Improvement in Quality of Life for Six Pregnant Patients Undergoing Chiropractic Care: The Promise of PROMIS

CASE SERIES

Improvement in Quality of Life for Six Pregnant Patients Undergoing Chiropractic Care: The Promise of PROMIS

Joel Alcantara, DC Bio & Jeanne Ohm, DC Bio

Journal of Pediatric, Maternal & Family Health - Chiropractic ~ Volume 2013 ~ Issue 1 ~ Pages 11-14

Abstract

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Introduction: The use of health-related quality of life (HRQoL) measures in chiropractic pregnant patients remains virtually non-existent.  In this paper pregnant patients are characterized showcasing the use of the NIH PROMIS program to determine baseline HRQoL measures.

Methods: In addition to describing sociodemographic and clinical data, patient-centered outcomes measures utilizing the PROMIS-29 Profile V1.0 are demonstrated.

Results:   Six pregnant patients (average age=33.33 years) with average parity at 0.33 and mean gestation of 20 weeks are described. Their primary caregivers were obstetrician/gynecologists, nurse-midwives and midwives. All were aware of concurrent chiropractic care. The patients presented with NMS complaints and for wellness care. The PROMIS scoring demonstrated the dynamic nature of the HRQoL domains in pregnant patients with improvements (i.e., fear/anxiety, pain interference and satisfaction with social roles) and decrements (i.e., physical functioning and sleep disturbance) in HRQoL domains.

Discussion:   Evidence-informed practice expects that some aspect of chiropractic patients’ HRQoL measures will have demonstrable improvements. The use of PROMIS within a chiropractic Practice Based Research Network (PBRN) offers promise in this regard.

Conclusion:  Pregnant patients attending chiropractic care within a PBRN are characterized using PROMIS HRQoL measures. The use of valid outcome measures to demonstrate chiropractic effectiveness should be further implemented in research and practice.

Keywords:  Chiropractic, Practice Based Research Network, pregnancy, Health-related quality of life, PROMIS

Allergies less common among kids born outside US

Children who move to the United States have a lower risk of allergies than kids born in this country, a new study suggests.

In the study, children who immigrated to the United States were about 44 percent less likely to have an allergy condition — including asthma, eczema, hay fever or food allergies — compared with kids born in the country.

The study is published today (April 29) in the journal JAMA Pediatrics.

Children need to "eat dirt" so to speak. We as parents need to expose our children to the environment around us and let the child's God given immune system get a workout. If you wanted to get stronger or run faster you need to exercise, the same is true for the immune system. Give it a workout and make sure it is functioning at its best. How do you know if it is not? Have them checked by a pediatric chiropractor. (That's me, Dr. Maly)

The findings support the " hygiene hypothesis," which proposes that exposure to germs or infections during early childhood may protect against some allergies, the study authors said.

However, the apparent protection from allergies seen in the study was not permanent. Foreign-born children who lived in the United States for more than 10 years were about three times more likely to develop an allergy compared to foreign-born children who lived in the country for two years or less, the study found.

The findings are in line with what the researchers had observed anecdotally in their own practice: people who immigrate to the United States tend to develop allergies at a later age than those who were born here, said study researcher Dr. Jonathan Silverberg, a dermatologist at St. Luke's-Roosevelt Hospital Center in New York City.

The new findings suggest that allergies may arise differently depending on where a person was born, a topic that needs further study, Silverberg said.

Previous studies had shown that the prevalence of childhood allergies is higher in the United States than in other countries such as Mexico and China. However, few studies had examined the risk of allergies among U.S. immigrants.

The new study was based on information from about 91,800 U.S. children. Parents were asked in a survey in 2007 and 2008 whether a doctor had ever told them that their child had asthma, eczema, hay fever or food allergies.

About 34 percent of children born in the United States had an allergy, compared with about 20 percent of those born outside the country. The link held true regardless of participants' ethnicity, income level or whether they lived in an urban or rural area.

