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Biomedical subjects

C Hawk

Publications and source records attributed to C Hawk.

At least 19 recordsLinked to original sources
PubMed2000

Chiropractic care for patients aged 55 years and older: report from a practice-based research program.

OBJECTIVE: To characterize patients aged 55 years and older and features of chiropractic care provided to them. DESIGN: Observational, practice-based research study. SETTING: Chiropractic offices in the United States and Canada, 1997-1998. PARTICIPANTS: Chiropractors in 96 practices in 32 states and two Canadian provinces collected data on 805 eligible patients aged 55 years and older during a 12-week study period. MEASUREMENTS: In addition to questionnaires on practice characteristics, patient demographics, chief complaints, and health habits, two standardized instruments were administered: for general health status, the Medical Outcomes Study 12-Item Short-Form Health Survey (SF-12); and for disability related to chronic pain, the Pain Disability Index (PDI). RESULTS: Of 805 study patients, 60.1% were women and' 94.7% were white. Overweight patients comprised 38.6% and obese 20.6% (n = 656) of the total; 9.7% of patients were hypertensive (n = 590). Smoking was reported by 12.7% and 50.2% reported regular exercise. The Physical Component Summary scores of the SF-12 seemed somewhat lower than population norms, whereas the Mental Component Summary scores differed very little from norms. Chief complaints were predominantly pain-related (72.3%), most commonly back pain (32.9%). The PDI mean baseline score for chronic patients was 16.3 (scale, 0-70), and 40.6% of study patients reported using at least one pain medication (prescription or nonprescription) more than three times per week. More than half of complaints (54.9%) had onsets more than 6 weeks before the baseline visit. For 66.6% of subjects, a chiropractor was the only provider for their current complaint. In addition to manipulation, most common features of care were recommendations on exercise (41.0%), heat or cold applications (40.8%), and food supplements (24.5%). At 4 weeks, 19.6% were discharged, 58.8% continued treatment, and 20.1% had discontinued care (self-discharged). For these three groups, those with higher PDI mean baseline scores showed more change at 4 weeks. For patients who were discharged by the doctor, the proportion of reported pain medication use decreased 7.3% from baseline to 4 weeks, increased for patients who discontinued care, and remained about the same for those continuing care. CONCLUSIONS: Further investigation of the PDI and a decrease in pain medication use as outcome measures seems warranted. The descriptive information in this study may assist providers of care to older adults to better understand their patients' use of chiropractic care.

Aged↗
PubMed2000

In response

Explore the source record for details and available documents.

Journal Article↗
PubMed1999

Preliminary study of the effects of a placebo chiropractic treatment with sham adjustments.

OBJECTIVE: To identify aspects of the delivery of placebo chiropractic treatments by using sham adjustments that may cause a treatment effect and that may affect the success of blinding. DESIGN AND SETTING: Two-period crossover design in a chiropractic college research clinic. SUBJECTS: Eighteen volunteer staff, students, and faculty of the chiropractic college who reported low-back pain within the last 6 months. INTERVENTIONS: Flexion-distraction technique was used to perform chiropractic adjustments, and a hand-held instrument (Activator adjusting instrument) with the pressure gauge set on the 0 was used to perform sham adjustments. The treatment period was 2 weeks, with a total of 4 visits. MAIN OUTCOME MEASURES: The Visual Analog Scale (VAS) for pain and Global Well-Being Scale (GWBS). RESULTS: Although VAS and GWBS scores improved with both treatments, a somewhat greater improvement occurred in most cases with the active treatment. Eight of 14 patients interviewed believed that the placebo had a treatment effect. CONCLUSION: This study provided preliminary information that was useful in planning the protocol for a placebo chiropractic treatment in the randomized clinical trial for which it was designed.

Adult↗
PubMed1999

Factors affecting use of chiropractic services in seven midwestern states of the United State.

