Journal of Chiropractic Humanities最新文献

{"title":"The McAndrews Leadership Lecture: February 2016, by Dr Greg Kawchuk. Putting the “Act” Back in Chiropractic","authors":"Gregory Neil Kawchuk DC, PhD","doi":"10.1016/j.echu.2017.09.002","DOIUrl":"10.1016/j.echu.2017.09.002","url":null,"abstract":"<div><p>The McAndrews Leadership Lecture was developed by the American Chiropractic<span> Association to honor the legacy of Jerome F. McAndrews, DC, and George P. McAndrews, JD, and their contributions to the chiropractic profession. This article is an edited and truncated version of the McAndrews Leadership Lecture given by Dr Greg Kawchuk on February 27, 2016, in Washington, DC, at the National Chiropractic Leadership Conference. This was the second McAndrews lecture in this annual series.</span></p></div>","PeriodicalId":39103,"journal":{"name":"Journal of Chiropractic Humanities","volume":"24 1","pages":"Pages 44-48"},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.echu.2017.09.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35849021","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":"Joint Manipulation: Toward a General Theory of High-Velocity, Low-Amplitude Thrust Techniques","authors":"Andrew S. Harwich DO","doi":"10.1016/j.echu.2017.01.001","DOIUrl":"10.1016/j.echu.2017.01.001","url":null,"abstract":"<div><h3>Objective</h3><p>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.</p></div><div><h3>Methods</h3><p><span>This study examined the movements described by authors from the fields of osteopathy, </span>chiropractic<span><span>, 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 </span>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.</span></p></div><div><h3>Results</h3><p>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.</p></div><div><h3>Conclusions</h3><p>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.</p></div>","PeriodicalId":39103,"journal":{"name":"Journal of Chiropractic Humanities","volume":"24 1","pages":"Pages 15-23"},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.echu.2017.01.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35849584","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":"A Literature Review of Electronic Health Records in Chiropractic Practice: Common Challenges and Solutions","authors":"David N. Taylor DC","doi":"10.1016/j.echu.2016.12.001","DOIUrl":"10.1016/j.echu.2016.12.001","url":null,"abstract":"<div><h3>Objective</h3><p><span>The purpose of this study was to review the literature on current challenges and propose solutions for the optimal utilization of the electronic health records (EHRs) in </span>chiropractic practice.</p></div><div><h3>Methods</h3><p>A search was performed in the PubMed, Index of Chiropractic Literature, and Current Index to Nursing and Allied Health Literature databases from November 2005 to February 2015. A combination of the following key words was used: <em>electronic health records</em>, <span><em>electronic medical records</em></span>, <em>implementation</em>, <em>documentation</em>, <em>benefits</em>, and <em>challenges</em>. Articles were categorized into common problems and solutions. These were filtered by application to chiropractic or educational institutions.</p></div><div><h3>Results</h3><p>The search resulted in 45 papers, which included case reports of EHR implementation, governmental insurance reports, commentaries, controlled studies, narrative reviews of past experiences with conversion from paper systems, and the implementation of EHRs in small offices and chiropractic offices. Minimal literature was found that directly related to chiropractic EHRs. Improper utilization, incorrect use of the software, faulty implementation, workflow burdens, financial considerations, and insufficient training were found to negatively affect the quality of the record.</p></div><div><h3>Conclusions</h3><p>Documentation errors are often innate in the EHR software. Improper utilization, insufficient training, or difficulty in integration of the EHR into the clinical office setting results in poor implementation of the electronic version of the clinical record. Solutions that may decrease documentation errors include EHR training, continued financial incentives, and appropriate implementation process and utilization of available software features.</p></div>","PeriodicalId":39103,"journal":{"name":"Journal of Chiropractic Humanities","volume":"24 1","pages":"Pages 31-40"},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.echu.2016.12.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35849586","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":"Toxins, Toxicity, and Endotoxemia: A Historical and Clinical Perspective for Chiropractors","authors":"David R. Seaman DC, MS","doi":"10.1016/j.echu.2016.07.003","DOIUrl":"10.1016/j.echu.2016.07.003","url":null,"abstract":"<div><h3>Objective</h3><p>The purpose of this commentary is to review the notion of toxicity in the context of chiropractic practice.