The concept of self-care is a many-layered one. Identifying the components in the definition of the term delineates the different areas for potential research in this area. When planning a research project, the definition of the key concept guides the research and shapes the approach to the investigation. For researchers in this area, this study illustrates the wealth and diversity of the definitions of self-care.

X-rays have been the gold standard for diagnosis, evaluation, and management of spinal scoliosis for decades as other assessment methods are indirect, too expensive, or not practical in practice. The average scoliosis patient will receive 10 to 25 spinal X-rays over several years equating to a maximum estimated dose of 10 to 25 mGy. Some patients, those getting diagnosed at a younger age and receiving early and ongoing treatments, may receive up to 40 to 50 X-rays, approaching at most 50 mGy. There are concerns that repeated radiographs given to patients are carcinogenic. Some studies have used the linear no-threshold model to derive cancer-risk estimates; however, it is invalid for low-dose irradiation (ie, X-rays); these estimates are untrue. Other studies have calculated cancer-risk ratios from long-term health data of historic scoliosis cohorts. Since data indicate reduced cancer rates in a cohort receiving a total radiation dose between 50 and 300 mGy, it is unlikely that scoliosis patients would get cancer from repeated X-rays. Moreover, since the threshold for leukemia is about 1100 mGy, scoliosis patients will not likely develop cancers from spinal X-rays. Scoliosis patients likely have long-term health consequences, including cancers, from the actual disease entity itself and not from protracted X-ray radiation exposures that are essential and indeed safe.

Objectives  The objective of this review was to appraise and synthesise best available evidence on the psychosocial spiritual experience of elderly individuals recovering from stroke. Inclusion criteria  This review considered qualitative studies whose participants were adults, mean age of 65 years and older, and who had experienced a minimum of one stroke. Studies were included that described the participant's own experience of recovering from stroke. Search strategy  The search strategy sought to find both published and unpublished studies and papers, not limited to the English language. An initial limited search of MEDLINE and CINAHL was undertaken followed by an analysis of text words contained in the title and abstract, and of index terms used to describe the article. A second extensive search was then undertaken using all identified key words and index terms. Methodological quality  Each paper was assessed by two independent reviewers for methodological quality prior to inclusion in the review using the Qualitative Assessment and Review Instrument (QARI) developed by the Joanna Briggs Institute. Disagreements were resolved through consultation with a third reviewer. Data collection  Information was extracted from each paper independently by two reviewers using the data extraction tool from QARI developed by the Joanna Briggs Institute. Disagreements were resolved through consultation with a third reviewer. Data synthesis  Data synthesis aimed to portray an accurate interpretation and synthesis of concepts arising from the selected population's experience during their recovery from stroke. Results  A total of 35 studies were identified and of those 27 studies were included in the review. These qualitative studies examined the perceptions of elderly individuals who had experienced a stroke. Findings were analysed using JBI-QARI. The process of meta-synthesis using this program involved categorising findings and developing synthesised topics from the categories. Four syntheses were developed related to the perceptions and experiences of stroke survivors: sudden unexpected event, connectedness, reconstruction of life and life-altering event. Conclusion  The onset and early period following a stroke is a confusing and terrifying experience. The period of recovery involves considerable psychological and physical work for elderly individuals to reconstruct their lives. For those with a spiritual tradition, connectedness to others and spiritual connection is important during recovery. The experience of stroke is a life-altering one for most elderly individuals, involving profound changes in functioning and sense of self.

Evidence-based contemporary spinal rehabilitation often requires radiography. Use of radiography (X-rays or computed tomography scans) should not be feared, avoided, or have their exposures lessened to decrease patient dose possibly jeopardizing image quality. This is because all fears of radiation exposures from medical diagnostic imaging are based on complete fabrication of health risks based on an outdated, invalid linear model that has simply been propagated for decades. We present 7 main arguments for continued use of radiography for routine use in spinal rehabilitation: (1) the linear no-threshold model for radiation risk estimates is invalid for low-dose exposures; (2) low-dose radiation enhances health via the body’s adaptive response mechanisms (ie, radiation hormesis); (3) an X-ray with low-dose radiation only induces 1 one-millionth the amount of cellular damage as compared to breathing air for a day; (4) radiography is below inescapable natural annual background radiation levels; (5) radiophobia stems from unwarranted fears and false beliefs; (6) radiography use leads to better patient outcomes; (7) the risk to benefit ratio is always beneficial for routine radiography. Radiography is a safe imaging method for routine use in patient assessment, screening, diagnosis, and biomechanical analysis and for monitoring treatment progress in daily clinical practice.

To remedy spine-related problems, assessments of X-ray images are essential to determine the spine and postural parameters. Chiropractic/manual therapy realignment of the structure of the spine can address a wide range of pain, muscle weakness, and functional impairments. Alternate methods to assess such spine problems are often indirect and do not reveal the root cause and could result in a significant misdiagnosis, leading to inappropriate treatment and harmful consequences for the patient. Radiography reveals the true condition and alignment of the spine; it eliminates guesswork. Contemporary approaches to spinal rehabilitation, guided by accurate imaging, have demonstrated superiority over primitive treatments. Unfortunately, there are well-meaning but misguided activists who advocate elimination or minimization of exposures in spine radiography. The radiation dose employed for a plain radiograph is very low, about 100 times below the threshold dose for harmful effects. Rather than increasing risk, such exposures would likely stimulate the patient’s own protection systems and result in beneficial health effects. Spine care guidelines need to be revised to reflect the potential benefits of modern treatments and the lack of health risks from low X-ray doses. This would encourage routine use of radiography in manual spine therapy, which differs from common pharmacologic pain relief practice.

