Manuela Deodato, Franco Guolo, Antonella Monticco, Mauro Fornari, Paolo Manganotti, Antonio Granato
{"title":"Osteopathic Manipulative Therapy in Patients With Chronic Tension-Type Headache: A Pilot Study.","authors":"Manuela Deodato, Franco Guolo, Antonella Monticco, Mauro Fornari, Paolo Manganotti, Antonio Granato","doi":"10.7556/jaoa.2019.093","DOIUrl":"10.7556/jaoa.2019.093","url":null,"abstract":"<p><strong>Context: </strong>Nonpharmacologic treatment, such as osteopathic manipulative therapy (OMTh; manipulative care provided by foreign-trained osteopaths) may be a beneficial complementary treatment for tension-type headache. However, to the authors' knowledge, the benefit of OMTh in the management of tension-type headache has not been explored, especially chronic tension-type headache (CTTH).</p><p><strong>Objective: </strong>To investigate the effectiveness of OMTh compared with traditional treatment in reducing pain intensity, frequency, and duration of CTTH, and to evaluate the objective postural measurement of the forward head posture (FHP) as an integral parameter in the assessment of the effects of OMTh and traditional management of CTTH.</p><p><strong>Methods: </strong>Patients with CTTH were registered at the Headache Centre of Trieste in Italy. At the time of the study, none of the patients had been taking any headache prophylaxis in the past 3 months. A 3-month baseline period was recorded by all patients with an ad hoc diary. Patients were randomly placed in the test or control group using a simple randomization program in Excel (Microsoft). Patients in the OMTh group underwent a 3-month period of OMTh, and patients in the control group were treated with amitriptyline. Pain intensity, frequency, and duration of headaches, as well as FHP were analyzed.</p><p><strong>Results: </strong>The study enrolled 10 patients (mean [SD] age, 42.6 [15.2] years) in the OMTh group and 10 patients (51.4 [17.3] years) in the control group. The final assessment of OMTh patients showed statistically significant changes in all headache parameters: pain intensity decreased from a mean (SD) score of 4.9 (1.4) to 3.1 (1.1) (P=.002); frequency decreased from 19.8 (6) to 8.3 (6.2) days per month (P=.002); and the duration of headaches decreased from 10 (4.2) to 6 (3) hours (P=.01). Significant improvement of all parameters was found in the control group as well: pain intensity decreased from a mean (SD) score of 5.9 (0.7) to 4.2 (1.75) (P=.03); frequency decreased from 23.4 (7.2) to 7.4 (8.7) days per month (P=.003); and duration decreased from 7.8 (2.9) to 3.6 (2.1) hours (P=.002). Forward head posture significantly improved in OMTh patients (P=.003).</p><p><strong>Conclusions: </strong>Our data suggested that OMTh may be an effective treatment to improve headaches in patients with CTTH. Our results also suggest that OMTh may reduce FHP.</p>","PeriodicalId":16639,"journal":{"name":"Journal of Osteopathic Medicine Journal of Osteopathic Medicine","volume":"119 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88196608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Response","authors":"J. Peters, Joseph Chien","doi":"10.7556/jaoa.2019.088","DOIUrl":"https://doi.org/10.7556/jaoa.2019.088","url":null,"abstract":"","PeriodicalId":16639,"journal":{"name":"Journal of Osteopathic Medicine Journal of Osteopathic Medicine","volume":"79 1","pages":"477a - 478"},"PeriodicalIF":0.0,"publicationDate":"2019-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84497149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jonathon Whipps, Sophia C. Mort, E. Beverly, E. Guseman
{"title":"Influence of Osteopathic Medical Students’ Personal Health on Attitudes Toward Counseling Obese Pediatric Patients","authors":"Jonathon Whipps, Sophia C. Mort, E. Beverly, E. Guseman","doi":"10.7556/jaoa.2019.090","DOIUrl":"https://doi.org/10.7556/jaoa.2019.090","url":null,"abstract":"Abstract Context Research has shown that physicians with positive health and lifestyle behaviors have more positive attitudes toward effective counseling, but little is known about how personal health behaviors of medical students influence their attitudes regarding pediatric obesity counseling before entering practice. Objective To determine whether the personal health status and habits of osteopathic medical students influence their attitudes toward counseling obese pediatric patients regarding lifestyle behaviors. Methods A cross-sectional survey was distributed electronically to first- through fourth-year osteopathic medical students. The survey