Options for providing financial access to such students are analyzed. The report was prepared for the Senate Budget Committee in response to a request by Senator Lawton Chiles as part of…

  4. 34 CFR 682.407 - Discharge of student loan indebtedness for survivors of victims of the September 11, 2001, attacks.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ..., documentation of the discharge may be used as an alternative to the documentation in paragraphs (d)(1) through..., documentation of the discharge may be used as an alternative to the documentation in paragraphs (d)(4) and (d)(5... rescue; and (iii) A certification by a physician, who is a doctor of medicine or osteopathy and legally...

  5. 34 CFR 682.407 - Discharge of student loan indebtedness for survivors of victims of the September 11, 2001, attacks.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ..., documentation of the discharge may be used as an alternative to the documentation in paragraphs (d)(1) through..., documentation of the discharge may be used as an alternative to the documentation in paragraphs (d)(4) and (d)(5... rescue; and (iii) A certification by a physician, who is a doctor of medicine or osteopathy and legally...

  6. 34 CFR 682.407 - Discharge of student loan indebtedness for survivors of victims of the September 11, 2001, attacks.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ..., documentation of the discharge may be used as an alternative to the documentation in paragraphs (d)(1) through..., documentation of the discharge may be used as an alternative to the documentation in paragraphs (d)(4) and (d)(5... rescue; and (iii) A certification by a physician, who is a doctor of medicine or osteopathy and legally...

  7. 34 CFR 682.407 - Discharge of student loan indebtedness for survivors of victims of the September 11, 2001, attacks.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ..., documentation of the discharge may be used as an alternative to the documentation in paragraphs (d)(1) through..., documentation of the discharge may be used as an alternative to the documentation in paragraphs (d)(4) and (d)(5... rescue; and (iii) A certification by a physician, who is a doctor of medicine or osteopathy and legally...

  8. The Relationship Between Air force Anesthesia Providers’ Job Satisfaction and Anticipated Turnover

    DTIC Science & Technology

    1997-10-01

    Nurse Anesthetists (CRNAs). An Anesthesiologist is defined as a Doctor of Medicine (MD) or Doctor of Osteopathy (~O) with four years of supervised...these identified components of job 24 satisfaction, the authors stress that the devised instrument must have the following objectives: ŕ) The...cou ld not find a single, most predictive model relating nursing turnover, job stress . and satisfaction . They note that " Historically, clear

  9. The Relationship Between Air Force Anesthesia Provider’s Job Satisfaction and Anticipated Turnover

    DTIC Science & Technology

    1997-10-14

    Osteopathy (DO) with four years of supervised postgraduate experience (residency) in an approved program of anesthesia training (Stoelting & Miller, 1994...these identified components of job 24 satisfaction, the authors stress that the devised instrument must have the following objectives: ŕ) The measure...single, most predictive model relating nursing turnover, job stress , and satisfaction. They note that "Historically, clear identification has been

  10. Primary Care Provider Utilization: A Descriptive Analysis of Family Practice Referral Rates Before and After the Family Practice Service Reorganization at Reynolds Army Community Hospital, Fort Sill, OK

    DTIC Science & Technology

    1997-05-01

    n=19) and doctors of osteopathy (DO) (n=5). The experience of these physicians ranges from residency graduates with six months of post-residency...training mission on post and the stresses of basic training. This also leads in to another question: What preventive medicine or educational training could

  11. Medical Services: Medical Record Administration and Health Care Documentation

    DTIC Science & Technology

    1999-05-03

    prepared for each patient who must have one. (5) Ensure that a blood sample for deoxyribonucleic acid ( DNA ) identification is on file with the DNA ...degenerative joint disease DM diabetes mellitus DNA deoxyribonucleic acid DNR do not resuscitate DO Doctor of Osteopathy DOA dead on arrival DOB date...vein thrombosis DWI driving while intoxicated Dx diagnosis EBL estimated blood loss EBV Epstein-Barr virus ECG; EKG electrocardiogram E. coli

  12. Suspected hypertrophic osteopathy in an ancient canid: Differential diagnosis of possible etiologies.

    PubMed

    Lawler, Dennis F; Reetz, Jennifer A; Sackman, Jill E; Evans, Richard H; Widga, Christopher

    2015-06-01

    Hypertrophic osteopathy (HO) has been reported in numerous mammalian species, but no reports address the range of conditions that can lead to HO, or the implications of those conditions, for archaeological diagnosis. We describe suspected HO from skeletal remains of an ancient large domestic dog recovered in Iowa, USA, at the Cherokee Sewer site. Canid remains from this site date 7430-7020calBP. The site is believed to have been a temporary, low-intensity campsite where bison were procured. Over 100 specimens from two small dogs, two large dogs, and a coyote, are present in the archaeofaunal assemblage. We document five pathological metapodials; an affected left ulna, radius, tuber calcaneus, accessory carpal, radial carpal; and an affected right central, second, and third tarsal within in a proliferative mass. HO was suspected based on gross morphology, radiography, and computed tomography. HO is a paraneoplastic syndrome with undetermined underlying pathogenesis; neuroendocrine complication of a number of neoplastic and non-neoplastic diseases is suspected. We review known disease associations of HO to provide a balanced field for considering differential diagnosis of suspect archaeological specimens, and suggest that definitive diagnosis of HO, or suspected HO, may be impossible in many instances where only skeletal remains are available for study. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Sensitization and Interoception as Key Neurological Concepts in Osteopathy and Other Manual Medicines.

    PubMed

    D'Alessandro, Giandomenico; Cerritelli, Francesco; Cortelli, Pietro

    2016-01-01

    Historically, approaches used in manual medicine to explain patient reported symptoms have been focused on the so-called exteroceptive paradigm. Arguably, this mindset lacks an appropriate "reading system" able to interpret musculoskeletal disorders from a different perspective, where the properties of the nervous system are embraced into a more holistic and functional-related context. Interestingly, if the underpinning mechanisms of a given treatment scenario/effect are taking into account, the majority of research outcomes focuses on a proprioceptive/exteroceptive explanation, leaving ting aside the additional or even central role of interoception. Currently, to date, the application of theoretical knowledge acquired on the relatively recent neuroscientific concepts and evidence concerning of interoception, sensitization, touch, autonomic functions, inflammation, and pain into a clinical/research manual medicine scenario is lacking, even if theoretically, the impact on the possible etiological mechanisms and treatment effects seems to be important. Here, we propose the conceptual foundations for a new way of interpreting and reading patients' clinical reported outcomes scenario based on interoception and sensitization. We argue that this will provide a foundation to create the ground for future research focusing on the hypotheses that manual therapies, specifically osteopathy, can intercede with sensitization states, at all levels, using interoceptive pathways.

  14. Sensitization and Interoception as Key Neurological Concepts in Osteopathy and Other Manual Medicines

    PubMed Central

    D'Alessandro, Giandomenico; Cerritelli, Francesco; Cortelli, Pietro

    2016-01-01

    Historically, approaches used in manual medicine to explain patient reported symptoms have been focused on the so-called exteroceptive paradigm. Arguably, this mindset lacks an appropriate “reading system” able to interpret musculoskeletal disorders from a different perspective, where the properties of the nervous system are embraced into a more holistic and functional-related context. Interestingly, if the underpinning mechanisms of a given treatment scenario/effect are taking into account, the majority of research outcomes focuses on a proprioceptive/exteroceptive explanation, leaving ting aside the additional or even central role of interoception. Currently, to date, the application of theoretical knowledge acquired on the relatively recent neuroscientific concepts and evidence concerning of interoception, sensitization, touch, autonomic functions, inflammation, and pain into a clinical/research manual medicine scenario is lacking, even if theoretically, the impact on the possible etiological mechanisms and treatment effects seems to be important. Here, we propose the conceptual foundations for a new way of interpreting and reading patients' clinical reported outcomes scenario based on interoception and sensitization. We argue that this will provide a foundation to create the ground for future research focusing on the hypotheses that manual therapies, specifically osteopathy, can intercede with sensitization states, at all levels, using interoceptive pathways. PMID:27013961

  15. UK: the current state of regulation of complementary and alternative medicine.

    PubMed

    Walker, L A; Budd, S

    2002-03-01

    There is no legislation that restricts the practice of CAM in the UK apart from the practice of chiropractic and osteopathy and limits on advertising the treatments of certain conditions such as cancer and tuberculosis. The UK government has increasingly recognised the need for comprehensive regulation of CAM, though it abandoned its original plan for a single overarching regulatory body. Initiatives to examine and hasten the process of regulation have included setting up a central, well-recognised charitable body to facilitate progress for individual professions, and an authoritative survey of the existing professional organisations. One pathway open to individual professions is statutory self-regulation, which requires a single governing body, a systematic corpus of knowledge, recognised training courses and demonstrated efficacy. The other pathway is voluntary self-regulation. Chiropractic and osteopathy have adopted statutory self-regulation, though this has proved expensive for individual members of these professions. A recent House of Lords report on CAM has recommended that the herbal medicine and acupuncture professions should also develop a system of statutory regulation. Other professions, such as aromatherapy, are in the process of establishing single professional bodies as a first step towards self-regulation. Among the issues that remain to be resolved is the relationship between the CAM professions and statutory registered practitioners who also practise CAM.

  16. Cognitive bias in back pain patients attending osteopathy: testing the enmeshment model in reference to future thinking.

    PubMed

    Read, Jessica; Pincus, Tamar

    2004-12-01

    Depressive symptoms are common in chronic pain. Previous research has found differences in information-processing biases in depressed pain patients and depressed people without pain. The schema enmeshment model of pain (SEMP) has been proposed to explain chronic pain patients' information-processing biases. Negative future thinking is common in depression but has not been explored in relation to chronic pain and information-processing models. The study aimed to test the SEMP with reference to future thinking. An information-processing paradigm compared endorsement and recall bias between depressed and non-depressed chronic low back pain patients and control participants. Twenty-five depressed and 35 non-depressed chronic low back pain patients and 25 control participants (student osteopaths) were recruited from an osteopathy practice. Participants were asked to endorse positive and negative ill-health, depression-related, and neutral (control) adjectives, encoded in reference to either current or future time-frame. Incidental recall of the adjectives was then tested. While the expected hypothesis of a recall bias by depressed pain patients towards ill-health stimuli in the current condition was confirmed, the recall bias was not present in the future condition. Additionally, patterns of endorsement and recall bias differed. Results extend understanding of future thinking in chronic pain within the context of the SEMP.

  17. The Battalion Surgeon: A Background Study and Analysis of His Military Training.

    DTIC Science & Technology

    1985-06-07

    commissioned officers who are qualified doctors of medicine or doctors of osteopathy . The Medical Corps encompasses those specialties filled by officers who...1981) states, stresses the "ethics of self-interest.ൈ Physicians were ඎgle, Military and Civilian Medicine, p. 1119. "mRichard A. Gabriel, "Modernism...Battalion Surgeon needs to in order to accomplish his duties and responsibilities. . Professionalism The literature findings continuously stressed the

  18. The Relevance of Empowerment to the Navy Medicine Executive Management Education Program

    DTIC Science & Technology

    1993-12-01

    They stress intrinsic motivation because they recognize it as being superior to the use of an extrinsic motivator such as profit sharing. In addition...executives in Navy Medicine, demonstrating the importance of empowerment competencies. The Healthcare Forum Survey stressed the need for a shift to...of Medical Doctor or Doctor of Osteopathy . The Nurse Corps (NC) consists principally of registered nurses with BSN degrees. The Dental Corps (DC

  19. Serum levels of innate immunity cytokines are elevated in dogs with metaphyseal osteopathy (hypertrophic osteodytrophy) during active disease and remission.

    PubMed

    Safra, Noa; Hitchens, Peta L; Maverakis, Emanual; Mitra, Anupam; Korff, Courtney; Johnson, Eric; Kol, Amir; Bannasch, Michael J; Pedersen, Niels C; Bannasch, Danika L

    2016-10-15

    Metaphyseal osteopathy (MO) (hypertrophic osteodystrophy) is a developmental disorder of unexplained etiology affecting dogs during rapid growth. Affected dogs experience relapsing episodes of lytic/sclerotic metaphyseal lesions and systemic inflammation. MO is rare in the general dog population; however, some breeds (Weimaraner, Great Dane and Irish Setter) have a much higher incidence, supporting a hereditary etiology. Autoinflammatory childhood disorders of parallel presentation such as chronic recurrent multifocal osteomyelitis (CRMO), and deficiency of interleukin-1 receptor antagonist (DIRA), involve impaired innate immunity pathways and aberrant cytokine production. Given the similarities between these diseases, we hypothesize that MO is an autoinflammatory disease mediated by cytokines involved in innate immunity. To characterize immune dysregulation in MO dogs we measured serum levels of inflammatory markers in 26 MO and 102 control dogs. MO dogs had significantly higher levels (pg/ml) of serum Interleukin-1beta (IL-1β), IL-18, IL-6, Granulocyte-macrophage colony stimulating factor (GM-CSF), C-X-C motif chemokine 10 (CXCL10), tumor necrosis factor (TNF), and IL-10. Notably, recovered MO dogs were not different from dogs during active MO disease, providing a suggestive mechanism for disease predisposition. This is the first documentation of elevated immune markers in MO dogs, uncovering an immune profile similar to comparable autoinflammatory disorders in children. Copyright © 2016 Elsevier B.V. All rights reserved.

  20. Video-assisted microwave ablation for the treatment of a metastatic lung lesion in a dog with appendicular osteosarcoma and hypertrophic osteopathy.

    PubMed

    Mazzaccari, Kaitlyn; Boston, Sarah E; Toskich, Beau B; Bowles, Kristina; Case, J Brad

    2017-11-01

    To describe video-assisted microwave ablation (VAMA) for the treatment of a metastatic lung lesion secondary to right forelimb osteosarcoma in a dog. Case report. A 10-year-old female spayed mixed breed dog with a metastatic lung lesion secondary to appendicular osteosarcoma. An osteosarcoma of the right distal scapula and proximal humerus that was suspected to be a radiation-induced osteosarcoma was treated with limb amputation and carboplatin chemotherapy. The patient developed pulmonary metastatic lesions and hypertrophic osteopathy (HO). VAMA of a metastatic lesion in the right caudal lung lobe was performed 227 days after amputation. The procedure was performed without complication. Follow-up information with the referring veterinarian 40 days after VAMA indicated that the patient was stable and that the clinical signs of HO had resolved. Thoracic radiographs taken by the referring veterinarian (RDVM) at monthly intervals showed that the previously treated metastatic lesion was stable. At 134 days from VAMA, the patient presented to the RDVM for lethargy and dyspnea and was transferred to an emergency clinic. The patient arrested and died 136 days from the VAMA procedure while hospitalized. A postmortem was not performed. VAMA for pulmonary metastatic lesions is technically feasible and allows for the treatment of symptoms associated with HO and minimally invasive management of pulmonary metastases in the case reported. © 2017 The American College of Veterinary Surgeons.

  1. From "Doctor of Osteopathy" to "Doctor of Osteopathic Medicine": a title change in the push for equality.

    PubMed

    Gevitz, Norman

    2014-06-01

    Nationally, the California merger created great solidarity among osteopathic members of state and national osteopathic associations. They rebuffed further efforts at amalgamation and championed the continuation of the DO degree. Even after the American Medical Association (AMA) opened its doors to DOs to join local and state medical associations as well as the AMA itself and gave its blessing to them entering allopathic residency programs and becoming MD board certified, the DOs stood fast for their independence. Yet some across the country wanted to become known as MDs. A few osteopathic physicians even went to federal court to claim-unsuccessfully-that state medical boards' refusal to license them or allow them to identify themselves as MDs violated their constitutional rights under the 1st and 14th Amendments. In the mid-1990s, the American Osteopathic Association (AOA) gave individual osteopathic medical colleges the option of indicating on their diplomas that the DO degree signified "Doctor of Osteopathic Medicine" rather than "Doctor of Osteopathy," a change that paralleled previous AOA policy changes regarding appropriate professional language. Nevertheless, some DOs and particularly a sizable number of osteopathic medical students continued to write of their desire for a change in the degree osteopathic medical colleges awarded. However, in July 2008 the AOA House of Delegates unanimously reaffirmed its commitment to continuing the traditional DO degree. © 2014 The American Osteopathic Association.

  2. Treatment of renal nephroblastoma in an adult dog.

    PubMed

    Seaman, Rebecca L; Patton, Clark S

    2003-01-01

    An 8-year-old Labrador retriever was diagnosed with a unilateral malignant nephroblastoma and hypertrophic osteopathy. The histopathologically malignant tumor was confined to the renal capsule, but the sarcomatous component was anaplastic, resulting in its classification as a Stage I tumor with unfavorable histopathology. The dog was treated with unilateral nephrectomy, vincristine, and doxorubicin. This dog has remained disease free for >25 months. Reported treatments of renal nephroblastoma in the dog have not described disease-free intervals of >8 months.

  3. The Development of an Experimental Structured Interview Protocol for Armed Forces Health Professions Scholarship Program Selection

    DTIC Science & Technology

    1991-08-01

    applicants who have been admitted to civilian medical schools or schools of osteopathy in return for a 3- to 4-year service obligation. Although physicians...followers Physical fitness/Life style Involvement in physical activities, absence of substance abuse Adaptability/Maturity Ability to handle stress and...improve? How do you generally react to stress ? Give an example. B-2 Describe one area in which you fell short of your expected goal, and why? Describe some

  4. Thalassemic osteopathy: a new marker of bone deposition.

    PubMed

    Baldini, M; Forti, S; Orsatti, A; Marcon, A; Ulivieri, F M; Airaghi, L; Zanaboni, L; Cappellini, M D

    2014-01-01

    Osteopathy represents a prominent cause of morbidity in patients with beta-thalassemia major (TM) and manifests as osteopenia/osteoporosis. Biochemical turnover markers (BTMs) are considered a useful, non-invasive tool for the clinical follow-up of osteoporotic patients; they can provide a dynamic view of the remodeling process and give information on the metabolic activity of bone tissue as well as on the pathogenesis of bone loss. The amino-terminal pro-peptide of type I procollagen (P1NP) is a recently introduced marker that is considered the most sensitive index of bone formation. Although demonstrated in several categories of patients with bone disease, there is little information on the clinical usefulness of this bone formation index in thalassemic patients. We evaluated the P1NP levels of 53 adult patients with b-thalassemia major (21 males and 32 females, mean age 34.5 ± 5.7, range 22-46 years) and associated osteopathy. We investigated the correlation between P1NP and bone condition as examined by dual X-ray photon absorptiometry and with BTMs expressing bone resorption and bone mineralization (carboxyterminal collagen cross-linked (CTX) terminal regions of type I collagen and osteocalcin, respectively). P1NP serum levels were correlated with CTX levels (r=0.545, p<0.001); the results were unchanged when males and females, as well as osteoporotic and osteopenic subgroups, were considered separately. No correlation was demonstrated neither between OC and CTX (r=0.17, p=ns), nor between P1NP and OC levels (r=0.11, p=ns). No correlation was demonstrated among the P1NP/CTX ratio and age, OC or densitometric values and no difference was found in the same ratio between osteopenic (0.19 ± 0.16) and osteoporotic (0.15 ± 0.14) patients. Similar results were obtained for the OC/CTX ratio, as it was not correlated with age, P1NP or densitometric values. This is the first report of circulating P1NP in patients with TM-associated osteoporosis. P1NP and CTX assays show good precision and low analytical CV, and, compared to other markers, they can acceptably reflect bone metabolic processes and promptly respond to antiosteoporotic treatments. We trust that this sensitive marker can be useful in the assessment of treatment efficacy and can overcome the pitfalls due to wide variability in the normal values of most BTMs that create difficulty in pinpointing the individual patient's response. © 2013.

  5. The efficacy of vitamin K2 and calcitriol combination on thalassemic osteopathy.

    PubMed

    Ozdemir, Mehmet A; Yilmaz, Kenan; Abdulrezzak, Ummuhan; Muhtaroglu, Sebahattin; Patiroglu, Turkan; Karakukcu, Musa; Unal, Ekrem

    2013-11-01

    Thalassemic osteopathy (TOSP) has emerged as a topic of interest, as the optimized transfusion regimens and iron chelations has markedly improved the survival of the patients suffering from thalassemia major (TM) and increased the life expectancy. The aim of this prospective monocentric pilot study was to investigate the effects of a dietary supplement with vitamin K2 (50 mcg menaquinone-7) and vitamin D (5 mcg calcitriol) on the patients with TOSP. Twenty children (12 girls, 8 boys; age varied from 3 to 18 y) with β TM, who underwent regular blood transfusion and iron chelation therapy, were enrolled in this study and investigated at the initial, sixth, and 12th month of the treatment. We detected a significant improvement in the bone mineral density and Z-score at the lumbar spine area of the patients at the sixth and 12th month of the treatment, especially in the prepubertal group. We also found a decrease in the ratio of undercarboxylated osteocalcin to carboxylated osteocalcin, however, this was not found to be significant. Although the natural course of TOSP is worsening or at least stabilizing, our pilot study demonstrated that vitamin K2 and calcitriol combination clearly has a positive effect on the bone mineral density of the children with TM during a 1-year period. Supplementation of menaquinone-7 instead of drugs is an augmented physiological intake and seems a beneficial alternative for the treatment of TOSP. Further studies on a large number of participants are necessary to highlight the effect of vitamin K2 on TOSP.

  6. Presentation and management of trapped neutrophil syndrome (TNS) in UK Border collies.

    PubMed

    Mason, S L; Jepson, R; Maltman, M; Batchelor, D J

    2014-01-01

    Three UK bred Border collie puppies were presented for investigation of pyrexia and severe lameness with associated joint swelling. Investigations revealed neutropenia, radiographic findings suggesting metaphyseal osteopathy, and polyarthritis and all dogs were subsequently confirmed with trapped neutrophil syndrome. Clinical improvement was seen after treatment with prednisolone and antibiotics and the dogs all survived to adulthood with a good short- to medium-term outcome. Trapped neutrophil syndrome is an important differential diagnosis for young Border collie dogs in the UK presenting with pyrexia, neutropenia and musculoskeletal signs. © 2013 British Small Animal Veterinary Association.

  7. A systematic review investigating the effectiveness of Complementary and Alternative Medicine (CAM) for the management of low back and/or pelvic pain (LBPP) in pregnancy.

    PubMed

    Close, Ciara; Sinclair, Marlene; Liddle, S Dianne; Madden, Elaine; McCullough, Julie E M; Hughes, Ciara

    2014-08-01

    To evaluate and summarize the current evidence on the effectiveness of complementary and alternative medicine for the management of low back pain and/or pelvic pain in pregnancy. International research demonstrates that 25-30% of women use complementary and alternative medicine to manage low back and pelvic pain in pregnancy without robust evidence demonstrating its effectiveness. A systematic review of randomized controlled trials to determine the effectiveness of complementary and alternative medicine for low back and/or pelvic pain in pregnancy. Cochrane library (1898-2013), PubMed (1996-2013), MEDLINE (1946-2013), AMED (1985-2013), Embase (1974-2013), Cinahl (1937-2013), Index to Thesis (1716-2013) and Ethos (1914-2013). Selected studies were written in English, randomized controlled trials, a group 1 or 2 therapy and reported pain reduction as an outcome measure. Study quality was reviewed using Risk of Bias and evidence strength the Cochrane Grading of Recommendations and Development Evaluation Tool. Eight studies were selected for full review. Two acupuncture studies with low risk of bias showed both clinically important changes and statistically significant results. There was evidence of effectiveness for osteopathy and chiropractic. However, osteopathy and chiropractic studies scored high for risk of bias. Strength of the evidence across studies was very low. There is limited evidence supporting the use of general CAM for managing pregnancy-related low back and/or pelvic pain. However, the restricted availability of high-quality studies, combined with the very low evidence strength, makes it impossible to make evidence-based recommendations for practice. © 2014 John Wiley & Sons Ltd.

  8. Iron as a possible aggravating factor for osteopathy in itai-itai disease, a disease associated with chronic cadmium intoxication

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Noda, M.; Yasuda, M.; Kitagawa, M.