Although chiropractic is used by approximately 10 percent of the U.S. population, predictors of its use have not been definitively described. Previous studies have suggested that chiropractic users differ from nonusers in a number of sociodemographic characteristics, but their findings are inconsistent, perhaps because of differences in populations sampled and dates of data collection, most of which are prior to 1990. Regional studies have been conducted in rural areas based on the premise that rural residents are more likely than non-rural residents to use chiropractice; however, this premise has not been definitively documented. The purpose of this study was to provide clarification of these sociodemographic predictors of chiropractic use in Illinois, Iowa, Minnesota, Missouri, Nebraska, South Dakota and Wisconsin by characterizing chiropractic users and nonusers in terms of sociodemographics, including rural or non-rural residence, and presence of low back pain. Data from 1,511 respondents to a 1994 population-based survey, conducted by the University of Iowa Social Science Institute, were analyzed. Unconditional logistic regression was used to derive odds ratios and 95 percent confidence intervals for univariate and multiple regression models. Overall, 15.1 percent of respondents had used chiropractic within the last year, most often for low back pain (57 percent). Chiropractic use was less likely in African Americans, Hispanics and Asians than whites, less likely by non-rural than rural residents, and less likely in Catholics than Protestants in states other than Iowa and South Dakota. Overall, 42.7 percent of workers with low back pain reported using chiropractic, and use increased with age but remained significantly related to race, rural or non-rural residence, state of residence and religious preference. Race, rural or non-rural residence, state of residence and religious preference, independently of low back pain, affect use of chiropractice in seven Midwestern states.

Adult↗
PubMed1999

Use of complementary healthcare practices among chiropractors in the United States: a survey.

CONTEXT: Although chiropractic is the most commonly used complementary healthcare practice, chiropractors have not been surveyed in depth about their attitudes toward and practice of complementary and alternative therapies apart from spinal manipulation. OBJECTIVES: To examine attitudes among US chiropractors on the role of their profession in complementary healthcare and to gather data on the types of complementary healthcare practices chiropractors use. DESIGN: Descriptive, cross-sectional study using a mail-in survey. SETTING: United States. PARTICIPANTS: Random sample of US chiropractors stratified by zip code region. RESULTS: A total of 563 surveys were completed, for a response rate of 30%. Respondents were almost equally divided on their responses to the question "Do you feel that chiropractic should at the present time be termed 'complementary'?" Although many respondents (68%) believed that chiropractic was viewed as a therapeutic modality, more (82%) believed that it should be viewed as a complete system. The therapies most commonly used by respondents in their practice were acupressure (72%), massage (72%), mineral supplements (63%), and herbs (56%). CONCLUSION: The disparity between the established view of chiropractic as synonymous with spinal manipulation and the profession's view of chiropractic as a complete system indicates a need for better interprofessional communication.

Chiropractic↗
PubMed1998

Research productivity of chiropractic college faculty.

BACKGROUND: There is a growing need for research to further the goals of the chiropractic profession. Because of available resources, chiropractic faculty may be in the best position to accomplish much of the profession's research needs. A widely used method of assessing faculty research productivity is to count the number of peer-reviewed research publications over a selected time frame. OBJECTIVE: To investigate the research productivity of chiropractic college faculty and identify parameters associated with increased peer-reviewed publication. STUDY DESIGN: A survey was administered to collect data in a cross-sectional design. METHOD: Data were collected through a survey administered to all full-time chiropractic college faculty working in the United States. Although the survey addressed many scholarly activities, the criterion variable selected for this study is the number of peer-reviewed journal articles published over the past 3 yr. RESULTS: Three groups of faculty had more publications: those primarily assigned to research, those with either a D.C. degree or a D.C. and Ph.D. degree, and finally those with a rank of full professor. Faculty age and gender were not associated with the reported number of publications. The majority of faculty members (72.2%) have not published a single peer-reviewed article in the last 3 yr. Less than 2% of the faculty members has published 10 or more peer-reviewed articles in the last 3 yr. CONCLUSION: Many faculty are not involved in research activities. Faculty development and incentive programs need to be implemented to stimulate these individuals. Increasing faculty research activities benefits the faculty, their institutions and their profession.

Adult↗
PubMed1997

Chiropractic care for women with chronic pelvic pain: a prospective single-group intervention study.