</p></div><div><h3>Discussion</h3><p><span><span>The belief that body toxicity is the cause of disease has been promoted for thousands of years. Prior to the emergence of the chiropractic profession, the medical profession embraced the notion that the body becomes “toxic,” requiring </span>detoxification interventions or surgery. The legacy of body toxicity within the chiropractic approach to patient care began with Daniel David Palmer. Today, some sectors within the medical and chiropractic professions continue to embrace the concept of body toxicity and the related need to engage in detoxifying </span>treatments<span><span><span>. The most common areas of focus for detoxification are the intestines and liver; however, the nature of the toxicity in these organs has yet to be defined or measured. In contrast, diet-induced systemic bacterial endotoxemia is a measureable state that is known to be promoted by a diet rich in sugar, flour, and refined oil. This suggests that </span>bacterial endotoxin<span> may be a candidate toxin to consider in the clinical context, as many common conditions, such as obesity, metabolic syndrome, diabetes, </span></span>interstitial cystitis, depression, and migraine headache, are known to be promoted by endotoxemia.</span></p></div><div><h3>Conclusion</h3><p>A diet rich in refined sugar, flour, and oils may induce proinflammatory changes within intestinal microbiota that lead to systemic, low-grade endotoxemia, which is a common variety of “toxicity” that is measurable and worthy of research consideration. Introducing a diet to reduce endotoxemia, rather than attempting to target a specific organ, appears to be a rational clinical approach for addressing the issue of toxicity.</p></div>","PeriodicalId":39103,"journal":{"name":"Journal of Chiropractic Humanities","volume":"23 1","pages":"Pages 68-76"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.echu.2016.07.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54127342","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":"Chiropractic Identity in the United States: Wisdom, Courage, and Strength","authors":"Christopher J. Good DC, MA(Ed)","doi":"10.1016/j.echu.2016.08.001","DOIUrl":"10.1016/j.echu.2016.08.001","url":null,"abstract":"<div><h3>Objective</h3><p>The objective of this paper was to discuss the chiropractic profession’s identity and 3 contentious issues related to identity.</p></div><div><h3>Discussion</h3><p>The various clinical specialties and independent groups in the chiropractic profession<span> are so different in their beliefs, practice styles, and political agendas that a common identity is unlikely to be created. Areas of disagreement, including advanced practice, vertebral subluxation, and the philosophy of chiropractic, continue to separate those in the profession. Doctors of chiropractic should accept that differences within the profession will remain for the foreseeable future and that the profession should allow each group to live peacefully and supportively alongside each other.</span></p></div><div><h3>Conclusions</h3><p>If the profession embraces the ideals of truth, respect, and tolerance, it can continue to grow and provide diverse health care services well into the future.</p></div>","PeriodicalId":39103,"journal":{"name":"Journal of Chiropractic Humanities","volume":"23 1","pages":"Pages 29-34"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.echu.2016.08.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54127351","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":"Spine Care as a Framework for the Chiropractic Identity","authors":"Michael Schneider DC, PhD ,&nbsp;Donald Murphy DC ,&nbsp;Jan Hartvigsen DC, PhD","doi":"10.1016/j.echu.2016.09.004","DOIUrl":"10.1016/j.echu.2016.09.004","url":null,"abstract":"<div><h3>Objective</h3><p>The purpose of this commentary is to provide an argument for the role and identity of chiropractors<span> as spine care providers within the context of the greater health care system.</span></p></div><div><h3>Discussion</h3><p><span>Surveys of the general public and chiropractors indicate that the majority of patients seek chiropractic services for back and neck pain. Insurance company utilization data confirm these findings. Regulatory and legal language found in chiropractic practice acts reveals that most jurisdictions define the chiropractic </span>scope of practice<span><span> as based on a foundation of spine care. Educational accrediting and testing organizations have been shaped around a chiropractic education that produces graduates who focus on the diagnosis and treatment of spine and </span>musculoskeletal disorders. Spine care is thus the common denominator and theme throughout all aspects of chiropractic practice, legislation, and education globally.</span></p></div><div><h3>Conclusion</h3><p>Although the chiropractic profession may debate internally about its professional identity, the chiropractic identity seems to have already been established by society, practice, legislation, and education as a profession of health care providers whose area of expertise is spine care.</p></div>","PeriodicalId":39103,"journal":{"name":"Journal of Chiropractic Humanities","volume":"23 1","pages":"Pages 14-21"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.echu.2016.09.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54127390","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":"The Swiss Master in Chiropractic Medicine Curriculum: Preparing Graduates to Work Together With Medicine to Improve Patient Care","authors":"B. Kim Humphreys DC, PhD,&nbsp;Cynthia K. Peterson DC, MMedEd","doi":"10.1016/j.echu.2016.09.001","DOIUrl":"10.1016/j.echu.2016.09.001","url":null,"abstract":"<div><h3>Objective</h3><p>In 2007, chiropractic<span> became 1 of the 5 medical professions in Switzerland. This required a new chiropractic program that was fully integrated within a Swiss medical school. The purpose of this article was to discuss the Master in Chiropractic Medicine (MChiroMed) program at the University of Zürich, including advantages, opportunities, and challenges.