    1991-03-01

    Itai-itai disease is thought to be the result of chronic cadmium (Cd) intoxication. We examined 23 autopsy cases of itai-itai disease and 18 cases of sudden death as controls. Urine and blood samples from 10 patients were collected before they died and revealed the presence of severe anemia and renal tubular injuries. Undecalcified sections of iliac bone were stained with Aluminon reagent, and ammonium salt of aurintricarboxylic acid, and Prussian blue reagent in all cases of itai-itai disease. These two reagents reacted at the same mineralization fronts. X-ray microanalysis revealed the presence of iron at mineralization fronts in itai-itai disease.more » Five patients showed evidence of hemosiderosis in the liver, spleen, and pancreas, probably as a result of post transfusion iron overload. Renal calculi and calcified aortic walls were also stained with Prussian blue reagent in several patients. Neither ferritin nor transferrin were visualized at mineralization fronts in itai-itai disease by immunohistochemical staining. These results suggest that iron is bound to calcium or to calcium phosphate by a physicochemical reaction. A marked osteomalacia was observed in 10 cases of itai-itai disease by histomorphometry. Regression analyses of data from cases of itai-itai disease suggested that an Aluminon-positive metal inhibited mineralization and that renal tubules were injured. Since bone Cd levels were increased in itai-itai disease, it is likely that renal tubules were injured by exposure to Cd. Therefore, stainable bone iron is another possible aggravating factor for osteopathy in itai-itai disease, and a synergistic effect between iron and Cd on mineralization is proposed.« less

  9. A Mokken scale analysis of the peer physical examination questionnaire.

    PubMed

    Vaughan, Brett; Grace, Sandra

    2018-01-01

    Peer physical examination (PPE) is a teaching and learning strategy utilised in most health profession education programs. Perceptions of participating in PPE have been described in the literature, focusing on areas of the body students are willing, or unwilling, to examine. A small number of questionnaires exist to evaluate these perceptions, however none have described the measurement properties that may allow them to be used longitudinally. The present study undertook a Mokken scale analysis of the Peer Physical Examination Questionnaire (PPEQ) to evaluate its dimensionality and structure when used with Australian osteopathy students. Students enrolled in Year 1 of the osteopathy programs at Victoria University (Melbourne, Australia) and Southern Cross University (Lismore, Australia) were invited to complete the PPEQ prior to their first practical skills examination class. R, an open-source statistics program, was used to generate the descriptive statistics and perform a Mokken scale analysis. Mokken scale analysis is a non-parametric item response theory approach that is used to cluster items measuring a latent construct. Initial analysis suggested the PPEQ did not form a single scale. Further analysis identified three subscales: 'comfort', 'concern', and 'professionalism and education'. The properties of each subscale suggested they were unidimensional with variable internal structures. The 'comfort' subscale was the strongest of the three identified. All subscales demonstrated acceptable reliability estimation statistics (McDonald's omega > 0.75) supporting the calculation of a sum score for each subscale. The subscales identified are consistent with the literature. The 'comfort' subscale may be useful to longitudinally evaluate student perceptions of PPE. Further research is required to evaluate changes with PPE and the utility of the questionnaire with other health profession education programs.

  10. Influence of perceived difficulty of cases on student osteopaths' diagnostic reasoning: a cross sectional study.

    PubMed

    Noyer, Aurelien L; Esteves, Jorge E; Thomson, Oliver P

    2017-01-01

    Diagnostic reasoning refers to the cognitive processes by which clinicians formulate diagnoses. Despite the implications for patient safety and professional identity, research on diagnostic reasoning in osteopathy remains largely theoretical. The aim of this study was to investigate the influence of perceived task difficulty on the diagnostic reasoning of students osteopaths. Using a single-blinded, cross sectional study design, sixteen final year pre-registration osteopathy students diagnosed two standardized cases under two context conditions (complex versus control). Context difficulty was manipulated via verbal manipulation and case order was randomized and counterbalanced across subjects to ensure that each case was diagnosed evenly under both conditions (i.e. half of the subjects performed either case A or B first). After diagnosis, participants were presented with items (literal, inferred and filler) designed to represent analytical and non-analytical reasoning. Response time and error rate for each item were measured. A repeated measures analysis of variance (concept type x context) was performed to identify differences across conditions and make inferences on diagnostic reasoning. Participants made significantly more errors when judging literal concepts and took significantly less time to recognize filler concepts in the complex context. No significant difference in ability to judge inferred concepts across contexts was found. Although speculative and preliminary, our findings suggest the perception of complexity led to an increased reliance on analytical reasoning at the detriment of non-analytical reasoning. To reduce the associated cognitive load, osteopathic educational institutions could consider developing the intuitive diagnostic capabilities of pre-registration students. Postgraduate mentorship opportunities could be considered to enhance the diagnostic reasoning of professional osteopaths, particularly recent graduates. Further research exploring the influence of expertise is required to enhance the validity of this study.

  11. Skin and skeletal system lesions of european pond turtles (Emys orbicularis) from natural habitats.

    PubMed

    Aleksić-Kovačević, Sanja; Ozvegy, József; Krstić, Nikola; Rusvai, Miklós; Jakab, Csaba; Stanimirović, Zoran; Becskei, Zsolt

    2014-06-01

    Water pollution is known to play an important role in the pathogenesis of plastron, carapace and skin diseases of turtles. In this study, a total of 150 European pond turtles (Emys orbicularis) of different age and both sexes, originating from natural habitats in Serbia, were examined for morphological changes of the skin, plastron, carapace and skeletal system. The turtles were taken out from their natural habitats in Lake Ludas, Lake Palic and Lake Tresetiste. After artificial hibernation, they were subjected to detailed examination, sampled and treated, and finally returned into their natural habitat. Biopsies from the skin and shell were subjected to histopathological examination and microbiological analysis. X-ray scanning was also performed to detect changes in the skeletal system. Macroscopic changes of the skin, most frequently degenerative, inflammatory or neoplastic diseases, were diagnosed in 49.33% of the turtles examined. Dermatitis of different origin and form was the most prominent histopathological finding (28.00%). In the plastron, inflammatory and degenerative processes were frequently found. Osteopathy and mechanical injuries were the dominant findings. Macroscopic changes of the plastron, carapace and skeletal system were diagnosed in 67.33% of the turtles examined. Using X-ray scanning, generalised osteopathy, anomalies and malformations of different aetiology were also diagnosed on the tail and legs. Microbiological examinations showed the presence of a variety of bacterial and fungal agents, either primary pathogens or potential polluters, which invaded the skin and shell, or were present in cloacal swab samples. Bacterial infection was diagnosed in 76.66% of the turtles, first of all in those with skin and shell necrosis. Mycoses were diagnosed in 33.33% of the animals.

  12. [Intestinal absorption of Ca47 in chronic renal insufficiency before and after treatment with 1,25 dihydroxycholecalciferol].

    PubMed

    Vattimo, A

    1979-12-01

    The effects of vitamin D3 follow its metabolisation in the liver and then in the kidney. Its most active metabolite is 1,25 (OH)2D3, produced by the liver precursor 25(OH)D3. In chronic renal insufficiency, demineralising osteopathy can be corrected by administering 1,25 (OH)2D3 to make up for its under-production by the kidneys. An assessment if is made of 47Ca intestinal transport in patients with chronic renal insufficiency before and after such treatment. It was found that the effects of the metabolite on calcium transport were dose-dependent.

  13. Metabolic bone diseases during long-term total parenteral nutrition.

    PubMed

    Acca, M; Ragno, A; Francucci, C M; D'Erasmo, E

    2007-01-01

    Long-term total parenteral nutrition (TPN) is a procedure commonly applied to patients with advanced forms of intestinal malabsorption. Among TPN complications, bone metabolic diseases, such as osteoporosis and osteomalacia, are a common finding. Initially considered to be a manifestation of aluminium toxicity which followed massive contamination with the element of the solutions used in TPN, metabolic osteopathy during TPN is currently considered a multiform syndrome, with a multifactorial pathogenesis, which may manifest itself with vague or clear clinical pictures. In this review, we analyse clinical, pathogenetic, and therapeutic aspects of the most common bone metabolic diseases in patients undergoing long-term TPN.

  14. Professional and spatial mobility of osteopathic physicians.

    PubMed

    Hassinger, E W; Gill, L S; Hobbs, D J; Hageman, R L

    1979-12-01

    The study examines changes in location of osteopathic and medical doctors in a 20-county area of rural Missouri over a 14-year period. Losses of osteopathic physicians were greater than medical doctors. However, there was a convergence over the 14-year period in background characteristics of the two types of physicians. The finding of greater spatial mobility of DOs is placed in the context of professional mobility of osteopathy. It is also argued that as practice opportunities for DOs increase, background factors associated with early socialization become more influential in choice of practice sites. The relationship of practice opportunities to choice of practice sites can be extended to foreign medical school graduates and "new health practitioners."

  15. Use of the term subluxation in publications during the formative years of the chiropractic profession

    PubMed Central

    Johnson, Claire

    2011-01-01

    The term subluxation has come to have different meanings for different health care professions in the United States for over the past century. This controversy has resulted in some contention both internal and external to the chiropractic profession. Some current factions within the chiropractic profession hold the term subluxation to be synonymous with the identity of chiropractic itself; however, this term was not solely used by chiropractic during its formative years. The purpose of this article is to look at uses of the term by various professions (osteopathy, medicine, and chiropractic) at the turn of the century, a time in which the chiropractic profession was developing. PMID:22693477

  16. Neuroimaging findings of extensive sphenoethmoidal dysplasia in NF1.

    PubMed

    Tam, Allison; Sliepka, Joseph M; Bellur, Sunil; Bray, Collin Douglas; Lincoln, Christie M; Nagamani, Sandesh C S

    2018-05-16

    Whereas isolated sphenoid wing dysplasia (SWD) is a well-known clinical feature in neurofibromatosis 1 (NF1), extensive cranial defects involving multiple bones have been rarely reported in this disorder. In this report, we describe the clinical course of a 20-year-old male with NF1 and an extensive cranial bone dysplasia. The large sphenoethmoidal defect was associated with transethmoidal and orbital cephalocele as well as inferolateral herniation of the frontal lobe. In spite of the large defect, the individual did not have any symptoms or complications resulting from the osteopathy. We review the current knowledge of the pathogenesis and management of cranial bone dysplasia in NF1. Copyright © 2018 Elsevier Inc. All rights reserved.

  17. Manual Therapy in the Treatment of Idiopathic Scoliosis. Analysis of Current Knowledge.

    PubMed

    Czaprowski, Dariusz

    2016-10-28

    Apart from the recommended specific physiotherapy, the treatment of idiopathic scoliosis (IS) also incorporates non-specific manual therapy (NMT). The aim of this paper is to assess the efficacy of NMT (manual therapy, chiropractic, osteopathy) used in the treatment of children and adolescents with IS. The study analysed systematic reviews (Analysis 1) and other recent scientific publications (Analysis 2). Analysis 1 encompassed papers on the use of NMT in patients with IS. Works concerning specific physiotherapy (SP) or bracing (B) and other types of scoliosis were excluded from the analysis. Inclusion criteria for Analysis 2 were: treatment with NMT; subjects aged 10-18 years with IS. The following types of papers were excluded: works analysing NMT combined with SP or B, reports concerning adult pa tients, analyses of single cases and publications included in Analysis 1. Analysis 1: six systematic reviews contained 6 papers on the efficacy of NMT in the treatment of IS. The results of these studies are contradictory, ranging from Cobb angle reduction to no treatment effects whatsoever. The papers analysed are characterised by poor methodological quality: small group sizes, incomplete descriptions of the study groups, no follow-up and no control groups. Analysis 2: in total, 217 papers were found. None of them met the criteria set for the analysis. 1. Few papers verifying the efficacy of manual therapy, chiropractic and osteopathy in the treatment of idiopathic scoliosis have been published to date. 2. The majority are experimental studies with poor methodology or observational case studies. 3. At present, the efficacy of non-specific manual therapy in the treatment of patients with idiopathic scoliosis cannot be reliably evaluated. 4. It is necessary to conduct further research based on appropriate methods (prospective, rando mi s ed, controlled studies) in order to reliably assess the usefulness of non-specific manual therapy in the treatment of idiopathic scoliosis.

  18. A History of Manipulative Therapy

    PubMed Central

    Pettman, Erland

    2007-01-01

    Manipulative therapy has known a parallel development throughout many parts of the world. The earliest historical reference to the practice of manipulative therapy in Europe dates back to 400 BCE. Over the centuries, manipulative interventions have fallen in and out of favor with the medical profession. Manipulative therapy also was initially the mainstay of the two leading alternative health care systems, osteopathy and chiropractic, both founded in the latter part of the 19th century in response to shortcomings in allopathic medicine. With medical and osteopathic physicians initially instrumental in introducing manipulative therapy to the profession of physical therapy, physical therapists have since then provided strong contributions to the field, thereby solidifying the profession's claim to have manipulative therapy within in its legally regulated scope of practice. PMID:19066664

  19. [Positional plagiocephaly in infancy: diagnosis and management].

    PubMed

    Gautschi, Oliver P; Rilliet, Benedict; Schaller, Karl; Jenny, Benoît

    2013-12-11

    Positional plagiocephaly in the newborn corresponds to a posterior flattening and asymetry of the head. Its incidence has significantly increased since the "back to sleep" campain in the nineteen nineties to prevent sudden infant death syndrome. The posterior deformation usually worsens during the first six months of life when the skull is susceptible to posterior constant pressure which induces the deformation. Spontaneous outcome can be favorable. Treatment is always conservative and consists in positionnal exercise, physiotherapy and osteopathy. In some cases treatment with a helmet is recommended for a period of three months usually. Posterior positionnal plagiocephaly has no consequences on the brain's developement an is considered as an esthetic issue. In most cases good results are obtained after management with a custom fitted helmet when needed.

  20. Early Intervention and Nonpharmacological Therapy of Myopia in Young Adults

    PubMed Central

    Gładysiak, Aleksandra; Ślęzak, Daniel

    2018-01-01

    Myopia is a condition of the eye where parallel rays focus in front of, instead of on, the retina, which results in excessive refractive power of the cornea or the lens or eyeball elongation. Studies carried out in recent years show that the etiology of myopia is complex with genetic and environmental factors playing a role. Refraction defects decrease the quality of vision, while progressing myopia can lead to partial loss of vision, which can be particularly dramatic in young adults. Therefore, it is so crucial to take appropriate actions aimed at preventing myopia progression. This is a review of nonpharmacological therapeutic possibilities of refraction defect prevention in young adults, with special regard to myofascial therapy, osteopathy, and massage of acupuncture points surrounding the eye. PMID:29576878

  1. [Classification of prosthetic loosening and determination of wear particles].

    PubMed

    Otto, M

    2008-11-01

    Nowaday, loosening of orthopaedic implants implies important medical and socioeconomic problems. Implant loosening is caused by implant infections as well as aseptic loosening, due to particle disease and mechanical alterations. Clinically we divide the implant infection into early and late infections. Morphologically it is possible to reliably detect the infection by quantification of neutrophil granulocytes. Additionally molecular methods are suitable to detect micro-organisms which are responsible for the prosthetic joint infection including their resistance to antibiotics. Particle disease may be reproducibly classified by the detection of different types of wear particles, particularly polyethylene, metal, ceramic and cement. The aetiology of the indeterminate type of the periprosthetic membrane is obscure, but may be associated with osteopathies. This classification of the periprosthetic membrane morphology provides clinically significant information concerning clinical management of implant loosening.

  2. The transformation of osteopathic medical education.

    PubMed

    Gevitz, Norman

    2009-06-01

    Osteopathic medical schools and hospital-based postgraduate programs have long constituted small but important sources of physicians and surgeons, particularly for traditionally underserved areas of the United States. Though frequently marginalized in or even left out of standard histories and studies of U.S. medical education, these institutions have become much more difficult to ignore, given the rapid expansion of the number of osteopathic medical students in new and existing colleges and the size of their classes. By 2019, upwards of 25% of all U.S. medical school graduates produced annually will be doctors of osteopathic medicine. The author examines the process through which osteopathy was transformed into osteopathic medicine, how osteopathic medical schools achieved their present status as a significant source of U.S. graduates for residency training, and what challenges osteopathic medical education now faces.

  3. The paradox of sham therapy and placebo effect in osteopathy

    PubMed Central

    Cerritelli, Francesco; Verzella, Marco; Cicchitti, Luca; D’Alessandro, Giandomenico; Vanacore, Nicola

    2016-01-01

    Abstract Background: Placebo, defined as “false treatment,” is a common gold-standard method to assess the validity of a therapy both in pharmacological trials and manual medicine research where placebo is also referred to as “sham therapy.” In the medical literature, guidelines have been proposed on how to conduct robust placebo-controlled trials, but mainly in a drug-based scenario. In contrast, there are not precise guidelines on how to conduct a placebo-controlled in manual medicine trials (particularly osteopathy). The aim of the present systematic review was to report how and what type of sham methods, dosage, operator characteristics, and patient types were used in osteopathic clinical trials and, eventually, assess sham clinical effectiveness. Methods: A systematic Cochrane-based review was conducted by analyzing the osteopathic trials that used both manual and nonmanual placebo control. Searches were conducted on 8 databases from journal inception to December 2015 using a pragmatic literature search approach. Two independent reviewers conducted the study selection and data extraction for each study. The risk of bias was evaluated according to the Cochrane methods. Results: A total of 64 studies were eligible for analysis collecting a total of 5024 participants. More than half (43 studies) used a manual placebo; 9 studies used a nonmanual placebo; and 12 studies used both manual and nonmanual placebo. Data showed lack of reporting sham therapy information across studies. Risk of bias analysis demonstrated a high risk of bias for allocation, blinding of personnel and participants, selective, and other bias. To explore the clinical effects of sham therapies used, a quantitative analysis was planned. However, due to the high heterogeneity of sham approaches used no further analyses were performed. Conclusion: High heterogeneity regarding placebo used between studies, lack of reporting information on placebo methods and within-study variability between sham and real treatment procedures suggest prudence in reading and interpreting study findings in manual osteopathic randomized controlled trials (RCTs). Efforts must be made to promote guidelines to design the most reliable placebo for manual RCTs as a means of increasing the internal validity and improve external validity of findings. PMID:27583913

  4. The paradox of sham therapy and placebo effect in osteopathy: A systematic review.

    PubMed

    Cerritelli, Francesco; Verzella, Marco; Cicchitti, Luca; D'Alessandro, Giandomenico; Vanacore, Nicola

    2016-08-01

    Placebo, defined as "false treatment," is a common gold-standard method to assess the validity of a therapy both in pharmacological trials and manual medicine research where placebo is also referred to as "sham therapy." In the medical literature, guidelines have been proposed on how to conduct robust placebo-controlled trials, but mainly in a drug-based scenario. In contrast, there are not precise guidelines on how to conduct a placebo-controlled in manual medicine trials (particularly osteopathy). The aim of the present systematic review was to report how and what type of sham methods, dosage, operator characteristics, and patient types were used in osteopathic clinical trials and, eventually, assess sham clinical effectiveness. A systematic Cochrane-based review was conducted by analyzing the osteopathic trials that used both manual and nonmanual placebo control. Searches were conducted on 8 databases from journal inception to December 2015 using a pragmatic literature search approach. Two independent reviewers conducted the study selection and data extraction for each study. The risk of bias was evaluated according to the Cochrane methods. A total of 64 studies were eligible for analysis collecting a total of 5024 participants. More than half (43 studies) used a manual placebo; 9 studies used a nonmanual placebo; and 12 studies used both manual and nonmanual placebo. Data showed lack of reporting sham therapy information across studies. Risk of bias analysis demonstrated a high risk of bias for allocation, blinding of personnel and participants, selective, and other bias. To explore the clinical effects of sham therapies used, a quantitative analysis was planned. However, due to the high heterogeneity of sham approaches used no further analyses were performed. High heterogeneity regarding placebo used between studies, lack of reporting information on placebo methods and within-study variability between sham and real treatment procedures suggest prudence in reading and interpreting study findings in manual osteopathic randomized controlled trials (RCTs). Efforts must be made to promote guidelines to design the most reliable placebo for manual RCTs as a means of increasing the internal validity and improve external validity of findings.

  5. A Mokken analysis of the literacy in musculoskeletal problems questionnaire.

    PubMed

    Vaughan, Brett; Mulcahy, Jane; Coffey, Amy; Addinsall, Laura; Ryan, Stephanie; Fitzgerald, Kylie

    2017-12-21

    Limited health literacy is known to impact on medication adherence, hospital readmission and potentially poorer health outcomes. The literature on the health literacy of those with musculoskeletal conditions suggests greater functional limitations and increased pain levels. There are a number of measures of health literacy. One that specifically relates to musculoskeletal complaints is the Literacy in Musculoskeletal Problems (LiMP) questionnaire. The LiMP contains 9 multiple choice items that cover anatomy, musculoskeletal conditions and the diagnosis of musculoskeletal complaints. The aim of the study was to evaluate the dimensionality and internal structure of the LiMP in patients attending for osteopathy care at a student-led clinic, as a potential measure of musculoskeletal health literacy. Three hundred and sixty-one (n = 361) new patients attending the Victoria University Osteopathy Clinic completed the LiMP and a demographic and health information questionnaire prior to their initial consultation. Mokken scale analysis, a nonparametric item response theory approach, was used to evaluate the dimensionality and structure of the LiMP in this population, to ascertain whether the questionnaire was measuring a single latent construct - musculoskeletal health literacy. McDonald's omega and Cronbach's alpha were calculated as the reliability estimations. The relationship between the LiMP and a single item screen of health literacy was also undertaken. The 9 items on the LiMP did not form a Mokken scale and the reliability estimations were below an acceptable level (alpha and omega <0.45). LiMP items 5 and 8 were more likely to be answered correctly by those with higher health literacy (p < 0.05), however the effect sizes were small (<0.20). Calculation of a total score for the LiMP, as advocated by the original authors, is not supported based on data in the present study. Further research is required to explore the relationship of the LiMP items to demographic and clinical data, and to other broader measures of health literacy. Further research may also develop a health literacy measure that is specific to patients seeking manual therapy care for musculoskeletal complaints.

  6. Factors circulating in the blood of type 2 diabetes mellitus patients affect osteoblast maturation – Description of a novel in vitro model

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Ehnert, Sabrina, E-mail: sabrina.ehnert@gmail.com; Freude, Thomas, E-mail: tfreude@bgu-tuebingen.de; Ihle, Christoph, E-mail: cihle@bgu-tuebingen.de

    Type 2 diabetes mellitus (T2DM) is one of the most frequent metabolic disorders in industrialized countries. Among other complications, T2DM patients have an increased fracture risk and delayed fracture healing. We have demonstrated that supraphysiological glucose and insulin levels inhibit primary human osteoblasts' maturation. We aimed at developing a more physiologically relevant in vitro model to analyze T2DM-mediated osteoblast changes. Therefore, SCP-1-immortalized pre-osteoblasts were differentiated with T2DM or control (non-obese and obese) sera. Between both control groups, no significant changes were observed. Proliferation was significantly increased (1.69-fold), while AP activity and matrix mineralization was significantly reduced in the T2DM group.more » Expression levels of osteogenic marker genes and transcription factors were altered, e.g. down-regulation of RUNX2 and SP-7 or up-regulation of STAT1, in the T2DM group. Active TGF-β levels were significantly increased (1.46-fold) in T2DM patients' sera. SCP-1 cells treated with these sera showed significantly increased TGF-β signaling (2.47-fold). Signaling inhibition effectively restored osteoblast maturation in the T2DM group. Summarizing our data, SCP-1 cells differentiated in the presence of T2DM patients' serum exhibit reduced osteoblast function. Thus, this model has a high physiological impact, as it can identify circulating factors in T2DM patients' blood that may affect bone function, e.g. TGF-β. - Highlights: • We present here a physiologically relevant in vitro model for diabetic osteopathy. • Blood of T2DM patients contains factors that affect osteoblasts' function. • The model developed here can be used to identify these factors, e.g. TGF-β. • Blocking TGF-β signaling partly rescues the osteoblasts' function in the T2DM group. • The model is useful to demonstrate the role of single factors in diabetic osteopathy.« less

  7. A multidisciplinary approach to scars: a narrative review

    PubMed Central

    Zanier, Emiliano; Bordoni, Bruno

    2015-01-01

    The purpose of this article is to carry out a narrative review regarding the approach to scars through complementary and alternative medicine focusing on osteopathy, naturopathy, and other minor methods and traditional rehabilitative medicines, such as physiotherapy and manual therapies. We analyzed the existing literature regarding the possible influences of techniques relaxing the diaphragm – both manual and psychophysical relaxing techniques – and the consequent local response to events leading to scar tissue healing. The objective of the study is to become a useful instrument of knowledge for those manual therapists and professionals who deal with patients affected by discontinuity of the skin surface due to trauma or surgery. This article also intends to stimulate research in order to find and propose new methods of scar treatment, taking into consideration the information gained so far from other complementary and alternative disciplines. PMID:26316774

  8. Osteopathic manipulative treatment of a 26-year-old woman with Bell's palsy.

    PubMed

    Lancaster, David G; Crow, William Thomas

    2006-05-01

    Bell's palsy is caused by a lesion of the facial nerve and results in unilateral paralysis or paresis of the face. The condition affects approximately 23 in 100,000 persons, with onset typically occurring between the ages of 10 and 40 years. The authors report the case of a 26-year-old woman with Bell's palsy, whom they treated with osteopathic manipulative treatment that was focused on the enhancement of lymphatic circulation. The osteopathic manipulative procedures used involved reducing restrictions around four key diaphragms (thoracic outlet, respiratory diaphragm, suboccipital diaphragm, cerebellar tentorium), as well as applying the thoracic pump, muscle energy, primary respiratory mechanism, and osteopathy in the cranial field. The authors, who were guided by the four principles of osteopathic philosophy, report that the patient's symptoms resolved within 2 weeks, during which two sessions of osteopathic manipulative treatment, each lasting approximately 20 minutes, were held. Patient recovery occurred without the use of pharmaceuticals.

  9. THE JOURNAL OF THE CHIROPRACTIC & OSTEOPATHIC COLLEGE OF AUSTRALASIA

    PubMed Central

    Walker, Bruce F.