OBJECTIVE: To assess the role of chiropractic care for women with chronic pelvic pain (CPP) as a first step in designing a randomized clinical trial. DESIGN: Prospective single-group intervention study. SETTING: Chiropractic Research Center. SUBJECTS: Nineteen volunteer female subjects meeting inclusion/exclusion criteria for chiropractic treatment of chronic pelvic pain. INTERVENTIONS: Chiropractic treatment consisting of flexion/distraction and trigger point techniques administered by faculty clinician over a period of 6 wk. MAIN OUTCOME MEASURES: Pain Disability Index (PDI) was the primary measure; secondary outcome measures were Visual Analog Scale for pain (VAS), RAND-36 Health Survey and Beck Depression Inventory (BDI). All were administered at baseline and at 6 wk. RESULTS: Eighteen subjects completed the study, with an attrition rate of 5%. The mean improvement in the PDI score was 13.0 points (p = .001); in the VAS it was 4.0 cm (p = .001); and in the BDI it was 6.1 points (p < .001). All eight subscales of the RAND-36 Health Survey increased post-intervention, with the largest differences in role function limitations because of physical problems (45.8%), emotional problems (44.4%) and pain (40.6%). CONCLUSION: The chiropractic treatment used in this study had positive short-term effects. These results will be used to design a randomized clinical trial to investigate the efficacy of chiropractic care in the treatment of CPP.

Adolescent↗
PubMed1996

Influence of interleukin-2 regimens on circulating populations of lymphocytes after adoptive transfer of anti-CD3-stimulated T cells: results from a phase I trial in cancer patients.

The adoptive transfer of anti-CD3-stimulated T killer (T-AK) cells was tested with different bolus and infusional interleukin-2 (IL-2) regimens, and anti-CD3 stimulation procedures to determine immunologic and antitumor effects in patients with a variety of advanced cancers. Indium-111 labeling was used to observe traffic patterns of the infused T-AK. Autologous peripheral blood mononuclear cells were obtained by leukapheresis. Cyclophosphamide (300 mg/m2) was given to most patients immediately after leukapheresis. The harvested cells were activated ex vivo with anti-CD3 overnight or for 4 days, at which time cells were reinfused and an IL-2 regimen was begun. Treatment was repeated 28 days later. This treatment regimen induced significant increases in leukocytes, lymphocytes, and eosinophils in patients in most treatment cohorts. Circulating lymphocytes were predominantly CD3+ T cells with preferential expansion of the CD8+ subset. Patients receiving cells stimulated in vitro for 4 days had significant T-cell lymphocytosis with either infusional or bolus plus infusional IL-2 regimens. T-cell viability was decreased in culture after a second 4-day stimulation with anti-CD3 at day 28; this decrease could be prevented by adding IL-2 to the culture media. Cells stimulated overnight required both bolus and infusional IL-2 to show an atypical lymphocytosis in vivo. Overnight-stimulated T-AK did not show decreases in in vitro viability at the day 28 restimulation. Indium-III-labeled cells trafficked to the liver, spleen, and bone marrow. No increase in uptake was observed in tumor deposits. There were 2 patients with partial responses, 5 with minor responses, 19 with stable disease, and 88 with progressive disease. The length of in vitro anti-CD3 stimulation, and the dose and timing of IL-2 administration in vivo results in different circulating leukocyte populations after adoptive T-AK infusion. Generally, the CD8+ T-cell subset was preferentially expanded by this treatment approach. Repeated ex vivo stimulation with anti-CD3 may cause cell death.

Adolescent↗
PubMed1996

The role of chiropractors in the delivery of interdisciplinary health care in rural areas.

