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April 2013

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Chiropractic Has Better Results and More Cost Effective for Lower Back Problems

A release by the Foundation for Chiropractic Progress (F4CP) cites new studies showing that chiropractic care is not only more effective for helping people suffering from lower back problems, but is also more affordable. The F4CP release dated, April 08, 2013, cites the results of two recent studies documenting the chiropractic advantage for patients with lower back problems.

Gerard Clum, D.C., spokesperson for the F4CP commented on one of the studies by saying, "Chiropractic care is a cost-effective, evidence-based approach that is well-documented for its outstanding patient outcomes and satisfaction scores." The study he referenced was published on April 1, 2013 in the medical journal Spine, which found that spinal manipulation (as the study authors termed it) was significantly better than non-steroidal anti-inflammatory drug diclofenac and clinically superior to placebo for patients with acute non-specific low back pain. Dr. Clum added, "When used as a primary treatment option for back pain, chiropractic can boost avoidance of risky and costly measures, and promote equal or greater clinical outcomes."

The second study referenced by the F4CP release was published in the Journal of Manipulative and Physiological  Therapeutics in January 2013. The study titled, "Aging baby boomers and the rising cost of chronic back pain: secular trend analysis of longitudinal Medical Expenditures Panel Survey data for years 2000 to 2007," showed that with the common (medical) care of chronic lower back problems the costs will continue to escalate. The author concluded, "The prevalence of back pain, especially chronic back pain, is increasing. To the extent that the growth in chronic back pain is caused, in part, by an aging population, the growth will likely continue or accelerate. With relatively high cost per adult with chronic back pain, total expenditures associated with back pain will correspondingly accelerate under existing treatment patterns."

The F4CP makes the point that utilization of chiropractic care presents opportunities for improved patient outcomes and decreased costs. Dr. Clum emphasizes the point that chiropractic would lower the cost of chronic lower back care as well as overall healthcare by saying, "To improve the system, it will be essential that patient care approaches with clinical and economic advantages -- such as chiropractic care -- be the focal point of progressive healthcare and health policy discussions."

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Reports of Hospital Mistakes Now Available Online

The above is the headline from an April 7, 2013 article on Fosters.com of the Fosters Daily Democrat from Oregon. The article notes that hospitals are now starting to post mistakes online in an effort to improve patient safety.

The article notes that  for the first time, the U.S. Centers for Medicare and Medicaid (CMS) has released inspection reports for hospitals nationwide from the past two years. The release of these reports was in response to a request by the Association of Health Care Journalists, who has placed these reports onto a publicly searchable database.

According to the article, in Oregon alone, the database shows that, since January 2011, inspectors have found at least 82 violations. "We take every one of these seriously," said Cheryl Nester Wolfe, Salem hospital's chief operating officer. "It's a good opportunity to examine our system and figure out where we can make improvements."

An article in The Boston Globe dated April 09, 2013, about hospital safety specifically at Brigham and Women’s Hospital notes that the hospital publishes a newsletter that openly talks about errors made at the hospital. The newsletter, "Safety Matters" is not available to the general public, but copies are delivered to the newspapers such as the Boston Globe.

"Open-faced transparency is really valuable to staff at an institution because it causes them to know themselves better," said Paul O’Neill, a member of the Lucian Leape Institute at the National Patient Safety Foundation, a nonprofit research organization based in Boston. But few, if any, other hospitals are doing anything like what the Brigham does, he said: "Unfortunately, I would say it’s highly unusual."

On the Portland TV news station website KGW.com, on April 3, 2013 Jason McNichol, president of Health Advocacy Solutions commented on some of the additional benefits of  having hospitals publish errors online by stating, "It also gives hospitals an incentive to do the right thing because the more accountability and transparency there is, the more incentive there is for hospitals to clean up mistakes and problems when they see them.

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Chiropractors Seeing More Children

An article published on March 5, 2013 in the Medill Reports - Chicago, from Northwestern University reports how more children are going to chiropractors. The article titled,  "Chiropractors crack necks, backs and ankles - increasingly among children" , by Kristin Callahan, reports on the trend toward chiropractic for this younger demographic.

