Provision of nutrition counseling, referrals to registered dietitians, and sources of nutrition information among practicing chiropractors in the United States.

OBJECTIVE: To investigate US chiropractors' provision of nutrition counseling and referrals to registered dietitians and sources of nutrition information. Chiropractors' perceptions of the minimum educational requirement for registered dietitians and nutrition training received in chiropractic school were also examined. DESIGN: A descriptive study was conducted by use of a nationwide, mailed survey. SUBJECTS/SETTING: Surveys were sent to 1,590 practicing chiropractors in the United States, selected randomly from The National Directory of Chiropractic. Of the 410 responses received, 375 were usable (response rate = 23.6%). STATISTICAL ANALYSIS: Descriptive statistics were used to summarize data along with the Pearson chi 2 test and Kendall tc rank correlation to determine associations for categorical questions. RESULT: Nearly 90% of respondents provided nutrition counseling to their patients, even though the majority believed that they were inadequately trained in nutrition. One-on-one dietary instruction was the most common method of providing nutrition counseling, and supplement use was the most common health-related situation/condition for which nutrition counseling was used. Most respondents did not correctly select the minimum educational requirement for registered dietitians, did not refer patients to registered dietitians, and did not use registered dietitians as a source of nutrition information. Nevertheless, 65% of respondents anticipated increased collaborations between registered dietitians and chiropractors. APPLICATIONS/CONCLUSIONS: Chiropractors provide nutrition counseling to a large number of patients each year; thus, they have the potential to substantially affect patients' nutritional status. There is a clear need and opportunity for registered dietitians to collaborate with chiropractors.

Comparison of the obturation of lateral canals by six techniques.

The following obturation techniques were compared on their ability to obturate lateral canals in vitro, lateral condensation (LC), continuous wave of condensation (CW), warm vertical condensation (WV), carrier-based thermoplasticized gutta-percha (CB), warm lateral condensation (WL), and vertically condensed high-temperature gutta-percha (HT). A root canal system with lateral canals in the coronal, middle, and apical thirds was prepared in resin blocks. Each block was obturated using each technique (n = 30, 15 each, with and without sealer). The length of gutta-percha and sealer in each of the lateral canals was measured with a measuring microscope and statistically compared. All techniques obturated all three levels of lateral canals with sealer. WV, CB, and CW were able to fill the lateral canals with gutta-percha significantly better when root canal sealer was used. WV, CB, CW, and HT filled the coronal and middle lateral canals significantly better with gutta-percha than LC or WL condensation. CB and CW filled the apical lateral canal significantly better with gutta-percha than HT, WV, WL, or LC.

Anger, depression, and disability: a path analysis of relationships in a sample of chronic posttraumatic headache patients.

Anger and depression are common affective concomitants of chronic headache. Previous research suggests that the affective component of headache may contribute to the patient's perceptions of the degree to which the headache is disabling. The present study examined the relationship between anger expression, anger suppression, depression, and headache-related disability (interference with function) in a sample of chronic posttraumatic headache patients. A path analytic model indicated a direct relationship between depression and perceived disability. Anger suppression and anger expression each had a direct influence on depression, but their effects on disability were mediated through depression. The results partially replicate a previous path analytic study of the relationships among these variables in a chronic headache sample.

The relationship of anger, depression, and perceived disability among headache patients.

Depression is a common concomitant of headache. Conflict with regard to anger or the expression of anger has also been discussed in terms of its relationships to headache. The direction of the relationship between headaches and depression and/or anger is not clear from available research literature. Thus, the present study proposed to examine the interrelationships among measures of anger expression, depression and self-reported disability in a sample of chronic headache patients. It was predicted that there would be significant correlations between depression and perceived disability, and anger held in and perceived disability. Finally, it was predicted that anger held in would be shown to impact perceived disability by way of its relationship to depression. Path analysis was employed to investigate the relationships among the variables. Results showed a significant and positive relationship between depression and perceived disability, which supported the first hypothesis. Anger expression was not significantly related to perceived disability. Therefore, the second hypothesis was not supported. Anger-in, however, was strongly and positively related to depression. Although the causal direction of the relationships cannot be stated with certainty, the suppression of anger appears to be a moderating variable that amplifies the experience of depression among chronic headache patients.