OBJECTIVE: To examine the current and potential role of chiropractors in rural interdisciplinary health care teams. DESIGN: Information was gathered from three sources to summarize rural health care delivery needs and interdisciplinary practice as they relate to chiropractic to develop a position statement: a literature review, a series of semistructured phone interviews with health care providers and a workshop for interdisciplinary health care practitioners, rural chiropractors and chiropractic college faculty. RESULTS: The health care needs of rural populations are diverse and not adequately addressed in the current system. Interdisciplinary teams operating in a community base are recommended as one way to better serve rural needs. Chiropractors are not routinely involved on such teams. Both interprofessional barriers (no chiropractic "niche," lack of knowledge of chiropractic practice and training and lack of medical acceptance) and intraprofessional barriers (lack of consensus on scope of practice, lack of standardization of training and lack of knowledge of other professions) were identified. CONCLUSIONS: Strategies for increasing integration of chiropractic care into the health care delivery system were development of interdisciplinary preceptorships, development of post-graduate curricula for rural DCs in interdisciplinary team concepts and practices, dissemination of information about chiropractic and consensus on chiropractic scope of practice.

Chiropractic↗
PubMed1995

A survey of 492 U.S. chiropractors on primary care and prevention-related issues.

OBJECTIVE: To gain information on the issue of scope of chiropractic practice, particularly in relation to primary care and prevention. DESIGN: A survey was administered by mail to a random sample of 753 U.S. chiropractors. SETTING: The sampling frame was stratified into eight geographic regions with approximately equal numbers of D.C.'s to ensure that all areas of the U.S. were represented. PARTICIPANTS: Chiropractors listed in the National Directory of Chiropractic, 1993-4 edition, comprised the sampling frame. RESULTS: Of the 753 D.C.'s sampled, 492 completed surveys, for a response rate of 65.3%. The majority of respondents (90.4%) considered themselves primary care practitioners. Over 80% were accessible to patients at all times. Only 4.1% accepted payment in cash only. Fifty-eight percent did a regional physical exam, 29.0% a complete physical, and 71% a complete health history on every patient. Referrals to M.D.'s/D.O.'s were made by 78.1% and received by 46.0% within the last 3 months, although fewer than 20% included reports with referrals. Prevention practices related directly to musculoskeletal problems were most often designated as important to discuss with patients: lifting techniques (78.0%), postural education (76.4%), fitness exercise (69.3%) and injury prevention (68.3%). CONCLUSIONS: In general, respondents demonstrated a number of practice characteristics associated with primary care. However, it appears that they could further strengthen their position by routinely accompanying referrals with reports, and by increasing their emphasis on prevention, especially in areas not directly related to musculoskeletal conditions.

Adult↗
PubMed1993

An exercise therapy program for balance disorders.

Patients with chronic balance or disequilibrium disorders can be difficult to evaluate and treat, due to the complex integration of sensory systems which control balance function. There is a trend away from placing these patients on long-term sedative medication. In fact, long-term sedative medications may actually reduce or prevent central compensation. For patients with chronic balance disorders who have already been appropriately treated with medicine and/or surgery, we now strongly recommend an active exercise therapy program, which promotes central compensation and improves general fitness.

Exercise Therapy↗
PubMed1991

The noninvasive mouse ear swelling assay. I. Refinements for detecting weak contact sensitizers.

The noninvasive mouse ear swelling assay (MESA) is a model for delayed-type hypersensitivity that holds promise as a testing protocol for allergic contact dermatitis (ACD). The MESA employs only topical sensitization on the abdomen and does not use injections, adjuvants, anesthesia, occlusion, or disruption of the stratum corneum. Five days after induction, the ears are challenged topically and ear swelling measurements taken at 24, 48, and 72 hr indicate the extent of ACD. In this study, refinements of the assay were explored in BALB/cBy mice using dinitrofluorobenzene (DNFB) and dinitrochlorobenzene (DNCB). A complete dose-response curve was developed for DNFB and the dose which sensitized half the mice in a group (SD50, 0.001%, w/v) was used to test noninvasive enhancement protocols. Several triple-dose protocols tested produced no increase in responsiveness and daily dosing showed a trend toward tolerance induction yielding 20% positive responses. Dietary vitamin A supplementation produced a dramatic enhancement of the responses: ear thickness increase was doubled and the SD50 sensitized 94 to 100% of the mice in the vitamin A groups. We conclude that the MESA allowed identification of ACD potency for known sensitizers at very low concentrations which do not produce ACD with other techniques. The importance of dose-response studies for avoiding the high-dose reduced-response region was also shown. Based on the observation that the vitamin A-augmented MESA was considerably more sensitive than with regular feed, a companion study (P.S. Thorne. C. Hawk, S.D. Kaliszewski, P.D. Guiney, Fundam. Appl. Tox. 17, 807-820, 1991) presents tests of the enhancements to the MESA developed in this work, using weak sensitizers and complex mixtures.