Children born outside the United States were 73 percent less likely to have asthma, 55 percent less likely to have eczema, 66 percent less likely to have hay fever and 20 percent less likely to have a food allergy compared with kids born in the United States.

Children who were born in the United States but whose parents were immigrants also had a reduced risk of allergies.

Foreign-born children who lived in the United States for longer than 10 years were more likely to have eczema or hay fever than those who lived in the country for two years or less.

The new study cannot say why children born in the United States are at greater risk for allergies than those born in other countries.

Silverberg said he suspects that a number of factors, including climate, diet and obesity, play a role in triggering allergies. 

By Rachael Rettner, MyHealthNewsDaily

Carry on: Study finds it's good to hold your baby

When mothers in the study carried their babies while walking around, the infants became noticeably more relaxed and stopped crying and squirming. The babies' rapidly beating hearts also slowed down, evidence that the children were feeling calmer.A new study from Japan confirms what many mothers may know instinctively: Picking up and carrying a fussy baby usually calms down and relaxes the child, making the move a good one for both moms and infants. 

"Infants become calm and relaxed when they are carried by their mother," said study researcher Dr. Kumi Kuroda, who investigates social behavior at the RIKEN Brain Science Institute in Saitama, Japan. The study observed strikingly similar responses in mouse babies.

Since carrying (meaning holding while walking) can help stop an infant from crying, Kuroda said, it can offer mothers a way to soothe short-term irritations to their children, such as scary noises or vaccinations.

Getty Images stock

A new study confirms: Hold that baby as much as you want!

The findings were published online today (April 18) in the journal Current Biology.

A strong calming effect For the small study, researchers monitored the responses of 12 healthy infants ages 1 month to 6 months. The scientists wanted to discover the most effective way for mothers to calm a crying baby over a 30-second period — simply holding the baby or carrying the infant while walking.

Young babies carried by a walking mother were the most relaxed and soothed, compared with infants whose mothers sat in a chair and held them, the study found. As a mother stood up and started to walk with her child cradled close in her arms, scientists observed an automatic change in the baby's behavior.

These results held even after the researchers took into account other factors, such as the child's age and sex, and the mother's age and walking speed.

Kuroda said she was surprised by the strength of the calming effect from maternal holding and walking. In observing experiments on both humans and mice, she was amazed at how quickly the heart rate slowed, and by how much immediately after a mother started walking. (Mother mice pick up their young by the scruff of their neck with their mouths.)

According to the researchers, maternal walking may be more effective in calming infants than other kinds of rhythmic motion, such as rocking.

Advice for parents When an underlying reason for crying persists, such as hunger or sustained pain, the infant may start crying again soon after the end of carrying.

That's why Kuroda recommended that when a baby starts crying, a brief period of carrying may help parents to identify the cause of the tears. She acknowledged carrying might not completely stop the crying, but it may prevent parents from becoming frustrated by a crying infant.

The findings also have implications for one parenting technique in which parents let babies cry as a way to help them learn to fall asleep by themselves, the researchers said.

"Our study suggests why some babies do not respond well to the 'cry-it-out' parenting method," Kuroda said.

Proponents of the technique advise parents to let infants, after a certain age, cry themselves to sleep — without mom or dad comforting them — in the hopes the baby will learn how to soothe himself or herself.

But Kuroda said that calming by maternal carrying, as well as crying during separation, are both built-in mechanisms for infant survival. These behaviors have been hard-wired for millions of years. "Changing these reactions would be possible as infants are flexible, but it may take time," she said.

Although this study looked at a baby's behavior in response to its mother, Kuroda said the effect is not specific to moms, and any primary caregiver for the infant can perform the carrying. The researchers observed the same carrying-induced calming effects when fathers, grandmothers and an unfamiliar female with caregiving experience carried babies who were under 2 months old, Kuroda said.

Cari Nierenberg

MyHealthNewsDaily