    1998-01-01

    The first edition of the Journal of the Chiropractic and Osteopathic College of Australasia was known as COMSIG Review and was published in November, 1992 to coincide with a large conference that COCA had organised in Melbourne. In the first few years the majority of articles were magazine style reviews, similar to these found in the Australian Family Physician. The first Editor was Bruce Walker and subsequent Editors have included John Drinkwater, Stephanie Campbell and John Reggars. The current Editors in Chief, Peter Tuchin and Henry Pollard, are staff members at Macquarie University, Centre of Chiropractic, with a strong background in science and research and both are currently undertaking post-graduate research degrees. Over several years the magazine review style was changed in keeping with a more full journal format. An Editorial Board was formed, comprised of chiropractors, osteopaths and medical practitioners, some of whom are world renowned in their particular field of research. By March, 1996 it was decided to change the name of the journal to Australasian Chiropractic and Osteopathy (ACO). This was a purposeful move to reflect the maturing of the journal and also the growth of the College and in the five years since November 1992, seventy-nine scientific articles have been published. It is anticipated that the journal will continue to be widely distributed throughout the world, with current subscriptions from all Australian undergraduate chiropractic and osteopathic institutions and the vast majority of international undergraduate institutions. ACO is currently indexed with Mantis (formerly Chirolars). The Editorial Panel continue to strive for Australasian Chiropractic and Osteopathy inclusion into Index Medicus and thereby Medline. However, it is recognised that readership of chiropractic journals is very low throughout the world and it is unlikely in the near future that any chiropractic journal other than the Journal of Manipulative and Physiological Therapeutics will be included in Index Medicus. The lack of mainstream international indexing will not stop or prevent the College from producing a first rate journal into the future years of the professions. In fact with the now steady growth in Australian chiropractic and osteopathic research, it is envisaged that ACO will be Australia's leading professional journal. We trust our membership enjoy reading the journal and find many of its articles instructional. We look forward to any comments from members relating to the production of the journal and any suggestions will be welcomed. PMID:17989763

  10. What is the impact of immunosuppressive treatment on the post-transplant renal osteopathy?

    PubMed

    Blaslov, Kristina; Katalinic, Lea; Kes, Petar; Spasovski, Goce; Smalcelj, Ruzica; Basic-Jukic, Nikolina

    2014-05-01

    Although glucocorticoid therapy is considered to be the main pathogenic factor, a consistent body of evidence suggests that other immunosuppressants might also play an important role in the development of the post-transplant renal osteopathy (PRO) through their pleiotropic pharmacological effects. Glucocorticoids seem to induce osteoclasts' activity suppressing the osteoblasts while data regarding other immunosuppressive drugs are still controversial. Mycophenolate mofetil and azathioprine appear to be neutral regarding the bone metabolism. However, the study analyzing any independent effect of antimetabolites on bone turnover has not been conducted yet. Calcineurin inhibitors (CNIs) induce trabecular bone loss in rodent, with contradictory results in renal transplant recipients. Suppression of vitamin D receptor is probably the underlying mechanism of renal calcium wasting in renal transplant recipients receiving CNI. In spite of an increased 1,25(OH)2 vitamin D level, the kidney is not able to reserve calcium, suggesting a role of vitamin D resistance that may be related to bone loss. More efforts should be invested to determine the role of CNI in PRO. In particular, data regarding the role of mammalian target of rapamycin inhibitors (mTORi), such as sirolimus and everolimus, in the PRO development are still controversial. Rapamycin markedly decreases bone longitudinal growth as well as callus formation in experimental models, but also lowers the rate of bone resorption markers and glomerular filtration in clinical studies. Everolimus potently inhibits primary mouse and human osteoclast activity as well as the osteoclast differentiation. It also prevents the ovariectomy-induced loss of cancellous bone by 60 %, an effect predominantly associated with a decreased osteoclast-mediated bone resorption, resulting in a partial preservation of the cancellous bone. At present, there is no clinical study analyzing the effect of everolimus on bone turnover in renal transplant recipients or comparing sirolimus versus everolimus impact on bone, so only general conclusions could be drawn. Hence, the use of mTORi might be useful in patients with PRO due to their possible potential to inhibit osteoclast activity which might lead to a decreased rate of bone resorption. In addition, it should be also emphasized that they might inhibit osteoblast activity which may lead to a decreased bone formation and adynamic bone disease. Further studies are urgently needed to solve these important clinical dilemmas.

  11. Pulsed electromagnetic fields preserve bone architecture and mechanical properties and stimulate porous implant osseointegration by promoting bone anabolism in type 1 diabetic rabbits.

    PubMed

    Cai, J; Li, W; Sun, T; Li, X; Luo, E; Jing, D

    2018-05-01

    The effects of exogenous pulsed electromagnetic field (PEMF) stimulation on T1DM-associated osteopathy were investigated in alloxan-treated rabbits. We found that PEMF improved bone architecture, mechanical properties, and porous titanium (pTi) osseointegration by promoting bone anabolism through a canonical Wnt/β-catenin signaling-associated mechanism, and revealed the clinical potential of PEMF stimulation for the treatment of T1DM-associated bone complications. Type 1 diabetes mellitus (T1DM) is associated with deteriorated bone architecture and impaired osseous healing potential; nonetheless, effective methods for resisting T1DM-associated osteopenia/osteoporosis and promoting bone defect/fracture healing are still lacking. PEMF, as a safe and noninvasive method, have proven to be effective for promoting osteogenesis, whereas the potential effects of PEMF on T1DM osteopathy remain poorly understood. We herein investigated the effects of PEMF stimulation on bone architecture, mechanical properties, bone turnover, and its potential molecular mechanisms in alloxan-treated diabetic rabbits. We also developed novel nontoxic Ti2448 pTi implants with closer elastic modulus with natural bone and investigated the impacts of PEMF on pTi osseointegration for T1DM bone-defect repair. The deteriorations of cancellous and cortical bone architecture and tissue-level mechanical strength were attenuated by 8-week PEMF stimulation. PEMF also promoted osseointegration and stimulated more adequate bone ingrowths into the pore spaces of pTi in T1DM long-bone defects. Moreover, T1DM-associated reduction of bone formation was significantly attenuated by PEMF, whereas PEMF exerted no impacts on bone resorption. We also found PEMF-induced activation of osteoblastogenesis-related Wnt/β-catenin signaling in T1DM skeletons, but PEMF did not alter osteoclastogenesis-associated RANKL/RANK signaling gene expression. We reveal that PEMF improved bone architecture, mechanical properties, and pTi osseointegration by promoting bone anabolism through a canonical Wnt/β-catenin signaling-associated mechanism. This study enriches our basic knowledge for understanding skeletal sensitivity in response to external electromagnetic signals, and also opens new treatment alternatives for T1DM-associated osteopenia/osteoporosis and osseous defects in an easy and highly efficient manner.

  12. Prevalence and characteristics of women who consult with osteopathic practitioners during pregnancy; a report from the Australian Longitudinal Study on Women's Health (ALSWH).

    PubMed

    Frawley, Jane; Sundberg, Tobias; Steel, Amie; Sibbritt, David; Broom, Alex; Adams, Jon

    2016-01-01

    The use of complementary medicine (CM) is common during pregnancy with visits to osteopathic practitioners growing in recent years. This study was conducted to investigate the prevalence and characteristics of women who consult osteopathic practitioners during pregnancy. The study sample was obtained via the Australian Longitudinal Study on Women's Health (ALSWH). The women answered questions about consultations with osteopathic practitioners, pregnancy-related health concerns and attitudes to CM use. A total response rate of 79.2% (1835) was obtained. Of these, 104 women (6.1%) consulted with an osteopath during pregnancy for a pregnancy-related health condition. Women were more likely to consult an osteopath if they suffered from back pain, sadness, weight management issues, or had a history of retained placenta. Women are visiting osteopaths for help with common pregnancy health complaints, highlighting the need for research to evaluate the safety, clinical and cost effectiveness of osteopathy in pregnancy. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. Thalassaemic osteopathy: a cross-sectional preliminary study from Sri Lanka.

    PubMed

    Dissanayake, Ruwangi; de Silva, Shamya; Lekamwasam, Sarath; Abeysekara, Gayan; Dissanayake, Vajira H W

    2014-03-01

    The objectives of this study were to demonstrate the presence of low bone mineral density (BMD) and to examine the association of known risk factors for low BMD in patients with beta thalassaemia major in Sri Lanka. Thirty-eight patients were studied. Their examination and laboratory investigation findings were recorded (haematology, biochemistry, hormonal profile, COL1A1 rs1800012G>T genotype, dual energy X-ray absorptiometry (DXA) scanning). Mean age was 10.95 years (range 5-21.4). 20 (52.6%) were male. BMD was low (z score ≤-2.0) in 12 (31.5%). Regression analysis of BMD on known risk factors (age, sex, pubertal stage, ferritin level, average pre-transfusion haemoglobin, serum calcium level and COL1A1 rs1800012G>T genotype) controlling for confounding factors on each comparison, showed that only age was significantly associated with low BMD (p=0.005). Approximately one-third of patients had a low BMD. Only age was significantly associated with a low BMD.

  14. [History of conservative spinal therapy].

    PubMed

    Kladny, B

    2015-12-01

    Hippocrates was the first to intensively describe and document the principles for the treatment of injuries and diseases of the spine. His principles for abrupt treatment of the "hunchback" were followed by physicians even up to the end of the nineteenth century. The non-operative treatment of scoliosis was improved in the beginning of the sixteenth century by the introduction of mechanical devices that started the development of corsets which are still in use in modern scoliosis treatment. Stretching beds were only in temporary use. With the beginning of the nineteenth century gymnastics and physiotherapy became more and more important. Manual therapy was exercised by physicians until the late Middle Ages. After a long period of time in which bonesetters and other laymen performed manual therapy it was professionalized at the end of the nineteenth century again by the introduction of osteopathy and chiropractic. In Germany the development and introduction of manual treatment started relatively late in the twentieth century, predominantly as manual medicine.

  15. Effects of intermittent traction therapy in an experimental spinal column model.

    PubMed

    Shin, Jeong-Hun; Jun, Seung-lyul; Lee, Young-Jun; Kim, Jae-Hyo; Hwang, Sung-Yeoun; Ahn, Seong-Hun

    2014-04-01

    Traction therapy, which is known to be a treatment method for scoliosis, one of many muscles disease, has been used since Hippocrates introduced it. However, the effects of traction therapy are still not clear. In addition, the meridian sinew theory, which is related to muscle treatment and is mentioned in the book on meridian sinews in the Miraculous Pivot of Huangdi's Internal Classic, has not been the subject of much study. For these reasons, experimental spinal models were made for this study to observe and analyze the lengths of vertebral interspaces after intermittent traction therapy, which is known to be excellent among muscle treatment methods, with various tensile forces. The results showed that the effects of intermittent traction therapy were unclear and that it might be harmful, especially when the pain was induced by muscle weakness. Because the results of this study on intermittent traction therapy were different from those expected from osteopathy or craniosacral theory, better studies of the subject are necessary. Copyright © 2014. Published by Elsevier B.V.

  16. [Diagnosis and treatment of temporo-mandibular disorders in orthodontics].

    PubMed

    Bocquet, Emmanuelle; Moreau, Alexis; Danguy, Michel; Danguy, Chantal

    2010-03-01

    Orthodontists are fully prepared to treat the problems of occlusion that they are called upon to deal with every day. On the other hand temporo-mandibular joint disorders present more obscure difficulties from the point of view of detection and diagnosis as well the management of their treatment. That is why a profound understanding of the anatomical and physiological functioning of the temporo-mandibular joint has become indispensable for today's orthodontists who are now asked to detect and diagnose an assortment of TMJ disturbances whose etiology may vary greatly. By performing a rigorous diagnostic procedure, based on a thorough clinical examination supported by careful axiographic and radiological studies, of temporo-mandibular malfunctioning and its underlying etiological causes, which are primarily dento-alveolar and occlusal in nature, orthodontists will be able to adopt an appropriate therapeutic approach that might be purely orthodontic or multi-disciplinary and carried out with the collaboration of specialists in occlusion, oral surgery, and even osteopathy. EDP Sciences, SFODF, 2010.

  17. Self-management and psychological-sexological interventions in patients with endometriosis: strategies, outcomes, and integration into clinical care

    PubMed Central

    Buggio, Laura; Barbara, Giussy; Facchin, Federica; Frattaruolo, Maria Pina; Aimi, Giorgio; Berlanda, Nicola

    2017-01-01

    Endometriosis has a multifactorial etiology. The onset and progression of the disease are believed to be related to different pathogenic mechanisms. Among them, the environment and lifestyle may play significant roles. Diet, dietary supplements, physical exercise, osteopathy, massage, acupuncture, transcutaneous electrical nerve stimulation, and Chinese herbal medicine may represent a complementary and feasible approach in the treatment of symptoms related to the disease. In this narrative review, we aimed to examine the most updated evidence on these alternative approaches implicated in the self-management of the disease. In addition, several studies have demonstrated that endometriosis may negatively impact mental health and quality of life, suggesting that affected women may have an increased risk of developing psychological suffering as well as sexual problems due to the presence of pain. In light of these findings, we discuss the importance of integrating psychological interventions (including psychotherapy) and sexual therapy in endometriosis treatment. PMID:28496368

  18. Increased levels of Dickkopf-1 are indicative of Wnt/β-catenin downregulation and lower osteoblast signaling in children and adolescents with type 1 diabetes mellitus, contributing to lower bone mineral density.

    PubMed

    Tsentidis, C; Gourgiotis, D; Kossiva, L; Marmarinos, A; Doulgeraki, A; Karavanaki, K

    2017-03-01

    Higher levels of Dickkopf-1, which is an inhibitor of Wnt/β-catenin bone metabolic pathway, could be indicative of downregulated Wnt system, with possible lower osteoblast activation and higher osteoclast signaling in type 1 diabetes mellitus children and adolescents. Dickkopf-1 could significantly contribute to diabetes osteopathy. Increased fracture risk and elevated Dickkopf-1 levels, which is an inhibitor of Wnt/β-catenin bone metabolic pathway, have been documented in adult patients with type 2 diabetes mellitus (T2D), while no relevant data exist on childhood type 1 diabetes (T1D). Our aim was to study plasma Dickkopf-1 distribution in children and adolescents with T1D and to correlate Dickkopf-1 with metabolic bone markers and bone mineral density (BMD). We evaluated 40 children and adolescents with T1D (mean ± SD age 13.04 ± 3.53 years, T1D duration 5.15 ± 3.33 years) and 40 healthy age-matched and gender-matched controls (age 12.99 ± 3.3 years). Dickkopf-1 and bone metabolic markers were measured, while total body and lumbar spine BMD were evaluated with dual-energy X-ray absorptiometry (DXA). Dickkopf-1 demonstrated a Gaussian distribution, with higher levels in T1D patients (13.56 ± 5.34 vs 11.35 ± 3.76 pmol/L, p = 0.024). Higher values were found in boys and in prepubertal children. Dickkopf-1 correlated positively with osteoprotegerin and fasting glucose in patients, while positive correlation with sclerostin and total soluble receptor activator of nuclear factor-kappaB ligand (s-RANKL) was found in controls. Positive correlations with C-telopeptide cross-links (CTX), osteocalcin, alkaline phosphatase, phosphate, and insulin-like growth factor 1 (IGF1) were documented in both groups. Lumbar spine Z-score was positively associated with Dickkopf-1 in controls, while a negative trend was found in patients. Higher levels of Dickkopf-1 could indicate a downregulated Wnt/β-catenin system with possible lower osteoblast activation and higher osteoclast signaling in T1D children and adolescents. Dickkopf-1 could possibly be a significant contributor of T1D osteopathy. Future therapies could focus on Wnt/β-catenin metabolic pathway.

  19. What about OMT and nutrition for managing the irritable bowel syndrome? An overview and treatment plan.

    PubMed

    Collebrusco, Luca; Lombardini, Rita

    2014-01-01

    A chronic continuous or intermittent gastrointestinal tract dysfunction, the irritable bowel syndrome (IBS), appears to be due to dysregulation of brain-gut-microbiota communication. Furthermore, the "microbiota" greatly impacts the bi-directional brain-gut axis communication. This article describes IBS in relation to similar diseases, presents the background to osteopathy, and proposes osteopathic manipulative treatment (OMT) to manage IBS. In IBS, OMT focuses on the nervous and circulatory systems, spine, viscera, and thoracic and pelvic diaphragms in order to restore homeostatic balance, normalize autonomic activity in the intestine, promote lymphatic flow, and address somatic dysfunction. Lymphatic and venous congestion are treated by the lymphatic pump techniques and stimulation of Chapman׳s reflex points. A simple treatment plan designed to lessen chronic pain and inflammation in IBS is presented based on current evidence-based literature. Since food itself, food allergies, and intolerance could contribute to symptom onset or even cause IBS, this article also provides dietary modifications to consider for patients. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. Exploration of clinical changes following a novel mobilisation technique for treatment of chronic low back pain: A single cohort design.

    PubMed

    Hanson, Gail C; Jones, Bruce; Bacon, Catherine J; Moran, Robert W

    2016-07-01

    To explore clinical changes following a novel manual mobilisation technique, 24 participants who experienced 'moderate' to 'severe' chronic low back pain were recruited from new patients attending a suburban osteopathy clinic. The intervention was a previously undescribed side-lying mobilisation technique targeting the lumbosacral spine (median of 6 treatment sessions). After 8 weeks reductions were shown in Oswestry Disability Index of 15 points (95% CI: 9.3, 22.7; p < 0.0001 for overall ANOVA); Quadruple Visual Analogue Scale of 2.0 points (95% CI: 1.0, 3.0; p < 0.0001); and Patient Specific Functional Scale of 3.1 points (95% CI: 1.9, 4.3; p < 0.0001). The results indicate that pain intensity, disability and function improved in most participants following treatment. Further investigation is indicated using more robust research designs to compare this approach with other treatment approaches and usual care for the treatment of chronic low back pain. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Effect of synchronized or desynchronized music listening during osteopathic treatment: an EEG study.

    PubMed

    Mercadié, Lolita; Caballe, Julie; Aucouturier, Jean-Julien; Bigand, Emmanuel

    2014-01-01

    While background music is often used during osteopathic treatment, it remains unclear whether it facilitates treatment, and, if it does, whether it is listening to music or jointly listening to a common stimulus that is most important. We created three experimental situations for a standard osteopathic procedure in which patients and practitioner listened either to silence, to the same music in synchrony, or (unknowingly) to different desynchronized montages of the same material. Music had no effect on heart rate and arterial pressure pre- and posttreatment compared to silence, but EEG measures revealed a clear effect of synchronized versus desynchronized listening: listening to desynchronized music was associated with larger amounts of mu-rhythm event-related desynchronization (ERD), indicating decreased sensorimotor fluency compared to what was gained in the synchronized music listening condition. This result suggests that, if any effect can be attributed to music for osteopathy, it is related to its capacity to modulate empathy between patient and therapist and, further, that music does not systematically create better conditions for empathy than silence. Copyright © 2013 Society for Psychophysiological Research.

  2. [Acid-base homeostasis and the thyro-parathyroid glands].

    PubMed

    Cuisinier-Gleizes, P; George, A; Thomasset, M; Mathieu, H

    1975-05-12

    Chronic metabolic acidosis entails hyperparathyroidism and osteopathy. In order to elucidate the role of the thyroparathyroids in this bone lesion production the effects of acidic diet for 7 weeks were studied in parathyroidectomized (PTX), thyroparathyroidectomized (TPTX) and shamoperated (Sh-O) growing rats. In all animals urinary excretion of calcium, phosphate, ammonium and titrable acidity was similarly increased. The rise in hydroxyproline excretion and urinary 85-sr (that was injected previous to acidic feeding) was more marked in PTX and TPTX rats. Moreover, in these animals the serum calcium level was increased, the blood pH was decreased. According to these data, an acidic diet intake that is not sufficient to elicit a fall in blood pH of normal young rats can induce severe acidosis in chronically parathyroidectomized or thyroparathyroidectomized animals; moreover the bone resorption appears more marked. It is concluded that parathyroids are involved in the extra-cellular fluid defense mechanism against acidosis by a no bone resorptive mechanism. We hypothesize that the parathyroids permit the necessary and adequate supply of bicarbonates by the bone to maintain blood pH homeostasis.

  3. Are patients who use alternative medicine dissatisfied with orthodox medicine?

    PubMed

    Donnelly, W J; Spykerboer, J E; Thong, Y H

    1985-05-13

    Approximately 45% of asthmatic families and 47% of non-asthmatic families had consulted an alternative-medicine practitioner at some time. The most popular form of alternative medicine was chiropractic (21.1% and 26.4%, respectively), followed by homoeopathy/naturopathy (18.8% and 12.7%, respectively), acupuncture (9.4% and 10.9%, respectively), and herbal medicine (4.7% and 6.4%, respectively), while the remainder (20.3% and 11.8% respectively) was distributed among iridology, osteopathy, hypnosis, faith healing and megavitamin therapy. More families were satisfied with orthodox medicine (87.1% and 93.6%, respectively) than with alternative medicine (84.2% and 75.1%, respectively). Crosstabulation analysis of pooled data both from asthma and from non-asthma groups showed that 76.4% were satisfied both with orthodox and with alternative medicine, and 16.4% were satisfied with orthodox, but not with alternative, medicine. In contrast, only 2.7% were dissatisfied with orthodox medicine and satisfied with alternative medicine (chi2 = 9.33; P less than 0.01). These findings do not support the view that patients who use alternative medicine are those who are disgruntled with orthodox medicine.

  4. [Osteopathie bei gastroösophagealem Reflux mit Hiatushernie: Ein Fallbericht gemäß der CARE-Leitlinie].

    PubMed

    Rotter, Gabriele; Brinkhaus, Benno

    2017-01-01

    Hintergrund: Das Vorhandensein einer Hiatushernie kann das Auftreten einer gastroösophagealen Refluxerkrankung (GERD) als Komplikation bedingen. Konventionelle medizinische Therapiemaßnahmen können zu unerwünschten Ereignissen und Rezidiven führen. Bisher sind die Effekte von osteopathischen Behandlungen bei Hiatushernie und GERD nicht bekannt. Fallbericht: Eine 59-jährige Patientin mit endoskopisch diagnostizierter chronischer Gastritis, GERD und Hiatushernie beklagte einen persistierenden gastroösophagealen Reflux trotz konventionell-medizinischer konservativer Therapie. Die osteopathische Diagnostik ergab eine funktionelle Störung im Bereich des Magens und der Kardia mit einer Beteiligung zugehöriger Reflexzonen. Nach einer osteopathischen Behandlung als individuelle, befundorientierte Therapie ließen die Beschwerden erheblich nach. Die Hiatushernie war nach einer dieser Behandlung endoskopisch nicht mehr nachweisbar. Schlussfolgerungen: Dieser Fallbericht schildert die Symptomreduktion einer GERD nach osteopathischer Behandlung. In der endoskopischen Folgeuntersuchung fand sich die initial diagnostizierte Hiatushernie nicht mehr, diese Befund änderung könnte jedoch auf die unterschiedlichen Untersucher zurückgeführt werden. Prospektive kontrollierte klinische Studien sind notwendig, um den Stellenwert von osteopathischen Behandlungen bei GERD mit Hiatushernie zu untersuchen. © 2017 The Author(s). Published by S. Karger GmbH, Freiburg.

  5. Introducing an osteopathic approach into neonatology ward: the NE-O model.

    PubMed

    Cerritelli, Francesco; Martelli, Marta; Renzetti, Cinzia; Pizzolorusso, Gianfranco; Cozzolino, Vincenzo; Barlafante, Gina

    2014-01-01

    Several studies showed the effect of osteopathic manipulative treatment on neonatal care in reducing length of stay in hospital, gastrointestinal problems, clubfoot complications and improving cranial asymmetry of infants affected by plagiocephaly. Despite several results obtained, there is still a lack of standardized osteopathic evaluation and treatment procedures for newborns recovered in neonatal intensive care unit (NICU). The aim of this paper is to suggest a protocol on osteopathic approach (NE-O model) in treating hospitalized newborns. The NE-O model is composed by specific evaluation tests and treatments to tailor osteopathic method according to preterm and term infants' needs, NICU environment, medical and paramedical assistance. This model was developed to maximize the effectiveness and the clinical use of osteopathy into NICU. The NE-O model was adopted in 2006 to evaluate the efficacy of OMT in neonatology. Results from research showed the effectiveness of this osteopathic model in reducing preterms' length of stay and hospital costs. Additionally the present model was demonstrated to be safe. The present paper defines the key steps for a rigorous and effective osteopathic approach into NICU setting, providing a scientific and methodological example of integrated medicine and complex intervention.

  6. Introducing an osteopathic approach into neonatology ward: the NE-O model

    PubMed Central

    2014-01-01

    Background Several studies showed the effect of osteopathic manipulative treatment on neonatal care in reducing length of stay in hospital, gastrointestinal problems, clubfoot complications and improving cranial asymmetry of infants affected by plagiocephaly. Despite several results obtained, there is still a lack of standardized osteopathic evaluation and treatment procedures for newborns recovered in neonatal intensive care unit (NICU). The aim of this paper is to suggest a protocol on osteopathic approach (NE-O model) in treating hospitalized newborns. Methods The NE-O model is composed by specific evaluation tests and treatments to tailor osteopathic method according to preterm and term infants’ needs, NICU environment, medical and paramedical assistance. This model was developed to maximize the effectiveness and the clinical use of osteopathy into NICU. Results The NE-O model was adopted in 2006 to evaluate the efficacy of OMT in neonatology. Results from research showed the effectiveness of this osteopathic model in reducing preterms’ length of stay and hospital costs. Additionally the present model was demonstrated to be safe. Conclusion The present paper defines the key steps for a rigorous and effective osteopathic approach into NICU setting, providing a scientific and methodological example of integrated medicine and complex intervention. PMID:24904746

  7. [Osteomalacia and vitamin D deficiency].