Animals↗
PubMed1991

The noninvasive mouse ear swelling assay. II. Testing the contact sensitizing potency of fragrances.

The noninvasive mouse ear swelling assay (MESA) for contact allergy testing was evaluated using fragrance components and complex fragrance mixtures. The test materials represented weak sensitizers and nonsensitizers. Two versions of the MESA were investigated. Both were noninvasive and utilized only topical abdominal dosing and ear challenge with single applications in BALB/cBy mice. The vit A MESA differed from the regular MESA only in that mice were maintained on a diet with 17-fold higher levels of vitamin A (vit A) acetate beginning 3 weeks prior to induction. Sensitization reactions were determined by measuring the mean increase in ear swelling over baseline at 24, 48 and 72 hr postexposure. Irritation dose-response curves facilitated choosing a high nonirritating challenge dose. Sensitization dose-response curves were developed for cinnamaldehyde (CINN) and a complex fragrance mixture, F-16. From these curves, the SD50 was determined. This value represents the dose which sensitized half the animals and serves to rank the potency of compounds for allergic contact dermatitis and to compare values among different assays. The SD50 for CINN was 21.6% while the SD50vit A for F-16 was 26.6%. The other fragrance, isoeugenol (ISOE), and fragrance mixtures, F-07 and F-22, were also found to be weak sensitizers in the MESA and vit A MESA. The results in the MESA for CINN and ISOE were in the range observed with guinea pig test protocols but showed that the MESA was more sensitive than human test protocols. Two of the fragrance mixtures tested in the MESA gave comparable results in the Buehler guinea pig assay. However, the third (F-22) was negative in the Buehler assay and the MESA, but positive in the vit A MESA. The results of this work with weak sensitizers and the companion study (Thorne et al., 1991) with potent sensitizers at low doses illustrate that the noninvasive MESA is as sensitive as many standard guinea pig assays. In addition, it is easier and much less expensive to perform. The vit A MESA has the sensitivity and predictive power needed to test compounds and mixtures for contact sensitizing potency.

Animals↗
PubMed1991

Rural Youth Disability Prevention Project Survey: results from 169 Iowa farm families.

Agriculture is now the most hazardous occupation in the United States and it is the only one in which children not only comprise a significant part of the work force, but also live and play at the work site. Annually, 23,500 pediatric agricultural injuries are reported, with nearly 300 fatalities (Rivara, 1985). The Rural Youth Disability Prevention Project was designed to use innovative, community-oriented methods to address the unique problems of child safety in agriculture. Toward this end, a survey instrument was designed to gather data both to assist in program development and to serve as a pretest for the subsequent evaluation. Analysis of these data indicated several issues to target for intervention efforts. One is lack of supervision--more than 40 percent of children who operate equipment do so unsupervised. Approximately 30 percent of children more than 3 years old play alone in work areas, and 80 percent of these children play near machinery in operation. Another issue is operation of farm machinery by very young children--respondents' children began operating equipment at an average age of 12 years. Coupling this with the finding that the parents believe their children are not capable of operating equipment until age 15 exemplifies the most important issue, the disparity between parents' levels of safety knowledge and safety behavior. Using the survey data to increase local involvement, efforts are being directed toward facilitating an ongoing, community-sponsored intervention program to empower farm families to effect their own solutions.

Accident Prevention↗
PubMed1983

Subclasses of opioids based on body temperature change in rats: acute subcutaneous administration.