The author of the article starts by noting, "With the demand for complementary and alternative treatment increasing, more people are considering the use of chiropractic care for children and newborns."  The article also reports that according to a 2010 study done by the International Chiropractic Pediatric Association, (ICPA) chiropractic is the most popular form of alternative (non-medical) care for children.

The most recent data available in the ICPA study showed that an estimated 86 million pediatric visits were made to chiropractors throughout the United States, Canada and Europe in 2007. Dr. Sean Curry, a Chicago area chiropractor explained, "My most rewarding visits are with kids because they don’t have a lot of scar tissue build up, they respond to care the quickest and the fastest."

The article points out that one of the most common reasons that children are brought to the chiropractor is recurring ear infections. “These kids have gone through the medical protocol and have plateaued,” said Dr. Jeanne Ohm, a Pennsylvania chiropractor and CEO of the International Chiropractic Pediatric Association. “They are not functioning at a level the parents would like -- that’s when they go see a chiropractor.”

The article author reported on the growing trend toward chiropractic as well as the growing number of Doctors of Chiropractic. She reports, "In 2012, there were 70,000 chiropractors and 778,000 physicians in the United States. Every year there are more than 4,000 chiropractic graduates from 30 educational institutions, and due to increasing enrollment, the number of American chiropractors is expected to rise to 145,000 by 2015."

The article also notes that in a recent study in Montreal, Quebec fewer than half of the patients who went to chiropractors told their medical doctors that they were going. Some people fear being chastised by their medical doctor who may incorrectly think chiropractic adjustments are too forceful or can harm children. Dr. Robert Braile, a chiropractor from Georgia and former president of the International Chiropractors Association dismisses any thoughts of danger for children, "Chiropractic adjustments for children or infants are specific, scientific and safe." He continued, "A medical professional would not prescribe the same strength drug for an infant that they would for a 200 pound man. In the same light the adjustment that I give to a newborn is not the same as the one I give to an adult.

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Antibiotics Are 'Ticking Time-Bomb', Warns Medical Chief

The above headline comes from the United Kingdom on March 11, 2013 from The Telegraph. The article starts off by quoting Professor Dame Sally Davies, the UK Chief Medical Officer (CMO) who said that the threat posed by antibiotic resistance is a "ticking time-bomb", which should be put on the UK's National Risk Register.

Professor Davies's comments were based on her report published on March 11, 2013 titled, "Annual Report of the Chief Medical Officer". Highlighting the importance Professor Davies gives to this issue, the subtitle of her report reads, "Infections and the rise of antimicrobial resistance."

According to the Telegraph article, "The problem is a “ticking time bomb” and should be put on the National Risk Register — which also includes “catastrophic terrorist attacks” and other civil emergencies, Prof Dame Sally Davies said.

Another article on the same subject in The Guardian on March 17, 2013 points out how serious this issue is by saying, "Antibiotic-resistant bacteria kill far more people each year globally than terrorism."  The  Guardian further  illustrates their point by reporting that the, "World Health Organization estimates that for tuberculosis alone multi-drug resistance accounts for more than 150,000 deaths each year."

A number of the articles addressing this issue point out that the main reason for the rise in antibiotic resistance is the overuse and indiscriminant use of antibiotics.  One article notes that in years to come, if this problem is not kept in check, almost half of the people who have surgery, such as hip replacement, will succumb to an infection, and of those about 30% will die from it.

In an April 9, 2013 news article on the UK government website Professor Anthony Kessel, Director of Public Health Strategy at PHE, sums up the issue by saying: "We are very pleased that the CMO is giving the issue of antibiotic resistance her full attention. This is not a clinical issue but one that affects all of us and we must change our attitude towards antibiotics. They certainly have their place for treating bacterial infections but too often are given for viral illnesses which contribute towards the problems we are facing today. This will require more awareness raising and education both for clinicians and the public on how we use the antibiotics that we have."

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Infant with Colic and Torticollis Helped with Chiropractic - A Case Study

From the Journal of Pediatric, Maternal & Family Health comes a case study published on March 28, 2013 documenting the case of an infant who was suffering from colic and torticollis, who was helped by chiropractic care.

The study authors start by noting that colic affects 29% to 39% of infants. According to the US government website MedlinePlus, "Colic is crying in a baby that lasts for longer than 3 hours a day and is not caused by a medical problem. About 1 in 5 babies cry long enough to be considered colicky."   The study authors also note that the signs of colic go beyond just crying, "In addition to abdominal pain and distension, the patient will have excessive bowel gas and legs held in a position drawn up toward the body."

