ABSTRACT Background: Obesity is a strong risk factor for type 2 diabetes. However, few studies have compared the predictive power of overall obesity with that of central obesity. The cutoffs for waist circumference (WC) and waist-to-hip ratio (WHR) as measures of abdominal adiposity remain controversial. Objective: The objective was to compare body mass index (BMI), WC, and WHR in predicting type 2 diabetes. Design: A prospective cohort study (Health Professionals Follow-Up Study) of 27 270 men was conducted. WC, WHR, and BMI were assessed at baseline. Covariates and potential confounders were assessed repeatedly during the follow-up. Results: During 13 y of follow-up, we documented 884 incident type 2 diabetes cases. Age-adjusted relative risks (RRs) across quintiles of WC were 1.0, 2.0, 2.7, 5.0, and 12.0; those of WHR were 1.0, 2.1, 2.7, 3.6, and 6.9; and those of BMI were 1.0, 1.1, 1.8, 2.9, and 7.9 (P for trend < 0.0001 for all). Multivariate adjustment for diabetes risk factors only slightly attenuated these RRs. Adjustment for BMI substantially attenuated RRs for both WC and WHR. The receiver operator characteristic curve analysis indicated that WC and BMI were similar and were better than WHR in predicting type 2 diabetes. The cumulative proportions of type 2 diabetes cases identified according to medians of BMI (24.8), WC (94 cm), and WHR (0.94) were 82.5%, 83.6%, and 74.1%, respectively. The corresponding proportions were 78.9%, 50.5%, and 65.7% according to the recommended cutoffs. Conclusions: Both overall and abdominal adiposity strongly and independently predict risk of type 2 diabetes. WC is a better predictor than is WHR. The currently recommended cutoff for WC of 102 cm for men may need to be reevaluated; a lower cutoff may be more appropriate. American Journal of Clinical Nutrition, Vol. 81, No. 3, 555-563, March 2005 © 2005 American Society for Clinical Nutrition

In January, health care providers, including chiropractors, psychologists, counselors, podiatrists, acupuncturists, optometrists, physical and occupational therapists, nurse midwives, nurse practitioners, nurse anesthetists, nutritionists, orthotists, prosthetists, audiologists and speecfh and hearing therapists received Notice of a proposed settlement in a consolidated class action lawsuit brought against CIGNA and several other defendant insurers by thirteen individuals and six or more state and national organizations. The settlement proposes prospective relief as well as payment of cash compensation to providers who file valid claims. Click on the link below to open a slide presentation that explains the rudiments of the proposed CIGNA Settlement and what it could mean to you. Even if you treated no CIGNA Healthcare subscribers you still could be entitled to a portion of the cash settlement. Click on the link below to open the slide presentation to find out more.

ABSTRACT Background Little is known regarding the health effects of a raw food (RF) vegetarian diet. Methods We performed a cross-sectional study on 18 volunteers (mean ± SD age, 54.2 ± 11.5 years; male/female ratio, 11:7) on a RF vegetarian diet for a mean of 3.6 years and a comparison age- and sex-matched group eating typical American diets. We measured body composition, bone mineral content and density, bone turnover markers (C-telopeptide of type I collagen and bone-specific alkaline phosphatase), C-reactive protein, 25-hydroxyvitamin D, insulin-like growth factor 1, and leptin in serum. Results The RF vegetarians had a mean ± SD body mass index (calculated as weight in kilograms divided by the square of height in meters) of 20.5 ± 2.3, compared with 25.4 ± 3.3 in the control subjects. The mean bone mineral content and density of the lumbar spine (P= .003 and P<.001, respectively) and hip (P = .01 and P<.001, respectively) were lower in the RF group than in the control group. Serum C-telopeptide of type I collagen and bone-specific alkaline phosphatase levels were similar between the groups, while the mean 25-hydroxyvitamin D concentration was higher in the RF group than in the control group (P<.001). The mean serum C-reactive protein (P = .03), insulinlike growth factor 1 (P = .002), and leptin (P = .005) were lower in the RF group. Conclusion A RF vegetarian diet is associated with low bone mass at clinically important skeletal regions but is without evidence of increased bone turnover or impaired vitamin D status. Arch Intern Med. 2005;165:684-689. Author Affiliations: Section of Applied Physiology, Division of Geriatrics and Nutritional Science, Department of Internal Medicine, Washington University School of Medicine, St Louis, Mo (Drs Fontana, Holloszy, and Villareal and Ms Shew); and the Division of Food Science, Human Nutrition, and Health, Istituto Superiore di Sanitá, Rome, Italy (Dr Fontana).

