Standardisation de la palpation dynamique en chiropratique: une étude de fiabilité pour la région cervicale

Scientific literature on the dynamic palpation test in chiropractic usually indicates that it is not very reliable and clinically insufficient. The frequent references to the unreliability of this test may be due to the lack of sufficient standardization in performing the test. The multiple nature of the test may be the cause: the test is actually a group of six tests peformed in six directions at each intervertebral level. The palpation pressure and the interpretive aspects of the examiner''s tactile perception are other elements to be standardized. In addition, using students without a history of mechanical problems of the spine as subjects is not representative of the usual clinical clientele and could lead to a search for injuries that are too subtle. This pilot-study performed on typical patients, limits the test to the cervical region in only one direction of movement and also standardizes the other parameters of the test. This results in greater reliability between examiners than demonstrated until now. Statistical significance tables established for this type of testing have revealed reliability from moderate to very strong. In the final analysis, the author''s observations clearly illustrate the significant effect of standardization of the test on results obtained outside the study.     

Patient attitudes concerning the inclusion of spirituality into addiction treatment

The purpose of this exploratory study was 3-fold: (a) to determine how ‘spirituality’ is defined by inner-city HIV-positive drug users; (b) to determine perceived relationships between spirituality and abstinence, harm reduction, and health promotion; and (c) to assess interest in a spirituality-based intervention. Opioid-dependent patients enrolled in an inner-city methadone maintenance program participated in the study; 21 participated in focus groups and 47 completed a questionnaire. In the focus groups, two predominant themes emerged: spirituality as a source of strength/protection of self, and spirituality as a source of altruism/protection of others. A large majority of the larger sample expressed an interest in receiving spirituality-focused treatment, reporting that such an intervention would be helpful for reducing craving and HIV risk behavior, following medical recommendations, and increasing hopefulness. African American women perceived spirituality as more helpful in their recovery than did African American men.     

Differential changes in synaptic terminal protein expression between nucleus accumbens core and shell in the amphetamine-sensitized rat

Repeated, intermittent administration of psychostimulant drugs such as D-amphetamine (AMPH) produces a state of behavioral sensitization to the drug that can last up to weeks to months. The molecular basis of this enhanced sensitivity to AMPH is poorly understood; however, adaptive changes in the mesocorticolimbic dopamine system has been postulated to be of primary importance. In the present investigation we used Western blotting to examine the expression of candidate presynaptic proteins involved in regulating neurotransmitter release and synaptic plasticity. Specifically, syntaxin 1, synaptophysin and synapsin I protein levels were examined in the nucleus accumbens (Nacc) and ventral tegmental area (VTA) of Sprague-Dawley rats following AMPH-sensitization. Animals received five repeated administrations of AMPH (1.5 mg/kg, i.p. on alternate days) followed by 14 days of withdrawal. Levels of syntaxin 1 and synaptophysin were found to be significantly reduced in the Nacc core of sensitized animals compared to saline-treated and untreated controls. However, syntaxin 1 expression was significantly increased in the Nacc shell subregion of sensitized animals. No significant difference in the level of synapsin I was noted in any of the brain regions. Further, expression of none of the synaptic proteins was significantly altered in the VTA of sensitized animals. Given the importance of syntaxin and synaptophysin in learning and memory processes and in the regulation of neurotransmitter release, changes in these proteins suggest their involvement in the associative learning aspects of sensitization and differential neurotransmitter release in the Nacc subregions.