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Biomedical subjects

Jennifer R Jamison

Publications and source records attributed to Jennifer R Jamison.

9 recordsLinked to original sources

Teaching diagnostic decision making: student evaluation of a diagnosis unit.

OBJECTIVE: The aim of the study was to report on chiropractic students' response to a changed learning format and on how the students fared in their final examination. METHODS: A 13-week year-4 diagnosis unit that used a structured self-study guide, a prescribed text, classroom clinical simulations, WebCT-based learning, and self-assessment tasks is described. After 4 weeks of study, a questionnaire was used to assess the chiropractic students' interim evaluation of the various learning experiences. The ability of students to meet unit objectives was assessed in a summative examination. RESULTS: Most students found the learning experiences acceptable and believed the learning options provided would enable them to meet the unit aims. This belief was confirmed both on formative and summative student assessment. CONCLUSION: Diverse classroom teaching/learning opportunities combined with self-learning guides provide a viable alternative to more traditional teaching formats for introducing chiropractic students to differential diagnosis.

Chiropractic↗

Low back pain risk factors in a large rural Australian Aboriginal community. An opportunity for managing co-morbidities?

BACKGROUND: Low back pain (LBP) is the most prevalent musculo-skeletal condition in rural and remote Australian Aboriginal communities. Smoking, physical inactivity and obesity are also prevalent amongst Indigenous people contributing to lifestyle diseases and concurrently to the high burden of low back pain. OBJECTIVES: This paper aims to examine the association between LBP and modifiable risk factors in a large rural Indigenous community as a basis for informing a musculo-skeletal and related health promotion program. METHODS: A community Advisory Group (CAG) comprising Elders, Aboriginal Health Workers, academics, nurses, a general practitioner and chiropractors assisted in the development of measures to assess self-reported musculo-skeletal conditions including LBP risk factors. The Kempsey survey included a community-based survey administered by Aboriginal Health Workers followed by a clinical assessment conducted by chiropractors. RESULTS: Age and gender characteristics of this Indigenous sample (n = 189) were comparable to those reported in previous Australian Bureau of Statistics (ABS) studies of the broader Indigenous population. A history of traumatic events was highly prevalent in the community, as were occupational risk factors. Thirty-four percent of participants reported a previous history of LBP. Sporting injuries were associated with multiple musculo-skeletal conditions, including LBP. Those reporting high levels of pain were often overweight or obese and obesity was associated with self-reported low back strain. Common barriers to medical management of LBP included an attitude of being able to cope with pain, poor health, and the lack of affordable and appropriate health care services. Though many of the modifiable risk factors known to be associated with LBP were highly prevalent in this study, none of these were statistically associated with LBP. CONCLUSION: Addressing particular modifiable risk factors associated with LBP such as smoking, physical inactivity and obesity may also present a wider opportunity to prevent and manage the high burden of illness imposed by co-morbidities such as heart disease and type-2 diabetes.

Journal Article↗

Fostering critical thinking skills: a strategy for enhancing evidence based wellness care.