assessed students’ personal lifestyle habits and their top anticipated barriers to providing pediatric weight counseling. Results A total of 200 participants completed the survey. National physical activity recommendations were met by 81 participants (40.5%). These 81 participants had significantly more positive attitudes toward pediatric physical activity counseling than participants who did not meet the recommendations (H=−35.06, P=.001) or those who only met resistance training recommendations (H=40.63, P=.021). Participants with obesity had significantly lower pediatric weight management counseling scores than overweight participants (H=40.77, P=.028). Thirty-one participants (15.5%) consumed a healthy amount of both vegetables and fruit. These 31 participants had significantly higher dietary mean item counseling scores than those who did not (H=−30.40, P=.048). Participants identified the barriers “Time” (137 [68.5%]) and “Difficult for patients to change behavior” (99 [49.5%]) most frequently. Clinical participants identified “Poor or lacking reimbursement” (21 [28.0%]) more frequently than preclinical participants (12 [9.6]). Conclusion Medical students who exhibited healthier lifestyle habits were more likely to positively view pediatric obesity management counseling.","PeriodicalId":16639,"journal":{"name":"Journal of Osteopathic Medicine Journal of Osteopathic Medicine","volume":"75 1","pages":"488 - 498"},"PeriodicalIF":0.0,"publicationDate":"2019-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81204663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
V. Nahar, Amanda H. Wilkerson, Philip M Stephens, Richard W. Kim, M. Sharma
{"title":"Using the Multitheory Model to Predict Initiation and Sustenance of Physical Activity Behavior Among Osteopathic Medical Students","authors":"V. Nahar, Amanda H. Wilkerson, Philip M Stephens, Richard W. Kim, M. Sharma","doi":"10.7556/jaoa.2019.089","DOIUrl":"https://doi.org/10.7556/jaoa.2019.089","url":null,"abstract":"Abstract Context The multitheory model (MTM) is a newly developed fourth-generation theoretical framework that addresses both initiation and sustenance of health behavior change. Studies have shown that the MTM is efficacious in predicting a range of health behaviors. Objective To assess the utility of the MTM in predicting initiation and sustenance of physical activity behavior among osteopathic medical students. Methods In this cross-sectional study, a volunteer convenience sample was recruited from an osteopathic medical school student population at a university in the southeastern region of the United States. An online survey was used to collect self-reported data on sociodemographic information and MTM constructs. Multiple linear regression using the enter method for modeling was performed to determine the predictive ability of the MTM constructs. Results Of the 135 participants, 52.6% were women and 67.7% were white. The initiation model explained 25.8% of the variance (adjusted R2=0.238). Behavioral confidence was a statistically significant predictor of initiation of physical activity behavior change. The sustenance model explained 41.7% of the variance (adjusted R2=0.402). Changes in social environment and emotional transformation were statistically significant predictors of sustenance of physical activity behavior change. Conclusion The MTM appears to be a robust theoretical framework for designing behavior change interventions to increase physical activity among osteopathic medical students.","PeriodicalId":16639,"journal":{"name":"Journal of Osteopathic Medicine Journal of Osteopathic Medicine","volume":"43 1","pages":"479 - 487"},"PeriodicalIF":0.0,"publicationDate":"2019-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81365401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Stretch Receptor and Somatic Dysfunction: A Narrative Review","authors":"M. Andrews","doi":"10.7556/jaoa.2019.094","DOIUrl":"https://doi.org/10.7556/jaoa.2019.094","url":null,"abstract":"Abstract From its founding by Andrew Taylor Still, MD, DO, through the work of many contributors, one of the cornerstones of osteopathic medicine has been its ability to aid health by promoting neuromuscular homeostasis. As part of the understanding of osteopathic medicine since the time of Still, the proper functioning of stretch receptor organs (SROs) of skeletal muscle have been recognized as having a central role in this homeostasis. In doing so, the complexities of these numerous and vital sensors are described, including recent findings regarding their