Traditional Osteopathy and the General Osteopathic Treatment: A Historical Concept and a Modern Application

2021 ◽  
Vol 31 (4) ◽  
pp. 39-46
Author(s):  
Pascal J. Grolaux ◽  
Timothy J. Sparrow ◽  
François Lalonde
Keyword(s):  
Scientific Evidence ◽  
Original Form ◽  
Osteopathic Medicine ◽  
British School ◽  
Somatic Dysfunction ◽  
Osteopathic Treatment ◽  
The Usa ◽  
Unique Approach ◽  
Modern Application ◽  
Low Amplitude

Abstract Historically, Andrew Taylor Still, MD, DO, differentiated osteopathic medicine from allopathic medicine with its unique approach to treatment using manual therapy. Those treatments, known as osteopathic manipulative treatment (OMT), are currently used to treat somatic dysfunction. The Educational Council on Osteopathic Principles (ECOP) includes different treatment methods, such as muscle energy, high-velocity, low-amplitude, Still techniques, myofascial release, and counterstrain, amongst others, under the category of OMT. Conversely, osteopathic practitioners outside the USA, mostly from Europe, use some techniques that are not necessarily documented as OMT by the ECOP. This is the case of the General Osteopathic Treatment (GOT). The GOT found its origin with Dr. Still and was promoted, amongst his contemporaries, by Dr. John Martin Littlejohn, DO, who founded the British School of Osteopathy in London. The general treatment, based on a strong biomechanical background, was further spread in Europe by John Wernham, DO, a British osteopath and one of Littlejohn’s students. Wernham developed and taught the GOT in its original form based on the principles and philosophy of osteopathic medicine. The goals of this article are to give an historical perspective of the GOT, to describe the foundation and concepts behind it, and to provide a review of the scientific literature of this treatment approach. The GOT can be used to diagnose and directly treat somatic dysfunction using the TART principle in a clinical setting. Besides the recognized contra-indications of treating somatic dysfunction, there are no clear scientifically published findings of contraindications for the use of the GOT. Like other OMTs, the GOT needs more scientific evidence to better understand its clinical applications.

scholarly journals “A debriefer must be neutral” and other debriefing myths: a systemic inquiry-based qualitative study of taken-for-granted beliefs about clinical post-event debriefing

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Julia Carolin Seelandt ◽  
Katie Walker ◽  
Michaela Kolbe
Keyword(s):  
Interpersonal Relationships ◽  
Western Europe ◽  
Ad Hoc ◽  
Scientific Evidence ◽  
Clinical Event ◽  
Clinical Settings ◽  
Healthcare Organizations ◽  
The Usa ◽  
Open Coding ◽  
Healthcare Administrators

Abstract Background The goal of this study was to identify taken-for-granted beliefs and assumptions about use, costs, and facilitation of post-event debriefing. These myths prevent the ubiquitous uptake of post-event debriefing in clinical units, and therefore the identification of process, teamwork, and latent safety threats that lead to medical error. By naming these false barriers and assumptions, the authors believe that clinical event debriefing can be implemented more broadly. Methods We interviewed an international sample of 37 clinicians, educators, scholars, researchers, and healthcare administrators from hospitals, universities, and healthcare organizations in Western Europe and the USA, who had a broad range of debriefing experience. We adopted a systemic-constructivist approach that aimed at exploring in-depth assumptions about debriefing beyond obvious constraints such as time and logistics and focused on interpersonal relationships within organizations. Using circular questions, we intended to uncover new and tacit knowledge about barriers and facilitators of regular clinical debriefings. All interviews were transcribed and analyzed following a comprehensive process of inductive open coding. Results In total, 1508.62 min of interviews (25 h, 9 min, and 2 s) were analyzed, and 1591 answers were categorized. Many implicit debriefing theories reflected current scientific evidence, particularly with respect to debriefing value and topics, the complexity and difficulty of facilitation, the importance of structuring the debriefing and engaging in reflective practice to advance debriefing skills. We also identified four debriefing myths which may prevent post-event debriefing from being implemented in clinical units. Conclusion The debriefing myths include (1) debriefing only when disaster strikes, (2) debriefing is a luxury, (3) senior clinicians should determine debriefing content, and (4) debriefers must be neutral and nonjudgmental. These myths offer valuable insights into why current debriefing practices are ad hoc and not embedded into daily unit practices. They may help ignite a renewed momentum into the implementation of post-event debriefing in clinical settings.

