Public Health

An interview with Dr Greg Stewart, president of the WFC

By John Wiens DC|January 8, 2015|Public Health|

Dr Greg Stewart

Mari-Len De Guzman of Canadian Chiropractor magazine talked with the president of the World Federation of Chiropractic Dr Greg Stewart about global opportunities, collaboration and the chiropractic values.

What Dr Stewart is most excited about is the opportunity to help advance the chiropractic profession as an equal player in the global health care arena, helping solve some of the world’s most pressing health issues.

“The opportunities have never been better. It’s a matter of whether we have the courage to walk through the doors that are open”, says Stewart. The World Health Organization has acknowledged the need for leadership in the area of spinal disorders, which are now a greater contributor to the burden of disease than HIV/AIDS, malaria, stroke, lung and breast cancer, and diabetes.

Says Stewart, “We have the ability to change the way the world is dealing with their health care. It’s cost-effective, it’s drugless, it has unlimited possibilities to help improve the health of the world and decrease the burden of disability world-wide.”

There are many reasons to be encouraged. “We have situations like in Denmark and Switzerland, where the curriculum for chiropractic and medicine is the same for the first three years, with chiropractic and medical students in the same classes until they branch off to their different streams in later years, “ Stewart notes. This early exposure to one another is enabling a new generation of health care practitioners that is much more inclined to collaboration.

“We have to leave our little comfortable areas and actually go into areas that are challenging, and sometimes confrontational, in order to get ahead,” he says.

Stewart acknowledges there are still ongoing issues that may have to be ironed out within the profession, but cautions against letting these internal disagreements get in the way of progress for the profession.

Stewart is confident the profession can effect big changes in health care, nationally and globally. “It’s my personal goal to really move away from chiropractic just trying to survive, into a world where we flourish.”

Read the full interview at Canadian Chiropractor.

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Havard’s School of Public Health and Medical School sponsoring their course in clinical trials for FREE.

By stevev|June 9, 2013|Education, Ethics, Medicine, Public Health, Randomized Controlled Trial, Research|

HSPH-HMS214X Fundamentals of Clinical Trials is just one of the courses offered at www.edx.org.

Ever wonder what it would be like to take a course offered at an Ivy League University? Wonder no more! Harvard is part of a consortium of the most prestigious Universities in the world that is offering MOOC‘s (Massive Open Online Courses). There are no costs involved in taking a MOOC and you get all the same information that you would in an on ground course. The only differences are that you don’t get the instructor (or even TA’s) grading your papers nor will you get college credit on a transcript from Harvard. They are however the same information used in the universities’ on ground for-credit courses that can cost thousands of dollars.

MOOC’s typically use open source materials (available at no charge for personal use) and a type of self grading system based off of discussion forums in the course (It is totally up to the professor how that is handled, so it will vary depending on the course and instructor). They are a combination of one answer to cutting high educational and making it available to everyone.

The course begins October 14, 2013, runs a total of 13 weeks and depending on your background will take between 4-6 hours of your time each week. A background in biostatistics and epidemiology equivalent to the content of PH207X Health in Numbers: Quantitative Methods in Clinical & Public Health Research.

From the course site;

“This course will provide an introduction to the scientific, statistical, and ethical aspects of clinical trials research. Topics include the design, implementation, and analysis of trials, including first-in-human studies (dose-finding, safety, proof of concept, and Phase I), Phase II, Phase III, and Phase IV studies. All aspects of the development of a study protocol will be addressed, including criteria for the selection of participants, treatments, and endpoints, randomization procedures, sample size determination, data analysis, and study interpretation. The ethical issues that arise at each phase of therapy development will be explored.”

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Strokes May Seem Rare, But Can Occur 230% More Often Using The Pill

By Frank M. Painter|June 14, 2012|Announcement, Oral Contraceptives, Public Health, Stroke|

Strokes May Seem Rare, But Can Occur 230% More Often Using The Pill

The Chiro.Org Blog

SOURCE: MedPage Today ~ June 13, 2012

By Todd Neale, Senior Staff Writer

A large Danish registry study found that the risks of thrombotic stroke or myocardial infarction (MI) roughly doubled in women taking oral contraceptives with low-to-moderate doses of ethinyl estradiol.

Note that the overall number of thrombotic strokes or MIs was small.

The relative risks of thrombotic stroke and myocardial infarction (MI) are higher among users of hormonal contraception, although absolute risks remain low, a Danish study showed.

Use of oral contraceptives combining low-to-moderate doses of ethinyl estradiol and various progestins was associated with up to 2.3 times the risks of thrombotic stroke or MI compared with non-use, according to Øjvind Lidegaard, DrMedSci, of Copenhagen University Hospital, and colleagues.

The type of progestin in the pill had little effect on the risks, the researchers reported in the June 14 issue of the New England Journal of Medicine.

To put the risk in perspective, they estimated that among 10,000 women taking a pill combining desogestrel with ethinyl estradiol at a dose of 20 μg for 1 year, two will have arterial thrombosis and seven will have venous thrombosis.