The New York State Chiropractic Association proudly presents the 2nd program for Achieving Excellence in Chiropractic Practice In the 21st Century Certificate Program Saturday, April 9, 1 PM to 7:00 PM at the New York Chiropractic College Postgraduate Center Levittown, NY. Call the NYCC Postgraduate Center at 800-434-3955 Today and Reserve Your Please. This is the second in a series of symposiums designed to enhance your professional skills so you can master both the challenges of today’s managed care arena and tomorrows changing healthcare delivery system. The total series is 36 C.E. credit hours. There are 6 symposiums with a certificate included upon completion. Each symposium is 6 C.E. credits. The second Program will be broken down into a Six Hour session and will feature: • Comparison Shopping: Cost of Chiropractic Care vs. Medical Treatment, Dr. Anthony Rosner, Director of Research at the FCER, PhD. Harvard • Distinguishing Fact from Fiction in Clinical Studies, Dr. Anthony Rosner • Medicare P.A.R.T. Documentation: the National Standard, Dr. Peter Pramberger, NY Chiropractic Advisory Committee (CAC) representative (1 CA will be able to attend for an additional $25 for this discussion) The Fee for this sensational program is $120.00 per session for NYSCA members. For non-NYSCA members- $150.00 per session SEATING IS LIMITED, SO RESERVE YOUR SEAT TODAY! For Reservations, Please call the NYCC Postgraduate Center at 800-434-3955 Committee Members: Chairman: Louis Lupinacci, D.C., Mariangela Penna, D.C., Thomas Ventimiglia, D.C., James Kaufman, D.C., John Pellegrino, D.C., Angelo Ippolito, D.C., Janusz Richards, D.C., Michael Siciliano, D.C., Malcomb Levitin, D.C., Michael Bernstein, D.C., Lloyd Angel, D.C., Richard Scherer, D.C., Richard Meoli, D.C.., Peter Pramberger, D.C., Lloyd Kupferman, D.C., Bruce Silber, D.C. What is the Center for Excellence? The Center of Excellence for Chiropractic Practice in the Downstate region is a program sponsored by the New York State Chiropractic Association. The purpose of the program is to advance the clinical knowledge and skills of the doctor of chiropractic on a quest toward best practice procedures. The program emphasizes patient centered care that is effective and efficient. The program is designed for progressive doctors who wish to develop their skills and promote themselves in an integrated healthcare model. The Center for Excellence is the result of the New York State Chiropractic Association long range planning toward integrating the practice of chiropractic into the mainstream of healthcare The New York State Chiropractic Association has presented a series of conferences on the integration of chiropractic practice into mainstream health care over the last several years. We have discussed the challenges that face our profession today and in the future, and some possible solutions to these challenges. In light of the changes coming up on the horizon of health care, it is apparent that the need for change and new initiatives are more important than ever. Here is a brief list of some of the challenges we face: 1. The healthcare industry is demanding that the healthcare that is delivered be evidenced based 2. The trend toward consumer driven health care will shift more responsibility to the patient 3. There is a need for chiropractors to be part an integral part of the patient’s healthcare team 4. There is a need to define and establish a model for “best practice” chiropractic care Goals of the Center for Excellence 1. Integrate chiropractic into the mainstream of health care 2. Develop the skills of the field practitioner to work in interdisciplinary teams as the practitioner of choice in providing patient centered health care that is effective for neuromusculoskeletal care of spinal conditions (injuries, disorders, diseases, illnesses, ailments or complaints) 3. Train doctors to utilize evidence based practice parameters and best practices procedures by employing quality improvement outcome measures and informatics 4. Help develop models for the role of chiropractic care in mainstream healthcare such as the “Bridges for Excellence” program or the “Leap Frog Program” 5. Increase public awareness and the healthcare industry awareness of the role of chiropractic in today’s health care system and for the future 6. Help develop Wellness care protocols for the Doctor of Chiropractic Proposed Center for Excellence Action: The committee has come up with 5 specific projects that we feel the downstate area can develop. Project Planning Strategies: I. Initiate educational Center for Excellence Conferences throughout New York State Set up a series of conferences to keep doctors informed of current healthcare trends II. Develop a chiropractic model for integration with mainstream healthcare including: Develop protocols for working as a part of an integrated healthcare team Develop protocols for standards of patient centered care III. Develop a Low Back Pain Model for programs such as the Bridges to Excellence Help to establish professional interdisciplinary teams with the doctor of chiropractic as the doctor of choice for conservative care of the low back Help to promote NCQA accrediting protocols and AHRQ protocols for chiropractic IV. Initiate a Research in Practice Clearing Center for the practitioner Collect actuarial studies on the effectiveness of chiropractic care Collect existing research information for the public information committee Collect data and consensus documents for reasonable and customary chiropractic care Collect data and consensus documents on standards of chiropractic care and treatment V. Public Information Program: Promote the web based public service program to disseminate to the media Develop protocols to establish chiropractors as spinal experts Develop protocols to establish chiropractors as health/wellness experts Develop a Speakers Bureau to work with media public services Develop NYSCA public policy resolutions The Center for Excellence Program will help you determine what an integrated practice may look like, and how to improve your practice procedures to become patient centered, more efficient and evidence influence. Chiropractic has a significant role in the health care arena, and our potential for growth is tremendous. The Center of Excellence will challenge our profession to establish cultural authority within the healthcare system. Chiropractic care should be a part of a mainstream healthcare interdisciplinary health team, with the doctor of chiropractic being the doctor of choice in providing conservative patient centered care that is most effective for neuromusculoskeletal spinal conditions.

The Logan Board of Trustees held its winter meeting on February 5 in Chesterfield near the Logan campus. Marc Malon, DC was elected chairperson of the board at the February meeting. Dr. Malon succeeds Anthony Bilott, DC of Butler, Penn. who recently reached the maximum tenure of nine consecutive years as a Logan trustee. A 1981 Logan graduate, Dr. Malon has a chiropractic practice in Biddeford, Maine. He is a past president of the Maine Chiropractic Association and has served as the delegate from Maine to the American Chiropractic Association. He first became a Logan trustee in 1997. Dr. Malon was chosen as the 1995 Maine Chiropractic Association “Chiropractor of The Year.” He serves on Maine Governor John Baldacci’s Office of Health Policy and Finance Health Action Team. He is a Fellow of the American Back Society, serves on numerous Biddeford-area boards and is active with local area charitable organizations. Continuing as vice chairperson of the board of trustees is Frank Ungerland, DC, a 1976 Logan graduate from Tulsa, Okla. Re-elected to a new three-year term as a trustee was Susan Crump Baker, DC, a 1967 Logan graduate from Bridgeton, MO. Appointed by Dr. Malon to serve on the board’s executive committee was trustee Steve Roberts, a St. Louis entrepreneur and a past member of the St. Louis Board of Aldermen (1979-91). The Logan trustees’ executive committee consists of the chairperson and the vice chairperson of the board, and one additional board member. Re-elected to a new one-year term as a member of the trustees’ advisory council was Mark Reeve, DC, a 1979 Logan graduate from Austin, Minn. Dr. Reeve was the Logan Alumni Association representative on the board of trustees from 2001-04. Anthony Bilott, DC has been elected to serve on the advisory council for 2004-05. A 1981 Logan graduate, he became the chairperson of the Logan board of trustees in 2003. Also elected to one-year terms as advisory council members were Debra Hoffman, DC and Paul Henry, DC. Dr. Hoffman, 1980 Logan graduate, has a chiropractic practice in Tampa, Fla. She has served on the board of directors of the Florida Chiropractic Association since 1998. Dr. Henry, a 1993 Logan graduate, enrolled at Logan after a career as a governmental financial analyst and manager. He now has a chiropractic practice in Baltimore and is president of the Maryland Chiropractic Association, where he is completing his term this year.