ALARA is the acronym for “As Low As Reasonably Achievable.” It is a radiation protection concept borne from the linear no-threshold (LNT) hypothesis. There are no valid data today supporting the use of LNT in the low-dose range, so dose as a surrogate for risk in radiological imaging is not appropriate, and therefore, the use of the ALARA concept is obsolete. Continued use of an outdated and erroneous principle unnecessarily constrains medical professionals attempting to deliver high-quality care to patients by leading to a reluctance by doctors to order images, a resistance from patients/parents to receive images, subquality images, repeated imaging, increased radiation exposures, the stifling of low-dose radiation research and treatment, and the propagation of radiophobia and continued endorsement of ALARA by regulatory bodies. All these factors result from the fear of radiogenic cancer, many years in the future, that will not occur. It has been established that the dose threshold for leukemia is higher than previously thought. A low-dose radiation exposure from medical imaging will likely upregulate the body’s adaptive protection systems leading to the prevention of future cancers. The ALARA principle, as used as a radiation protection principle throughout medicine, is scientifically defunct and should be abandoned.

To systematically review the literature on the use of cervical extension traction methods for increasing cervical lordosis in those with hypolordosis and cervical spine disorders. [Methods] Literature searches for controlled clinical trials were performed in Pubmed, PEDro, Cochrane, and ICL databases. Search terms included iterations related to the cervical spine, neck pain and disorders, and extension traction rehabilitation. [Results] Of 1,001 initially located articles, 9 met the inclusion/exclusion criteria. The trials demonstrated increases in radiographically measured lordosis of 12-18°, over 5-15 weeks, after 15-60 treatment sessions. Untreated controls/ comparison groups not receiving extension traction showed no increase in cervical lordosis. Several trials demonstrated that both traction and comparison treatment groups experienced immediate pain relief. Traction treatment groups maintained their pain and disability improvements up to 1.5 years later. Comparative groups not receiving lordosis improvement experienced regression of symptoms towards pre-treatment values by 1 years' follow-up.[Conclusion] There are several high-quality controlled clinical trials substantiating that increasing cervical lordosis by extension traction as part of a spinal rehabilitation program reduces pain and disability and improves functional measures, and that these improvements are maintained long-term. Comparative groups who receive multimodal rehabilitation but not extension traction experience temporary relief that regresses after treatment cessation.

Low back and neck pain disorders are among the leading causes for work loss, suffering, and health care expenditures throughout the industrialized world. It has been extensively demonstrated that sagittal plane alignment of the cervical and lumbar spines impacts human health and well-being. Today there are reliable and predictable means through the application of extension spinal traction as part of comprehensive rehabilitation programs to restore the natural curvatures of the spine. High-quality evidence points to Chiropractic BioPhysics® (CBP®) methods offering superior long-term outcomes for treating patients with various craniocervical and lumbosacral disorders. CBP technique is a full spine and posture rehabilitation approach that incorporates mirror image® exercises, spinal and postural adjustments, and unique traction applications in the restoration of normal/ideal spinal alignment. Recent randomized controlled trials using CBP's unique extension traction methods in conjunction with various conventional physiotherapeutic methods have demonstrated those who restore normal lordosis (cervical or lumbar) get symptomatic relief that lasts up to 2 years after treatment. Comparative groups receiving various 'cookie-cutter' conventional treatments experience only temporary symptomatic relief that regresses as early as 3 months after treatment. The economic impact/benefit of CBPs newer sagittal spine rehabilitation treatments demand continued attention from clinicians and researchers alike.systematically as the Harrison group [4][5][6][7][8][9][10][11]. Elliptical shape modeling of the path of the posterior longitudinal ligament along the posterior vertebral body margins was chosen due to the ease of clear identification of these spine landmark points and for the ability to easily make measurements of spine segmental and total angle of curvature on patient radiographs to compare patient measurements to model predictions. Modeling was performed on radiographic samples of asymptomatic participants. Computer iterations of spinal shape modeling was applied to determine best-fit geometric spine shapes by fitting various ellipses of altering minor-to-major axes ratios to digitized posterior vertebral body corners on samples of radiographs of the cervical [4-6], thoracic [7,8], and lumbar spinal regions [9][10][11] (Figure 3).The Harrison normal spinal model (Figure 3) features a circular cervical lordosis, and portions of an elliptical curve for both the thoracic kyphosis (more curvature cephalad), and lumbar lordosis (more curvature caudad). Consequently, features of the normal human spine reveal that the opposite thoracic and lumbar curves meet together at the thoraco-lumbar junction being essentially straight; the upper, deeper curve of the upper thoracic spine reflects oppositely at the cervico-thoracic junction (between T1 and T2) and continues into the cervical lordosis; the lower lumbar spine increases its lordotic alignment having two-thirds of its curve between L4-S1 as it meets the forward tilted sacral base. T...