UNLABELLED: Chiropractic has traditionally regarded itself a wellness profession. As wellness care is postulated to play a central role in the future growth of chiropractic, the development of a wellness ethos acceptable within conventional health care is desirable. This paper describes a unit which prepares chiropractic students for the role of "wellness coaches". Emphasis is placed on providing students with exercises in critical thinking in an effort to prepare them for the challenge of interfacing with an increasingly evidence based health care system. METHODS: This case study describes how health may be promoted and disease prevented through development of personalized wellness programs. As critical thinking is essential to the provision of evidence based wellness care, diverse learning opportunities for developing and refining critical thinking skills have been created. Three of the learning opportunities are an intrinsic component of the subject and, taken together, contributed over 50% of the final grade of the unit. They include a literature review, developing a client wellness contract and peer evaluation. In addition to these 3 compulsory exercises, students were also given an opportunity to develop their critical appraisal skills by undertaking voluntary self- and unit evaluation. Several opportunities for informal self-appraisal were offered in a structured self-study guide, while unit appraisal was undertaken by means of a questionnaire and group discussion at which the Head of School was present. RESULTS: Formal assessment showed all students capable of preparing a wellness program consistent with current thinking in contemporary health care. The small group of students who appraised the unit seemed to value the diversity of learning experiences provided. Opportunities for voluntary unit and self-appraisal were used to varying degrees. Unit evaluation provided useful feedback that led to substantial changes in unit structure. CONCLUSION: Students have demonstrated themselves capable of applying critical thinking in construction of evidence based wellness programs. With respect to unit design, selective use of learning opportunities highlighted the desirability of using obligatory learning opportunities to ensure exposure to core constructs while student feedback was found to provide useful information for enriching unit review. It is hoped inclusion of critical thinking learning opportunities in the undergraduate chiropractic curriculum will contribute to the development of an evidence based ethos in chiropractic care.

Journal Article↗

Prescribing wellness: a case study exploring the use of health information brochures.

OBJECTIVE: A case study was undertaken to ascertain the potential usefulness of brochures as a strategy for encouraging short-term and longer-term acquisition of healthy behaviors at the consumer-health care system interface. METHOD: Purposive sampling of chiropractic clinics and convenience sampling of patients attending these primary contact practitioners were undertaken. Patients were asked to complete a questionnaire. Interested patients were given a health information brochure on topics of their choice. Patients who had requested health information brochures were phoned at 3 weeks, 3 months, and 1 year after completing the initial questionnaire and asked if they had implemented any of the suggestions for health promotion or risk prevention. A minimum of 4 attempts were made to contact each participant by telephone. Data were analyzed using descriptive statistics. RESULTS: Twenty-one chiropractic clinics and 781 patients participated. Although every third patient requested one or more health information brochures, fewer than 1 in 4 of those receiving brochures implemented some health-promoting behavior. Although some patients persisted with their newly initiated health-promoting behaviors, compliance diminished over time. Exercise and dietary change were the behaviors most likely to be modified. CONCLUSION: Implementation of even one healthy behavior can have a ubiquitous health benefit. Despite dwindling compliance, it is therefore suggested that suitably formulated health information brochures that inform and encourage adoption of healthy behaviors by motivated patients deserve consideration by all health professionals working at the consumer-health care system interface.

Adult↗

Herbal and nutrient supplementation practices of chiropractic patients: an Australian case study.

BACKGROUND: Escalating interest in alternative health care has resulted in increased use of nutritional supplements and herbs by consumers. A number of these neutraceuticals interact with prescription drugs and may have adverse effects. OBJECTIVE: This study explored the extent to which chiropractic patients are likely to inform their chiropractic practitioner of their medication practices. METHOD: A case study that included patients attending 21 chiropractic clinics in 5 states and the Australian Capital Territory was undertaken. Seven hundred fifty-eight patients provided information on their nutritional and herbal supplementation practices. Data were collected using a questionnaire that inquired about general life-style and sought particular information about self-initiated and professionally recommended medication practices. A list of medications that could influence coagulation was provided. Patients were specifically requested to indicate whether they had informed their chiropractor about any of the medications, herbs, or nutrients they were taking. RESULTS: More than 1 in 3 of the chiropractic patients in this study were taking, either on the advice of a health professional or, more often, on their own initiative, a nutritional supplement and/or herb. Yet, chiropractors were only occasionally informed about the medication practices of their patients. CONCLUSION: In view of the potential health risks and drug interactions, chiropractors should routinely inquire whether their patients are taking herbs or nutritional supplements.

Australia↗

Insomnia: does chiropractic help?