ABSTRACT Background The risk of sudden death from cardiac causes in the general population peaks from 6 a.m. to noon and has a nadir from midnight to 6 a.m. Obstructive sleep apnea is highly prevalent and associated with neurohormonal and electrophysiological abnormalities that may increase the risk of sudden death from cardiac causes, especially during sleep. Methods We reviewed polysomnograms and the death certificates of 112 Minnesota residents who had undergone polysomnography and had died suddenly from cardiac causes between July 1987 and July 2003. For four intervals of the day, we compared the rates of sudden death from cardiac causes among people with obstructive sleep apnea and the following: the rates among people without obstructive sleep apnea, the rates in the general population, and the expectations according to chance. For each interval, we assessed the median apnea–hypopnea index and the relative risk of sudden death from cardiac causes. We similarly analyzed sudden death from cardiac causes during three time intervals that correlate with usual sleep–wake cycles. Results From midnight to 6 a.m., sudden death from cardiac causes occurred in 46 percent of people with obstructive sleep apnea, as compared with 21 percent of people without obstructive sleep apnea (P=0.01), 16 percent of the general population (P<0.001), and the 25 percent expected by chance (P<0.001). People with sudden death from cardiac causes from midnight to 6 a.m. had a significantly higher apnea–hypopnea index than those with sudden death from cardiac causes during other intervals, and the apnea–hypopnea index correlated directly with the relative risk of sudden death from cardiac causes from midnight to 6 a.m. For people with obstructive sleep apnea, the relative risk of sudden death from cardiac causes from midnight to 6 a.m. was 2.57 (95 percent confidence interval, 1.87 to 3.52). The analysis of usual sleep–wake cycles showed similar results. Conclusions People with obstructive sleep apnea have a peak in sudden death from cardiac causes during the sleeping hours, which contrasts strikingly with the nadir of sudden death from cardiac causes during this period in people without obstructive sleep apnea and in the general population. The New England Journal of Medicine Volume 352:1206-1214

ABSTRACT Objective: The objective of this study was to review the evidence that behavioral and emotional factors are triggers of acute coronary syndromes. Method: Systematic review of the published literature from 1970 to 2004 of trigger events, defined as stimuli or activities occurring within 24 hours of the onset of acute coronary syndromes. Results: There is consistent evidence that physical exertion (particularly by people who are not normally active), emotional stress, anger, and extreme excitement can trigger acute myocardial infarction and sudden cardiac death in susceptible individuals. Many triggers operate within 1 to 2 hours of symptom onset. There are methodologic limitations to the current literature, including sampling, retrospective reporting, and presentation biases, the role of memory decay and salience, and reverse causation because of silent prodromal events. Conclusions: Behavioral and emotional factors are probable triggers of acute coronary syndromes in vulnerable individuals, and the pathophysiological processes elicited by these stimuli are being increasingly understood. The benefits to patients of knowledge to these processes have yet to accrue. Psychosomatic Medicine 67:179-186 (2005) © 2005

ABSTRACT Objective: To explore early changes and predictors of bone mass in children with juvenile idiopathic arthritis (JIA) in order to identify patients who will develop bone mass reductions. Methods: We conducted a prospective cohort study of 108 children with early JIA (ages 6-18 years; mean disease duration 19.3 months) who were individually matched with 108 healthy children for age, sex, race, and county of residence. Bone mass and changes in total body, spine, femur, and forearm bone mineral density and bone mineral content (BMC), body composition, growth, and biochemical parameters of bone turnover were examined at baseline and at followup a mean of 24 months later. Low bone mass was defined as a Z score >1 SD below the reference population. Results: Of the 200 children evaluated at followup, the 100 healthy children had greater gains in total body BMC (P = 0.035), distal radius BMC (P < 0.001), and total body lean mass (P < 0.001) than did the 100 JIA patients. Low or very low total body BMC was observed in 24% of the patients and 12% of the healthy children. Bone formation, bone resorption, and weight-bearing activities were reduced in the patients compared with the healthy children. Multiple regression analysis showed that in patients with JIA, serum bone-specific alkaline phosphatase, serum C-telopeptide of type I collagen, and weight-bearing activities were independent predictors of changes in total body BMC. Total body BMC was lower in patients with polyarticular onset than in those with oligoarticular disease onset. Conclusion: Patients with JIA have moderate reductions in bone mass gains, bone turnover, and total body lean mass early in the disease course. Arthritis & Rheumatism - Volume 52, Issue 3, Pages 833 - 840