structure, function, and the nature of their neural connections. In their homeostatic role, SROs conduct information centrally for integration in proprioceptive and autonomic reflexes. By virtue of their integral role in muscle reflexes, they are putatively involved in somatic dysfunction and segmental facilitation. In reviewing some well-established knowledge regarding the SRO and introducing more recent scientific findings, an attempt is made to offer insights on how this knowledge may be applied to better understand somatic dysfunction.","PeriodicalId":16639,"journal":{"name":"Journal of Osteopathic Medicine Journal of Osteopathic Medicine","volume":"39 1","pages":"511 - 519"},"PeriodicalIF":0.0,"publicationDate":"2019-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76032724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Contemporary Routes of Cannabis Consumption","authors":"Julianne Moy","doi":"10.7556/jaoa.2019.087","DOIUrl":"https://doi.org/10.7556/jaoa.2019.087","url":null,"abstract":"I would first like to commend Peters and Chien on the concise information they provided regarding the modalities, forms, and dosing of cannabis in their February 2018 article on cannabis. I agree with the authors that cannabis use will become even more omnipresent in medicine than it already is. However, I strongly disagree and even refute their statement that “Physicians have little reason to advocate for cannabis use, as data are limited on its beneficial effects.” I am a cannabis clinician in Ohio, which means that I have a certificate to recommend medical marijuana in the state. Medical marijuana legislation was passed in Ohio in 2016, and the state is currently in the early stages of rollout: patient registries opened December 2018, in-state grown cannabis greenhouses have cultivated their first harvests, and the first dispensaries opened in February 2019. It is a very exciting time for cannabis in Ohio, so I was disheartened when this article came across my desk. I agree that there is limited evidencebased literature regarding cannabis currently, but existing data coupled with current ongoing research are more than positive. The National Institutes of Health have been funding Israeli cannabis research since the early 1960s. In a 2018 review, Tashkin concluded that smoking marijuana habitually did not increase the likelihood of lung cancer, possibly because of the immunoprotectant properties of cannabis. Additionally, evidence has shown that cannabis is a safer alternative to opioids; in the face of the ongoing opioid epidemic, this news is welcoming. Cannabis has also been shown to be beneficial in acute opioid withdrawal and as a harm reduction tool in opioid use disorder. Furthermore, in June 2018, Epidiolex (GW Pharmaceuticals plc) was the first drug approved by the Food and Drug Administration that contains a purified substance derived from cannabis to treat patients with seizures associated with Lennox-Gastaut and Dravet syndromes. The evidence is growing, but we must be vigilant in our search and not be blinded by long-antiquated societal views. Yes, clinicians will have the challenge of keeping up with the ever-evolving use of cannabis, both medically and recreationally, but this challenge is one I gladly accept. (doi:10.7556/jaoa.2019.087)","PeriodicalId":16639,"journal":{"name":"Journal of Osteopathic Medicine Journal of Osteopathic Medicine","volume":"52 1","pages":"477 - 477"},"PeriodicalIF":0.0,"publicationDate":"2019-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73881049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Hojat, S. Shannon, Jennifer DeSantis, Mark R Speicher, Lynn Bragan, Leonard Calabrese
{"title":"Empathy in Medicine National Norms for the Jefferson Scale of Empathy: A Nationwide Project in Osteopathic Medical Education and Empathy (POMEE)","authors":"M. Hojat, S. Shannon, Jennifer DeSantis, Mark R Speicher, Lynn Bragan, Leonard Calabrese","doi":"10.7556/jaoa.2019.091","DOIUrl":"https://doi.org/10.7556/jaoa.2019.091","url":null,"abstract":"Abstract Context National norms are necessary to assess individual scores from validated instruments. Before undertaking this study, no national norms were available on empathy scores. The Project in Osteopathic Medical Education and Empathy (POMEE) provided a unique opportunity to develop the first national norms for medical students. Objective To develop national norms for the assessments of osteopathic medical students’ empathy scores on the broadly used and well-validated Jefferson Scale of Empathy (JSE) at all levels