Current Issue:  Volume 5, Issue 4 (2014)

Topics in Integrative Health Care: an International Journal (TIHC) is a peer-reviewed, open-access online journal. It is dedicated to advancing the integration of multiple disciplines, both complementary and mainstream, into diverse health care settings in order to provide optimal patient care. It presents themed issues on topics of current relevance to health care providers interested in integrative, conservative care, health promotion and disease prevention. It includes international, interdisciplinary Grand Rounds in order to facilitate communication and patient comanagement among various health professions, for the good of patients everywhere.

Topics in Integrative Health Care (TIHC) is published by Healthindex, Inc. (ChiroACCESS).


Topics in Integrative Health Care

Cheryl Hawk, DC, PhD, CHES    

Topics in Integrative Health Care 2014, Vol. 5(4)     ID: 5.4001   

Topics in Integrative Health Care welcomes unsolicited manuscripts with original research, Grand Rounds, clinical briefs and “fast facts” collections. All submissions are peer-reviewed.


Anterior-to-posterior Protective Capabilities of the Spine Buddy® Jockey Vest Support Pad

John Ward, DC, MA, MS

Jesse Coats, D.C., B.S., D.A.A.P.M.

Topics in Integrative Health Care 2014, Vol. 5(4)     ID: 5.4002   

Background: The Spine Buddy® jockey vest support pad was developed to be added underneath an existing jockey vest, against the spine, to protect the torso of jockeys from being trampled by horses.

Purpose: The purpose of this study was to determine the force absorptive properties of the additional pad added to a jockey vest through two experiments: a simulated model and a human model.

Methods:  The simulated model experiment involved dropping a 90-pound horse hoof simulator onto a force plate from a height of 12 inches under three different conditions at 10 repetitions per condition: 1) bare force plate, 2) anterior aspect of a standard jockey vest, and 3) posterior aspect of a jockey vest with the addition of the Spine Buddy® support pad. The human experiment involved dropping a significantly lighter and safer load, a 1.5-pound weight, onto the sternum of 14 male study participants laying supine on a force plate from a height of 24 inches. This occurred under the following conditions: 1) jockey vest with Spine Buddy® support pad, 2) jockey vest alone, and 3) no jockey vest. Outcome measures during all six conditions were peak force.  

Results: For the simulated experiment the additional support pad reduced peak force 28.1% more than with the jockey vest alone (p=0.010). In the human experiment the additional support pad reduced peak force 6.4% more than the jockey vest alone (p=0.380).

Conclusion: Preliminarily, the results of this study demonstrate that the addition of an extra cushioned support pad to a jockey vest can add to the protective capabilities of the vest in an anterior-to-posterior direction.

Can Vegans Have Healthy Bones? A Literature Review

Kenice Morehouse-Grand, DC

Stephen Grand, DC, MS

Topics in Integrative Health Care 2014, Vol. 5(4)     ID: 5.4003   

Introduction: Osteoporosis is a pervasive disease with a high price tag. Over 200 million people worldwide have the disease. Major health initiatives include recommendations for dairy products. However, approximately two percent of Americans choose to follow a vegan diet. Despite the general acceptance of dairy products as a necessary component of a healthy diet to prevent osteoporosis, some studies have demonstrated that a vegan diet may be equivalent, or even superior, to this accepted wisdom. This paper explores whether the potential deficiencies of following a vegan diet result in an adverse effect on bone health.

Methods: Literature search was performed using PubMed, Mantis, and the Cochrane Library databases. Search terms included osteoporosis, vegan and vegetarian and bone health, in combination with one another. Articles that discussed the impact of vegetarian or vegan diets on osteoporosis were selected.

Results: Vegan diets are at risk for deficiencies in protein, calcium, and vitamin D3. Dairy products are a common source of calcium in the American diet. The relationships among vegan diets, bone loss, and fracture rates have been equivocal.

Discussion: The importance of protein, calcium, and vitamin D on bone health is well established. Although at risk for deficiencies in these areas, some literature suggests that well-balanced vegan diets may be adequate to maintain bone health. Higher than normal intakes of fruits and vegetables have been shown to support healthy bones. Since vegan diets are ideally high in fruit and vegetable intake, this may explain these findings.

A Qualitative Analysis of Various Definitions of Integrative Medicine and Health

Beth Rosenthal, MPH, MBA, PhD

Anthony J. Lisi, DC

Topics in Integrative Health Care 2014, Vol. 5(4)     ID: 5.4004   

Introduction: Many terms have been used to describe the provision of healthcare services that historically had not been part of mainstream medicine. The variety of names includes complementary medicine, complementary and alternative medicine, integrative medicine, integrated medicine, complementary and integrative medicine, and others. This variation can impede understanding and comparison of the features and practices of care.

Objective: The purpose of this work is to analyze the components of a group of integrative medicine-related definitions thought to have the greatest current usage and impact in the field.

Methods: This study was a qualitative content analysis of English language definitions of select IM/H related terms. It explored the usage and context of occurring terms. Purposive sampling was used to identify sources of IM/H definitions by querying a group of subject matter experts. Summative content analysis was conducted on the text of each definition.

Results: Eight definitions were identified and analyzed, and a group of eleven themes emerged. The most common elements included whole person focus, evidence-informed, optimal health/wellness, and combination of complementary and alternative medicine (CAM) with conventional medicine. Differences existed with respect to terms such as modality/therapy versus profession/discipline.

Conclusion: The themes described may be relevant to clarify discussion of future research and policy efforts.

Clinical Brief: Identifying Symptoms of Ovarian Cancer in Chiropractic and Complementary Health Care Settings

Rebecca J. Burkhalter, PhD

Mark T. Pfefer, RN, MS, DC

Topics in Integrative Health Care 2014, Vol. 5(4)     ID: 5.4005   

The purpose of this brief is to discuss the clinical presentation of ovarian cancer and to review risk factors, symptoms, and current diagnosis and treatment strategies. Here, we concisely review the incidence, risk factors, signs & symptoms, diagnosis and treatment of ovarian cancer. The diagnosis of ovarian cancer can be difficult in clinical practice.  Since it may be encountered at various stages by all clinicians, chiropractors and other complementary health care providers should be aware of the clinical picture with which it might present to assist in earlier diagnosis of their patients.

Fast Facts

Fast Facts

Topics in Integrative Health Care 2014, Vol. 5(4)     ID: 5.4006   

Readers are welcome to contribute to Fast Facts. Please include the original abstract (with citation) that is the source of your contribution. Contributors’ names will be included along with the item.

The following is an excerpt:

This report provides an overview of the complex therapy currently used within the German health system. Complex therapies in inpatient care in Germany establish the basis for an integrative and interdisciplinary provision of services. They define minimal criteria for the organization of a hospital, enable the integration of different therapeutic approaches, and therefore, lead to an intensive and holistic treatment by a specially trained team. The German model can be viewed as a pilot program for the introduction of integrative patient-centered care in other hospitals around the world.

Romeyke T, Stummer H. Evidence-based complementary and alternative medicine in inpatient care: take a look at Europe. J Evid Based Complementary Altern Med 2014.