Health & wellness focused chiropractic practice based research network (PBRN) foundedA new chiropractic practice based research network (PBRN) has been established to “address research questions that require a real world setting to be answered.” The Integrated Chiropractic Outcomes Network (ICON)

Health & wellness-focused chiropractic practice-based research network (PBRN) founded 

A new chiropractic practice-based research network (PBRN) has been established to “address research questions that require a real-world setting to be answered.” The Integrated Chiropractic Outcomes Network (ICON) was created by Cheryl Hawk, DC, PhD and others specifically with a focus on examining health and wellness outcomes of chiropractic treatment. The mission: “Conduct collaborative research through a partnership between researchers and practitioners with the ultimate goal of enhancing the health of the public and contributing to the scientific evidence base related to health promotion and disease prevention.” The headline of the solicitation to chiropractors to join the network is ICON’s planned focus on wellness.” This is in contradistinction to the “chiropractic research, to date, [that] has focused more on pain and symptom management than on prevention and health promotion, even though chiropractic has traditionally considered itself to be prevention-oriented.” ICON is using a forum in ChiroACCESS to get rolling.”

Comment:  This is a timely development, particularly given the elevated interest of NIH NCCAM in the real world, and a nascent but apparently significant interest in health and wellness outcomes. My only concern is for Hawk, who seems to have started up a dozen useful projects and relationships in the last year, for which she was honored in the Integrator Top 10 People for 2010. Hawk appears to be making the argument for human cloning.

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Impacts of the American Herbal Pharmaciopoeia recounted by exec Roy Upton 

Roy Upton, RH, DAy, executive director and founder of the American Herbal Pharmacopoeia (AHP), recently reported to his board a list of impacts AHP “has had on the botanical world worldwide.” AHP was formed in 1995 “to promote the responsible use of herbal products and herbal medicines.” Upton shared this overview of the organization’s recent contributions:

  • “Canada: When the Natural Health Product Directorate was formed in Canada, some of the consultants to Health Canada brought our St. John’s wort monograph to the regulators as an example of what was needed in Canada. This led to the adoption of the monograph system that they now have in place. They likely would have come to that conclusion without AHP but it greased the wheels and was a no-brainer. Canada formally acknowledges the authoritativeness of AHP monographs and recently entered into a collaboration to develop a bacopa monograph.
  • “Hong Kong: After the publication of [AHP’s] Schisandra and Reishi monographs, two researchers from Hong Kong’s Baptist University came up to me at a conference there and excitedly told me they had proposed and it was adopted to develop a similar set of monographs for Chinese herbs in Hong Kong. This gave birth to the Hong Kong standards, now a corner stone of TCM quality assurance.
  • “Africa and South America: AHP was partly responsible for inspiring the development of the South American and African Herbal Pharmacopoeias, the latter of which was just published. At USP, their researchers told me that whenever they are going to do a botanical monograph they first look to see if AHP has done one and then takes their lead from that.
  • “US Pharmascopoeia: AHP’s monograph format was also almost completely emulated by USP in their recently published Dietary Supplement Compendium. [Upton was a member of the committee that did this.]
  • “HPLTC and Microscopy: Eike Reich of Camag, the world’s leader in HPTLC [High Performance Thin Layer Chromatography] equipment, used AHP’s focus on HPTLC and inclusion of HPTLC images as a spring-board to show USP, the European Pharmacopoeia, Indian Pharmacopoeia, and Chinese Pharmacopeia how valuable it is to have the images. As of that time, none of them provided images. Now they are all developing compendia to present the images. And, HPTLC, which prior to AHP’s work was relegated to the doldrums of analytical technologies in the botanical world, has become a fully integrated component of the QC programs of many companies. We have pushed the community on microscopy as well with USP seeing our work and developing their own micro images in the Compendium.”

Comment: This is quite a track record for an under-funded organization braced significantly by Upton’s own labors. Good work, Roy!

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Health coaches get boost from Atul Gawande’s recent New Yorker piece 

Comment: The writings of Atul Gawande, MD on the state of the US healthcare system have had a particularly significant influence on policy makers since Barack Obama singled out his June 2009 New Yorker article on the shocking variations in Medicare payments in McAllen, Texas compared to other parts of the country. Gawande’s January 17, 2011 New Yorker article, The Hot Spotters: Can we lower costs by giving the neediest patients better care, is stimulating a similarly high level of interest. One beneficiary will certainly be health coaches and health coaching. In examining how one medical group works with its most expensive an demanding clientele, Gawande reports that a central strategy is the employment of a small battalion of health coaches. This visibility for health coaches gives added urgency to the initiative led by Harvard’s Margaret Moore, RN and University of Minnesota’s Karen Lawson, MD to set standards of education and credentialing for this emerging field. That initiative, reported here, is presently developing a white paper that is expected to be completed by April 1, 2011. 

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