    PubMed

    Rader, C P; Corsten, N; Rolf, O

    2015-09-01

    Vitamin D and calcium deficiency has a higher incidence in the orthopedic-trauma surgery patient population than generally supposed. In the long term this can result in osteomalacia, a form of altered bone mineralization in adults, in which the cartilaginous, non-calcified osteoid does not mature to hard bone. The current value of vitamin D and its importance for bones and other body cells are demonstrated. The causes of vitamin D deficiency are insufficient sunlight exposure, a lack of vitamin D3 and calcium, malabsorption, and rare alterations of VDR signaling and phosphate metabolism. The main symptoms are bone pain, fatigue fractures, muscular cramps, muscle pain, and gait disorders, with an increased incidence of falls in the elderly. Osteopathies induced by pharmaceuticals, tumors, rheumatism or osteoporosis have to be considered as the main differential diagnoses. In addition to the recording of symptoms and medical imaging, the diagnosis of osteomalacia should be ensured by laboratory parameters. Adequate treatment consists of the high-dose intake of vitamin D3 and the replacement of phosphate if deficient. Vitamin D is one of the important hormone-like vitamins and is required in all human cells. Deficiency of vitamin D has far-reaching consequences not only for bone, but also for other organ systems.

  8. Colic in infants.

    PubMed

    Lucassen, Peter

    2010-02-05

    Colic in infants causes one in six families (17%) with children to consult a health professional. One systematic review of 15 community-based studies found a wide variation in prevalence, which depended on study design and method of recording. We conducted a systematic review and aimed to answer the following clinical question: What are the effects of treatments for colic in infants? We searched: Medline, Embase, The Cochrane Library, and other important databases up to September 2009 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). We found 27 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. In this systematic review we present information relating to the effectiveness and safety of the following interventions: advice to increase carrying, advice to reduce stimulation, casein hydrolysate milk, cranial osteopathy, crib vibrator device, focused counselling, gripe water, infant massage, low-lactose milk, simethicone, soya-based infant feeds, spinal manipulation, and whey hydrolysate milk.

  9. Colic in infants

    PubMed Central

    2010-01-01

    Introduction Colic in infants causes one in six families (17%) with children to consult a health professional. One systematic review of 15 community-based studies found a wide variation in prevalence, which depended on study design and method of recording. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical question: What are the effects of treatments for colic in infants? We searched: Medline, Embase, The Cochrane Library, and other important databases up to September 2009 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 27 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: advice to increase carrying, advice to reduce stimulation, casein hydrolysate milk, cranial osteopathy, crib vibrator device, focused counselling, gripe water, infant massage, low-lactose milk, simethicone, soya-based infant feeds, spinal manipulation, and whey hydrolysate milk. PMID:21729336

  10. Cross-cultural differences in GPs' attitudes towards complementary and alternative medicine: a survey comparing regions of the UK and Germany.

    PubMed

    Schmidt, K; Jacobs, P A; Barton, A

    2002-09-01

    To investigate whether there is a difference in general practitioners' attitudes towards CAM in the UK and Germany. A descriptive questionnaire was developed and sent to 97 GPs in the UK and 99 GPs in Germany. The overall response rate was 68%. German GPs showed a (non-significant) overall more positive attitude towards CAM than did British GPs. British GPs made more referrals to complementary practitioners. The most popular CAM therapies that UK GPs referred their patients to were chiropractic treatment, acupuncture and osteopathy. German GPs referred their patients mainly to acupuncture treatment, chiropractic treatment and herbal medicine. A significantly higher number of German GPs reported having practised as a CAM practitioner before and having personally used CAM themselves. Seventy percent of British GPs and 76% of German GPs thought it is safe to prescribe complementary medicine and therapies to patients. There are small national differences in referring patients to various CAM modalities. Both nations have an overall positive attitude toward and a high interest in CAM. Lack of scientific evidence and information on training opportunities were important points that were continuously raised by GPs in both countries.

  11. Joint Manipulation: Toward a General Theory of High-Velocity, Low-Amplitude Thrust Techniques.

    PubMed

    Harwich, Andrew S

    2017-12-01

    The objective of this study was to describe the initial stage of a generalized theory of high-velocity, low-amplitude thrust (HVLAT) techniques for joint manipulation. This study examined the movements described by authors from the fields of osteopathy, chiropractic, and physical therapy to produce joint cavitation in both the metacarpophalangeal (MCP) joint and the cervical spine apophysial joint. This study qualitatively compared the kinetics, the similarities, and the differences between MCP cavitation and cervical facet joint cavitation. A qualitative vector analysis of forces and movements was undertaken by constructing computer-generated, simplified graphical models of the MCP joint and a typical cervical apophysial joint and imposing the motions dictated by the clinical technique. Comparing the path to cavitation of 2 modes of HVLAT for the MCP joint, namely, distraction and hyperflexion, it was found that the hyperflexion method requires an axis of rotation, the hinge axis, which is also required for cervical HVLAT. These results show that there is an analogue of cervical HVLAT in one of the MCP joint HVLATs. The study demonstrated that in a theoretical model, the path to joint cavitation is the same for asymmetric separation of the joint surfaces in the cervical spine and the MCP joints.

  12. Patients' expectations of osteopathic care: a qualitative study.

    PubMed

    Cross, Vinette; Leach, C M Janine; Fawkes, Carol A; Moore, Ann P

    2015-10-01

    Research has shown that patients' expectations of health care and health-care practitioners are complex and may have a significant impact on outcomes of care. Little is known about the expectations of osteopathic patients. To explore osteopathic patients' expectations of private sector care. Focus groups and individual interviews with purposively selected patients; this was the qualitative phase of a mixed methods study, the final phase being a patient survey. A total of 34 adult patients currently attending for treatment at private osteopathic practices across the United Kingdom. Focus group discussions and individual interviews around expectations before, during and after osteopathic care. Thematic analysis of text data to identify topics raised by patients and to group these into broad themes. Many components of expectation were identified. A preliminary conceptual framework describing the way the therapeutic encounter is approached in osteopathy comprised five themes: individual agency, professional expertise, customer experience, therapeutic process and interpersonal relationship. The components of expectation identified in this phase of the study provided potential question topics for the survey questionnaire in the subsequent phase of the investigation. The model developed in this study may add a new perspective to existing evidence on expectations. Further research is recommended to test the findings both within private practice and the National Health Service. © 2013 John Wiley & Sons Ltd.

  13. [Which treatments for infantile colics?].

    PubMed

    Bruyas-Bertholon, Virginie; Lachaux, Alain; Dubois, Jean-Pierre; Fourneret, Pierre; Letrilliart, Laurent

    2012-07-01

    Infantile colics or excessive crying represent a source of stress for parents and a frequent reason for encounter in primary care. To assess the effectiveness of treatments of this syndrome from a systematic review. Medline, Cochrane and Embase databases. We used the following inclusion criteria: therapeutic assessment of infant colics or excessive crying, randomized controlled trials or meta-analyses, published in English or French language. Thirty-one randomized controlled trials and one meta-analysis have been included. Allopathic drugs have not proved effectiveness (simethicone, lactase) and some of them can cause potentially serious adverse reactions (dicyclomine). Protein hydrolysate or soy formulas seem to be effective, but soy milk can induce allergies. Sucrose solutions provide some benefit in studies with low level of evidence. Effectiveness is likely for a probiotics (Lactobacillus reuteri) and for herbal mixtures containing fennel extracts. Evidence is lacking for manual (osteopathy, acupuncture) and behavioural therapies (decreased stimulations, reassurance of parents). The definition of infantile colics and the methods used for crying measurement changed across trials. The included trials were of variable quality, especially with no double-blind procedure in 17 trials. The most validated treatments for infantile colics are the substitution of cows' milk by a hydrolysed formula, the use of L. reuteri and of fennel extracts. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  14. Spirocercosis in owned and stray dogs in Grenada.

    PubMed

    Chikweto, A; Bhaiyat, M I; Tiwari, K P; de Allie, C; Sharma, R N

    2012-12-21

    The aim of this retrospective study was to estimate the prevalence of Spirocerca lupi and its associated lesions in owned and stray dogs in Grenada. During 2001-2011 necropsies were carried out on 1022 owned and 450 stray dogs at the pathology diagnostic laboratory, School of Veterinary Medicine, St. George's University, Grenada. Lesions due to S. lupi characterized by focal to multifocal granulomatous esophagitis with aneurysms, mineralized plaques and nodules in the adjacent thoracic aorta were found in 90 (8.8%; 95% confidence interval, 7.1-10.5%) of owned dogs and 64 (14.2%; 95% CI, 11.2-17.6%) of stray dogs. Stray dogs were significantly more affected by spirocercosis than owned dogs (p=0.0022). Of the 90 owned dogs with spirocercosis, 3 dogs had aberrant migration to the thoracic vertebral column with resultant spondylitis; 1 dog each had aberrant migration involving the stomach and the lung. Two dogs had ruptured aorta with hemothorax. Among the 64 stray dogs with spirocercosis, one dog had an esophageal granuloma that transformed into a fibroblastic osteosarcoma; spondylitis due to aberrant migration of S. lupi and hypertrophic osteopathy. We report spirocercosis for the first time in the dogs from a tropical island of Grenada. Copyright © 2012 Elsevier B.V. All rights reserved.

  15. Family medicine's search for manpower: the American Osteopathic Association accreditation option.

    PubMed

    Cummings, Mark; Kunkle, Judith L; Doane, Cheryl

    2006-03-01

    In recent years, family medicine has encountered problems recruiting and filling its Accreditation Council for Graduate Medical Education (ACGME)-accredited residencies. In addressing these reverses, one increasingly popular strategy has been to acquire American Osteopathic Association (AOA) accreditation as a way to tap into the growing number of osteopathic graduates. This stratagem is founded on assumptions that parallel-accredited postdoctoral programs are attractive to doctor of osteopathy (DO) graduates, that collaboration with sponsoring colleges of osteopathic medicine (COMs) provides direct access to osteopathic students, and that DOs can play an important role in replacing the increasing scarcity of United States medical graduates who are selecting specialty residencies. Within the past 5 years, nearly 10% of all ACGME family medicine residency programs have voluntarily obtained a second level of accreditation to also qualify as AOA-accredited family medicine residency programs. This strategy has produced mixed outcomes, as noted from the results of the osteopathic matching program. The flood of osteopathic graduates into these parallel-accredited programs has not occurred. In addition, recent AOA policy changes now require ACGME-accredited programs to make a deeper educational commitment to osteopathic postdoctoral education. The most successful ACGME/AOA-accredited programs have been those that are closely affiliated with and in near proximity of a COM and also train osteopathic students in required clerkship rotations.

  16. Oncogenous osteomalacia and myopericytoma of the thoracic spine: a case report.

    PubMed

    Brunschweiler, Benoit; Guedj, Nathalie; Lenoir, Thibault; Faillot, Thierry; Rillardon, Ludovic; Guigui, Pierre

    2009-11-01

    A case report. To illustrate a rare case of oncogenous osteomalacia caused by a spinal thoracic myopericytoma. Osteomalacia related to a tumor is well known. The cause of the disorder is usually a highly vascularized, benign tumor of mesenchymal origin. Location of the tumor in the spine is very rare. Removal of the tumor is followed by resolution of osteomalacia. Diagnosis of oseomalacia was established on the presence of cardinal clinical, biologic, and radiologic features of osteomalacia. Localization of the tumor at T5 and T6 levels was obtained by magnetic resonance imaging. Surgical treatment consisted in a circumferential correction-fusion with hemivertebrectomy of T5 and T6 and tumor removal. Tumor removal was rapidly followed by disappearance of the clinical symptoms of osteomalacia, and by correction of hypophosphatemia. At 2-years follow-up, no recurrence of the tumor was detectable on imaging studies-the correction fusion remained stable. Histologically, the tumor was classified as a myopericytoma. There was no relapse of the clinical features of osteomalacia. However, secondary recurrence of the biologic markers due to an incomplete tumor removal was disclosed. Removal of the tumor was followed by healing of the clinical features of osteomalacia, demonstrating the causal connection between the myopericytoma and the osteopathy.

  17. A qualitative grounded theory study of the conceptions of clinical practice in osteopathy - a continuum from technical rationality to professional artistry.

    PubMed

    Thomson, Oliver P; Petty, Nicola J; Moore, Ann P

    2014-02-01

    How practitioners conceive clinical practice influences many aspects of their clinical work including how they view knowledge, clinical decision-making, and their actions. Osteopaths have relied upon the philosophical and theoretical foundations upon which the profession was built to guide clinical practice. However, it is currently unknown how osteopaths conceive clinical practice, and how these conceptions develop and influence their clinical work. This paper reports the conceptions of practice of experienced osteopaths in the UK. A constructivist grounded theory approach was taken in this study. The constant comparative method of analysis was used to code and analyse data. Purposive sampling was employed to initially select participants. Subsequent theoretical sampling, informed by data analysis, allowed specific participants to be sampled. Data collection methods involved semi-structured interviews and non-participant observation of practitioners during a patient appointment, which was video-recorded and followed by a video-prompted reflective interview. Participants' conception of practice lay on a continuum, from technical rationality to professional artistry and the development of which was influenced by their educational experience, view of health and disease, epistemology of practice knowledge, theory-practice relationship and their perceived therapeutic role. The findings from this study provide the first theoretical insight of osteopaths' conceptions of clinical practice and the factors which influence such conceptions. Copyright © 2013 Elsevier Ltd. All rights reserved.

  18. Comparing specialist medical care with specialist medical care plus the Lightning Process for chronic fatigue syndrome or myalgic encephalomyelitis (CFS/ME): study protocol for a randomised controlled trial (SMILE Trial).

    PubMed

    Crawley, Esther; Mills, Nicola; Hollingworth, Will; Deans, Zuzana; Sterne, Jonathan A; Donovan, Jenny L; Beasant, Lucy; Montgomery, Alan

    2013-12-26

    Chronic fatigue syndrome or myalgic encephalomyelitis (CFS/ME) is a relatively common and potentially serious condition with a limited evidence base for treatment. Specialist treatment for paediatric CFS/ME uses interventions recommended by National Institute for Health and Clinical Excellence (NICE) including cognitive behavioural therapy, graded exercise therapy and activity management. The Lightning Process (LP) is a trademarked intervention derived from osteopathy, life-coaching and neuro-linguistic programming, delivered over three consecutive days as group sessions. Although over 250 children with CFS/ME attend LP courses each year, there are no reported studies on the effectiveness or cost-effectiveness. This pragmatic randomised controlled trial is set within a specialist paediatric CFS/ME service in the south west of England. Children and young people with CFS/ME (n = 80 to 112), aged 12 to 18 years old will be randomised to specialist medical care (SMC) or SMC plus the LP. The primary outcome will be physical function (SF-36 physical function short form) and fatigue (Chalder Fatigue Scale). This study will tell us whether adding the LP to SMC is effective and cost-effective compared to SMC alone. This study will also provide detailed information on the implementation of the LP and SMC. Current Controlled Trials ISRCTN81456207 (31 July 2012).

  19. [Medical treatment for the management of painful endometriosis without infertility: CNGOF-HAS Endometriosis Guidelines].

    PubMed

    Sauvan, M; Chabbert-Buffet, N; Canis, M; Collinet, P; Fritel, X; Geoffron, S; Legendre, G; Wattier, J-M; Fernandez, H

    2018-03-01

    To provide clinical practice guidelines for the management of painful endometriosis in women without infertility. Systematic review of the literature literature since 2006, level of evidence rating, external proofreading and grading of the recommendation grade by an expert group according to HAS methodology. Combined hormonal contraceptives (COP) and the levonorgestrel-releasing intra-uterin system (LNG-IUS) are recommended as first-line hormonal therapies for the treatment of painful endometriosis (grade B). Second-line therapy relies on oral desogestrel microprogestative, etonogestrel-releasing implant, GnRH analogs (GnRHa) and dienogest (grade C). It is recommended to use add-back therapy containing estrogen in association with GnRHa (grade B). After endometriosis surgery, hormonal treatment relying on COP or LNG-IUS is recommended to prevent pain recurrence (grade B). COP is recommended to reduce the risk of endometrioma recurrence after surgery (grade B) but the prescription of GnRHa is not recommended (grade C). Continuous COP is recommended in case of dysmenorrhea (grade B). GnRHa is not recommended as first line endometriosis treatment for adolescent girl because of the risk of bone demineralization (grade B). The management of endometriosis-induced chronic pain requires an interdisciplinary evaluation. Physical therapies improving the quality of life such as yoga, relaxation or osteopathy can be proposed (expert agreement). Promising medical alternatives are currently under preclinical and clinical evaluation. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

  20. Audit of conservative management of chronic low back pain in a secondary care setting--part I: facet joint and sacroiliac joint interventions.

    PubMed

    Chakraverty, Robin; Dias, Richard

    2004-12-01

    The work of a chronic back pain service in secondary care in the West Midlands is reported. The service offers acupuncture, spinal injection procedures, osteopathy and a range of other interventions for patients whose back pain has not responded to conservative management. This section of the report focuses on injection procedures for lumbar facet joint and sacroiliac joint pain, which have been shown to be the cause of chronic low back pain in 16-40% and 13-19% of patients respectively. Diagnosis relies on the use of intra-articular or sensory nerve block injections with local anaesthetic. Possible treatments following diagnosis include intra-articular corticosteroid, radiofrequency denervation (for facet joint pain) or ligament prolotherapy injections (for sacroiliac joint pain). The results of several hospital audits are reported. At six month follow up, 50% of 38 patients undergoing radiofrequency denervation following diagnostic blocks for facet joint pain had improved by more than 50%, compared to 29% of 34 patients treated with intra-articular corticosteroid injection. Sixty three per cent of 19 patients undergoing prolotherapy following diagnostic block injection for sacroiliac joint pain had improved at six months, compared to 33% of 33 who had intra-articular corticosteroid. Both radiofrequency denervation and sacroiliac prolotherapy showed good long-term outcomes at one year.

  1. Osteoporosis and Osteopathy Markers in Patients with Mastocytosis

    PubMed Central

    Alpay Kanıtez, Nilüfer; Erer, Burak; Doğan, Öner; Büyükbabani, Nesimi; Baykal, Can; Sindel, Dilşad; Tanakol, Refik; Yavuz, Akif Selim

    2015-01-01

    Objective: Osteoporosis, osteosclerosis, and lytic bone lesions have been observed in patients with systemic mastocytosis (SM). We examined bone mineral density (BMD) biochemical turnover markers and serum tryptase levels in SM, which is considered a rare disease. Materials and Methods: Seventeen adult patients (5 females, 12 males; median age: 33 years, range: 20-64) with mastocytosis were included in this study. We investigated the value of quantitative ultrasound (QUS) of the calcaneus in the assessment of BMD in SM patients, as well as BMD of the lumbar spine (L1-L4), femoral neck, and distal radius using dual energy x-ray absorptiometry (DXA) and plasma tryptase levels, biochemical markers of bone turnover. Results: At lumbar spine L1-L4, the femoral neck, and the distal radius or as calcaneus stiffness, 12 of 17 patients had T-scores of less than -1 at least at 1 site, reflecting osteopenia. Three of 17 patients had T-scores showing osteoporosis (T-score <-2.5). There was no relationship between DXA and bone lesion severity. We also found a significant positive correlation between tryptase levels and disease severity, as well as between disease severity and pyridinoline (p<0.01 by Spearman’s test). Conclusion: DXA and calcaneal QUS may not be appropriate techniques to assess bone involvement in SM patients because of the effects of osteosclerosis. This study further shows that the osteoclastic marker pyridinoline is helpful in patients with severe disease activity and sclerotic bone lesions to show bone demineralization. PMID:25805674

  2. [Imaging of diabetic osteopathy].

    PubMed

    Patsch, J; Pietschmann, P; Schueller-Weidekamm, C

    2015-04-01

    Diabetic bone diseases are more than just osteoporosis in patients with diabetes mellitus (DM): a relatively high bone mineral density is paired with a paradoxically high risk of fragility fractures. Diabetics exhibit low bone turnover, osteocyte dysfunction, relative hypoparathyroidism and an accumulation of advanced glycation end products in the bone matrix. Besides typical insufficiency fractures, diabetics show a high risk for peripheral fractures of the lower extremities (e.g. metatarsal fractures). The correct interdisciplinary assessment of fracture risks in patients with DM is therefore a clinical challenge. There are two state of the art imaging methods for the quantification of fracture risks: dual energy X-ray absorptiometry (DXA) and quantitative computed tomography (QCT). Radiography, multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) are suitable for the detection of insufficiency fractures. Novel research imaging techniques, such as high-resolution peripheral quantitative computed tomography (HR-pQCT) provide non-invasive insights into bone microarchitecture of the peripheral skeleton. Using MR spectroscopy, bone marrow composition can be studied. Both methods have been shown to be capable of discriminating between type 2 diabetic patients with and without prevalent fragility fractures and thus bear the potential of improving the current standard of care. Currently both methods remain limited to clinical research applications. DXA and HR-pQCT are valid tools for the quantification of bone mineral density and assessment of fracture risk in patients with DM, especially if interpreted in the context of clinical risk factors. Radiography, CT and MRI are suitable for the detection of insufficiency fractures.

  3. Survey of the incidence, diagnosis, clinical manifestations and treatment of Spirocerca lupi in South Africa.

    PubMed

    Lobetti, R G

    2000-03-01

    A questionnaire survey of 716 veterinary practices was undertaken to determine the incidence of Spirocerca lupi in dogs in South Africa. In total, 49% of the questionnaires were returned, indicating a possible incidence of 28%. Fewer than 4 cases per year were recorded by 82% of the respondents; 4-12 by 14%; 12-24 by 3%; and more than 48 by only 1%. No seasonal incidence was reported by 48% of the respondents. Large breeds were considered to be at greater risk by 43% of respondents. No specific age or sex was identified to be at higher risk. The most common complaints by owners and clinical findings were vomiting (46%), weight loss (27%), coughing (21%) or regurgitation (20%), although 14% of respondents reported no abnormal clinical findings. Diagnostic methods used were radiology (74%), endoscopy (27%), post mortem examination (34%) and faecal flotation (4%). Complications associated with S. lupi were reported by 76% of respondents, which included oesophageal neoplasia (41%), hypertrophic osteopathy (38%) and acute haemothorax (30%). Specific treatments were used by 58% of the respondents, whereas 42% of the respondents either used no treatment (72%) or recommended euthanasia (28%). Of the treatment group, 52% used ivermectin, 27% doramectin, 13% other deworming drugs (benzimidazoles, nitroscanate), and 8% used disophenol. Sixty-three percent of the respondents considered their treatment ineffective, whereas 31% considered it effective, and 6% were unsure. The overall mortality rate was high.

  4. Clinical decision-making and therapeutic approaches in osteopathy - a qualitative grounded theory study.

    PubMed

    Thomson, Oliver P; Petty, Nicola J; Moore, Ann P

    2014-02-01

    There is limited understanding of how osteopaths make decisions in relation to clinical practice. The aim of this research was to construct an explanatory theory of the clinical decision-making and therapeutic approaches of experienced osteopaths in the UK. Twelve UK registered osteopaths participated in this constructivist grounded theory qualitative study. Purposive and theoretical sampling was used to select participants. Data was collected using semi-structured interviews which were audio-recorded and transcribed. As the study approached theoretical sufficiency, participants were observed and video-recorded during a patient appointment, which was followed by a video-prompted interview. Constant comparative analysis was used to analyse and code data. Data analysis resulted in the construction of three qualitatively different therapeutic approaches which characterised participants and their clinical practice, termed; Treater, Communicator and Educator. Participants' therapeutic approach influenced their approach to clinical decision-making, the level of patient involvement, their interaction with patients, and therapeutic goals. Participants' overall conception of practice lay on a continuum ranging from technical rationality to professional artistry, and contributed to their therapeutic approach. A range of factors were identified which influenced participants' conception of practice. The findings indicate that there is variation in osteopaths' therapeutic approaches to practice and clinical decision-making, which are influenced by their overall conception of practice. This study provides the first explanatory theory of the clinical decision-making and therapeutic approaches of osteopaths. Copyright © 2013 Elsevier Ltd. All rights reserved.

  5. Do placebo effects associated with sham osteopathic procedure occur in newborns? Results of a randomized controlled trial.

    PubMed

    Martelli, Marta; Cardinali, Lucia; Barlafante, Gina; Pizzolorusso, Gianfranco; Renzetti, Cinzia; Cerritelli, Francesco

    2014-04-01

    Placebo effect has been largely studied and debated in medicine. Research focused mainly on children and adults but not on newborns. In osteopathy, few studies documented this effect and no research has been conducted in newborns. To assess the presence of placebo effect in newborns using sham osteopathic manipulative treatment. Randomized control trial. Neonatal Intensive Care Unit in Italy. Two groups (103 patients each) of preterm infants aged 29-36 weeks without medical complications received routine pediatric care and osteopathic sham therapy was administrated to the study group only for the entire period of hospitalization. Primary end point was the mean reduction of length of stay at discharge. Secondary objective was the change in daily weight gain. 206 newborns entered the study. No difference between sham and control group was found for the primary outcome length of stay (30.0±20.3; 28.8±18.9; p=0.70). Multivariate analysis showed no difference between study and control group on length of stay. A negative association was found for gestational age (-2.33; 95% CI -3.81 to -0.85; p=0.002), birth weight (-0.01; 95% CI -0.02 to -0.01; p<0.001) and milk volume at study enrollment (-0.02; 95% CI -0.05 to -0.01; p=0.01). To the best of our knowledge, this study is the first in the field showing no placebo effect on newborns. Further discussions are opened concerning the age when placebo effect starts. Copyright © 2014 Elsevier Ltd. All rights reserved.