</span></p></div><div><h3>Discussion</h3><p>In 2008, the MChiroMed program began with its first student cohort. The MChiroMed program is a 6-year Bologna model 2-cycle (bachelor and master) “spiral curriculum,” with the first 4 years being fully integrated within the medical curriculum. A review of the main features of the curriculum revealed the advantages, opportunities, and challenges of this program in comparison with other contemporary chiropractic educational programs. Advantages and opportunities include an integrated curriculum within a university, medical school, and musculoskeletal hospital, with their associated human and physical resources. Many opportunities exist for high-level research collaborations. The rigorous entrance qualifications and small student cohorts result in bright, motivated, and enthusiastic students; appropriate assessments; and timely feedback on academic and clinical subjects. Early patient contact in hospitals and clinical facilities encourages the integration of academic theory and clinical practice. The main challenges faced by this program include difficulty recruiting a sufficient number of students because of the rigorous entrance requirements and curriculum overload resulting from undertaking a full medical curriculum and chiropractic modules.</p></div><div><h3>Conclusions</h3><p>The MChiroMed program is a unique chiropractic curriculum that integrates medical and chiropractic education within a spiral curriculum at a world-class Swiss university medical school. The expectation is that graduates, with their expanded diagnostic and therapeutic knowledge, skills, and experience, will become future experts in primary spine care in Switzerland. It is hoped that this curriculum model will be adopted by other countries and jurisdictions seeking to enhance the role of chiropractic in health care.</p></div>","PeriodicalId":39103,"journal":{"name":"Journal of Chiropractic Humanities","volume":"23 1","pages":"Pages 53-60"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.echu.2016.09.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54127357","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":"Chiropractic Identity: A Neurological, Professional, and Political Assessment","authors":"Anthony L. Rosner PhD, LLD (Hon)","doi":"10.1016/j.echu.2016.05.001","DOIUrl":"10.1016/j.echu.2016.05.001","url":null,"abstract":"<div><h3>Objective</h3><p><span>The purpose of this article is to propose a focused assessment of the identity of chiropractic<span> and its profession, triangulating multiple viewpoints converging upon various aspects and definitions of </span></span>neurology<span>, manual medicine, and alternative or mainstream medicine.</span></p></div><div><h3>Discussion</h3><p><span>Over 120 years since its inception, chiropractic has struggled to achieve an identity for which its foundations could provide optimal health care. Despite recognition of the benefits of </span>spinal manipulation<span><span> in various government guidelines, advances in US military and Veterans Administration, and persistently high levels of patient satisfaction, the chiropractic profession remains underrepresented in most discussions of health care delivery. Distinguishing characteristics of doctors of chiropractic include the following: (1) they embrace a model of holistic, </span>preventive medicine<span> (wellness); (2) they embrace a concept of neurological imbalance in which form follows function, disease follows disturbed biochemistry, and phenomenology<span> follows physiology; (3) they diagnose, and their institutions of training are accredited by a body recognized by the US Department of Education; (4) they manage patients on a first-contact basis, often as primary care providers in geographical areas that are underserved; (5) the spine is their primary—but not exclusive—area of interaction; (6) they deliver high-velocity, low-amplitude adjustments with a superior safety record compared with other professions; and (7) they use a network of institutions worldwide that have shown increasing commitments to research.</span></span></span></p></div><div><h3>Conclusion</h3><p>This article provides an overview of chiropractic identity from 6 points of view: (1) concepts of manual medicine; (2) areas of interest beyond the spine; (3) concepts of the chiropractic subluxation; (4) concepts of neurology; (5) concepts of mainstream or alternative health care; and (6) concepts of primary care, first-contact provider, or specialist.</p></div>","PeriodicalId":39103,"journal":{"name":"Journal of Chiropractic Humanities","volume":"23 1","pages":"Pages 35-45"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.echu.2016.05.