ABSTRACT Study Design: A systematic review within the Cochrane Collaboration Back Review Group. Objectives: To report the main results from the updated version of the Cochrane Review on bed rest for low back pain. Summary of Background Data: There has been a growing amount of evidence showing that bed rest is not beneficial for people with low back pain. However, existing systematic reviews are unclear regarding the effects of bed rest for different types of low back pain. Methods: All randomized studies available in systematic searches up to March 2003 were included. Two reviewers independently selected trials for inclusion assessed the validity of included trials and extracted data. Investigators were contacted to obtain missing information. Results: Two new trials comparing advice to rest in bed with advice to stay active were included. There is high quality evidence that people with acute low back pain who are advised to rest in bed have a little more pain (standardized mean difference 0.22, 95% confidence interval: 0.02-0.41) and a little less functional recovery (standardized mean difference 0.29, 95% confidence interval: 0.05-0.45) than those advised to stay active. For patients with sciatica, there is moderate quality evidence of little or no difference in pain (standardized mean difference -0.03, 95% confidence interval: -0.24-0.18) or functional status (standardized mean difference 0.19, 95% confidence interval: -0.02-0.41) between bed rest and staying active. Conclusion: For people with acute low back pain, advice to rest in bed is less effective than advice to stay active. For patients with sciatica, there is little or no difference between advice to rest in bed and advice to stay active. Hagen KB, et al. Spine. March 1, 2005; Vol. 30, No. 5, pp. 542-546.

ABSTRACT Background: Patients with TIA are at increased risk of ischemic stroke and require preventive treatment. However, clinical guidelines differ on how urgently patients should be assessed. Objective: To determine the potential consequences of delays in investigation and treatment, the authors studied the timing of TIAs preceding ischemic stroke. Methods: The authors studied patients who presented with a recent ischemic stroke and had a preceding TIA in two population-based studies (Oxford Vascular Study [OXVASC]; Oxfordshire Community Stroke Project [OCSP]) and two randomized trials (UK TIA Aspirin Trial [UK-TIA]; European Carotid Surgery Trial [ECST]). Results: Of 2,416 patients who had presented with an ischemic stroke, 549 (23%) gave a history of a preceding TIA (18% in OXVASC, 15% in OCSP, 23% in UK-TIA, 26% in ECST). Where a preceding TIA had occurred, the timing was highly consistent across the studies, with 17% occurring on the day of the stroke, 9% on the previous day, and 43% at some point during the 7 days prior to the stroke. No clinical characteristics or vascular risk factors identified patients in whom there was a close temporal association between TIA and stroke. Conclusion: In patients presenting with ischemic stroke, TIAs occur most often during the hours and days immediately preceding the stroke. From the Stroke Prevention Research Unit (Dr. Rothwell), Department of Clinical Neurology, Radcliffe Infirmary, Oxford, and Department of Clinical Neurosciences (Dr. Warlow), Western General Hospital, Edinburgh, UK. NEUROLOGY 2005;64:817-820

ABSTRACT Objective. Reports of large increases in autism prevalence have been a matter of great concern to clinicians, educators, and parents. This analysis uses a national data source to compare the prevalence of autism with that of other disabilities among successive birth cohorts of US school-aged children. Design. Comparison of birth cohort curves constructed from administrative data. Setting and Population. US children 6 to 17 years of age between 1992 and 2001. Main Outcome Measures. A disability category classification of autism, mental retardation, speech and language impairment, traumatic brain injury, or other health impairment, as documented by state departments of education and reported to the Office of Special Education Programs, US Department of Education. Results. Prevalences of disability category classifications for annual birth cohorts from 1975 to 1995 were calculated by using denominators from US Census Bureau estimates. For the autism classification, there were birth cohort differences, with prevalences increasing among successive (younger) cohorts. The increases were greatest for annual cohorts born from 1987 to 1992. For cohorts born after 1992, the prevalence increased with each successive year but the increases did not appear to be as great, although there were fewer data points available within cohorts. No concomitant decreases in categories of mental retardation or speech/language impairment were seen. Curves for other health impairments, the category including children with attention-deficit/hyperactivity disorder, also showed strong cohort differences. Conclusions. Cohort curves suggest that autism prevalence has been increasing with time, as evidenced by higher prevalences among younger birth cohorts. The narrowing in vertical separation of the cohort curves in recent years may mark a slowing in the autism prevalence increase. PEDIATRICS Vol. 115 No. 3 March 2005, pp. e277-e282