  6. Dipeptidyl Peptidase-4 Inhibitor, Vildagliptin, Improves Trabecular Bone Mineral Density and Microstructure in Obese, Insulin-Resistant, Pre-diabetic Rats.

    PubMed

    Charoenphandhu, Narattaphol; Suntornsaratoon, Panan; Sa-Nguanmoo, Piangkwan; Tanajak, Pongpan; Teerapornpuntakit, Jarinthorn; Aeimlapa, Ratchaneevan; Chattipakorn, Nipon; Chattipakorn, Siriporn

    2018-02-02

    Obese insulin resistance and type 2 diabetes mellitus profoundly impair bone mechanical properties and bone quality. However, because several antidiabetes drugs, especially thiazolidinediones, further aggravate bone loss in individuals with diabetes, diabetic osteopathy should not be treated by using simply any glucose-lowering agents. Recently, incretins have been reported to affect osteoblast function positively. The present study aimed to investigate the effects of vildagliptin, an inhibitor of dipeptidyl peptidase-4, on bone of rats with high-fat-diet-induced prediabetes. Male rats were fed a high-fat diet for 12 weeks to induce obese insulin resistance and then treated with vildagliptin for 4 weeks. The effects of the drug on bone were determined by microcomputed tomography and bone histomorphometry. Vildagliptin markedly improved insulin resistance in these obese insulin-resistant rats. It also significantly increased volumetric bone mineral density. Specifically, vildagliptin-treated obese insulin-resistant rats exhibited higher trabecular volumetric bone mineral density than vehicle-treated obese insulin-resistant rats, whereas cortical volumetric bone mineral density, cortical thickness and area were not changed. Bone histomorphometric analysis in a trabecular-rich area (i.e. tibial metaphysis) revealed greater trabecular bone volume and number and less trabecular separation without change in trabecular thickness, osteocyte lacunar area or cortical thickness in the vildagliptin-treated group. Vildagliptin had a beneficial effect on the bone of obese insulin-resistant rats with prediabetes, particularly at the trabecular site. Such benefit probably results from enhanced bone formation rather than from suppressed bone resorption. Copyright © 2018 Diabetes Canada. Published by Elsevier Inc. All rights reserved.

  7. Usage of alternative medical systems, acupuncture, homeopathy and anthroposophic medicine, by older German adults.

    PubMed

    Büssing, Arndt; Ostermann, Thomas; Heusser, Peter; Matthiessen, Peter F

    2011-08-01

    The manifold studies on the usage of complementary and alternative medicine (CAM) indicate that its utilization differs with respect to socio-cultural background, gender, age and underlying disease. This study intended to analyze the usage of specific CAM practices among a population of older German adults with health insurance coverage. Data of 5 830 older individuals who participated in an anonymous cross sectional survey among German insurance beneficiaries were analyzed with respect to usage of CAM treatments applied by medical doctors or non-medical practitioners within the last 5 years. The most frequently used approaches were acupuncture/traditional Chinese medicine (21%), homeopathy (21%), movement therapies/physical exercises (19%), osteopathy/chiropractic (12%), herbs/phytotherapy (7%), diets/specific food recommendations (6%) and foot reflexology (5%). Anthroposophic medicine was used only to a minor degree. Acupuncture and homeopathy users were likely to choose more than one CAM treatment simultaneously, particularly the combination of homeopathy and acupuncture. Moreover, this study can confirm significant differences between women and men in the use of the main relevant CAM interventions. The relative proportion of acupuncture usage was similar to homeopathy, which is an alternative whole medical system originating from Western Europe. This means that an Eastern alternative system is established also in Germany. In several cases not only one CAM treatment was used but distinct combinations existed (particularly homeopathy and acupuncture); thus one should be cautious to draw predictive conclusions from studies with broad and unspecific CAM categories, for among them there are several therapies which should not be regarded as CAM.

  8. Bone mineral density of vegetarian and non-vegetarian adults in Taiwan.

    PubMed

    Wang, Yuh-Feng; Chiu, Jainn-Shiun; Chuang, Mei-Hua; Chiu, Jing-Er; Lin, Chin-Lon

    2008-01-01

    Diet is thought to be one of the leading causes of bone mineral loss in aging people. In this study, we explored the potential impact of a vegetarian diet on bone mineral density (BMD) in adult Taiwanese men and women. This was a cross-sectional study of the relationship between diet (vegetarian versus non-vegetarian) and BMD and the incidence of osteoporosis. Bone mineral density was determined in a cohort of 1865 adult male and female patients who underwent routine examination in a regional teaching hospital in Taiwan between February 2003 and February 2004. Subjects with definite vertebral problems, known osteopathy, or poor posture were excluded. Dual-energy X-ray absorptiometry (DEXA) was used to determine BMD, on the right hip in men and on lumbar vertebrae L2 to L4 in women. The subjects were grouped according to sex and diet, and were then stratified by age within each of the four groups. The outcome measures were the BMD value and the incidence of osteopenia or osteoporosis according to defined criteria. Bone mineral density gradually declined with increasing age in Taiwanese men, while Taiwanese women showed a precipitous decrease in BMD after the 5th decade. However, no statistical differences in BMD were observed between vegetarians and non-vegetarians of either sex. The proportion of subjects with osteopenia or osteoporosis also appeared comparable between vegetarians and non-vegetarians of either sex. BMD shows an age-related decline in Taiwanese men and women, and eating a vegetarian diet does not appear to affect this decline.

  9. The use of complementary and alternative medicine in the general population: results from a longitudinal community study.

    PubMed

    Rössler, Wulf; Lauber, Christoph; Angst, Jules; Haker, Helene; Gamma, Alex; Eich, Dominique; Kessler, Ronald C; Ajdacic-Gross, Vladeta

    2007-01-01

    Many patients with psychological or physical problems are interested in non-medical approaches. The reasons for the growing popularity of complementary and alternative medicine (CAM) are not well understood considering that evidence of the effectiveness of conventional therapies is greater than ever before. We have examined data from the Zurich Study to determine trends and predictors of CAM use in Switzerland. The Zurich Study is a longitudinal community study that was started in 1979 with a sample of 591 participants born in 1958 and 1959. In 1999, the last of six interview waves with face-to-face interviews was conducted. CAM use was analyzed with data from interviews in 1993 and 1999. Polytomous logistic regression analysis focused on the personal, demographic and sociocultural background of CAM users. CAM use in the last 12 months was reported by 21.9% of the participants in 1993 and by 29.5% in 1999. CAM use among those exhibiting either physical or psychological problems was in the ratio of two to one. There was a trend from alternative variants of CAM (homeopathy) to complementary ones (massage, osteopathy, acupuncture). The vast majority of CAM use was in addition to conventional therapies. Predictors of CAM use were, among others, attribution of physical complaints to stress and other psychological variables, very low education level in parents, and lacking political interest. Besides the sociocultural background, characteristics such as the psychological attribution style play an important role in CAM use. CAM use in Switzerland is mainly of a complementary rather than an alternative nature.

  10. Prevalence and characteristics of rib fractures in ex-preterm infants.

    PubMed

    Lucas-Herald, Angela; Butler, Sandra; Mactier, Helen; McDevitt, Helen; Young, David; Ahmed, Syed Faisal

    2012-12-01

    This study aimed to identify the prevalence and characteristics of rib fractures in ex-preterm infants. Infants born at <37 weeks' gestation and admitted before 2011 to 3 regional neonatal units were identified from admission registers. For 2 centers, these data were available from 2000 onward and, for another center, from 2005. Electronic records were searched to identify chest radiographs performed up to age 1 year. Chest radiograph reports were then reviewed for evidence of rib fractures, and the case notes of all affected individuals were scrutinized. Of the 3318 eligible preterm infants, 1446 had a total of 9386 chest radiographs. Of these infants, 26 (1.8%) were identified as having a total of 62 rib fractures. Their median (range) gestation at birth was 26 weeks (23-34). The median chronological age of these infants at the time of the radiograph was 14 weeks (5 weeks to 8 months). The median corrected gestational age at the time of the radiograph was 39 weeks (34 weeks to 4 months). Of the 62 fractures, 27 (36%) were sited posteriorly, and 15 (53%) of the infants with posterior rib fractures were diagnosed with osteopathy of prematurity. Classic risk including conjugated hyperbilirubinemia and diuretics, were present in 23 of 26 (88%) infants. A full skeletal survey was performed in 8 of 26 (31%). Investigations for nonaccidental injury occurred in 4 of 26 (15%) cases. Evidence of rib fractures is present in ~2% of ex-preterm infants. The evaluation of these fractures in infancy requires a detailed neonatal history irrespective of the site of rib fracture.

  11. How effective are spiritual care and body manipulation therapies in pediatric oncology? A systematic review of the literature.

    PubMed

    Poder, Thomas G; Lemieux, Renald

    2013-12-10

    The effects of cancer and associated treatments have a considerable impact on the well-being and quality of life of pediatric oncology patients. To support children and their families, complementary and alternative medicines are seen by nurses and doctors as practical to integrate to the services offered by hospitals. The purpose of this paper is to examine if the practice of complementary and alternative medicine, specifically spiritual care and treatments based on body manipulation, is likely to improve the health and well-being of children suffering from cancer. This objective is achieved through a systematic review of the literature. The level of evidence associated with each practice of complementary and alternative medicine was assessed according to the methodological design used by the studies reviewed. Studies reviewed are of a methodological quality that could be described as fair due to the small sample size of patients and the existence of a number of biases in the conduct and analysis of these studies. However, results obtained are consistent from one study to another, allowing us to make certain recommendations. It is thus advisable to consider the introduction of hypnotherapy in pediatric oncology services. Based on the data collected, it is the complementary and alternative medicine with the most evidence in favor of effectiveness of the well-being of pediatric oncology patients, especially during painful procedures. It is also recommended to use art therapy and music therapy. Conversely, too little evidence is present to be able to recommend the use of acupuncture, chiropractic or osteopathy.

  12. Manual therapy as a conservative treatment for adolescent idiopathic scoliosis: a systematic review

    PubMed Central

    Romano, Michele; Negrini, Stefano

    2008-01-01

    Background The treatment of adolescent idiopathic scoliosis is contingent upon many variables. Simple observation is enough for less serious curvatures, but for very serious cases surgical intervention could be proposed. Between these there is a wide range of different treatments. Manual therapy is commonly used: the aim of this paper is to verify the data existing in the literature on the efficacy of this approach. Methods A systematic review of the scientific literature published internationally has been performed. We have included in the term manual therapy all the manipulative and generally passive techniques performed by an external operator. In a more specific meaning, osteopathic, chiropractic and massage techniques have been considered as manipulative therapeutic methods. We performed our systematic research in Medline, Embase, Cinhal, Cochrane Library, Pedro with the following terms: idiopathic scoliosis combined with chiropractic; manipulation; mobilization; manual therapy; massage; osteopathy; and therapeutic manipulation. The criteria for inclusion were as follows: Any kind of research; diagnosis of adolescent idiopathic scoliosis; patients treated exclusively by one of the procedures established as a standard for this review (chiropractic manipulation, osteopathic techniques, massage); and outcome in Cobb degrees. Results We founded 145 texts, but only three papers were relevant to our study. However, no one of the three satisfied all the required inclusion criteria because they were characterized by a combination of manual techniques and other therapeutic approaches. Conclusion The lack of any kind of serious scientific data does not allow us to draw any conclusion on the efficacy of manual therapy as an efficacious technique for the treatment of Adolescent idiopathic scoliosis. PMID:18211702

  13. Manual therapy as a conservative treatment for adolescent idiopathic scoliosis: a systematic review.

    PubMed

    Romano, Michele; Negrini, Stefano

    2008-01-22

    The treatment of adolescent idiopathic scoliosis is contingent upon many variables. Simple observation is enough for less serious curvatures, but for very serious cases surgical intervention could be proposed. Between these there is a wide range of different treatments. Manual therapy is commonly used: the aim of this paper is to verify the data existing in the literature on the efficacy of this approach. A systematic review of the scientific literature published internationally has been performed. We have included in the term manual therapy all the manipulative and generally passive techniques performed by an external operator. In a more specific meaning, osteopathic, chiropractic and massage techniques have been considered as manipulative therapeutic methods. We performed our systematic research in Medline, Embase, Cinhal, Cochrane Library, Pedro with the following terms: idiopathic scoliosis combined with chiropractic; manipulation; mobilization; manual therapy; massage; osteopathy; and therapeutic manipulation. The criteria for inclusion were as follows: Any kind of research; diagnosis of adolescent idiopathic scoliosis; patients treated exclusively by one of the procedures established as a standard for this review (chiropractic manipulation, osteopathic techniques, massage); and outcome in Cobb degrees. We founded 145 texts, but only three papers were relevant to our study. However, no one of the three satisfied all the required inclusion criteria because they were characterized by a combination of manual techniques and other therapeutic approaches. The lack of any kind of serious scientific data does not allow us to draw any conclusion on the efficacy of manual therapy as an efficacious technique for the treatment of Adolescent idiopathic scoliosis.

  14. How Effective Are Spiritual Care and Body Manipulation Therapies in Pediatric Oncology? A Systematic Review of the Literature

    PubMed Central

    Poder, Thomas G.; Lemieux, Renald

    2014-01-01

    Background: The effects of cancer and associated treatments have a considerable impact on the well-being and quality of life of pediatric oncology patients. To support children and their families, complementary and alternative medicines are seen by nurses and doctors as practical to integrate to the services offered by hospitals. Objective: The purpose of this paper is to examine if the practice of complementary and alternative medicine, specifically spiritual care and treatments based on body manipulation, is likely to improve the health and well-being of children suffering from cancer. Method: This objective is achieved through a systematic review of the literature. The level of evidence associated with each practice of complementary and alternative medicine was assessed according to the methodological design used by the studies reviewed. Results and Conclusion: Studies reviewed are of a methodological quality that could be described as fair due to the small sample size of patients and the existence of a number of biases in the conduct and analysis of these studies. However, results obtained are consistent from one study to another, allowing us to make certain recommendations. It is thus advisable to consider the introduction of hypnotherapy in pediatric oncology services. Based on the data collected, it is the complementary and alternative medicine with the most evidence in favor of effectiveness of the well-being of pediatric oncology patients, especially during painful procedures. It is also recommended to use art therapy and music therapy. Conversely, too little evidence is present to be able to recommend the use of acupuncture, chiropractic or osteopathy. PMID:24576371

  15. Development of hypertrophic osteodystrophy and antibody response in a litter of vaccinated Weimaraner puppies.

    PubMed

    Harrus, S; Waner, T; Aizenberg; Safra, N; Mosenco, A; Radoshitsky, M; Bark, H

    2002-01-01

    Two different vaccination protocols were compared with regard to the development of hypertrophic osteodystrophy (HOD) (also termed metaphyseal osteopathy) and effectiveness of immunisation in a litter of 10 Weimaraner puppies. Five puppies (group 1) were vaccinated with a modified live canine parvovirus vaccine (CPV) and then two weeks later with a trivalent vaccine containing modified live canine distemper virus and adenovirus type 2 combined with a Leptospira bacterin (DHL). The CPV and DHL vaccine protocols were administered a further two times, at two-week intervals. Group 2 was vaccinated with three consecutive multivalent vaccines containing modified live canine distemper virus, canine parvovirus, parainfluenza and adenovirus type 2 combined with a Leptospira bacterin, at four-week intervals. All puppies were first vaccinated at the age of eight weeks. Three dogs in group 1 developed HOD, while all five dogs in group 2 developed HOD during the study period. Dogs in group 2 had more episodes of HOD than those in group 1. Dogs in group 1 developed higher antibody titres to canine distemper virus and parvovirus compared with those in group 2. Only two out of the 10 dogs developed protective antibody titres to parvovirus. The results of this study suggest that the two different vaccination protocols affected the pattern of appearance of HOD and immunisation in this litter of Weimaraner puppies. The results obtained and the previously reported data suggest that a larger controlled study is needed to further elucidate the effect of different vaccination protocols on HOD and immunisation in Weimaraner puppies.

  16. Longitudinal changes in bone metabolism and bone mineral content in children with celiac disease during consumption of a gluten-free diet.

    PubMed

    Barera, Graziano; Beccio, Sabrina; Proverbio, Maria Carla; Mora, Stefano

    2004-01-01

    A gluten-free diet (GFD) rapidly corrects the bone mineral deficit of children with untreated celiac disease. The mechanisms underlying such changes are still poorly understood. In a longitudinal study, we monitored changes in bone metabolism during consumption of a GFD. We studied 22 white patients with celiac disease (11 girls) aged 10.5 +/- 1.0 y at the time of diagnosis. We compared bone metabolism and bone mass values in these patients with those in 428 healthy white children aged 11.3 +/- 0.2 y. Bone-specific alkaline phosphatase (a bone formation index) and N-terminal telopeptide of type I collagen (NTx; a bone resorption marker) were measured at the time of diagnosis and after 2, 6, and 12 mo of the GFD. Bone mineral content was measured at the lumbar spine and for the whole skeleton. The bone mineral content of patients was significantly lower than that of control subjects at the time of diagnosis but not after 1 y of the GFD. Serum bone-specific alkaline phosphatase concentrations of patients were significantly lower than those of control subjects at the time of diagnosis (P = 0.0064) and increased gradually and significantly during the GFD (ANOVA F = 4.71; P = 0.024). Conversely, patients with untreated disease had significantly higher urinary concentrations of NTx than did healthy control subjects (P < 0.0001). Urinary concentrations of NTx were not significantly affected by treatment (P = 0.37). The rate of bone metabolism is altered in children with untreated celiac disease, and these alterations may be the cause of osteopathy. Remarkable changes occur after the initiation of a GFD, and they result in a more balanced equilibrium.

  17. Osteoporosis in pediatric patients suffering from chronic inflammatory bowel disease with and without steroid treatment.

    PubMed

    Walther, Frank; Fusch, Christoph; Radke, Michael; Beckert, Sybille; Findeisen, Annette

    2006-07-01

    Children and adolescents suffering from inflammatory bowel disease (IBD) are at risk of developing osteoporosis as a result of treatment with corticosteroids as well as of nonsteroidal factors like inflammation and malnutrition. To study the impact of these factors on development of osteopathy, we compared the rate of osteoporosis in steroid-naive and steroid-treated pediatric IBD patients. In 90 patients (50 girls) with IBD (34 steroid-naive, 53 steroid-treated, 3 not known) aged 8.8 to 19.2 (14.4 +/- 2.2) years and 52 controls (27 girls) aged 6.1 to 17.6 (12.9 +/- 3.0) years, bone mineral density (BMD) of the lumbar spine was assessed with dual energy x-ray absorptiometry. Areal BMD values were transformed into volumetric densities called bone mineral apparent density (BMAD) and expressed as standard deviation scores (SDS) on the basis of the BMAD values of the controls. The rate of osteoporotic patients (BMAD-SDS < -2) was 8% in girls and 20% in boys. There was a similar proportion of osteoporosis in steroid-naive (12%) and steroid-treated (11%) patients. SDS of body height showed a significant positive correlation with BMD-SDS but not with BMAD-SDS in almost all patient subgroups, indicating an interfering dependency of BMD from bone size. The prevalence of osteoporosis in pediatric patients with IBD is approximately the same as in adult patients. Osteoporosis is already present before steroid treatment. Data of dual energy x-ray absorptiometry measurements should be transformed into volumetric parameters to compensate for short stature. Otherwise, a lot of growth-stunted patients may be falsely diagnosed as osteopenic.

  18. CAM practitioners in the Australian health workforce: an underutilized resource

    PubMed Central

    2012-01-01

    Background CAM practitioners are a valuable but underutilizes resource in Australian health care. Despite increasing public support for complementary and alternative medicine (CAM) little is known about the CAM workforce. Apart from the registered professions of chiropractic, osteopathy and Chinese medicine, accurate information about the number of CAM practitioners in the workforce has been difficult to obtain. It appears that many non-registered CAM practitioners, although highly qualified, are not working to their full capacity. Discussion Increasing public endorsement of CAM stands in contrast to the negative attitude toward the CAM workforce by some members of the medical and other health professions and by government policy makers. The marginalisation of the CAM workforce is evident in prejudicial attitudes held by some members of the medical and other health professions and its exclusion from government policy making. Inconsistent educational standards has meant that non-registered CAM practitioners, including highly qualified and competent ones, are frequently overlooked. Legitimising their contribution to the health workforce could alleviate workforce shortages and provide opportunities for redesigned job roles and new multidisciplinary teams. Priorities for better utilisation of the CAM workforce include establishing a guaranteed minimum education standard for more CAM occupation groups through national registration, providing interprofessional education that includes CAM practitioners, developing courses to upgrade CAM practitioners' professional skills in areas of indentified need, and increasing support for CAM research. Summary Marginalisation of the CAM workforce has disadvantaged those qualified and competent CAM practitioners who practise evidence-informed medicine on the basis of many years of university training. Legitimising and expanding the important contribution of CAM practitioners could alleviate projected health workforce shortages, particularly for the prevention and management of chronic health conditions and for health promotion. PMID:23116374

  19. Osteopathic manipulative treatment: A systematic review and critical appraisal of comparative effectiveness and health economics research.

    PubMed

    Steel, Amie; Sundberg, Tobias; Reid, Rebecca; Ward, Lesley; Bishop, Felicity L; Leach, Matthew; Cramer, Holger; Wardle, Jon; Adams, Jon

    2017-02-01

    In recent years, evidence has emerged regarding the effectiveness of osteopathic manipulative treatments (OMT). Despite growing evidence in this field, there is need for appropriate research designs that effectively reflect the person-centred system of care promoted in osteopathy and provide data which can inform policy decisions within the healthcare system. The purpose of this systematic review is to identify, appraise and synthesise the evidence from comparative effectiveness and economic evaluation research involving OMT. A database search was conducted using CINAHL, PubMed, PEDro, AMED, SCOPUS and OSTMED.DR, from their inception to May 2015. Two separate searches were undertaken to identify original research articles encompassing the economic evaluation and comparative effectiveness of OMT. Identified comparative effectives studies were evaluated using the Cochrane risk of bias tool and appraised using the Good Reporting of Comparative Effectiveness (GRACE) principles. Identified economic studies were assessed with the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) guidelines. Sixteen studies reporting the findings of comparative effectiveness (n = 9) and economic evaluation (n = 7) research were included. The comparative effectiveness studies reported outcomes for varied health conditions and the majority (n = 6) demonstrated a high risk of bias. The economic evaluations included a range of analyses and considerable differences in the quality of reporting were evident. Despite some positive findings, published comparative effectiveness and health economic studies in OMT are of insufficient quality and quantity to inform policy and practice. High quality, well-designed, research that aligns with international best practice is greatly needed to build a pragmatic evidence base for OMT. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. Evaluation of a filmed clinical scenario as a teaching resource for an introductory pharmacology unit for undergraduate health students: A pilot study.

    PubMed

    East, Leah; Hutchinson, Marie

    2015-12-01

    Simulation is frequently being used as a learning and teaching resource for both undergraduate and postgraduate students, however reporting of the effectiveness of simulation particularly within the pharmacology context is scant. The aim of this pilot study was to evaluate a filmed simulated pharmacological clinical scenario as a teaching resource in an undergraduate pharmacological unit. Pilot cross-sectional quantitative survey. An Australian university. 32 undergraduate students completing a healthcare degree including nursing, midwifery, clinical science, health science, naturopathy, and osteopathy. As a part of an undergraduate online pharmacology unit, students were required to watch a filmed simulated pharmacological clinical scenario. To evaluate student learning, a measurement instrument developed from Bloom's cognitive domains (knowledge, comprehension, application, analysis, synthesis and evaluation) was employed to assess pharmacological knowledge conceptualisation and knowledge application within the following fields: medication errors; medication adverse effects; medication interactions; and, general pharmacology. The majority of participants were enrolled in an undergraduate nursing or midwifery programme (72%). Results demonstrated that the majority of nursing and midwifery students (56.52%) found the teaching resource complementary or more useful compared to a lecture although less so compared to a tutorial. Students' self-assessment of learning according to Bloom's cognitive domains indicated that the filmed scenario was a valuable learning tool. Analysis of variance indicated that health science students reported higher levels of learning compared to midwifery and nursing. Students' self-report of the learning benefits of a filmed simulated clinical scenario as a teaching resource suggest enhanced critical thinking skills and knowledge conceptualisation regarding pharmacology, in addition to being useful and complementary to other teaching and learning methods. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Profile of osteopathic practice in Spain: results from a standardized data collection study.

    PubMed

    Alvarez Bustins, Gerard; López Plaza, Pedro-Victor; Carvajal, Sonia Roura

    2018-04-11

    There is limited research regarding patients' profiles and consumer attitudes and habits of osteopathy in Spain. The purpose of this study was to profile patients who regularly receive osteopathic care in Spain using an internationally developed standardized data collection tool. During the period between April 2014 and December 2015, a UK-developed standardized data collection tool was distributed to Spanish osteopaths who voluntarily agreed to participate in this cross-sectional study. Thirty-six osteopaths participated in this study and returned a total of 314 completed datasets. Of 314 patients, 61% were women and 39% were men, with a mean age of 40 years (SD 17.02 years, range 0 to 83 years). Forty-four percent were full-time salaried workers, and in 78% of cases, receiving osteopathic treatment was the patient's own choice. Chronic spinal pain presentations were the most frequent reasons for consultation. Seventy-five percent of patients presented with a coexisting condition, mainly gastrointestinal disorders and headaches. The main treatment approach consisted of mobilization techniques, followed by soft tissue, cranial and high velocity thrust techniques. Improvement or resolution of the complaint was experienced by 93% of patients after a small number of sessions. Adverse events were minor and occurred in 7% of all cases. This is the first study carried out in Spain analyzing the profile of patients who receive osteopathic care. The typical patient who receives osteopathic care in Spain is middle-aged, presents mainly with chronic spinal pain, and voluntarily seeks osteopathic treatment. Osteopathic treatment produces a significant improvement in the majority of cases with a low rate of minor adverse events reported.