(more…)

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Where the U.S. Spends its Spine Dollars

By Frank M. Painter|June 6, 2012|Chiropractic Care, Cost-Effectiveness, Public Health, Spinal Manipulation|

Where the U.S. Spends its Spine Dollars: Expenditures on Different Ambulatory Services for the Management of Back and Neck Conditions

The Chiro.Org Blog

SOURCE: Spine (Phila Pa 1976). 2012 (Mar 16)

Davis, Matthew A. DC, MPH; Onega, Tracy PhD;
Weeks, William MD, MBA; Lurie, Jon MD, MS

The Dartmouth Institute for Health Policy and Clinical Practice,
Lebanon, NH 03766, USA

Study Design Serial, cross-sectional, nationally representative surveys of non-institutionalized adults.

Objective To examine expenditures on common ambulatory health services for the management of back and neck conditions.

Summary of Background Data Although it is well recognized that national costs associated with back and neck conditions have grown considerably in recent years, little is known about the costs of care for specific ambulatory health services that are used to manage this population.

Methods We used the Medical Expenditure Panel Survey (MEPS) to examine adult (age ≥ 18 years) respondents from 1999 to 2008 who sought ambulatory health services for the management of back and neck conditions. We used complex survey design methods to make national estimates of mean inflation-adjusted annual expenditures on medical care, chiropractic care, and physical therapy per user for back and neck conditions.

Results Approximately 6% of US adults reported an ambulatory visit for a primary diagnosis of a back or neck condition (13.6 million in 2008).

Between 1999 and 2008, the mean inflation-adjusted annual expenditures on medical care for these patients increased by 95% (from $487 to $950); most of the increase was accounted for by increased costs for medical specialists, as opposed to primary care physicians. (more…)

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Steps Set for Livestock Antibiotic Ban

By John Wiens DC|March 24, 2012|Public Health|

Source NY Times

The Obama administration must warn drug makers that the government may soon ban agricultural uses of some popular antibiotics that many scientists say encourage the proliferation of dangerous infections and imperil public health, a federal magistrate judge ruled on Thursday.

The order, issued by Judge Theodore H. Katz of the Southern District of New York, effectively restarts a process that the Food and Drug Administration began 35 years ago, but never completed, intended to prevent penicillin and tetracycline, widely used antibiotics, from losing their effectiveness in humans because of their bulk use in animal feed to promote growth in chickens, pigs and cattle.

The order comes two months after the Obama administration announced restrictions on agricultural uses of cephalosporins, a critical class of antibiotics that includes drugs like Cefzil and Keflex, which are commonly used to treat pneumonia, strep throat and skin and urinary tract infections.

Siobhan DeLancey, an F.D.A. spokeswoman, would not say whether the government planned to appeal. “We are studying the opinion and considering appropriate next steps,” she said.

In a separate move, the F.D.A. is expected to issue draft rules within days that ask drug makers to voluntarily end the use of antibiotics in animals without the oversight of a veterinarian. (more…)

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Chiropractic Research & Practice: State of the Art

By Frank M. Painter|February 24, 2012|Cost-Effectiveness, Evidence-based Medicine, Health Care Reform, Outcome Assessment, Patient Satisfaction, Prevention, Public Health, Research, Spinal Manipulation, Wellness Care|

Chiropractic Research & Practice State of the Art

The Chiro.Org Blog

SOURCE: Cleveland Chiropractic College

By Daniel Redwood, D.C., professor,
Cleveland Chiropractic College

Peer Reviewers: Carl S. Cleveland III, D.C., J.
Michael Flynn, D.C., Cheryl Hawk, D.C., PhD., and
Anthony Rosner, PhD.

Chiropractic Research & Practice

State of the Art

Since chiropractic’s breakthrough decade in the 1970s — when the U.S. federal government included chiropractic services in Medicare and federal workers’ compensation coverage, approved the Council on Chiropractic Education (CCE) as the accrediting body for chiropractic colleges, and sponsored a National Institutes of Health (NIH) conference on the research status of spinal manipulation — the profession has grown and matured into an essential part of the nation’s healthcare system.

Chiropractic was born in the United States in the late 19th century and the U.S. is home to approximately 65,000 of the world’s 90,000 chiropractors. [1] The chiropractic profession is the third largest independent health profession in the Western world, after medicine and dentistry. Doctors of chiropractic are licensed throughout the English-speaking world and in many other nations as primary contact providers, licensed for both diagnosis and treatment without medical referral. In 2005, the World Health Organization (WHO) published WHO Guidelines on Basic Training and Safety in Chiropractic, which documented the status of chiropractic education and practice worldwide and sought to ensure high standards in nations where chiropractic is in the early stages of development. [2]

Rigorous educational standards are supervised by government-recognized accrediting agencies in many nations, including CCE in the United States. After fulfilling college science prerequisites similar to those required to enter medical schools, chiropractic students must complete a chiropractic college program of four academic years, which includes a wide range of courses in anatomy, physiology, pathology, and diagnosis, as well as spinal adjusting, physiotherapy, rehabilitation, public health and nutrition. (more…)

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