Multidisciplinary Conference on Manual Therapies If you canft attend the ACC-RAC Conference in Las Vegas this week (Mar 17-20) because of distance, family and practice commitments, then the conference offering below is a must attend alternative. On June 9-10, 2005, the U.S. National Institutes of Health (NIH) and the Canadian Institutes of Health Research (CIHR) will sponsor a conference entitled The Biology of Manual Therapies in Bethesda, Maryland. The conference will emphasize research in neuroscience, immunology, endocrinology, biomechanics, and imaging as they relate to manipulation, massage, and mobilization. The cost of the conference registration is only $35. Experts from the U.S. National Institutes of Health and the Canadian Institutes of Health Research will join academic, patient advocacy, and professional organizations to assess current knowledge and identify opportunities for further research on manual therapies. Manual therapies include a host of techniques that focus primarily on the structures and systems of the body, including the bones and joints, the soft tissues, and the circulatory and lymphatic systems. There is increasing evidence that manual therapies may trigger a cascade of cellular, biomechanical, neural, and/or extracellular events as the body adapts to the external stress. This conference is vital to the future of chiropractic. Researchers, health care practitioners, patient advocates, and the public are all invited to participate. Manipulative and Body-base Therapeutics: An Overview Under the umbrella of manipulative and body-based practices is a heterogeneous group of CAM interventions and therapies. These include chiropractic and osteopathic manipulation, massage therapy, Tui Na, reflexology, rolfing, Bowen technique, Trager bodywork, Alexander technique, Feldenkrais method, and a host of others (a list of definitions is given at the end of this report). Surveys of the U.S. population suggest that between 3 percent and 16 percent of adults receive chiropractic manipulation in a given year, while between 2 percent and 14 percent receive some form of massage therapy.1-5 In 1997, U.S. adults made an estimated 192 million visits to chiropractors and 114 million visits to massage therapists. Visits to chiropractors and massage therapists combined represented 50 percent of all visits to CAM practitioners.2 Data on the remaining manipulative and body-based practices are sparser, but it can be estimated that they are collectively used by less than 7 percent of the adult population. For more information on Manipulative and Body-base therapies click on the following link: Body-base therapies Tentative Conference Agenda (Link) Tentative Agenda--Workshop on the Biology of Manual Therapies Natcher Conference Center, National Institutes of Health June 9-10, 2005 June 9, 2005 œ Introduction by NIH and CIHR Staff œ Introduction by Session Chairs œ Historical Perspective Murray Goldstein, D.O., M.P.H. Medical Director for the United Cerebral Palsy Research and Educational Foundation œ Overview: Current Use of Manual Therapies in Canada and U.S. Maria Verhoef, Ph.D. Department of Community Health Sciences University of Calgary Janet R. Kahn, Ph.D., L.M.T. Integrative Consulting Break Session 1: Neuroscience Joel Pickar, D.C., Ph.D, (co-chair) Professor Palmer Center for Chiropractic Research James Henry, Ph.D. (co-chair) Professor and Chair in Central Pain McMaster University Scientific Director Michael G. DeGroote Institute for Pain Research and Care Partap S. Khalsa, D.C., Ph.D. Biomedical Engineering State University of New York at Stony Brook Kerstin Uvnas-Moberg, M.D., Ph.D. Professor, Department Of Physiology and Pharmacology Karokinska Institute Summary/Comments by Session Chair--Questions from Audience Lunch Session 2: Immunology/Endocrinology/Other Leslie J. Crofford, M.D. (co-chair) Chair, Department of Rheumatology University of Kentucky Serge Rivest, Ph.D. (co-chair) Laboratory of Molecular Endocrinology CHUL Research Center Department of Anatomy and Physiology Laval University Dan Clauw, M.D. Professor of Internal Medicine, Division of Rheumatology Director, Chronic Pain and Fatigue Research Program Director, Center for the Advancement of Clinical Research University of Michigan Summary/Comments by Session Chair--Questions from Audience June 10, 2005 Session 3: Biomechanics and Imaging John J. Triano, D.C., Ph.D. (co-chair) Research Professor Department of Engineering University of Texas, Arlington Co-director for Research Texas Back Institute Hermano Igo Krebs, Ph.D. Principal Research Scientist & Lecturer Massachusetts Institute of Technology Helene Langevin, M.D., L.Ac. Research Associate Professor, Department of Neurology University of Vermont David G. Wilder, Ph.D., P.E., C.P.E. Director, Jolt/Vibration/Seating Lab Senior Research Scientist Iowa Spine Research Center Associate Professor Biomedical & Mechanical Engineering Summary/Comments by Session Chair--Questions from Audience Lunch Breakout groups Breakout groups lead by session chairs to discuss research gaps and opportunities. Members of patient advocacy groups and professional organizations are invited to participate in the groups. Other conference attendances will self-assign at time of registration. Attendance at breakout groups limited to 50-75 individuals depending on room. Break Session chairs report back to main body--Q & A from audience Closing Comments--NIH and CIHR Staff For more information or to register for the conference, visit: NCCAM

Dr. Frank R. Cartica 05/10/1954 - 02/26/2005 It is with great sadness that we acknowledge the passing of NYSCA’s former member Dr. Frank R Cartica, D.C. of Yonkers, New York on Saturday February 26, 2005. He is survived by his wife Lois, and children Matthew, Jonathan, Genevieve, Jeremy Cartica and his mother Mary Cartica and brother of Kevin, Keith, James, John and Marybeth Muir. I am sure we will all agree that Dr. Cartica has done much for the Chiropractic profession and will be deeply missed. We ask that you keep his wife, children and family in your thoughts and prayers. Memorial Mass will be celebrated Thursday 11:00 AM at the Annunciation Church, 470 Westchester Avenue, Tuckahoe (Crestwood), NY 10707 - Tel. 914-779-4145. In lieu of flowers, memorial donations may be made to New York Fire Fighters Burn Center Foundation, 21 Asch Loop, Bronx, NY 10475.