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54127322","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":"Core and Complementary Chiropractic: Lowering Barriers to Patient Utilization of Services","authors":"John J. Triano DC, PhD,&nbsp;Marion McGregor DC, PhD","doi":"10.1016/j.echu.2016.07.001","DOIUrl":"10.1016/j.echu.2016.07.001","url":null,"abstract":"<div><h3>Objective</h3><p>The use of chiropractic services has stalled while interest in accessing manipulation services is rising. The purpose of this paper is to consider this dilemma in the context of the dynamics of professional socialization, surveys of public attitudes, and a potential strategic action.</p></div><div><h3>Discussion</h3><p><span>This is a reflection work grounded in the literature on professional socialization and the attitudes held regarding chiropractic in modern society, to include its members, and in original data on training programs. Data were interpreted on the background of the authors’ cross-cultural experiences spanning patient care, research, education, and interprofessional collaboration. Recommendation on a strategic action to counter barriers in patient<span> referrals was synthesized. Professional socialization is the process by which society enables professional privilege. Illustration of typical and divergent professional socialization models emerged that explain cognitive dissonance toward the profession. Questions of trust are commensurate with the experiences during patient encounters rather than with a common identity for the profession. Diversity among encounters perpetuates the uncertainty that affects referral sources. Commonality as an anchor for consistent professional identity and socialization through the content of core chiropractic, defined by training and practice, offers a means to offset uncertainty. Complementary chiropractic, analogous to </span></span>complementary medicine, provides an outlet under professional socialization for the interests to explore additional methods of care.</p></div><div><h3>Conclusion</h3><p>The practice workplace is an effective lever for altering barriers to the use of services. Clarifying rhetoric through conceptualization of core and complementary practices simplifies the socialization dynamic. Further, it takes advantage of accepted cultural semantics in meaningful analogy while continuing to empower practical diversity in care delivery in response to evolving scientific evidence.</p></div>","PeriodicalId":39103,"journal":{"name":"Journal of Chiropractic Humanities","volume":"23 1","pages":"Pages 1-13"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.echu.2016.07.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54127327","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":"Analysis and Adjustment of Vertebral Subluxation as a Separate and Distinct Identity for the Chiropractic Profession: A Commentary","authors":"John Hart DC, MHSc","doi":"10.1016/j.echu.2016.09.002","DOIUrl":"10.1016/j.echu.2016.09.002","url":null,"abstract":"<div><h3>Objective</h3><p><span>The purpose of this paper is to discuss various statements related to chiropractic identity from</span>¹ D. D. Palmer²; selected chiropractic organizations, associations, and colleges; and³ attitudes and perceptions of chiropractic from chiropractic students, practitioners, and patients.</p></div><div><h3>Discussion</h3><p><span>For comparison purposes, identity statements and perceptions from the various chiropractic associations and colleges, as well as from students and patients, were explored. Identity statements for chiropractic were searched in various sources such as Palmer’s 1910 textbook, recent literature on viewpoints from chiropractic students and practitioners, and websites for chiropractic colleges and organizations. Palmer taught that the chiropractor’s focus was on vertebral subluxation<span>. Today, a number of chiropractic colleges and organizations continue to include the vertebral subluxation model in their instruction, with a majority of students and practitioners subscribing to the model. Conversely, a number of other colleges and organizations portray chiropractic as being essentially about the treatment<span> of back and neck pain, which is what patients associate with chiropractic. However, settling on any particular identity for the chiropractic profession will likely be met with resistance by some, given the plethora of opinions among chiropractic professionals as to what the identity of the chiropractic profession should be. Common ground between the different factions within the chiropractic profession might be found in a unifying expression such as “functional </span></span></span>neurology.”</p></div><div><h3>Conclusion</h3><p>When a profession’s identity is not clear with respect to its area of interest and mission, then the public may be less inclined to seek its services. Identifying the chiropractic profession with a focus on vertebral subluxation would give the profession uniqueness not duplicated by other health care professions and, therefore, might legitimatize the existence of chiropractic as a health care profession. An identity having a focus on vertebral subluxation would also be consistent with the original intent of the founding of the chiropractic profession.</p></div>","PeriodicalId":39103,"journal":{"name":"Journal of Chiropractic Humanities","volume":"23 1","pages":"Pages 46-52"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.echu.2016.09.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54127366","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}