RESUMO
Objective: To develop evidence-based recommendations on best practices for delivery of clinical preventive services by chiropractors and to offer practical resources to empower provider applications in practice. Design: Clinical practice guideline based on evidence-based recommendations of a panel of practitioners and experts on clinical preventive services. Methods: Synthesizing the results of a literature search for relevant clinical practice guidelines and systematic reviews, a multidisciplinary steering committee with training and experience in health promotion, clinical prevention, and/or evidence-based chiropractic practice drafted a set of recommendations. A Delphi panel of experienced practitioners and faculty, primarily but not exclusively chiropractors, rated the recommendations by using the formal consensus methodology established by the RAND Corporation/University of California. Results: The Delphi consensus process was conducted during January-February 2021. The 65-member Delphi panel reached a high level of consensus on appropriate application of clinical preventive services for screening and health promotion counseling within the chiropractic scope of practice. Interprofessional collaboration for the successful delivery of clinical preventive services was emphasized. Recommendations were made on primary, secondary, tertiary, and quaternary prevention of musculoskeletal pain. Conclusions: Application of this guideline in chiropractic practice may facilitate consistent and appropriate use of screening and preventive services and foster interprofessional collaboration to promote clinical preventive services and contribute to improved public health.
Assuntos
Quiroprática , Manipulação Quiroprática , Dor Musculoesquelética , Adulto , Consenso , Promoção da Saúde , Humanos , Dor Musculoesquelética/prevenção & controle , Guias de Prática Clínica como AssuntoRESUMO
This roadmap outlines the potential roles of metallic nanoparticles (MNPs) in the field of radiation therapy. MNPs made up of a wide range of materials (from Titanium, Z = 22, to Bismuth, Z = 83) and a similarly wide spectrum of potential clinical applications, including diagnostic, therapeutic (radiation dose enhancers, hyperthermia inducers, drug delivery vehicles, vaccine adjuvants, photosensitizers, enhancers of immunotherapy) and theranostic (combining both diagnostic and therapeutic), are being fabricated and evaluated. This roadmap covers contributions from experts in these topics summarizing their view of the current status and challenges, as well as expected advancements in technology to address these challenges.
Assuntos
Nanopartículas Metálicas/uso terapêutico , Nanomedicina Teranóstica/métodos , Humanos , Hipertermia InduzidaRESUMO
Localized tumor hyperthermia therapy has been intensively studied for the past three decades. One engineering limitation has been the difficulty of specifically targeting cancerous tissues in the normal tissue surroundings. Recent attention has turned to the deposition of nanoparticles in the tumor to enhance heating relative to its surroundings. The work in magnetic nanoparticles has focused on resonant hysteresis loop heating in the 100 to 300 kHz range, where that mechanism dominates - however extremely high magnetic field strengths are required to realize an advantage, up to 10(5) (A/m). We introduce experimental evidence that substantial advantages in heating can also be obtained at the microwave ISM frequency of 2.45 GHz when γ-hematite (Fe(2)O(3)) is dispersed in media at concentrations on the order of 10(12) particles/mL.