In this case a 3 month old baby boy was brought to the chiropractor suffering from incessant crying and torticollis. Infant torticollis is when the baby's head is tilted to one side and the chin turned toward the other, due to muscle contraction. The baby's history revealed he was born six weeks early by cesarean section and spent two weeks in the Neonatal Intensive Care Unit. He started experiencing gastric reflux and colic in his first month of life. At the baby's first pediatric check-up he was diagnosed with colic, torticollis and flattening of the bones on the top of his head as well as the left side of the back of his head.  The boy's mother noted that he could not turn his head comfortably to either side. His medical doctor suggested a helmet for the torticollis.

The boy cried during the entire chiropractic examination. The results of the examination showed a number of postural abnormalities and restrictions in ranges of motion. His abdomen was extremely sensitive to touch with the muscles being hard. It was determined based on the chiropractic examination that the child had a subluxation of the top bone in his neck, C1, as well as misalignments in his pelvis and mid back area. Specific chiropractic adjustments were initiated to correct the baby's subluxations.

The case reports notes that on the second chiropractic visit the mother reported that her son was able to sleep with his head turned to the left, which he had not been able to do previously. His mother also reported that her son exhibited positive behavioral changes, noting that he was a happier baby and was crying less. By the third visit the baby was sleeping better and continued to cry less. By the fourth visit the patient’s mother stated that her son's torticollis as well as the colic were completely resolved. The child continued to be healthy and happy from that point forward.

The authors of the study summed up the outcome by stating, "The child showed marked improvement after each chiropractic visit with complete resolution of the colic and torticollis after just four visits. This completely changed the demeanor and character of this child illustrating the positive effect of chiropractic on this child as well as his parent’s lives."

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One in Ten U.S. Kids Diagnosed With ADHD

The above is a headline from a HealthDay article appearing on WebMD on April 1, 2013. What is interesting is the sub-headline for this story which reads, "But many children who get diagnosis may not really have the condition, experts say."

According to a recent report released by the Centers for Disease Control and Prevention, approximately 11 percent of all children attending school, and a whopping 19 percent of high school males, are diagnosed with attention-deficit/hyperactivity disorder (ADHD). A total of 6.4 million school-age children have been diagnosed with ADHD which is a 16 percent rise since 2007 and a 53 percent increase since 2003 as reported by the New York Times.

Approximately two-thirds of the children are prescribed Adderall, Ritalin, or other psychotropic drugs which carry side effects such as  anxiety, psychosis, and addiction.  According to a New York Times article dated April 6, 2013, doctors are increasingly concerned about the overuse of the ADHD diagnosis and the overuse of the drug treatments for ADHD in US school children.

"Mild symptoms are being diagnosed so readily, which goes well beyond the disorder and beyond the zone of ambiguity to pure enhancement of children who are otherwise healthy," said Dr. William Graf, a pediatric neurologist in New Haven, Conn., and a professor at the Yale School of Medicine.

The over-diagnosis of ADHD is expected to get worse with the newest version of the American Psychiatric Association’s manual, the DSM5. According to the online Australian, new.com.au article by Sue Dunlevy on March 31, 2013, Australian psychiatrists are calling for a boycott of DSM5 because of their concerns. Australian psychiatrist Professor Jon Jureidini believes the adoption of the DSM5 will bring about the over-diagnosis of mental conditions such as ADHD that will subsequently lead to over-medication.

US psychiatrist Professor Allen Frances supports the Australian psychiatrists’ fears stating that "…it will provoke a rash of new fad diagnoses that will see young children heavily medicated."

According to an April 9, 2013 article on the Huffington Post blog "The Psycho-Therapeutic School System: Pathologizing Childhood" by John W. Whitehead, children with symptoms such as distraction, fidgeting, daydreaming, nonstop talking, and trouble sitting still, are usual and normal behaviors for children. Because there is no clinical test for ADHD, normal childish behaviors in perfectly normal children are being diagnosed as ADHD.

CDC director Dr. Thomas Friedan characterized the nation's current fixation on ADHD as an over diagnosis and a "misuse [of ADHD medications that] appears to be growing at an alarming rate."

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