OBJECTIVE: To evaluate the effect of chiropractic care on insomnia. DESIGN: Tripartite pilot study. METHODS: The expectations of the chiropractic community were canvassed, a retrospective study to recall changes in sleep patterns was undertaken, and a prospective pilot study to monitor sleep patterns after chiropractic care was carried out. Convenience sampling was used. RESULTS: The 221 patients and 15 chiropractors who completed the expectation study tended to believe that patients with sleeping difficulties benefited from chiropractic care. The chiropractors were more guarded in their expectations than participating patients. One third of the 154 patients who completed the semistructured interview reported their sleep pattern was changed immediately after their chiropractic adjustment. All but 1 of these 52 patients reported improvement. Twenty patients with insomnia participated in the prospective study. Although compared with the report in their screening questionnaire, improvement was noted in certain sleep parameters in the 6 days after their adjustment, no temporal trends emerged in the days and/or weeks after the chiropractic consultation. Most patients reported experiencing less or no discomfort during the duration of the study. CONCLUSION: Although a number of patients do perceive chiropractic care offers temporary respite from their insomnia problem, when changes were more objectively monitored, improvements were erratic and no consistent temporal trends were detectable. Convincing evidence has yet to be produced before routine chiropractic care can be considered adequate intervention for patients with sleeping difficulties. More definitive answers may result from future research being undertaken in sleep laboratories.

Adult↗

Chiropractic management of cow's milk protein intolerance in infants with sleep dysfunction syndrome: a therapeutic trial.

OBJECTIVE: In addition to the more usual cutaneous, gastrointestinal, and respiratory problems, infants with cow's milk intolerance (CMI) may present with a disturbed sleep pattern. Frustrated mothers may turn to their doctor of chiropractic for assistance. This pilot study shows how a therapeutic trial may offer a realistic, noninvasive approach to the chiropractic management of infants with this clinical problem. METHODS: A pilot study to describe the presentation and treatment of infants presenting with disturbed sleep patterns to a chiropractic clinic was undertaken. Infants fulfilling a clinical screening protocol for CMI were selected for a therapeutic trial. The sleep behavior of subjects was monitored over a 4-week period during which they were managed by dietary change and a high-impulse, low-amplitude whole-of-body chiropractic management protocol. RESULTS: Fifty-nine infants presented with disturbed sleep. Of these, 19 met the clinical criteria used to establish the diagnosis CMI. The mothers of breast-fed infants were counseled on how to implement a dairy-free diet, and those infants who were artificially fed were changed from cow's milk-based formulae to either a partially or wholly hydrolyzed formula. Fourteen achieved a stable sleep pattern within the study period. In 5 instances, the sleep pattern remained problematic, but other clinical evidence of hypersensitivity reactions attributable to CMI disappeared. By the end of the study, no subject had demonstrable evidence of either biomechanical derangement or functional neurologic imbalance. CONCLUSION: CMI should be considered as a possibility in infants with disturbed sleep patterns who present for chiropractic care. This study describes how a therapeutic trial involving dietary modification, parental counseling, and comprehensive chiropractic care may offer a noninvasive approach to excluding and/or managing this condition. Further research is required before definitive recommendations can be made.

Counseling↗

Dietary diversity: case study of fruit and vegetable consumption by chiropractic patients.

BACKGROUND: A distinct health advantage has been linked with eating a wide variety of fresh fruit and vegetables. OBJECTIVE: This study explores the diversity of fruits and vegetables consumed by chiropractic patients and inquires into their preferred purchasing patterns. METHOD: A case study that included patients attending 24 chiropractic practices in 5 states and the Australian Capital Territory was undertaken. Seven hundred eighty-two patients were asked to complete a questionnaire providing general information about their life-style and particular information about the number of servings of fruits and vegetables that they usually consumed. RESULTS: Although overall chiropractic patients reported adhering to a number of healthy life-style behaviors, participants in this study would benefit from eating a greater diversity of fruits and vegetables. CONCLUSION: In view of the substantial health benefits associated with eating a wide variety of fruits and vegetables, it is suggested that chiropractic patients be encouraged to follow a color code system for purchasing their fresh produce.

Activities of Daily Living↗