scholarly journals Feasibility of using a biofeedback device in mindfulness training - a pilot randomized controlled trial

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Brenna Lin ◽  
Christopher Prickett ◽  
Steven Woltering
Keyword(s):  
College Students ◽  
Mindfulness Meditation ◽  
Controlled Trial ◽  
Scientific Evidence ◽  
Well Being ◽  
Open Science ◽  
Control Group ◽  
Test Procedures ◽  
The Usa ◽  
Biofeedback Device

Abstract Background Stress can negatively impact an individual’s health and well-being and high levels of stress are noted to exist among college students today. While traditional treatment methods are plagued with stigma and transfer problems, newly developed wearable biofeedback devices may offer unexplored possibilities. Although these products are becoming commonplace and inexpensive, scientific evidence of the effectiveness of these products is scarce and their feasibility within research contexts are relatively unexplored. Conversely, companies are not required, and possibly reluctant, to release information on the efficacy of these products against their claims. Thus, in the present pilot, we assess the feasibility of using a real-time respiratory-based biofeedback device in preparation for a larger study. Our main aims were to assess device-adherence and collaboration with the company that develops and sells the device. Method Data were collected from 39 college students who self-identified as experiencing chronic stress at a Southwestern university in the USA. Students were randomized into either a mindfulness-only control group without a biofeedback device (n = 21), or an experimental group with biofeedback device (n = 18). Both groups received mindfulness meditation training. Pre-test and post-test procedures were conducted 2 weeks apart. Further, both participant compliance and company compliance were assessed and collaboration with the company was evaluated. Results Participant device-adherence as well as the company’s collaboration necessary for a full-scale study was determined to be low. This may also have affected our results which showed a strong main effect for time for all outcome variables, suggesting all groups showed improvement in their levels of stress after the intervention period. No group by time effects were identified, however, indicating no added benefit of the biofeedback device. Conclusions Our findings suggest feasibility of future studies requires full collaboration and detailed and agreed upon data sharing procedures with the biofeedback company. The particular device under investigation added no value to the intervention outcomes and it was not feasible to continue a larger-scale study. Further, as the technology sector is innovating faster than it can validate products, we urge for open science collaborations between public and private sectors to properly develop evidence-based regulations that can withstand technological innovation while maintaining product quality, safety, and effectiveness. Trial registration NCT02837016. Registered 19 July 2016.

FDA’s reduced exposure marketing order for IQOS: why it is not a reliable global model

2021 ◽  
pp. tobaccocontrol-2020-056316
Author(s):  
Lauren Kass Lempert ◽  
Stella Bialous ◽  
Stanton Glantz
Keyword(s):  
Public Relations ◽  
Tobacco Control ◽  
Scientific Evidence ◽  
Tobacco Product ◽  
Tobacco Products ◽  
Sales And Marketing ◽  
Philip Morris ◽  
The Us ◽  
The Usa ◽  
The Difference