  2. Derangement of calcium metabolism in diabetes mellitus: negative outcome from the synergy between impaired bone turnover and intestinal calcium absorption.

    PubMed

    Wongdee, Kannikar; Krishnamra, Nateetip; Charoenphandhu, Narattaphol

    2017-01-01

    Both types 1 and 2 diabetes mellitus (T1DM and T2DM) are associated with profound deterioration of calcium and bone metabolism, partly from impaired intestinal calcium absorption, leading to a reduction in calcium uptake into the body. T1DM is associated with low bone mineral density (BMD) and osteoporosis, whereas the skeletal changes in T2DM are variable, ranging from normal to increased and to decreased BMD. However, both types of DM eventually compromise bone quality through production of advanced glycation end products and misalignment of collagen fibrils (so-called matrix failure), thereby culminating in a reduction of bone strength. The underlying cellular mechanisms (cellular failure) are related to suppression of osteoblast-induced bone formation and bone calcium accretion, as well as to enhancement of osteoclast-induced bone resorption. Several other T2DM-related pathophysiological changes, e.g., osteoblast insulin resistance, impaired productions of osteogenic growth factors (particularly insulin-like growth factor 1 and bone morphogenetic proteins), overproduction of pro-inflammatory cytokines, hyperglycemia, and dyslipidemia, also aggravate diabetic osteopathy. In the kidney, DM and the resultant hyperglycemia lead to calciuresis and hypercalciuria in both humans and rodents. Furthermore, DM causes deranged functions of endocrine factors related to mineral metabolism, e.g., parathyroid hormone, 1,25-dihydroxyvitamin D 3 , and fibroblast growth factor-23. Despite the wealth of information regarding impaired bone remodeling in DM, the long-lasting effects of DM on calcium metabolism in young growing individuals, pregnant women, and neonates born to women with gestational DM have received scant attention, and their underlying mechanisms are almost unknown and worth exploring.

  3. Chronic inflammatory disease and osteopathy: a systematic review.

    PubMed

    Cicchitti, Luca; Martelli, Marta; Cerritelli, Francesco

    2015-01-01

    Chronic inflammatory diseases (CID) are globally highly prevalent and characterized by severe pathological medical conditions. Several trials were conducted aiming at measuring the effects of manipulative therapies on patients affected by CID. The purpose of this review was to explore the extent to which osteopathic manipulative treatment (OMT) can be benefi-cial in medical conditions also classified as CID. This review included any type of experimental study which enrolled sub-jects with CID comparing OMT with any type of control procedure. The search was conducted on eight databases in January 2014 using a pragmatic literature search approach. Two independent re-viewers conducted study selection and data extraction for each study. The risk of bias was evaluated according to the Cochrane methods. Heterogeneity was assessed and meta-analysis performed where possible. 10 studies met the inclusion criteria for this review enrolling 386 subjects. The search identified six RCTs, one laboratory study, one cross-over pilot studies, one observation-al study and one case control pilot study. Results suggest a potential effect of osteopathic medicine on patients with medical pathologies associated with CID (in particular Chronic Obstructive Pul-monary Disease (COPD), Irritable Bowel Syndrome, Asthma and Peripheral Arterial Disease) com-pared to no treatment or sham therapy although data remain elusive. Moreover one study showed possible effects on arthritis rat model. Meta-analysis was performed for COPD studies only show-ing no effect of any type of OMT applied versus control. No major side effects were reported by those receiving OMT. The present systematic review showed inconsistent data on the effect of OMT in the treatment of medical conditions potentially associated with CID, however the OMT appears to be a safe approach. Further more robust trials are needed to determine the direction and magnitude of the effect of OMT and to generalize favorable results.

  4. Methicillin-resistant Staphylococcus aureus: an overview for manual therapists().

    PubMed

    Green, Bart N; Johnson, Claire D; Egan, Jonathon Todd; Rosenthal, Michael; Griffith, Erin A; Evans, Marion Willard

    2012-03-01

    Methicillin-resistant Staphylococcus aureus (MRSA) is associated with difficult-to-treat infections and high levels of morbidity. Manual practitioners work in environments where MRSA is a common acquired infection. The purpose of this review is to provide a practical overview of MRSA as it applies to the manual therapy professions (eg, physical and occupational therapy, athletic training, chiropractic, osteopathy, massage, sports medicine) and to discuss how to identify and prevent MRSA infections in manual therapy work environments. PubMed and CINAHL were searched from the beginning of their respective indexing years through June 2011 using the search terms MRSA, methicillin-resistant Staphylococcus aureus, and Staphylococcus aureus. Texts and authoritative Web sites were also reviewed. Pertinent articles from the authors' libraries were included if they were not already identified in the literature search. Articles were included if they were applicable to ambulatory health care environments in which manual therapists work or if the content of the article related to the clinical management of MRSA. Following information extraction, 95 citations were included in this review, to include 76 peer-reviewed journal articles, 16 government Web sites, and 3 textbooks. Information was organized into 10 clinically relevant categories for presentation. Information was organized into the following clinically relevant categories: microbiology, development of MRSA, risk factors for infection, clinical presentation, diagnostic tests, screening tests, reporting, treatment, prevention for patients and athletes, and prevention for health care workers. Methicillin-resistant S aureus is a health risk in the community and to patients and athletes treated by manual therapists. Manual practitioners can play an essential role in recognizing MRSA infections and helping to control its transmission in the health care environment and the community. Essential methods for protecting patients and health care workers include being aware of presenting signs, patient education, and using appropriate hand and clinic hygiene.

  5. Healthcare provider perceptions of clinical prediction rules

    PubMed Central

    Richardson, Safiya; Khan, Sundas; McCullagh, Lauren; Kline, Myriam; Mann, Devin; McGinn, Thomas

    2015-01-01

    Objectives To examine internal medicine and emergency medicine healthcare provider perceptions of usefulness of specific clinical prediction rules. Setting The study took place in two academic medical centres. A web-based survey was distributed and completed by participants between 1 January and 31 May 2013. Participants Medical doctors, doctors of osteopathy or nurse practitioners employed in the internal medicine or emergency medicine departments at either institution. Primary and secondary outcome measures The primary outcome was to identify the clinical prediction rules perceived as most useful by healthcare providers specialising in internal medicine and emergency medicine. Secondary outcomes included comparing usefulness scores of specific clinical prediction rules based on provider specialty, and evaluating associations between usefulness scores and perceived characteristics of these clinical prediction rules. Results Of the 401 healthcare providers asked to participate, a total of 263 (66%), completed the survey. The CHADS2 score was chosen by most internal medicine providers (72%), and Pulmonary Embolism Rule-Out Criteria (PERC) score by most emergency medicine providers (45%), as one of the top three most useful from a list of 24 clinical prediction rules. Emergency medicine providers rated their top three significantly more positively, compared with internal medicine providers, as having a better fit into their workflow (p=0.004), helping more with decision-making (p=0.037), better fitting into their thought process when diagnosing patients (p=0.001) and overall, on a 10-point scale, more useful (p=0.009). For all providers, the perceived qualities of useful at point of care, helps with decision making, saves time diagnosing, fits into thought process, and should be the standard of clinical care correlated highly (≥0.65) with overall 10-point usefulness scores. Conclusions Healthcare providers describe clear preferences for certain clinical prediction rules, based on medical specialty. PMID:26338684

  6. Retrospective study of morbidity and mortality of captive Iberian lynx (Lynx pardinus) in the ex situ conservation programme (2004-June 2010).

    PubMed

    Martínez, Fernando; Manteca, Xavier; Pastor, Josep

    2013-12-01

    Medical records of 120 Iberian lynx (Lynx pardinus) from the captive breeding population (CBP), 96 of which were older than 1 wk old, were studied from January 2004 to June 2010. From a total of 413 clinical signs recorded, it was possible to obtain a diagnosis in 258 (62.5%). Inappetence, skin wound, and vomiting had the highest incidence. Adult (2 to 6 yr old) and juvenile (1 wk to 1 yr old) animals accounted for most of the clinical signs. Vitamin D toxicosis and intraspecific trauma accounted for 55.4% and 15.1% of the clinical signs, respectively. Renal toxicosis due to the administration of supplements with an excess of vitamin D occurred in 2009 and affected a total of 39 individuals. Intraspecific trauma cases were predominantly observed from sibling aggression. Diet-related conditions consisted of sporadic cases of fatal salmonellosis, dermatophytosis, and gastrointestinal episodes. Suspected idiopathic epilepsy and femoral neck metaphyseal osteopathy were also observed. A total of 15 animals older than 1 wk old died including five vitamin D toxicosis cases and three juveniles due to intraspecific trauma. Mycobacterium bovis was found as a secondary infection in two animals that died from vitamin D toxicosis. Abortions, premature births, and stillbirths accounted for 12 mortalities, and 13 neonatal deaths due to maternal neglect or bacterial sepsis were observed. Data show that improvement of diet-related conditions is a key factor in preserving the health of animals in the CBP. Thus, the control of food and supplement composition, rabbit farm suppliers, and hygiene should be standardized and improved. Furthermore, data recording and diagnostic protocols should be standardized.

  7. Follow-up survey of the prevalence, diagnosis, clinical manifestations and treatment of Spirocerca lupi in South Africa.

    PubMed

    Lobetti, Remo

    2014-11-14

    Spirocercosis is an important disease in South Africa. The object of this study was to determine if there had been a change in the prevalence, clinical manifestations and treatment of Spirocerca lupi over a 14-year period. A questionnaire was sent to 577 veterinary practices throughout South Africa in 2012. Of responders, 76% indicated that S. lupi occurred in their area, whilst 24% indicated that it did not; 84% considered S. lupi not to be a new phenomenon, whereas 16% considered it to be new. Monthly or seasonal distribution of the disease was not reported, and 76% of responders reported it to occur in no specific breed of dog, whereas 24% reported a breed risk, most considering large breeds to be at greater risk. No specific age or sex was identified as at higher risk. Common owner complaints were vomiting, weight loss, cough, or regurgitation. Reported clinical findings tended to mirror the clinical signs reported by owners. Most common diagnostic methods used were radiology, endoscopy, faecal flotation, and post mortem examination. Forty-four percent did not report seeing asymptomatic cases, 40% reported asymptomatic cases and 16% did not know. Associated complications were reported by 85% of responders, and included oesophageal neoplasia, hypertrophic osteopathy and acute haemothorax. Four different drugs were used as therapy: doramectin, ivermectin, milbemycin and Advocate®, with 9% of the responders using a combination of these four; 85% considered treatment to be effective and 15% ineffective. Treatment was considered more effective if the disease was diagnosed early and there were no complications. Two important conclusions were that more cases are being seen and that efficacy of therapy has increased, with a decrease in the mortality rate.

  8. Family medicine residents’ perceived level of comfort in treating common sports injuries across residency programs in the United States

    PubMed Central

    Amoako, Adae O; Amoako, Agyenim B; Pujalte, George GA

    2015-01-01

    Background and objective Family physicians are expected to be comfortable in treating common sports injuries. Evidence shows a limited level of comfort in treating these injuries in pediatric and internal medicine residents. Studies are lacking, however, in family medicine residents. The purpose of this study is to assess the comfort level of family medicine residents in treating common sports injuries in adults and children based on their perceived level of knowledge and attitudes. Methods This is a cross-sectional study of family medicine residents in the United Sates. A written survey of 25 questions related to sports injury knowledge and factors affecting comfort level were collected. A chi-square test was implemented in calculating P-values. Results Five hundred and fifty-seven residents responded to the survey. A higher percentage of doctors of osteopathy (86.6%, 82.5%, 69.6%, and 68.7%) compared to doctors of medicine (78.5%, 71.6%, 53.4%, and 52.8%) respectively identified ankle sprain, concussion, plantar fasciitis, and lateral epicondylitis as common injuries, and felt comfortable in treating them (P-values =0.015, 0.004, 0.0001, and 0.0002, respectively). Residents with high interest in sports medicine correctly identified the injuries as common and felt comfortable treating them as well (knowledge, P=0.027, 0.0029, <0.0001, and 0.0001, respectively; comfort level, P=0.0016, <0.0001, 0.0897, and 0.0010, respectively). Conclusion Medical education background, factors that affect training, and an interest in sports medicine contribute to residents’ knowledge and comfort level in treatment of common sports injuries. PMID:25848326

  9. Molecular Characterization of Three Canine Models of Human Rare Bone Diseases: Caffey, van den Ende-Gupta, and Raine Syndromes.

    PubMed

    Hytönen, Marjo K; Arumilli, Meharji; Lappalainen, Anu K; Owczarek-Lipska, Marta; Jagannathan, Vidhya; Hundi, Sruthi; Salmela, Elina; Venta, Patrick; Sarkiala, Eva; Jokinen, Tarja; Gorgas, Daniela; Kere, Juha; Nieminen, Pekka; Drögemüller, Cord; Lohi, Hannes

    2016-05-01

    One to two percent of all children are born with a developmental disorder requiring pediatric hospital admissions. For many such syndromes, the molecular pathogenesis remains poorly characterized. Parallel developmental disorders in other species could provide complementary models for human rare diseases by uncovering new candidate genes, improving the understanding of the molecular mechanisms and opening possibilities for therapeutic trials. We performed various experiments, e.g. combined genome-wide association and next generation sequencing, to investigate the clinico-pathological features and genetic causes of three developmental syndromes in dogs, including craniomandibular osteopathy (CMO), a previously undescribed skeletal syndrome, and dental hypomineralization, for which we identified pathogenic variants in the canine SLC37A2 (truncating splicing enhancer variant), SCARF2 (truncating 2-bp deletion) and FAM20C (missense variant) genes, respectively. CMO is a clinical equivalent to an infantile cortical hyperostosis (Caffey disease), for which SLC37A2 is a new candidate gene. SLC37A2 is a poorly characterized member of a glucose-phosphate transporter family without previous disease associations. It is expressed in many tissues, including cells of the macrophage lineage, e.g. osteoclasts, and suggests a disease mechanism, in which an impaired glucose homeostasis in osteoclasts compromises their function in the developing bone, leading to hyperostosis. Mutations in SCARF2 and FAM20C have been associated with the human van den Ende-Gupta and Raine syndromes that include numerous features similar to the affected dogs. Given the growing interest in the molecular characterization and treatment of human rare diseases, our study presents three novel physiologically relevant models for further research and therapy approaches, while providing the molecular identity for the canine conditions.

  10. High fat diet attenuates hyperglycemia, body composition changes, and bone loss in male streptozotocin-induced type 1 diabetic mice.

    PubMed

    Carvalho, Adriana Lelis; DeMambro, Victoria E; Guntur, Anyonya R; Le, Phuong; Nagano, Kenichi; Baron, Roland; de Paula, Francisco José Albuquerque; Motyl, Katherine J

    2018-02-01

    There is a growing and alarming prevalence of obesity and the metabolic syndrome in type I diabetic patients (T1DM), particularly in adolescence. In general, low bone mass, higher fracture risk, and increased marrow adipose tissue (MAT) are features of diabetic osteopathy in insulin-deficient subjects. On the other hand, type 2 diabetes (T2DM) is associated with normal or high bone mass, a greater risk of peripheral fractures, and no change in MAT. Therefore, we sought to determine the effect of weight gain on bone turnover in insulin-deficient mice. We evaluated the impact of a 6-week high-fat (HFD) rich in medium chain fatty acids or low-fat diet (LFD) on bone mass and MAT in a streptozotocin (STZ)-induced model using male C57BL/6J mice at 8 weeks of age. Dietary intervention was initiated after diabetes confirmation. At the endpoint, lower non-fasting glucose levels were observed in diabetic mice fed with high fat diet compared to diabetic mice fed the low fat diet (STZ-LFD). Compared to euglycemic controls, the STZ-LFD had marked polydipsia and polyphagia, as well as reduced lean mass, fat mass, and bone parameters. Interestingly, STZ-HFD mice had higher bone mass, namely less cortical bone loss and more trabecular bone than STZ-LFD. Thus, we found that a HFD, rich in medium chain fatty acids, protects against bone loss in a T1DM mouse model. Whether this may also translate to T1DM patients who are overweight or obese in respect to maintenance of bone mass remains to be determined through longitudinal studies. © 2017 Wiley Periodicals, Inc.

  11. Molecular Characterization of Three Canine Models of Human Rare Bone Diseases: Caffey, van den Ende-Gupta, and Raine Syndromes

    PubMed Central

    Hytönen, Marjo K.; Arumilli, Meharji; Lappalainen, Anu K.; Owczarek-Lipska, Marta; Jagannathan, Vidhya; Hundi, Sruthi; Salmela, Elina; Venta, Patrick; Sarkiala, Eva; Jokinen, Tarja; Gorgas, Daniela; Kere, Juha; Nieminen, Pekka

    2016-01-01

    One to two percent of all children are born with a developmental disorder requiring pediatric hospital admissions. For many such syndromes, the molecular pathogenesis remains poorly characterized. Parallel developmental disorders in other species could provide complementary models for human rare diseases by uncovering new candidate genes, improving the understanding of the molecular mechanisms and opening possibilities for therapeutic trials. We performed various experiments, e.g. combined genome-wide association and next generation sequencing, to investigate the clinico-pathological features and genetic causes of three developmental syndromes in dogs, including craniomandibular osteopathy (CMO), a previously undescribed skeletal syndrome, and dental hypomineralization, for which we identified pathogenic variants in the canine SLC37A2 (truncating splicing enhancer variant), SCARF2 (truncating 2-bp deletion) and FAM20C (missense variant) genes, respectively. CMO is a clinical equivalent to an infantile cortical hyperostosis (Caffey disease), for which SLC37A2 is a new candidate gene. SLC37A2 is a poorly characterized member of a glucose-phosphate transporter family without previous disease associations. It is expressed in many tissues, including cells of the macrophage lineage, e.g. osteoclasts, and suggests a disease mechanism, in which an impaired glucose homeostasis in osteoclasts compromises their function in the developing bone, leading to hyperostosis. Mutations in SCARF2 and FAM20C have been associated with the human van den Ende-Gupta and Raine syndromes that include numerous features similar to the affected dogs. Given the growing interest in the molecular characterization and treatment of human rare diseases, our study presents three novel physiologically relevant models for further research and therapy approaches, while providing the molecular identity for the canine conditions. PMID:27187611

  12. Integrating Behavioral Health into Pediatric Primary Care: Implications for Provider Time and Cost.

    PubMed

    Gouge, Natasha; Polaha, Jodi; Rogers, Rachel; Harden, Amy

    2016-12-01

    Integrating a behavioral health consultant (BHC) into primary care is associated with improved patient outcomes, fewer medical visits, and increased provider satisfaction; however, few studies have evaluated the feasibility of this model from an operations perspective. Specifically, time and cost have been identified as barriers to implementation. Our study aimed to examine time spent, patient volume, and revenue generated during days when the on-site BHC was available compared with days when the consultant was not. Data were collected across a 10-day period when a BHC provided services and 10 days when she was not available. Data included time stamps of patient direct care; providers' direct reports of problems raised; and a review of medical and administrative records, including billing codes and reimbursement. This study took place in a rural, stand-alone private pediatric primary care practice. The participants were five pediatric primary care providers (PCPs; two doctors of medicine, 1 doctor of osteopathy, 2 nurse practitioners) and two supervised doctoral students in psychology (BHCs). Pediatric patients (N = 668) and their parents also participated. On days when a BHC was present, medical providers spent 2 fewer minutes on average for every patient seen, saw 42% more patients, and collected $1142 more revenue than on days when no consultant was present. The time savings demonstrated on days when the consultant was available point to the efficiency and potential financial viability of this model. These results have important implications for the feasibility of hiring behavioral health professionals in a fee-for-service system. They have equally useful implications for the utility of moving to a bundled system of care in which collaborative practice is valued.

  13. Spine Tango registry data collection in a conservative spinal service: a feasibility study.

    PubMed

    Morris, Samuel; Booth, James; Hegarty, James

    2016-09-01

    The study reports the feasibility of implementing routine registry data collection and sustaining a high rate of data capture within a secondary care spinal osteopathy service, using the Spine Tango Conservative registry data collection tool (STC) with multiple patient-reported outcome measures (PROMs): Oswestry Disability Index (ODI), Neck Disability Index (NDI), COMI Low Back Conservative, COMI Neck Conservative and EQ-5D-3L. Data collection rates were studied during the implementation of a registry data collection project from October 2011 to June 2015. The primary outcome was completion rate of PROMs and the STC, measured as a percentage of total expected data collection. Descriptive statistics were used to illustrate completion rates by year, age group, sex, region of spinal complaint, baseline ODI or NDI score and number of PROMs required to complete the data set. Data were collected on 349 patients. Overall data collection rates increased from 54.8 % in January-June 2012 to 90.4 % in January-June 2015. The percentage of fully completed data sets was lower in the patient group required to complete 4-5 PROMs at each data collection point (15.4 %) than it was in the patient group required to complete 2-3 PROMs (37.4 %). Other comparisons showed no clear patterns. Our analysis shows that a high rate of data capture can be sustained in a clinical setting using the STC and multiple PROMs. However, increasing the burden of data collection on patients and practitioners was associated with increased data loss. We describe measures taken to reduce data loss in the future and to increase the efficiency of the data collection project.

  14. CAM practitioners in the Australian health workforce: an underutilized resource.

    PubMed

    Grace, Sandra

    2012-11-02

    CAM practitioners are a valuable but underutilizes resource in Australian health care. Despite increasing public support for complementary and alternative medicine (CAM) little is known about the CAM workforce. Apart from the registered professions of chiropractic, osteopathy and Chinese medicine, accurate information about the number of CAM practitioners in the workforce has been difficult to obtain. It appears that many non-registered CAM practitioners, although highly qualified, are not working to their full capacity. Increasing public endorsement of CAM stands in contrast to the negative attitude toward the CAM workforce by some members of the medical and other health professions and by government policy makers. The marginalisation of the CAM workforce is evident in prejudicial attitudes held by some members of the medical and other health professions and its exclusion from government policy making. Inconsistent educational standards has meant that non-registered CAM practitioners, including highly qualified and competent ones, are frequently overlooked. Legitimising their contribution to the health workforce could alleviate workforce shortages and provide opportunities for redesigned job roles and new multidisciplinary teams. Priorities for better utilisation of the CAM workforce include establishing a guaranteed minimum education standard for more CAM occupation groups through national registration, providing interprofessional education that includes CAM practitioners, developing courses to upgrade CAM practitioners' professional skills in areas of indentified need, and increasing support for CAM research. Marginalisation of the CAM workforce has disadvantaged those qualified and competent CAM practitioners who practise evidence-informed medicine on the basis of many years of university training. Legitimising and expanding the important contribution of CAM practitioners could alleviate projected health workforce shortages, particularly for the prevention and management of chronic health conditions and for health promotion.

  15. Human subject research: reporting ethics approval and informed consent in 3 chiropractic journals.

    PubMed

    Lawrence, Dana J

    2011-11-01

    To date, there have been no reports of ethics board approval or informed consent within the chiropractic literature or within chiropractic research. The purpose of this study was to assess the reporting of ethics approval and informed consent in articles published during the 2008 volume year of 3 chiropractic research journals included in PubMed. A quantitative assessment of the articles published in each journal for the 2008 volume year was performed. Information collected included if the article involved human subject research, if it reported ethics board approval, and if informed consent was given to subjects. Data were collected as descriptive statistics (frequency counts and percentages). In aggregate, 50 articles of a total of 143 published involved human subject research (35%). 44 reported ethics board approval (88%), and 28 reported that informed consent had been obtained (56%). Forty-five percent of articles published in the Journal of Manipulative and Physiological Therapeutics involved human subject research (39/87), of which 95% reported ethics board approval (37/39) and 64% reported informed consent (25/39); 12.5% of articles from the Journal of the Canadian Chiropractic Association involved human subject research (5/40), of which 80% reported ethics board approval (4/5) and 40% reported informed consent (2/5); and 37.5% of articles published in Chiropractic and Osteopathy involved human subject research (6/16), of which 50% reported ethics board approval (3/6) and 17% reported informed consent (1/6). Overall, most articles reported ethics approval, and more than half reported consent. This was harmonious with research on this topic from other disciplines. This situation indicates a need for continued quality improvement and for better instruction and dissemination of information on these issues to researchers, to manuscript reviewers, to journal editors, and to the readers. Copyright © 2011 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.