Morphine and a number of opioid agonists and agonist-antagonists were injected into rats to examine their effects on body temperature after acute systemic administration. Dose- and time-response curves were constructed for each drug alone and in the presence of the antagonist naloxone. Based on these data, the opioids could be subdivided into several groups. The first group, made up of morphine, heroin, l-methadone, etorphine, fentanyl and levorphanol, caused hyperthermia at lower doses and hypothermia at higher ones. Both effects could be blocked by naloxone. A second group, consisting of buprenorphine, nalbuphine and l-pentazocine, produced only a naloxone-sensitive increase in body temperature, whereas the group comprising ethylketazocine, ketazocine, l-cyclazocine and normeperidine caused only a decrease. This fall in temperature was relatively less sensitive to naloxone blockade. Still another group of drugs (meperidine, normorphine and d-pentazocine) had little effect themselves but, in combination with naloxone, induced hypothermia. The fifth group (N-allylnormetazocine, d-cyclazocine, dextrorphan and d-methadone) had no effect whether alone or in the presence of the antagonist. These findings can be explained in terms of a two-receptor model by ascribing distinct thermoregulatory functions to each receptor type.

Animals↗
PubMedDate not supplied

Preliminary study of the reliability of assessment procedures for indications for chiropractic adjustments of the lumbar spine.

OBJECTIVE: To assess the intraexaminer and interexaminer reliability of clinicians trained in flexion-distraction technique to determine the need for chiropractic adjustment of each segment of the lumbar spine. DESIGN: This was an intraexaminer and interexaminer reliability study of commonly used chiropractic assessment procedures, including static and motion palpation and visual observation. SETTING: Chiropractic college; by four licensed chiropractors trained in flexion-distraction technique, two with more than 20 years' experience and two with 3 or fewer years' experience. SUBJECTS: Subjects were 18 volunteers; 16 were symptom free, and 2 had low back pain at the time the study was conducted. MAIN OUTCOME MEASURE: The kappa statistic was computed for all comparisons and interpreted in categories ranging from "poor" (<0.00) to "almost perfect" (>0.80). RESULTS: Intraexaminer reliability was greater than interexaminer reliability. For intraexaminer reliability there was considerable variation by segment and among the four examiners, but intraexaminer reliability appeared generally higher than interexaminer reliability. Overall, more subluxations were identified on the second examination than on the first. For interexaminer reliability, kappa scores were generally in the "poor" to "slight" categories. DISCUSSION: The results of this study, similar to those of other studies, indicate that even chiropractors trained in the same technique seem to show little consensus on the indications for the necessity to adjust specific segments of the spine. A more standardized assessment approach might be helpful in improving the reliability of diagnostic assessments.

Adult↗
PubMedDate not supplied

Chiropractors' attitudes toward training in prevention: results of a survey of 492 U.S. chiropractors.

OBJECTIVE: To assist in assessing practicing DCs' attitudes toward and expressed needs for prevention-related training, particularly those topics most relevant to a primary care practice. DESIGN: Data were obtained from a mail survey of a random sample of 753 U.S. chiropractors. Data analysis included stratification and multiple logistic regression to examine the effects of gender, years of practice and chiropractic college attended on training, reported in 23 prevention topics. Responses were compared with those from a similar published survey of MDs. SETTING: The sampling frame was stratified into eight geographic regions with approximately equal numbers of DCs. PARTICIPANTS: The sampling frame consisted of chiropractors listed in the 1993-4 edition of the National Directory of Chiropractic. RESULTS: The survey response rate was 65.3%. Although 90.4% of respondents consider themselves primary care practitioners, a significantly fewer (p = .00) 78.5% reported adequate training as such in chiropractic college. Fewer women than men reported adequate training. Respondents with fewer years in practice reported more training in chiropractic college for fourteen of twenty-three prevention topics than respondents with more years in practice. Differences in reported training were detected among graduates of different chiropractic colleges in two topics: cancer detection and immunization, con aspect. Comparing this survey to that of MDs, more primary care MDs than DCs reported training in every topic. When training in addition to that in chiropractic college was reported, DCs reported training that more closely approximated primary care MDs. CONCLUSIONS: The self-reported information in this survey may provide some insight into respondents' perception of their education in prevention and their need for additional training. These findings indicate that although prevention training seems to be increasing in the chiropractic colleges, an apparent need exists for further emphasis on preventive care, particularly in areas most relevant to a primary care practice.

Attitude of Health Personnel↗