of osteopathic medical school education. Methods Participants were students from 41 of 48 participating campuses of osteopathic medical schools. Students were invited to complete a web-based survey, which included the JSE, in the 2017-2018 academic year. Results A total of 16,149 completed surveys were used to create national norm tables. Three national norm tables were developed for first-year matriculants and for students in preclinical (years 1 and 2) and clinical (years 3 and 4) phases of medical school. The norm tables allow any raw score on the JSE for male and female osteopathic medical students from matriculation to graduation to be converted to a percentile rank to assess an individual's score against national data. Conclusions National norms developed in this project, for men and women and at different levels of medical school education, can not only be used for the assessment of student's individual scores on the JSE, but can also serve as a supplementary measure for admissions to medical school and postgraduate medical education programs.","PeriodicalId":16639,"journal":{"name":"Journal of Osteopathic Medicine Journal of Osteopathic Medicine","volume":"7 1","pages":"520 - 532"},"PeriodicalIF":0.0,"publicationDate":"2019-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79121125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Novel Approach to Introducing an Ultrasonography Curriculum With Limited Instructor Resources","authors":"Danika Evans, M. Thiessen","doi":"10.7556/jaoa.2019.095","DOIUrl":"https://doi.org/10.7556/jaoa.2019.095","url":null,"abstract":"Abstract Context Ultrasonography is becoming more prevalent in clinical practice, but medical schools looking to implement preclinical training are limited by financial and faculty resources. Objective To design a single-instructor model to save faculty resources and to determine whether this model is effective at teaching ultrasonography to preclinical medical students. Methods This single-instructor model included 3 components: (1) flipped classroom, where students watched an online lecture covering examination techniques; (2) in-person scanning sessions, where students scanned each other after the instructor went through lecture content and pathologic images, a video camera to show probe placement and examination technique, and a live feed from an ultrasonography demonstration; and (3) feedback on written examination questions and course evaluations. Results When compared with a traditional ultrasonography curriculum, which requires approximately 600 instruction hours annually, this program required 96 hours. Students reported appreciation of exposure to ultrasonography but expressed desire for smaller group sizes and greater individual instruction. Students performed well on written test questions, with the first-year class answering 88% correctly and the second-year class answering 90.6% correctly. Conclusions Although this educational format was used successfully to teach introductory ultrasonography to preclinical students, feedback suggested that students would prefer more individual instruction. The authors look toward implementing a peer-instructor format, forming smaller laboratory groups, and improving skill assessment.","PeriodicalId":16639,"journal":{"name":"Journal of Osteopathic Medicine Journal of Osteopathic Medicine","volume":"49 1","pages":"533 - 540"},"PeriodicalIF":0.0,"publicationDate":"2019-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79141605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Barium Contrast Aspiration","authors":"Parth M. Desai, C. Mbachi, Michael Alebich","doi":"10.7556/jaoa.2019.097","DOIUrl":"https://doi.org/10.7556/jaoa.2019.097","url":null,"abstract":"","PeriodicalId":16639,"journal":{"name":"Journal of Osteopathic Medicine Journal of Osteopathic Medicine","volume":"15 1","pages":"541 - 541"},"PeriodicalIF":0.0,"publicationDate":"2019-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79592957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Official Call: 2019 Annual Business Meeting of the American Osteopathic Association","authors":"William S. Mayo, Ray L. Morrison","doi":"10.7556/jaoa.2019.073","DOIUrl":"https://doi.org/10.7556/jaoa.2019.073","url":null,"abstract":"","PeriodicalId":16639,"journal":{"name":"Journal of Osteopathic Medicine Journal of Osteopathic Medicine","volume":"69 1","pages":"344 - 344"},"PeriodicalIF":0.0,"publicationDate":"2019-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90681311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}