  16. Chronic Inflammatory Disease and Osteopathy: A Systematic Review

    PubMed Central

    Cicchitti, Luca; Martelli, Marta; Cerritelli, Francesco

    2015-01-01

    Background Chronic inflammatory diseases (CID) are globally highly prevalent and characterized by severe pathological medical conditions. Several trials were conducted aiming at measuring the effects of manipulative therapies on patients affected by CID. The purpose of this review was to explore the extent to which osteopathic manipulative treatment (OMT) can be benefi-cial in medical conditions also classified as CID. Methods This review included any type of experimental study which enrolled sub-jects with CID comparing OMT with any type of control procedure. The search was conducted on eight databases in January 2014 using a pragmatic literature search approach. Two independent re-viewers conducted study selection and data extraction for each study. The risk of bias was evaluated according to the Cochrane methods. Heterogeneity was assessed and meta-analysis performed where possible. Results 10 studies met the inclusion criteria for this review enrolling 386 subjects. The search identified six RCTs, one laboratory study, one cross-over pilot studies, one observation-al study and one case control pilot study. Results suggest a potential effect of osteopathic medicine on patients with medical pathologies associated with CID (in particular Chronic Obstructive Pul-monary Disease (COPD), Irritable Bowel Syndrome, Asthma and Peripheral Arterial Disease) com-pared to no treatment or sham therapy although data remain elusive. Moreover one study showed possible effects on arthritis rat model. Meta-analysis was performed for COPD studies only show-ing no effect of any type of OMT applied versus control. No major side effects were reported by those receiving OMT. Conclusion The present systematic review showed inconsistent data on the effect of OMT in the treatment of medical conditions potentially associated with CID, however the OMT appears to be a safe approach. Further more robust trials are needed to determine the direction and magnitude of the effect of OMT and to generalize favorable results. PMID:25781621

  17. Complementary and alternative medicine for pediatric otitis media.

    PubMed

    Levi, Jessica R; Brody, Robert M; McKee-Cole, Katie; Pribitkin, Edmund; O'Reilly, Robert

    2013-06-01

    To review the literature involving complementary and alternative medicine (CAM) for pediatric otitis media. Multiple modalities are discussed, including prevention involving breastfeeding, nutrition, and vaccination; symptomatic treatment involving homeopathy, natural health products, and probiotics; manual manipulations involving osteopathy and chiropractics; and traditional Chinese and Japanese medicine. The information presented will assist physicians in advising patients on their decision-making during the early stages of otitis media when antibiotics and surgery are not yet indicated. A systematic literature search was conducted through January 2012 in PubMed using MESH term "otitis media" in conjunction with "complementary therapies," "homeopathy," "manipulation, osteopathic," "manipulation, chiropractic," "acupuncture therapy," "probiotics," "naturopathy," and "xylitol." Theses searches yielded 163 unique results. Abstracts and titles were evaluated for relevance. Case reports, case series, randomized controlled trials, and basic science research were included. Publications not relevant to the discussion of alternative medicine in otitis media were excluded. Bibliographies were checked for further publications. Thirty-six unique publications were reviewed. Of all therapies in complementary and alternative medicine, only xylitol has been studied in well-designed, randomized, blinded trials; it is likely effective, but compliance limits its applicability. Management of acute otitis media begins with watchful waiting. Herbal eardrops may help relieve symptoms. Homeopathic treatments may help decrease pain and lead to faster resolution. Prevention should be emphasized with elimination of risk factors, such as second hand smoke and bottle-feeding, as well as maintaining nutrition and vaccinations. Vitamin supplementation may be helpful. Probiotics and xylitol may be beneficial as well. Traditional Chinese/Japanese therapies show promising results but remain speculative until further research is conducted. Severe cases of otitis media with complications or those that fail to improve with observation or CAM (after 48-72h) should be treated with antibiotics and, in some cases, surgical intervention. It is best to consult a physician when making treatment decisions for full guidance on the risks and benefits of any treatment option. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  18. Use of complementary and alternative medicine (CAM) by parents in their children and adolescents with epilepsy - Prevelance, predictors and parents' assessment.

    PubMed

    Hartmann, Nicole; Neininger, Martina P; Bernhard, Matthias K; Syrbe, Steffen; Nickel, Petra; Merkenschlager, Andreas; Kiess, Wieland; Bertsche, Thilo; Bertsche, Astrid

    2016-01-01

    The use of complementary and alternative medicine (CAM) is popular. Parents of children suffering from epilepsy may also consider administering CAM to their children. Systematic data about frequency of and motivations for CAM use, however, are scarce. In a university hospital's neuropaediatric department parents of patients aged 0-18 years suffering from epilepsy were consecutively invited to take part in a structured interview during 4 months in 2014. Of the invited parents, 164/165 (99%) agreed to participate. From those, 21/164 (13%) stated that they used CAM in their child. The highest independent predictive value of CAM use was the occurrence of adverse drug events (ADE) of anticonvulsants as judged by parents. Patients affected by ADE had a 5.6 higher chance of receiving CAM compared to patients without ADE. Most commonly used were homeopathy (14/21, 67%) and osteopathy (12/21, 57%). The internet was the most frequently used source of information (14/21, 67%). Of the parents, 10/21 (48%) described positive effects of CAM on seizure frequency, 12/21 (57%) on general condition of their child, and 20/21 (95%) wished to continue CAM for epilepsy therapy. From the non-users of CAM, 91/143 (66%) expressed the desire to learn more about CAM for epilepsy therapy. Our study was performed in a university hospital in a large urban city in Eastern Germany. CAM user rates can differ in other parts of Germany and Europe, in other institutions and for chronic diseases other than epilepsy. The main reason for CAM use was the occurrence of ADE of anticonvulsants. More than half of the parents saw a benefit of CAM for their children. Almost all parents wished to continue CAM use, even those who did not see concrete positive effects. Copyright © 2015 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

  19. Sickness absence due to musculoskeletal diagnoses and risk of diagnosis-specific disability pension: a nationwide Swedish prospective cohort study.

    PubMed

    Jansson, Catarina; Alexanderson, Kristina

    2013-06-01

    Musculoskeletal disorders constitute major public health problems. Few studies have, however, examined risk of disability pension among persons sickness absent due to musculoskeletal diagnoses. Thus, we constructed a prospective nationwide population-based cohort study based on Swedish registers, consisting of all 4,687,756 individuals living in Sweden December 31, 2004/2005, aged 20-64 years, who were not on disability or old-age pension. Those individuals who were sickness absent in 2005 due to musculoskeletal diagnoses were compared to those sickness absent due to non-musculoskeletal diagnoses and those with no sickness absence. Musculoskeletal diagnoses were categorized as follows: 1) artropathies/systemic connective tissue disorders, 2) dorsopathies, and 3) soft tissue disorders/osteopathies/chondropathies/other musculoskeletal disorders. All-cause and diagnosis-specific incident disability pension were followed from 2006 to 2009. Incidence rate ratios (IRRs) and 95% confidence intervals (CIs) were estimated by Cox proportional hazards regression. In models adjusted for socio-demographic factors and morbidity, sickness absence due to all categories of musculoskeletal diagnoses was associated with 12- to 18-fold increased risks of all-cause disability pension (adjusted model, category 2 diagnoses, IRR = 18.57, 95% CI = 18.18-18.97). Similar associations were observed among both women and men sickness absent due to all 3 musculoskeletal diagnostic categories. Moreover, increased risks of disability pension because of cancer, mental, circulatory and musculoskeletal diagnoses were observed among individuals sickness absent because of any musculoskeletal diagnostic category (disability pension due to musculoskeletal diagnoses, adjusted model, category 2 diagnoses, IRR = 50.66, 95% CI = 49.06-52.32). In conclusion, this nationwide cohort study reveals strongly increased risks of all-cause and diagnosis-specific disability pension among those sickness absent due to musculoskeletal diagnoses. Copyright © 2013 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  20. Juvenile Paget’s Disease In An Iranian Kindred With Vitamin D Deficiency And Novel Homozygous TNFRSF11B Mutation

    PubMed Central

    Saki, Forough; Karamizadeh, Zohreh; Nasirabadi, Shiva; Mumm, Steven; McAlister, William H.; Whyte, Michael P.

    2013-01-01

    Juvenile Paget’s disease (JPD) is a rare heritable osteopathy characterized biochemically by markedly increased serum alkaline phosphatase (ALP) activity emanating from generalized acceleration of skeletal turnover. Affected infants and children typically suffer bone pain and fractures and deformities, become deaf, and have macrocranium. Some who survive to young adult life develop blindness from retinopathy engendered by vascular microcalcification. Most cases of JPD are caused by osteoprotegerin (OPG) deficiency due to homozygous loss-of-function mutations within the TNFRSF11B gene that encodes OPG. We report a 3-year-old Iranian girl with JPD and craniosynostosis who had vitamin D deficiency in infancy. She presented with fractures during the first year-of-life followed by bone deformities, delayed development, failure-to-thrive, and pneumonias. At 1 year-of-age, biochemical studies of serum revealed marked hyperphosphatasemia together with low-normal calcium and low inorganic phosphate and 25-hydroxyvitamin D levels. Several family members in previous generations of this consanguineous kindred may also have had JPD and vitamin D deficiency. Mutation analysis showed homozygosity for a unique missense change (c.130T>C, p.Cys44Arg) in TNFRSF11B that would compromise the cysteine-rich domain of OPG that binds receptor activator of NF-κB ligand (RANKL). Both parents were heterozygous for this mutation. The patient’s serum OPG level was extremely low and RANKL level markedly elevated. She responded well to rapid oral vitamin D repletion followed by pamidronate treatment given intravenously. Our patient is the first Iranian reported with JPD. Her novel mutation in TNFRSF11B plus vitamin D deficiency in infancy was associated with severe JPD uniquely complicated by craniosynostosis. Pamidronate treatment with vitamin D sufficiency can be effective treatment for the skeletal disease caused by the OPG deficiency form of JPD. PMID:23322328

  1. Usage of Complementary Medicine in Switzerland: Results of the Swiss Health Survey 2012 and Development Since 2007

    PubMed Central

    Klein, Sabine D.; Torchetti, Loredana; Frei-Erb, Martin; Wolf, Ursula

    2015-01-01

    Background Complementary medicine (CM) is popular in Switzerland. Several CM methods (traditional Chinese medicine/acupuncture, homeopathy, anthroposophic medicine, neural therapy, and herbal medicine) are currently covered by the mandatory basic health insurance when performed by a certified physician. Treatments by non-medical therapists are partially covered by a supplemental and optional health insurance. In this study, we investigated the frequency of CM use including the evolvement over time, the most popular methods, and the user profile. Methods Data of the Swiss Health Surveys 2007 and 2012 were used. In 2007 and 2012, a population of 14,432 and 18,357, respectively, aged 15 years or older answered the written questionnaire. A set of questions queried about the frequency of use of various CM methods within the last 12 months before the survey. Proportions of usage and 95% confidence intervals were calculated for these methods and CM in general. Users and non-users of CM were compared using logistic regression models. Results The most popular methods in 2012 were homeopathy, naturopathy, osteopathy, herbal medicine, and acupuncture. The average number of treatments within the 12 months preceding the survey ranged from 3 for homeopathy to 6 for acupuncture. 25.0% of the population at the age of 15 and older had used at least one CM method in the previous 12 months. People with a chronic illness or a poor self-perceived health status were more likely to use CM. Similar to other countries, women, people of middle age, and those with higher education were more likely to use CM. 59.9% of the adult population had a supplemental health insurance that partly covered CM treatments. Conclusions Usage of CM in Switzerland remained unchanged between 2007 and 2012. The user profile in Switzerland was similar to other countries, such as Germany, United Kingdom, United States or Australia. PMID:26513370

  2. The origins and early history of the National Chiropractic Association

    PubMed Central

    Keating, Joseph C; Rehm, William S

    1993-01-01

    Early organization in chiropractic was prompted by the profession’s need to promote itself and to defend against the onslaught of political medicine and organized osteopathy. The first priorities were legal defense against prosecution for unlicensed practice and malpractice insurance. The Universal Chiropractors’ Association (UCA), organized at the Palmer School of Chiropractic (PSC) in 1906, sought to meet these needs by insuring its members and by developing a legal department under the supervision of attorney Tom Morris, one time lieutenant governor of Wisconsin. The public relations and marketing needs of chiropractors were largely served by the PSC and its legendary leader. However, as chiropractors increasingly sought to avoid prosecution by passage of chiropractic laws, Palmer’s efforts to direct this legislation so as to limit chiropractors’ scope of practice increasingly alienated many in the profession. The American Chiropractic Association (ACA) was founded in 1922 to provide a broadscope alternative to BJ’s UCA. With Palmer’s departure from the UCA following the neurocalometer debacle, ACA and UCA sought amalgamation. Simultaneously, organized medicine renewed its attack on the profession by introducing basic science legislation, which prompted chiropractors to try to upgrade and standardize chiropractic education. Early efforts to bring about the needed consensus were centered in the International Chiropractic Congress (ICC), particularly its division of state examining boards. In 1930 the ACA and UCA combined to form the National Chiropractic Association (NCA), and by 1934 the ICC had merged with the NCA to form part of its council structure. With this modicum of solidarity the NCA began the process of educational boot-strapping at its 1935 convention in Los Angeles, when its Committee on Education, a forerunner of today’s Council on Chiropractic Education, was proposed by C.O. Watkins of Montana. ImagesFigure 2Figure 3Figure 4Figure 5Figure 6Figure 7Figure 9

  3. High fluoride and low calcium levels in drinking water is associated with low bone mass, reduced bone quality and fragility fractures in sheep.

    PubMed

    Simon, M J K; Beil, F T; Rüther, W; Busse, B; Koehne, T; Steiner, M; Pogoda, P; Ignatius, A; Amling, M; Oheim, R

    2014-07-01

    Chronic environmental fluoride exposure under calcium stress causes fragility fractures due to osteoporosis and bone quality deterioration, at least in sheep. Proof of skeletal fluorosis, presenting without increased bone density, calls for a review of fracture incidence in areas with fluoridated groundwater, including an analysis of patients with low bone mass. Understanding the skeletal effects of environmental fluoride exposure especially under calcium stress remains an unmet need of critical importance. Therefore, we studied the skeletal phenotype of sheep chronically exposed to highly fluoridated water in the Kalahari Desert, where livestock is known to present with fragility fractures. Dorper ewes from two flocks in Namibia were studied. Chemical analyses of water, blood and urine were executed for both cohorts. Skeletal phenotyping comprised micro-computer tomography (μCT), histological, histomorphometric, biomechanical, quantitative backscattered electron imaging (qBEI) and energy-dispersive X-ray (EDX) analysis. Analysis was performed in direct comparison with undecalcified human iliac crest bone biopsies of patients with fluoride-induced osteopathy. The fluoride content of water, blood and urine was significantly elevated in the Kalahari group compared to the control. Surprisingly, a significant decrease in both cortical and trabecular bones was found in sheep chronically exposed to fluoride. Furthermore, osteoid parameters and the degree and heterogeneity of mineralization were increased. The latter findings are reminiscent of those found in osteoporotic patients with treatment-induced fluorosis. Mechanical testing revealed a significant decrease in the bending strength, concurrent with the clinical observation of fragility fractures in sheep within an area of environmental fluoride exposure. Our data suggest that fluoride exposure with concomitant calcium deficit (i) may aggravate bone loss via reductions in mineralized trabecular and cortical bone mass and (ii) can cause fragility fractures and (iii) that the prevalence of skeletal fluorosis especially due to groundwater exposure should be reviewed in many areas of the world as low bone mass alone does not exclude fluorosis.

  4. Osteopathic manipulative treatment and pain in preterms: study protocol for a randomised controlled trial.

    PubMed

    Cerritelli, Francesco; Cicchitti, Luca; Martelli, Marta; Barlafante, Gina; Renzetti, Cinzia; Pizzolorusso, Gianfranco; Lupacchini, Mariacristina; D'Orazio, Marianna; Marinelli, Benedetta; Cozzolino, Vincenzo; Fusilli, Paola; D'Incecco, Carmine

    2015-03-08

    Recent evidence proved the necessity to improve health care and pain management in newborns. Osteopathic manipulative treatment (OMT) has been largely used to treat painful syndromes as well as term and preterm newborns. Recent studies have demonstrated positive results of osteopathy in reducing length of stay and costs. However, no trials were carried out on pain in newborns. The aim of the present clinical trial is to explore the effectiveness of osteopathic treatment in reducing pain in a sample of preterms. A three-armed single blinded placebo-control randomised controlled trial protocol has been designed to primarily evaluate the extent to which OMT is effective in reducing pain in preterms. One hundred and twenty newborns will be enrolled from one tertiary neonatal intensive care unit in central Italy and randomised in three groups: study, sham and control. The study group will be further prospectively randomised in two subgroups: experienced osteopaths and students. All preterms will receive standard medical care. Osteopathic treatment will be applied to the study group only whilst 'soft touch' will be administer to the sham group only. Newborns will undergo manual sessions once a week for the entire period of hospitalisation. Blinding will be assured for neonatal staff and outcome assessor. Primary outcome will be the mean difference in baseline score changes of PIPP questionnaire between discharge and entry among the three groups. Secondary outcomes will be: mean difference in length of stay and costs between groups. Statistical analyses will use per-protocol analysis method. Missing data will be handled using last observation carried forward imputation technique. The present single blinded randomised controlled trial has been designed to explore potential advantages of OMT in the management of newborns' pain. Currently, based on a patient-centred need-based approach, this research will be looking at the benefit of osteopathic care rather than the efficacy of a specific technique or a pre-determined protocol. The protocol has been registered on ClinicalTrials.gov ( NCT02146677 ) on 20 May 2014.

  5. Complementary and alternative medicine (CAM) use in an Italian cohort of pediatric headache patients: the tip of the iceberg.

    PubMed

    Dalla Libera, D; Colombo, B; Pavan, G; Comi, G

    2014-05-01

    The use of complementary alternative medicine (CAM) in paediatric populations is considerably increased, especially for pain and chronic conditions, as demonstrated by epidemiological surveys both in Europe and in the USA. In our study, CAM was used in 76 % patients of a cohort of 124 children affected by headache (age 4-16 years; 67 % female; 70 % migraine without aura, 12 % migraine with aura, 18 % tensive headache according to IHS criteria) consecutively recruited at a Pediatric Headache University Center. CAM was used as preventive treatment in 80 % cases. The main reasons for seeking CAM were: the wish of avoiding chronic use of drugs with their related side effects, the desire of an integrated approach, the reported inefficacy of conventional medicine, and a more suitable children disposition to CAM than to pharmacological compound. Female gender, younger age, migraine without aura, parents' higher educational status, maternal use of CAM and other associated chronic conditions, correlated with CAM use (p < 0.05). 73 % patients chose CAM also to treat other diseases (i.e. allergies, colitis, asthma, insomnia, muscle-scheletric disorders and dysmenorrhoea). The most assumed CAM were: herbal remedies (64 %) such as Valeriana, Ginkgo biloba, Boswellia serrata, Vitex agnus-castus, passion flower, Linden tree; vitamins/minerals supplements (40 %) with magnesium, 5-Hydroxytryptophan, vitamin B6 or B12, Multivitamin compounds; Homeopathy (47 %) with Silicea, Ignatia Amara, Pulsatilla, Aconitum, Nux Vomica, Calcarea phosphorica; physical treatment (45 %) such as Ayurvedic massage, shiatsu, osteopathy; yoga (33 %); acupuncture (11 %). CAM-often integrated with conventional care-was auto-prescribed in 30 % of the cases, suggested by non-physician in 22 %, by the General Practitioner in 24 % and by paediatrician in 24 %. Both general practitioners and neurologists were mostly unaware of their patients' CAM use. In conclusion, neurologists should inquire for CAM use and be prepared to learn about CAM therapies or to directly interact with CAM trained experts, in order to coordinate an integrative approach to health, as especially required in paediatric headache patients and their parents. Further studies are required to investigate safety and efficacy of CAM in pediatric headache, as a possible side-medicine to conventional pharmacological approach.

  6. [Case-control study on spinal leveraging manipulation and medicine for the treatment of degenerative scoliosis].

    PubMed

    Tian, Gang; Shen, Mao-rong; Jiang, Wei-guo; Xie, Fu-rong; Wei, Wen-wu

    2015-06-01

    To compare clinical effects of spinal leveraging manipulation and medicine for the treatment of degenerative scoliosis in pain and function. From July 2010 to June 2013, 38 patients with degenerative scoliosis were randomly divided into spinal leveraging manipulation group and medicine group by coin tossing. In manipulation group, there were 9 males and 11 females aged from 58 to 74 years old with an average of (66.63±7.73), the courses of diseases ranged from 3 to 8 months with an average of (5.65±2.58), spinal leveraging manipulation(following meridian to straighten tendon,relieving spasm, osteopathy and massage, clearing and activating the channels and collaterals) were performed for 30 min, once a day, 4 days for a period treatment, totally 9 courses. In medicine group, there were 8 males and 10 females aged from 57 to 70 years old with an average of (63.51±6.61) the courses of diseases ranged from 3 to 5 months with an average of (4.82±1.43), celecoxib with eperisone hydrochloride were orally taken, 4 days for a period treatment, totally 9 courses. VAS score, Cobb angle and ODI score were measured. After treatment, VAS score in manipulation group was (5.38±0.99), (6.36±1.31) in medicine group,and had significant meaning (t=2.618, P<0.05); there was significant differences in Cobb angle between manipulation group (16.51±4.89)° and medicine group (19.85±5.03) °(t=2.074,P<0.05); and had obviously meaning in ODI score between manipulation group (20.20±2.93) and medicine group (26.01±3.11) (t=5.592, P<0.05). Spinal leveraging manipulation for degenerative scoliosis could regulate muscle balance on both side of spine, correct coronal imbalances in spine, recover normal sequence of spine, reduce and remove opperssion and stimulation of nerve root, relieve pain in leg and waist and further improve quality of life.

  7. Long-term musculoskeletal morbidity after adult burn injury: a population-based cohort study

    PubMed Central

    Randall, Sean M; Fear, Mark W; Wood, Fiona M; Rea, Suzanne; Boyd, James H; Duke, Janine M

    2015-01-01

    Objective To investigate if adults who are hospitalised for a burn injury have increased long-term hospital use for musculoskeletal diseases. Design A population-based retrospective cohort study using linked administrative health data from the Western Australian Data Linkage System. Subjects Records of 17 753 persons aged at least 20 years when hospitalised for a first burn injury in Western Australia during the period 1980–2012, and 70 758 persons who were age and gender-frequency matched with no injury admissions randomly selected from Western Australia's electoral roll. Main outcome measures Admission rates and cumulative length of stay for musculoskeletal diseases. Negative binomial and Cox proportional hazards regression modelling were used to generate incidence rate ratios (IRR) and HRs with 95% CIs, respectively. Results After adjustment for pre-existing health status and demographic characteristics, the burn cohort had almost twice the hospitalisation rate for a musculoskeletal condition (IRR, 95% CI 1.98, 1.86 to 2.10), and spent 3.70 times as long in hospital with a musculoskeletal diagnosis (95% CI 3.10 to 4.42) over the 33-year period, than the uninjured comparison cohort. Adjusted survival analyses of incident post-burn musculoskeletal disease admissions found significant increases for the 15-year post burn discharge period (0–6 months: HR, 95% CI 2.51, 2.04 to 3.11; 6 months–2 years: HR, 95% CI 1.77, 1.53 to 2.05; 2–15 years: HR, 95% CI 1.32, 1.23 to 1.42). Incident admission rates were significantly elevated for 20 years post-burn for minor and severe burn injury for a range of musculoskeletal diseases that included arthropathies, dorsopathies, osteopathies and soft tissue disorders. Conclusions Minor and severe burn injuries were associated with significantly increased post-burn incident admission rates, long-term hospital use and prolonged length of stay for a range of musculoskeletal diseases. Further research is required that facilitates identification of at-risk patients and appropriate treatment pathways, to reduce the long-term morbidity associated with burns. PMID:26362668

  8. The use of Complementary and Alternative Medicine in pregnancy: data from the Avon Longitudinal Study of Parents and Children (ALSPAC).

    PubMed

    Bishop, J L; Northstone, K; Green, J R; Thompson, E A

    2011-12-01

    To report the frequency of Complementary and Alternative Medicine (CAM) use by a population of pregnant women in the UK. Four postal self-completion questionnaires completed at 8, 12, 18 and 32 weeks' gestation provided the source of CAMs used. Questions asked for written descriptions about the use of any treatments, pills, medicines, ointments, homeopathic medicines, herbal medicines, supplements, drinks and herbal teas. An observational, population-based, cohort study of parents and children of 14,541 pregnant women residing within the former county of Avon in south-west England. Data was available for 14,115 women. Over a quarter (26.7%; n=3774) of women had used a CAM at least once in pregnancy, the use rising from 6% in the 1st trimester to 12.4% in the 2nd to 26.3% in the 3rd. Herbal teas were the most commonly reported CAM at any time in pregnancy (17.7%; n=2499) followed by homeopathic medicine (14.4%; n=2038) and then herbal medicine (5.8%; n=813). The most commonly used herbal product was chamomile used by 14.6% of women, the most commonly used homeopathic product was Arnica used by 3.1% of women. Other CAMs (osteopathy, aromatherapy, acupuncture/acupressure, Chinese herbal medicine, chiropractic, cranial sacral therapy, hypnosis, non-specific massage and reflexology) accounted for less than 1% of users. CAM use in pregnancy, where a wide range of CAMs has been assessed, has not been widely reported. Studies that have been conducted report varying results to this study (26.7%) by between 13.3% and 87% of pregnant women. Survey results will be affected by a number of factors namely the inclusion/exclusion of vitamins and minerals, the timing of data collection, the country of source, the number of women surveyed, and the different selection criteria of either recruiting women to the study or of categorising and identifying a CAM treatment or product. Copyright © 2011 Elsevier Ltd. All rights reserved.

  9. [Conventional analgesics and non-pharmacological multidisciplinary therapeutic treatment in endometriosis: CNGOF-HAS Endometriosis Guidelines].