The US Food and Drug Administration (FDA) issued orders in July 2020 authorising Philip Morris Products S.A. to market its heated tobacco product (HTP) IQOS inside the USA with claims that it reduces exposure to some dangerous substances. FDA’s ‘reduced-exposure’ orders explicitly prohibit the marketing of IQOS with claims that IQOS will reduce harm or the risk of tobacco-related diseases. Under US law, FDA’s IQOS orders are problematic because FDA disregarded valid scientific evidence that IQOS increases exposure to other dangerous toxins and that Philip Morris Products S.A. failed to demonstrate that consumers understand the difference between reduced-exposure and reduced-harm claims. Unfortunately, both ‘reduced-exposure’ and ‘reduced-harm’ are classified as ‘modified risk tobacco products’ under US law. Exploiting this confusion, Philip Morris International used the FDA decision as the basis for marketing and public relations campaigns outside the USA to press governments to reverse policies that ban or regulate the sales and marketing of HTPs, including IQOS. Parties to the WHO Framework Convention on Tobacco Control should reject tobacco companies’ unsubstantiated explicit or implied claims of reduced harm associated with HTPs and resist Philip Morris International’s and other companies’ calls to relax HTP regulations based on the FDA’s actions. Instead, parties should adopt policies aligned with the Framework Convention on Tobacco Control when dealing with HTPs and other novel tobacco products.

scholarly journals Evidentiary needs of US public health departments with a mission to advance equity and health: a qualitative analysis

BMJ Open ◽  
2018 ◽  
Vol 8 (9) ◽  
pp. e022033 ◽  
Author(s):  
Kimberly Danae Cauley Narain ◽  
Frederick J Zimmerman ◽  
Jessica Richards ◽  
Jonathan Fielding ◽  
Brian Cole ◽  
...  
Keyword(s):  
Public Health ◽  
Scientific Evidence ◽  
Qualitative Interviews ◽  
Grant Writing ◽  
Health Departments ◽  
Scientific Content ◽  
Public Health Departments ◽  
Geographical Regions ◽  
The Usa ◽  
Public Health Officials

ObjectivesWe sought the perspectives of lead public health officials working to improve health equity in the USA regarding the drivers of scientific evidence use, the supply of scientific evidence and the gap between their evidentiary needs and the available scientific evidence.DesignWe conducted 25 semistructured qualitative interviews (April 2017 to June 2017) with lead public health officials and their designees. All interviews were transcribed and thematically analysed.SettingPublic health departments from all geographical regions in the USA.ParticipantsParticipants included lead public health officials (20) and their designees (5) from public health departments that were either accredited or part of the Big Cities Health Coalition.ResultsMany respondents were using scientific evidence in the context of grant writing. Professional organisations and government agencies, rather than specific researchers or research journals, were the primary sources of scientific evidence. Respondents wanted to see more locally tailored cost-effectiveness research and often desired to participate in the planning phase of research projects. In addition to the scientific content recommendations, respondents felt the usefulness of scientific evidence could be improved by simplifying it and framing it for diverse audiences including elected officials and community stakeholders.ConclusionsRespondents are eager to use scientific evidence but also need to have it designed and packaged in ways that meet their needs.

scholarly journals THE EFFECT OF ANKLE AND SUBTALAR JOINT SOMATIC DYSFUNCTION CORRECTION TO IMPROVE ORIENTEER STATIC BALANCE

2016 ◽  
Vol 3 ◽  
pp. 553
Author(s):  
Baiba Smila ◽  
Andra Fernāte ◽  
Velga Zaļaiskalna
Keyword(s):  
Effective Means ◽  
Static Stability ◽  
Ankle Injuries ◽  
Static Balance ◽  
Effectiveness Analysis ◽  
Somatic Dysfunction ◽  
Balance Exercises ◽  
Ankle Joints ◽  
Osteopathic Treatment ◽  
The One

The most frequent injuries among sports orienteers are the ankle injuries. The one of the most effective means to prevent the ankle injuries and recurrent ankle injuries is balance and stability development. The aim of this study is to find out the most effective method to develop static stability in the previously injured ankle for orienteers: osteopathic treatment of the ankle and subtalar joints or balance exercises, or the combination of osteopathic treatment of the ankle and subtalar joints and balance exercises. The effectiveness analysis of the intervention methods was conducted with the use of Digital Balance Analyzer (DBA) for the assessment of statical balance. 36 orienteers (12 to 18 years old) were randomized in three groups to an intervention, after being assessed at baseline and then reassessed one week later. Static balance improvements are only when using osteopathy and ankle joints subtalar somatic dysfunction correction together with balance exercises. Separate osteopathy or balance exercises will not give results as effective as the combination of these two effects.