After a period of information gathering and careful planning, the Palmer Chiropractic University System Board of Trustees has approved a number of resolutions and permanent appointments that will have a significant, positive impact on the future of Palmer. At their annual meeting held Feb. 4-5 in San Diego, Calif., the Board’s efforts focused on building a solid foundation from which Palmer can continue to be the leader in chiropractic education. This process resulted from a year of collecting information from a cross section of each Palmer campus. Among the resolutions announced by the Board are: Presidential Appointments: Donald Kern, D.C., and Peter Martin, D.C., were named president of Palmer College of Chiropractic and Palmer College of Chiropractic West, respectively. Their appointments are effective immediately. “We conducted a full and thorough evaluation of their performance during the past year and found that they both had achieved outstanding success in reaching the one-year goals the Board had set,” said John Huston, chair of the Board evaluation team. “During our interviews with staff and administrators, as well as from those who participated in the evaluation forums, we heard overwhelmingly that the greatest constituency of the colleges wanted this to happen. This will bring needed stability and the ability to move forward seamlessly with our program.” “The Board concluded that it would be in Palmer’s best interest to remove the interim titles and appoint each as president of their respective campuses,” said Vickie Palmer, chairman of the Board and great-granddaughter of D.D. Palmer, the founder of chiropractic. “These two exceptional individuals provide a great blend of experience and leadership, and we are fortunate to have them leading us forward.” Plans for an investiture ceremony marking their official appointments are underway. In addition, the Board determined that there also should be a President at the Florida campus. These three presidents will report directly to the Board of Trustees. The Board will immediately begin a search for a president of Palmer Florida. As announced on Jan. 31, Donald Gran, D.C., M.S.Ed., will serve as acting senior campus administrator of that campus while the search is conducted. Palmer’s new organizational structure will include a CEO position that will report directly to the Board and will deal with business issues and assure proper integration of the three campuses. This position will be open in the future. Until the position is filled, Mr. Larry Patten will continue to assist the Board with these matters. One College, Three Campuses: The Board reemphasized that Palmer is one college with three campuses. Because it will continue to focus its attention on assuring that it is the highest-quality chiropractic institution in the world, therefore, it will discontinue the use of the term “university.” “Universities are more commonly made up of colleges of multiple disciplines under one umbrella, which is the university. By the common definition, identifying Palmer as a university implies that we offer programs other than chiropractic, which isn’t the case,” explained Vickie Palmer. “Therefore, to eliminate confusion and to solidify and strengthen the Palmer brand nationwide, we will refer to ourselves as Palmer College of Chiropractic with our three campuses identified as Palmer College of Chiropractic, also known as The Fountainhead, Palmer College of Chiropractic-West and Palmer College of Chiropractic-Florida. Regardless of the campus name, we are dedicated to our students by ensuring that the educational program at each campus reflects the same quality of delivery as well as the same Palmer philosophy. We intend to be certain that is carried out.” The Fountainhead: The Board affirmed the significance of the Davenport campus as The Fountainhead of Chiropractic. “No other college in the world enjoys this distinction, since chiropractic began in Davenport,” said Vickie Palmer. “In a way, all chiropractic colleges and all chiropractors are part of the Palmer family since it all began here in Davenport, Iowa. Having additional campuses within Palmer does not and will not diminish the legacy of the Davenport campus. It simply provides those who wish to obtain a Palmer chiropractic education in another location an opportunity to do so. All students who complete our program will have earned the honor of being a Palmer graduate.” Clinics: The Board stated its commitment to ensuring that students are sufficiently prepared through a curriculum that includes a solid clinic experience. The clinical operation must be a seamless part of the curriculum at each campus. It was agreed that, in order to achieve that outcome, the curriculum must be driven with the clinical experience clearly in mind. Philosophy: The Board also agreed that Palmer and its three campuses are in the business of chiropractic education of the highest quality. It maintains a centrist view of chiropractic as defined by its mission, tenets and philosophy. The boundaries of this view include physiotherapy as part of the core curriculum, due to its potential benefit to chiropractic patients. This decision was based on research conducted by the ad hoc Education Committee. The statement of philosophy shared late last summer received strong support from Palmer faculty, staff and alumni. Enrollment: With a new emphasis on enrollment management, the Board approved opening a new position of Chief of Enrollment Management for which it will immediately begin a nationwide search. The campuses will also open up other necessary positions in this area to ensure that it has a quality team of enrollment management specialists to efficiently work with students wishing to enroll. Interim Positions: The College will now begin working on filling other positions that have been filled on an interim basis during the past year. This may include opening new positions in certain areas as deemed necessary by the College. Technology: The Board approved a new initiative to update the Davenport and West campuses with current technological resources. It has asked the administration to prepare an action and implementation plan. Educational Advisory Committee: The Palmer Board of Trustees is committed to establishing an advisory committee made up of selected alumni. This committee will work with the College as it works to continue to offer the best chiropractic education possible. The committee will also build upon the sense of pride that comes with a Palmer diploma by working to continually improve the Palmer experience. PCCW Location: There have been discussions in the past that the PCCW campus may move to a new city. The Board wishes to lay this idea to rest by affirming that the Palmer West campus will continue to be located in the bay area in California. Curriculum: Providing students with the skills to become a successful chiropractor is considered the highest priority. With that, the Board is committed to working with all constituencies to assess the curriculum and to ensure that it is working effectively. Current Board Members Attending the meeting in San Diego were: Vickie A. Palmer, H.C.D. (Hon.), chairman, Trevor Ireland, D.C, vice chair, Charles J. Keller, D.C., secretary, Hewett M. (Mack) Alden, D.C., Dennis J. Fitterer, D.C., Harley D. Gilthvedt, D.C., Merlyn A. Green, D.C., Michael J. Hahn, D.C., John Huston, Kenneth Koupal, Paul S. Peterson, D.C., William L. Wilke and Ex Officio Member Mark A. Heslip, D.C. John Willis, D.C., attended the meeting on behalf of Ex Officio Member Kirk Lee, D.C. Board member Kent M. Forney, J.D., was unable to attend. Frank Bemis, D.C., Fletcher Keith, D.C., and Byrd Krumbholz have completed their terms on the Board. The Board would like to thank them for their service and support of Palmer. Comments from Board Members “Change never comes without some pain,” said Dr. Keller, secretary of the Board. “However, the efforts of the Board over the past year have been so productive and provided such a clear direction for the future that whatever pain we have been through will, in the long run, prove to be worth it when we measure the value of our outcomes.” “We’ve implemented a new foundation of discovery that will help us establish a framework for a strong direction for the future of chiropractic education,” said Vickie Palmer. “This process has generated a new beginning for our colleges. I’m confident that the bold and aggressive initiatives put in place will ensure that Palmer continues to provide the highest-quality chiropractic education in the world.” “We have done our job,” added Trevor Ireland, D.C., vice chair of the Board. “We have worked diligently as a Board to ensure that we do what is right for Palmer. Our decisions were based on careful deliberations and, as a Board, we are together and strong in our resolve to see our initiatives carried through.” “I would also like to thank everyone–on all three Palmer campuses–who provided input to the Board over the past year,” added Vickie Palmer. “Your commitment and ongoing support are a strong testimony of the quality of individuals who are part of the Palmer family.” The next full Board meeting will be held in June. To learn more visit click on the link below:

As you are aware the changes with Blue Cross and Blue Shield will dramatically affect your practice. Now is the time for you to get involved. On February 15, 2005, the ACA Blue CCHIP representatives met with Empire Blue Cross/ Blue Shield and ASH representatives to discuss the implementation of the Empire Blue Cross/ Blue Shield Chiropractic utilization process. Present at the meeting were representatives from both the New York State Chiropractic Association and the New York Chiropractic Council. What is Blue CCHIP? The Blue Chiropractic Clinical Healthplan Integration Program (CCHIP) is a program developed by the American Chiropractic Association in conjunction with the national Blue Cross/Blue Shield association. This Clinical Integration Program has chiropractic liaisons throughout the country, in almost every state, working with the local Blue Cross/Blue Shield plans to provide the most effective chiropractic care. The following issues were addressed 1. At our request, Empire BC/BS is re-evaluating an issue that we feel may violate our scope of practice where the doctor of chiropractic is required to refer patients back to the medical doctor for necessary diagnostic tests and laboratory services. 2. All doctors will need to be credentialed by ASH to treat Empire patients in network, even if you are already in any Blue Cross/Blue Shield plans. The March 1, 2005 is not the deadline for credentialling, but it is the hard deadline for the start of this program. All doctors who wish to join ASH should get their application in as soon as possible. For those doctors who wish to withdraw from the Empire plans and become non-participating, written notice is required to be sent to Empire. 60 days after receipt of this letter your participation will be terminated (should be sent certified/return receipt requested). 3. Out of network benefits rendered by non participating doctors are not subject to ASH authorization parameters. The fee schedule for out of network will remain as it has been, subject to any deductible or policy limits. 4. A Blue CCHIP grievance committee will be set up for direct contact with both BC and ASH with representatives from the New York State Chiropractic Association and the New York Chiropractic Council. Additional points will be forthcoming as we receive clarification from Empire and/or ASH. The New York State Chiropractic Association and the New York Chiropractic Council are working for YOU! Attend your next district meeting to find out the full information and what you can do!

Attorney General Eliot Spitzer said today that 21 health plans operating in New York have agreed to take new steps to ensure that consumers have the information they need to intelligently shop for health coverage and obtain medically necessary care. Under the agreements, the health plans have pledged to be more responsive to requests from consumers for so-called "clinical review criteria," which is used to determine whether health care claims will be covered. In the past, health plans have sometimes failed to disclose these criteria and other essential coverage information, discouraging access to needed care. "Consumers need clear and complete information from health care plans," Spitzer said. "These agreements obligate the health plans to provide that information and help consumers make the right decisions in choosing a health plan and obtaining medically-necessary care. The agreements may also make it easier for chronically-ill New Yorkers to enroll in plans that meet their special coverage needs." The agreements stem from a March 2004 report by Spitzer's Health Care Bureau. The report found that all of the plans offering individual coverage in New York failed to comply with state coverage information disclosure requirements. In compiling the report, members of Spitzer's staff posed as prospective health plan enrollees. For example, one letter stated that the writer was a diabetic who wanted to buy an individual insurance policy. The writer requested information about how the health plan would decide whether an insulin pump would be a covered expense. Information was also sought for coverage of nutritional supplements and more serious procedures, including arthroscopic knee surgery, breast reduction surgery and surgery for Crohn's disease. Five letters were sent to each plan requesting information on the standards used to determine whether or not a treatment for five different conditions was medically necessary and therefore covered by insurance. Disclosure of this information is specifically required under the state's Managed Care Consumer Bill of Rights. Spitzer's staff analyzed the responses from the health plans and assigned the plans grades based on the number of satisfactory responses. Out of 22 plans studied, half (11) received an "F" for compliance, seven plans received a "D," three plans received a "C," and only one plan got a "B." No plan received an "A." Twenty-six percent of the 110 letters received no response from the plans at all. The clinical review criteria are extremely important to consumers with existing medical conditions because they contain the standards that the health plans use to determine whether a specific treatment is medically necessary; if not, coverage is denied and the consumer is left with the choice of either foregoing medical care or paying out-of-pocket. The State Managed Care Consumer Bill of Rights requires health plans to disclose these criteria to both current and prospective enrollees upon written request. Noting that all of the plans cooperated fully with the inquiry, Spitzer commended certain plans for agreeing to present the required information in a way that was particularly useful to consumers. For example, Excellus Health Plans, based in Rochester, agreed to make its clinical review criteria available to all consumers on its Internet website. MDNY, a Long Island health plan, agreed to translate the medical jargon in some of its criteria into simpler, lay language. Spitzer renewed his call on the Governor and State Legislature to pass legislation originally proposed by the Attorney General in 2001, to establish clear penalties for violations of the Managed Care Consumer Bill of Rights. Currently, there are no specific penalties for violations of this consumer protection statute. The settlements announced today specifically require the health plans to ensure that all consumer requests for clinical review criteria are honored and to submit annual compliance reports to the Attorney General's Office. Each plan will also pay $5,000 in costs to the state. The case was handled by Assistant Attorneys General Paul Beyer, Heather Hussar and Susan Kirchheimer, and Section Chief Troy Oechsner under the supervision of Joseph Baker, Health Care Bureau Chief. The full text of the report is available on the Attorney General's website: www.oag.state.ny.us. Consumers and providers with questions or concerns about health care matters can call the Attorney General's Health Care Bureau Hotline at 1-800-771-7755. NEW YORK HEALTH PLANS PARTICIPATING IN SETTLEMENT Aetna US Healthcare Atlantis Health Plan Capital District Physicians' Health Plan (CDPHP) CIGNA Healthcare of New York ConnectiCare of New York Empire HealthChoice Excellus Health Plan Group Health Inc. (GHI) HealthFirst New York Health Insurance Plan of Greater New York (HIP) Health Net of New York HealthNow New York Horizon Healthcare of New York Independent Health Association MDNY Healthcare MVP Health Plan Oxford Health Plans of New York Preferred Care United Healthcare of New York Vytra Health Plans WellCare of New York