    PubMed

    Wattier, J-M

    2018-03-01

    A major symptom of endometriosis is pelvic pain with a wide range of intensity, rhythm, type, and expression, without clearly established relationship between pain and the disease. Endometriosis-associated pain has physical, psychological/behavioral and social consequences with a significant impact on patient quality-of-life in relation with the biopsychosocial model of chronic pain. Pain assessment in all of its dimensions, as well as assessing the consequences of pain is therefore a crucial part of therapeutic management. Conventional analgesics are commonly used although studies demonstrating their efficacy in the treatment of endometriosis-related pelvic pain are lacking. Non-steroid anti-inflammatory drugs (NSAIDs), known to be effective in dysmenorrhea unrelated to endometriosis, have not been recently re-assessed in patients with endometriosis. Following rigorous assessment, the characterization of neuropathic components of endometriosis-related pelvic pain may lead to treatment with antiepileptic of antidepressant drugs, although gabapentin and amitriptyline have yet to be specifically assessed in the setting of endometriosis-related pain. Other pharmacologically active compounds have been tested to treat endometriosis-related pain but did not demonstrate efficacy with sufficient level of evidence. Diets, dietary supplements and herbal medicine are often proposed and/or used as adjuncts without any conclusive evidence. Although the effects on endometriosis-related pain are methodologically difficult to assess, physical adjunctive therapies such as acupuncture, transcutaneous neurostimulation, osteopathy/chiropractics, physical therapy and physical activity, the long-term therapeutic relationship they establish may potentiate beneficial effects perceived by patients. However, it remains difficult to demonstrate significant effects of cognitive and/or behavioral interventions on endometriosis-related pain. The complexity of managing endometriosis-related pain requires a holistic approach with sustained attention to the patient. Treatments, either pharmacologic or non-pharmacologic, including adjuvant therapies, associate a technical expertise to which a human approach must be added in order to bring value to these treatments. Multidisciplinary and/or inter disciplinary approaches are therefore essential to the care of patients suffering from endometriosis. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

  10. Knowledge, attitudes, and practice of travelers' diarrhea management among frontline providers.

    PubMed

    Hayat, Aatif M; Tribble, David R; Sanders, John W; Faix, Dennis J; Shiau, Danny; Armstrong, Adam W; Riddle, Mark S

    2011-01-01

    Many studies have found acute gastrointestinal infections to be among the most likely reason for clinic visits among forward deployed soldiers and are considered a significant contributor to morbidity in this population. This occurs despite the controlled food and water distribution systems under which military populations operate. Furthermore, recent studies have indicated that providers often fail to appropriately identify and treat the typical causes of these infections. To adequately address this issue, an assessment of gaps in knowledge, practice, and management of acute diarrhea in deployed troops was conducted. A multiple-choice survey was developed by clinical researchers with expertise in travelers' diarrhea (TD) and provided to a convenience sample of clinical providers with a broad range of training and operational experience. The survey evaluated provider's knowledge of TD along with their ability to identify etiologies of various syndromic categories of acute gastrointestinal infections. Providers were also queried on selection of treatment approaches to a variety of clinical-based scenarios. A total of 117 respondents completed the survey. Most were aware of the standard definition of TD (77%); however, their knowledge about the epidemiology was lower, with less than 24% correctly answering questions on etiology of diarrhea, and 31% believing that a viral pathogen was the primary cause of watery diarrhea during deployment. Evaluation of scenario-based responses showed that 64% of providers chose not to use antibiotics to treat moderate TD. Furthermore, 19% of providers felt that severe inflammatory diarrhea was best treated with hydration only while 25% felt hydration was the therapy of choice for dysentery. Across all provider types, three practitioner characteristics appeared to be related to better scores on responses to the nine management scenarios: having a Doctor of Medicine or Doctor of Osteopathy degree, greater knowledge of TD epidemiology, and favorable attitudes toward antimotility or antibiotic therapy. Results from this survey support the need for improving knowledge and management of TD among deploying providers. The information from this study should be considered to support the establishment and dissemination of military diarrhea-management guidelines to assist in improving the health of military personnel. © 2011 International Society of Travel Medicine.

  11. Evaluation of the acceptability of Peer Physical Examination (PPE) in medical and osteopathic students: a cross sectional survey

    PubMed Central

    2013-01-01

    Background Peer physical examination (PPE) is a method of training in medical and osteopathic curricula. The aim of this study was to compare the acceptability of PPE in two classes of medical and osteopathic students after their first experience, to obtain comparative information useful for an understanding of the different professional approaches. The leading hypothesis was that osteopathic students enter the curriculum with a more positive attitude to bodily contact. As a secondary aim, this study validated the new version of a questionnaire to assess the acceptability of PPE. Methods A new version of a previously validated questionnaire and an instrument from the literature (the Examining Fellow Student [EFS] questionnaire) were used for a cross-sectional survey in a class of 129 3rd year medical students and in two parallel classes of 1st year osteopathic students (total of 112 students). Results The mean score of the new questionnaire was significantly higher for the osteopathic students than for the medical students (53.4 ± 6.3 vs. 43.4 ± 8.9; p < 0.01). The only independent variables that were significantly predictive of the score in a linear regression analysis were gender and the condition of medical or osteopathic student. The EFS mean score also showed a significant difference between the osteopathic and medical students (30.76 ± 2.9 vs. 27.85 ± 4.3; p < 0.01). Factor analysis of the new questionnaire identified three factors (appropriateness and usefulness, sexual implications and passive role) accounting for 62.8% of the variance. Criterion validity was assessed by correlation with the EFS (Pearson’s r coefficient = 0.61). Reliability was expressed in terms of Cronbach’s alpha coefficient, which equals 0.86. Conclusions These quantitative results are consistent with previous qualitative research on the process of embodiment both in medicine and osteopathy. The new questionnaire proved to be valid and reliable. The objective assessment of the acceptability of PPE is a way to determine differences in students’ attitudes towards contact with the body and can be used for counselling students regarding career choice. This study can also highlight differences between students from different professions and serve as a basis for reflection for improved mutual interprofessional understanding and future interprofessional education. PMID:23968312

  12. Evaluation of the acceptability of Peer Physical Examination (PPE) in medical and osteopathic students: a cross sectional survey.

    PubMed

    Consorti, Fabrizio; Mancuso, Rosaria; Piccolo, Annalisa; Consorti, Giacomo; Zurlo, Joseph

    2013-08-22

    Peer physical examination (PPE) is a method of training in medical and osteopathic curricula. The aim of this study was to compare the acceptability of PPE in two classes of medical and osteopathic students after their first experience, to obtain comparative information useful for an understanding of the different professional approaches. The leading hypothesis was that osteopathic students enter the curriculum with a more positive attitude to bodily contact.As a secondary aim, this study validated the new version of a questionnaire to assess the acceptability of PPE. A new version of a previously validated questionnaire and an instrument from the literature (the Examining Fellow Student [EFS] questionnaire) were used for a cross-sectional survey in a class of 129 3rd year medical students and in two parallel classes of 1st year osteopathic students (total of 112 students). The mean score of the new questionnaire was significantly higher for the osteopathic students than for the medical students (53.4 ± 6.3 vs. 43.4 ± 8.9; p < 0.01). The only independent variables that were significantly predictive of the score in a linear regression analysis were gender and the condition of medical or osteopathic student. The EFS mean score also showed a significant difference between the osteopathic and medical students (30.76 ± 2.9 vs. 27.85 ± 4.3; p < 0.01).Factor analysis of the new questionnaire identified three factors (appropriateness and usefulness, sexual implications and passive role) accounting for 62.8% of the variance. Criterion validity was assessed by correlation with the EFS (Pearson's r coefficient = 0.61). Reliability was expressed in terms of Cronbach's alpha coefficient, which equals 0.86. These quantitative results are consistent with previous qualitative research on the process of embodiment both in medicine and osteopathy. The new questionnaire proved to be valid and reliable. The objective assessment of the acceptability of PPE is a way to determine differences in students' attitudes towards contact with the body and can be used for counselling students regarding career choice. This study can also highlight differences between students from different professions and serve as a basis for reflection for improved mutual interprofessional understanding and future interprofessional education.

  13. Additional weekend allied health services reduce length of stay in subacute rehabilitation wards but their effectiveness and cost-effectiveness are unclear in acute general medical and surgical hospital wards: a systematic review.

    PubMed

    Sarkies, Mitchell N; White, Jennifer; Henderson, Kate; Haas, Romi; Bowles, John

    2018-06-18

    Are additional weekend allied health services effective and cost-effective for acute general medical and surgical wards, and subacute rehabilitation hospital wards? Systematic review and meta-analysis of studies published between January 2000 and May 2017. Two reviewers independently screened studies for inclusion, extracted data, and assessed methodological quality. Meta-analyses were conducted for relative measures of effect estimates. Patients admitted to acute general medical and surgical wards, and subacute rehabilitation wards. All services delivered by allied health professionals during weekends (Saturday and/or Sunday). This study limited allied health professions to: occupational therapy, physiotherapy, social work, speech pathology, dietetics, art therapy, chiropractic, exercise physiology, music therapy, oral health (not dentistry), osteopathy, podiatry, psychology, and allied health assistants. Hospital length of stay, hospital re-admission, adverse events, discharge destination, functional independence, health-related quality of life, and cost of hospital care. Nineteen articles (20 studies) were identified, comprising 10 randomised and 10 non-randomised trials. Physiotherapy was the most commonly investigated profession. A meta-analysis of randomised, controlled trials showed that providing additional weekend allied health services in subacute rehabilitation wards reduced hospital length of stay by 2.35days (95% CI 0.45 to 4.24, I 2 =0%), and may be a cost-effective way to improve function (SMD 0.09, 95% CI -0.01 to 0.19, I 2 =0%), and health-related quality of life (SMD 0.10, 95% CI -0.01 to 0.20, I 2 =0%). For acute general medical and surgical hospital wards, it was unclear whether the weekend allied health service model provided in the two identified randomised trials led to significant changes in measured outcomes. The benefit of providing additional allied health services is clearer in subacute rehabilitation settings than for acute general medical and surgical wards in hospitals. PROSPERO CRD76771. [Sarkies MN, White J, Henderson K, Haas R, Bowles J, Evidence Translation in Allied Health (EviTAH) Group (2018) Additional weekend allied health services reduce length of stay in subacute rehabilitation wards but their effectiveness and cost-effectiveness are unclear in acute general medical and surgical hospital wards: a systematic review. Journal of Physiotherapy XX: XX-XX]. Copyright © 2018 Australian Physiotherapy Association. Published by Elsevier B.V. All rights reserved.

  14. An integrative review of complementary and alternative medicine use for back pain: a focus on prevalence, reasons for use, influential factors, self-perceived effectiveness, and communication.

    PubMed

    Murthy, Vijayendra; Sibbritt, David W; Adams, Jon

    2015-08-01

    Back pain is the most prevalent of musculoskeletal conditions, and back pain sufferers have been identified as high users of complementary and alternative medicine (CAM). Despite lacking evidence, CAM treatments (e.g., acupuncture, chiropractic, and massage) and CAM products (eg, vitamins, supplements, and aromatherapy oils) for back pain care have become widely available internationally, and CAM use by back pain sufferers has become a significant health service issue. However, to date, there has been no integrative review on CAM use for back pain. This study aims to conduct an integrative review on CAM use for back pain focusing on prevalence of use, commonly used CAM, characteristics of users, factors influencing decision making, self-perceived effectiveness, and communication with health-care providers. The study is based on an integrative literature review. A comprehensive search of international literature from 2000 to 2014 in MEDLINE, CINHAL, AMED, DARE, EMBASE, ExceptaMedica, psycINFO, and SCOPUS databases was conducted. The search was limited to peer-reviewed articles published in English language and reporting empirical research findings on CAM use for back pain. The review reveals a considerable variation in prevalences of CAM use for back pain internationally. Acupuncture, chiropractic, osteopathy, and massage therapy are the commonly used CAM treatments besides a range of self-prescribed CAM, and back pain sufferers use CAM alongside conventional medical treatments. Female gender, chronicity of back pain, and previous exposure to CAM are key predictors of CAM use for back pain as highlighted from the reviewed literature. Family, friends, and recommendation by doctors appear to influence decision making on CAM use for back pain. The review reveals that users of CAM for back pain tend to report CAM as beneficial, but there is little knowledge on communication between CAM users with back pain and health-care providers about such use. Existing literature is largely based on the research investigating CAM use for back pain among a range of other health conditions. Further rigorous research is needed to investigate the use of a wider range of CAM treatments, particularly self-prescribed CAM for back pain. The review findings provide insights for health-care providers and policy makers on the range of CAM treatments used by back pain sufferers. Conventional medical and CAM practitioners should be aware of back pain sufferers' decision making regarding a range of CAM treatments and be prepared to communicate with patients on safe and effective CAM treatments for back pain. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Person-centered osteopathic practice: patients' personality (body, mind, and soul) and health (ill-being and well-being).

    PubMed

    Fahlgren, Elin; Nima, Ali A; Archer, Trevor; Garcia, Danilo

    2015-01-01

    Background. Osteopathic philosophy and practice are congruent with the biopsychosocial model, a patient-centered approach when treating disease, and the view of the person as a unity (i.e., body, mind, and soul). Nevertheless, a unity of being should involve a systematic person-centered understanding of the patient's personality as a biopsychosociospiritual construct that influences health (i.e., well-being and ill-being). We suggest Cloninger's personality model, comprising temperament (i.e., body) and character (i.e., mind and soul), as a genuine paradigm for implementation in osteopathic practice. As a first step, we investigated (1) the relationships between personality and health among osteopathic patients, (2) differences in personality between patients and a control group, and (3) differences in health within patients depending on the presenting problem and gender. Method. 524 osteopathic patients in Sweden (age mean = 46.17, SD = 12.54, 388 females and 136 males) responded to an online survey comprising the Temperament and Character Inventory and measures of health (well-being: life satisfaction, positive affect, harmony in life, energy, and resilience; ill-being: negative affect, anxiety, depression, stress, and dysfunction and suffering associated to the presenting problem). We conducted two structural equation models to investigate the association personality-health; graphically compared the patients' personality T-scores to those of the control group and compared the mean raw scores using t-tests; and conducted two multivariate analyses of variance, using age as covariate, to compare patients' health in relation to their presenting problem and gender. Results. The patients' personality explained the variance of all of the well-being (R (2) between .19 and .54) and four of the ill-being (R (2) between .05 and .43) measures. Importantly, self-transcendence, the spiritual aspect of personality, was associated to high levels of positive emotions and resilience. Osteopathic patients, compared to controls, scored higher in six of the seven personality dimensions. These differences were, however, not considerably large (divergences in T-scores were <1 SD, Cohen's d between 0.12 and 0.40). Presenting problem and gender did not have an effect on any of the health measures. Conclusion. The patient's personality as a ternary construct (i.e., body, mind, and soul), which is in line with osteopathy, is associated to both well-being and ill-being. The lack of substantial differences in personality between patients and controls implies that the patients had not any personality disorders. Hence, osteopaths might, with proper education, be able to coach their patients to self-awareness. The lack of differences in health variables between osteopathic patients with different presenting problems suggests that practitioners should focus on the person's health regardless of the type of presenting problem.

  16. Person-centered osteopathic practice: patients’ personality (body, mind, and soul) and health (ill-being and well-being)

    PubMed Central

    Nima, Ali A.; Archer, Trevor

    2015-01-01

    Background. Osteopathic philosophy and practice are congruent with the biopsychosocial model, a patient-centered approach when treating disease, and the view of the person as a unity (i.e., body, mind, and soul). Nevertheless, a unity of being should involve a systematic person-centered understanding of the patient’s personality as a biopsychosociospiritual construct that influences health (i.e., well-being and ill-being). We suggest Cloninger’s personality model, comprising temperament (i.e., body) and character (i.e., mind and soul), as a genuine paradigm for implementation in osteopathic practice. As a first step, we investigated (1) the relationships between personality and health among osteopathic patients, (2) differences in personality between patients and a control group, and (3) differences in health within patients depending on the presenting problem and gender. Method. 524 osteopathic patients in Sweden (age mean = 46.17, SD = 12.54, 388 females and 136 males) responded to an online survey comprising the Temperament and Character Inventory and measures of health (well-being: life satisfaction, positive affect, harmony in life, energy, and resilience; ill-being: negative affect, anxiety, depression, stress, and dysfunction and suffering associated to the presenting problem). We conducted two structural equation models to investigate the association personality-health; graphically compared the patients’ personality T-scores to those of the control group and compared the mean raw scores using t-tests; and conducted two multivariate analyses of variance, using age as covariate, to compare patients’ health in relation to their presenting problem and gender. Results. The patients’ personality explained the variance of all of the well-being (R2 between .19 and .54) and four of the ill-being (R2 between .05 and .43) measures. Importantly, self-transcendence, the spiritual aspect of personality, was associated to high levels of positive emotions and resilience. Osteopathic patients, compared to controls, scored higher in six of the seven personality dimensions. These differences were, however, not considerably large (divergences in T-scores were <1 SD, Cohen’s d between 0.12 and 0.40). Presenting problem and gender did not have an effect on any of the health measures. Conclusion. The patient’s personality as a ternary construct (i.e., body, mind, and soul), which is in line with osteopathy, is associated to both well-being and ill-being. The lack of substantial differences in personality between patients and controls implies that the patients had not any personality disorders. Hence, osteopaths might, with proper education, be able to coach their patients to self-awareness. The lack of differences in health variables between osteopathic patients with different presenting problems suggests that practitioners should focus on the person’s health regardless of the type of presenting problem. PMID:26528411

  17. Pattern and predictors of complementary and alternative medicine (CAM) use among pediatric patients with epilepsy.

    PubMed

    Doering, Jan H; Reuner, Gitta; Kadish, Navah E; Pietz, Joachim; Schubert-Bast, Susanne

    2013-10-01

    Parents of pediatric patients with chronic conditions such as epilepsy increasingly opt for complementary and alternative medicine (CAM). However, data on the pattern and reasons of CAM use in childhood epilepsy are scarce. The objectives of this study were as follows: first, to characterize CAM use among pediatric patients with epilepsy by assessing its spectrum, prevalence, costs, and frequency of use; second, to evaluate the influence of CAM use on compliance and satisfaction with conventional care as well as to explore parent-child neurologist communication concerning CAM; and third, to investigate predictors of CAM use. A postal survey was administered to all parents of pediatric outpatients with epilepsy aged 6 to 12, who have received treatment at the neuropediatric outpatient clinic of the University Children's Hospital Heidelberg between 2007 and 2009. One hundred thirty-two of the 297 distributed questionnaires were suitable for inclusion in statistical analysis (44.7%). Forty-nine participants indicated that their children used CAM during the previous year (37.1%). Thirty different types of CAM were used, with homeopathy (55.1%), osteopathy (24.5%), and kinesiology (16.3%) being the most commonly named. A mean of 86€ (0€-500€) and 3h (1 h-30 h) per month was committed to CAM treatment. Only 53% of the users informed their child neurologist of the additional CAM treatment, while 85.6% of all parents wished to discuss CAM options with their child neurologist. Seventy-five percent of users considered the CAM treatment effective. Among the participants most likely to seek CAM treatment are parents whose children show a long duration of epileptic symptoms, parents who make use of CAM treatment themselves, and parents who value a holistic and natural treatment approach. A substantial portion of pediatric patients with epilepsy receive CAM treatment. The high prevalence of use and significant level of financial and time resources spent on CAM indicate the high importance of these treatment options for parents. On the other hand, communication concerning CAM with the child neurologist is largely insufficient despite the wish to speak about CAM. Complementary and alternative medicine users' high compliance with conventional treatment and high perceived effectiveness of CAM support an integrative approach to CAM for pediatric patients with epilepsy. Our study implies that in addition to open parent-child neurologist communication, active inquiry on CAM treatments is necessary to enable informed decision making by parents and to establish the suitability of CAM treatment for the patient. Reliable predictors for CAM use, which allow for improved identification of patients with a high likelihood to receive CAM treatment, are the duration of the illness, use of CAM by the parents themselves, and the desire of the parents to receive a holistic and natural treatment for their child. © 2013.

  18. Massage, reflexology and other manual methods for pain management in labour.

    PubMed

    Smith, Caroline A; Levett, Kate M; Collins, Carmel T; Dahlen, Hannah G; Ee, Carolyn C; Suganuma, Machiko

    2018-03-28

    Many women would like to avoid pharmacological or invasive methods of pain management in labour, and this may contribute towards the popularity of complementary methods of pain management. This review examined the evidence currently available on manual methods, including massage and reflexology, for pain management in labour. This review is an update of the review first published in 2012. To assess the effect, safety and acceptability of massage, reflexology and other manual methods to manage pain in labour. For this update, we searched Cochrane Pregnancy and Childbirth's Trials Register (30 June 2017), the Cochrane Central Register of Controlled Trials (CENTRAL; 2017, Issue 6), MEDLINE (1966 to 30 June 2017, CINAHL (1980 to 30 June 2017), the Australian New Zealand Clinical Trials Registry (4 August 2017), Chinese Clinical Trial Registry (4 August 2017), ClinicalTrials.gov, (4 August 2017), the National Center for Complementary and Integrative Health (4 August 2017), the WHO International Clinical Trials Registry Platform (ICTRP) (4 August 2017) and reference lists of retrieved trials. We included randomised controlled trials comparing manual methods with standard care, other non-pharmacological forms of pain management in labour, no treatment or placebo. We searched for trials of the following modalities: massage, warm packs, thermal manual methods, reflexology, chiropractic, osteopathy, musculo-skeletal manipulation, deep tissue massage, neuro-muscular therapy, shiatsu, tuina, trigger point therapy, myotherapy and zero balancing. We excluded trials for pain management relating to hypnosis, aromatherapy, acupuncture and acupressure; these are included in other Cochrane reviews. Two review authors independently assessed trial quality, extracted data and checked data for accuracy. We contacted trial authors for additional information. We assessed the quality of the evidence using the GRADE approach. We included a total of 14 trials; 10 of these (1055 women) contributed data to meta-analysis. Four trials, involving 274 women, met our inclusion criteria but did not contribute data to the review. Over half the trials had a low risk of bias for random sequence generation and attrition bias. The majority of trials had a high risk of performance bias and detection bias, and an unclear risk of reporting bias. We found no trials examining the effectiveness of reflexology.MassageWe found low-quality evidence that massage provided a greater reduction in pain intensity (measured using self-reported pain scales) than usual care during the first stage of labour (standardised mean difference (SMD) -0.81, 95% confidence interval (CI) -1.06 to -0.56, six trials, 362 women). Two trials reported on pain intensity during the second and third stages of labour, and there was evidence of a reduction in pain scores in favour of massage (SMD -0.98, 95% CI -2.23 to 0.26, 124 women; and SMD -1.03, 95% CI -2.17 to 0.11, 122 women). There was very low-quality evidence showing no clear benefit of massage over usual care for the length of labour (in minutes) (mean difference (MD) 20.64, 95% CI -58.24 to 99.52, six trials, 514 women), and pharmacological pain relief (average risk ratio (RR) 0.81, 95% CI 0.37 to 1.74, four trials, 105 women). There was very low-quality evidence showing no clear benefit of massage for assisted vaginal birth (average RR 0.71, 95% CI 0.44 to 1.13, four trials, 368 women) and caesarean section (RR 0.75, 95% CI 0.51 to 1.09, six trials, 514 women). One trial reported less anxiety during the first stage of labour for women receiving massage (MD -16.27, 95% CI -27.03 to -5.51, 60 women). One trial found an increased sense of control from massage (MD 14.05, 95% CI 3.77 to 24.33, 124 women, low-quality evidence). Two trials examining satisfaction with the childbirth experience reported data on different scales; both found more satisfaction with massage, although the evidence was low quality in one study and very low in the other.Warm packsWe found very low-quality evidence for reduced pain (Visual Analogue Scale/VAS) in the first stage of labour (SMD -0.59, 95% CI -1.18 to -0.00, three trials, 191 women), and the second stage of labour (SMD -1.49, 95% CI -2.85 to -0.13, two trials, 128 women). Very low-quality evidence showed reduced length of labour (minutes) in the warm-pack group (MD -66.15, 95% CI -91.83 to -40.47; two trials; 128 women).Thermal manual methodsOne trial evaluated thermal manual methods versus usual care and found very low-quality evidence of reduced pain intensity during the first phase of labour for women receiving thermal methods (MD -1.44, 95% CI -2.24 to -0.65, one trial, 96 women). There was a reduction in the length of labour (minutes) (MD -78.24, 95% CI -118.75 to -37.73, one trial, 96 women, very low-quality evidence). There was no clear difference for assisted vaginal birth (very low-quality evidence). Results were similar for cold packs versus usual care, and intermittent hot and cold packs versus usual care, for pain intensity, length of labour and assisted vaginal birth.Music One trial that compared manual methods with music found very low-quality evidence of reduced pain intensity during labour in the massage group (RR 0.40, 95% CI 0.18 to 0.89, 101 women). There was no evidence of benefit for reduced use of pharmacological pain relief (RR 0.41, 95% CI 0.16 to 1.08, very low-quality evidence).Of the seven outcomes we assessed using GRADE, only pain intensity was reported in all comparisons. Satisfaction with the childbirth experience, sense of control, and caesarean section were rarely reported in any of the comparisons. Massage, warm pack and thermal manual methods may have a role in reducing pain, reducing length of labour and improving women's sense of control and emotional experience of labour, although the quality of evidence varies from low to very low and few trials reported on the key GRADE outcomes. Few trials reported on safety as an outcome. There is a need for further research to address these outcomes and to examine the effectiveness and efficacy of these manual methods for pain management.

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