scholarly journals Heated tobacco product regulation under US law and the FCTC

2018 ◽  
Vol 27 (Suppl 1) ◽  
pp. s118-s125 ◽  
Author(s):  
Lauren Kass Lempert ◽  
Stanton A Glantz
Keyword(s):  
Tobacco Control ◽  
Scientific Evidence ◽  
Tobacco Product ◽  
Product Labelling ◽  
Tobacco Products ◽  
Control Laws ◽  
The Public ◽  
Philip Morris ◽  
Product Regulation ◽  
The Usa

Tobacco companies are marketing new ‘heated tobacco products’ (HTPs) composed of battery-powered holders, chargers and tobacco plugs or sticks. The non-tobacco HTP components have escaped effective regulation under many countries’ tobacco control laws because they are packaged and sold separately from the tobacco-containing components. In the USA, HTPs cannot be marketed unless the Food and Drug Administration determines that allowing their sale would be ‘appropriate for the protection of the public health’. Philip Morris International (PMI) is seeking permission to market its IQOS HTP in the USA with ‘modified risk tobacco product’ (MRTP) claims that it reduces exposure to harmful substances and is less harmful than other tobacco products. However, PMI has not submitted adequate scientific evidence required by US law to demonstrate that the product is significantly less harmful to users than other tobacco products, that its labelling would not mislead consumers, or that its marketing—with or without MRTP claims—would benefit the health of the population as a whole. Parties to the WHO Framework Convention on Tobacco Control (FCTC) must take measures to reduce tobacco use and nicotine addiction, and prevent false or misleading tobacco product labelling, advertising and promotions; the introduction of new HTPs must be assessed according to these goals. All components of HTPs should be regulated at least as stringently as existing tobacco products, including restrictions on labelling, advertising, promotion and sponsorship, sales to minors, price and taxation policies and smokefree measures. There is nothing in US law or the FCTC that prevents authorities from prohibiting HTPs.

scholarly journals Should the Critically Endangered Goliath grouper Epinephelus itajara be culled in Florida?

Oryx ◽  
2012 ◽  
Vol 47 (1) ◽  
pp. 88-95 ◽  
Author(s):  
Sarah Frias-Torres
Keyword(s):  
Wildlife Conservation ◽  
Scientific Evidence ◽  
Economic Benefits ◽  
Top Predator ◽  
Top Down ◽  
Morphological Studies ◽  
The Usa ◽  
Goliath Grouper ◽  
Red Lionfish ◽  
National Marine Fisheries Service

AbstractThe Goliath grouper Epinephelus itajara has been protected in the USA since 1990. In Florida commercial and recreational fishers consider the species a top predator of fish and lobster and advocate culling the grouper population as a solution to recover declining stocks. I examined the scientific evidence for and against culling the Goliath grouper, using commercial landing data from the National Marine Fisheries Service and the Florida Fish and Wildlife Conservation Commission (1950–2010), fisheries-independent diver-based surveys from the REEF Environmental Education Foundation (1993–2007), and published dietary and morphological studies. An analysis of the commercial extinction of the Goliath grouper in Florida indicates that its recovering population is not the cause of declining fish and lobster stocks. The recovering Goliath grouper population could provide ecological and socio-economic benefits: as top-down control on other lobster predators, in ecotourism, and as potential biocontrol of the invasive Indo-Pacific red lionfish Pterois volitans on Atlantic reefs.

LEGAL RESPONSIBILITY PRESCRIBING OFF-LABEL DRUGS: IS SPAIN DIFFERENT?

2015 ◽  
Vol 101 (1) ◽  
pp. e1.57-e1
Author(s):  
Maria A. Peire
Keyword(s):  
Ad Hoc ◽  
Scientific Evidence ◽  
General Rule ◽  
Drug Dose ◽  
Legal Responsibility ◽  
Royal Decree ◽  
Off Label ◽  
The Usa ◽  
Therapeutic Alternatives

– In Spain the compassionate use and off-label prescription, are both regulated in the same law: the Royal Decree 1015/2009. This norm facilitates the access to drugs in specific clinical situations, similar to US regulation and in a different way to the UE regulation.– It is a legal practice to prescribe in an off-label manner if the following requirements are followed: there are no authorized therapeutic alternatives, prescribed in health centers, when access to these drugs is provided through a protocol of use after justifying (written) and properly informing (verbal) and obtaining the patient's consent.– When prescribing off-label the doctor's decision is based on contrasted scientific evidence (not merely on personal intuition nor personal experience). In fact, this anticipates an eventual update of the data sheet for new indications or populations, unlike the French situation where they have the ATU (Temporary Utilization Authorization).– In Spain the holder of the Marketing Authorization is obliged not to promote or advertise the use of the drug in different conditions to those approved (unlike the USA regulation).– The jurisprudential analysis from the Spanish Courts states that the doctor's responsibility is equal than that concerning on-label prescription, that is, only in the case of bad medical praxis (as in the USA). The most important cause of sentencing were: the lack of informed consent, lack of control of the medication and lack of correct follow-up of the illness, whereas this does not include the drug, dose, duration or even the patient's age.– In European Union the general rule dictated by the Courts is to permit off-label use if this is according to the best medical practice (lex artis ad hoc). Even more, there are some specific cases (in Germany, like in the USA) where it is possible to generate doctor's responsibility for no prescribing in a off-label manner.

Recommendations for proficiency testing criteria for hemoglobin A1c based on the Shanghai Center for Clinical Laboratory’s study

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Yi Ju ◽  
Zhimin Tim Cao ◽  
Qing Li ◽  
Liping Tang ◽  
Yuanzhu Ou ◽  
...  
Keyword(s):  
Proficiency Testing ◽  
Clinical Utility ◽  
Hemoglobin A1c ◽  
Clinical Laboratory ◽  
Scientific Evidence ◽  
Target Values ◽  
The Us ◽  
The Usa ◽  
Glycated Hemoglobin A ◽  
Blood Specimens

Abstract Objectives The US Centers for Medicare & Medicaid Services proposed in 2019 that glycated hemoglobin A1c (HbA1c) be a CLIA′88 regulated analyte. People who commented expressed concerns that the proposed acceptance limit (AL, HbA1c in NGSP unit) ±10% for proficiency testing (PT) would be unable to maintain already improved analytical performance and guarantee the clinical utility of HbA1c testing. Assessing impact of various ALs on PT performance is needed to provide scientific evidence for adopting an appropriate AL. Methods Ten patient EDTA-whole blood specimens were distributed to 318 and 336 laboratories in the 2018 and 2019 PT events organized by Shanghai Center for Clinical Laboratory (SCCL). HbA1c concentrations were measured by participants using various methodologies commonly used in the USA and China. Targets were determined using secondary reference measurement procedures (SRM) at SCCL. “Failed Results” were those outside the SRM-defined target ± AL (5% through 10%). Laboratories with Failed Results ≥2 out of five samples per PT event obtained Event Unsatisfactory Status. Results HbA1c target values ranged 33.3 mmol/mol (5.2 NGSP%) −102.2 mmol/mol (11.5 NGSP%) for 2018 event, and 33.3 mmol/mol (5.2 NGSP%) −84.7 mmol/mol (9.9 NGSP%) for 2019 event. Overall Laboratory Event Unsatisfactory Rates were 11.3–12.2%, 4.8–5.3%, 0.9–3.1%, 0.6–2.2%, 0.6–1.4% and 0.6–1.4%, at AL of ±5, ±6, ±7, ±8, ±9 and ±10%, respectively. Conclusions The AL (in NGSP unit) of ±6% or ±7% for PT evaluation of HbA1c results would be appropriate, with satisfactory event scores for about 95% of participant laboratories in a PT event.

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