To many marketers, the press release is something of a "one size fits all" proposition. You want to get media coverage, you knock out a press release, send it to some journalists and sit back and wait. Of course, smart Publicity Insiders already know that's a prescription for failure. You know that your press release has to have a "hook", be well-written and sent to appropriate journalists in an active, not passive, manner. But there's another part of the puzzle that even savvy publicity-seekers sometimes miss -- you can't just write "a press release", you have to write the right kind of press release. There's no such thing as a "one size fits all" release. Smart publicists have variations of the press release model ready to go, depending on the occasion. (Note: for a general introduction to press release writing and formatting, see: PublicityInsider.com.) Let's look at some releases suitable for "harder" and more timely news... The News Release To some folks, "news release" and "press release" are interchangeable. Not to me. I use the phrase "news release" to refer to a release that, well, carries actual news. Let's face it, most of what a business has to say to a journalist isn't exactly "stop the presses" kind of stuff. But, on occasion, something of real significance occurs. A merger, a stock split, a major new contract, winning a national award...something that's truly timely and important. For these sorts of events, don't mess around. Craft a solid, hard-hitting News Release that's written in pure journalistic style (lead includes "who, what, when, why and how", language is in 3rd person and completely frëe of hyperbole). Use journalism's "inverted pyramid" -- most important information at the top, next most important info in the second paragraph and so on down. Tell the entire story in the headline and subhead. Again, don't get cute -- get straight to the point. The headline "Acme Corporation Selected by Pentagon to Supply Troops with Widgets" is far better than something like "Guess Who's Making Widgets for Uncle Sam?" or something "clever" like that. In the subhead, fill in some details: "$18 Million Contract Largest in Company's History". Talk about getting straight to the point! You've just given the journalist the meat of the story before she's even read your lead. Add a "dateline" (Akron, OH) at the beginning of your lead (first) paragraph. In the dateline, use your company's home town (or the location where some news has broken. You can be a bit creative hëre, if it helps maximize your impact. For the above example, you can dateline it Washington, DC and say that "The Pentagon today announced that it has selected an Akron company..."). In distributing the release, use e-mail, fax, a distribution service such as PRWeb or PR Newswire, or even overnight courier. The goal is to get it into journalists' hands on the same day you distribute it. Executive Appointment Release Most businesses send out a brief release and headshot when someone new is hired or a major promotion is made. That's fine, and it will get them in the "People on the Move" column on page 8 in the business section. It's an ego stroke for the employee, but that's about it. Savvy publicity seekers use the Executive Appointment release to generate real publicity. Here's the key -- don't just announce that someone's been hired or promoted. Rather, explain why the move is significant to the company -- and perhaps the market -- as a whole. For example, Jane Smith has been hired as your company's new director of sales. Not so exciting. However, the reason you hired her is because she came from a major online retailer and is planning to overhaul your salës system to compare with the state-of-the-art systems used by the big guys. Hmmmm...that's a lot more interesting. So why not tell the media about it? The key ingredient is context. Your headline may still look like that of a typical Executive Appointment release (Acme Names Jane Smith New Director of Sales), but starting with the subhead, you begin your journey off page 8 of the business section and onto page one (Hiring of Key Figure in Online Sales Explosion Marks Important Shift in Acme's Sales Strategy). Ah, now you've entered the realm of news, not business as usual. And a sharp business editor will see that a local company is doing something far more significant than just making a hire. Dateline the release, fax (or even messenger), email or regular mail it over to your local business editor and follow up with a phone call. Offer Jane Smith for interview, too. The Media Alert The Media Alert is a deceptively simple creature. It's essentially a memo from you to TV, radio and newspaper assignment editors, city desk editors and others who decide whether a particular news event is worth covering. They're used to alert the press about news conferences, charity events, publicity "stunts" and other events. The point of the Media Alert is to, in just a few seconds, tell a journalist about the event, how to cover it and why it's important that the media outlet, in fact, covers it. Most publicists are pretty good on the first two points -- almost all media alerts do a decent job of telling what the event is, where it will be held and what time it starts. It's the third aspect -- the "why" -- that will make the real difference, though. And it's the thing most publicists do a lousy of job of conveying. First, a word about format. Use standard press release headings (contact info, "For Immediate Release" and headline). The rest of the document should be a few paragraphs, spaced at least three lines apart from one another. The first paragraph, should begin with What: and continue with a one or two line description of the event (WidgetFest 2004, a celebration of young minds). Next paragraph, When:, after that Where: Now here's the key paragraph, Why You Should Cover WidgetFest 2004: The brightest young minds from around the region will gather to present their inventions, as Acme Corp. celebrates the state's top high school science students. The event will be a visual feast, with a host of awe-inspiring inventions, many colorful, active and exotic, on display. As part of the event, more than $10,000 in scholarships will be distributed to budding Einsteins by John Smith, Ohio's Science Teacher of the Year. The key? This line: "The event will be a visual feast, with a host of awe-inspiring inventions, many colorful, active and exotic, on display." I just spoke an assignment editor's language, telling him that this will provide lots of cool visuals, making for great video or photos. The bit about the scholarships and the Science Teacher of the Year assures him that this won't just be a promotional stunt. So what are we offering? A non-promotional, feel-good event with great visuals. Just what an assignment editor is looking for. About The Author Bill Stoller, the "Publicity Insider", has spent two decades as one of America's top publicists. Now, through his website, eZine and subscription newsletter, Free Publicity: The Newsletter for PR-Hungry Businesses he's sharing -- for the very first time -- his secrets of scoring big publicity. For free articles, killer publicity tips and much, much more, visit Bill's exclusive new site: