CANADIAN CHIROPRACTOR - July 2017

Roundup

2017-07-01 05:01:51

RESEARCH Ancient fossil reveals origins of human spine Analysis of a 3.3 million-year-old fossil skeleton reveals the most complete spinal column of any early human relative, including vertebrae, neck and rib cage. The findings, published recently in the Proceedings of the National Academy of Sciences, indicate that portions of the human spinal structure that enable efficient walking motions were established millions of years earlier than previously thought. The fossil, known as “Selam,” is a nearly complete skeleton of a two and a half year old child discovered in Dikika, Ethiopia in 2000 by Zeresenay (Zeray) Alemseged, professor of organismal biology and anatomy at the University of Chicago and senior author of the new study. Selam, meaning “peace” in the Ethiopian Amharic language, was an early human relative from the species Australopithecus afarensis – the same species as the famous Lucy skeleton. In the years since Alemseged discovered Selam, he and his lab assistant from Kenya, Christopher Kiarie, have been preparing the delicate fossil at the National Museum of Ethiopia. They slowly chipped away at the sandstone surrounding the skeleton and used advanced imaging tools to further analyze its structure. “Continued and painstaking research on Selam shows that the general structure of the human spinal column emerged over 3.3 million years ago, shedding light on one of the hallmarks of human evolution,” Alemseged said. “This type of preservation is unprecedented, particularly in a young individual whose vertebrae are not yet fully fused.” Many features of the human spinal column and rib cage are shared among primates. But the human spine also reflects our distinctive mode of walking upright on two feet. For instance, humans have fewer rib-bearing vertebrae – bones of the back – than those of our closest primate relatives. Humans also have more vertebrae in the lower back, which allows us to walk effectively. When and how this pattern evolved has been unknown until now because complete sets of vertebrae are rarely preserved in the fossil record. “For many years we have known of fragmentary remains of early fossil species that suggest that the shift from rib-bearing, or thoracic, vertebrae to lumbar, or lower back, vertebrae was positioned higher in the spinal column than in living humans. But we have not been able to determine how many vertebrae our early ancestors had,” said Carol Ward, a curator’s distinguished professor of pathology and anatomical sciences in the University of Missouri School of Medicine, and lead author on the study. “Selam has provided us the first glimpse into how our early ancestors’ spines were organized.” To be analyzed, Selam was taken to the European Synchrotron Radiation Facility in Grenoble, France, where the research team used high-resolution imaging technology to visualize the bones. The scans indicated that Selam had the distinctive thoracic-to-lumbar joint transition found in other fossil human relatives, but the specimen is the first to show that, like modern humans, our earliest ancestors had only twelve thoracic vertebrae and twelve pairs of ribs. That is fewer than in most apes. The study, “Thoracic Vertebral Count and Thoracolumbar Transition in Australopithecus afarensis,” was supported by Margaret and Will Hearst, the National Science Foundation and the European Synchrotron Radiation Facility. – Newswise NEWS Manitoba cuts funding for chiropractic services The Manitoba government has implemented a new funding formula that will see subsidies for chiropractic services cut by $4.8 million. This is part of the province’s efforts to get back more than $250 million from health care alone. Beginning June 1st, chiropractors billed the province $8.20 per patient visit, a decrease from $12.30, but that amount will go up to $10 by April 1, 2018. The new rule also puts a cap on provincial funding for chiropractic services to a maximum of seven visits annually instead of 12. Health Minister Kelvin Goertzen’s office has declined to comment on the decision, citing Manitoba’s Election Financing Act, which restricts what government officials can and can’t say during a byelection period. In a statement, the Manitoba Chiropractic Association (MCA) expressed “disappointment” over the government’s decision to cut funding saying it potentially puts the most vulnerable patients – seniors, and low-income, working Manitobans – at a disadvantage by reducing access to care. “Without question, this change will reduce the access of Manitobans seeking chiropractic care each year,” said Dr. Perry Taylor, president of the MCA. Despite the cuts, however, the MCA still views the government’s decision to continue funding chiropractic care as an “opportunity for the province to further engage the profession in its fight to cut ER wait times and lessen the opioid crisis.” There are currently more than 280 chiropractors in Manitoba. Manitoba is curently the only province in Canada that offers broad coverage for chiropractic patients. Dr. Greg Stewart, a spokesperson for the MCA, said this decision “flies in the face of the national opioid strategy.” “Although we have the provincial government signing on to the federal government’s national opioid strategy about improving access to nonpharmacological care, at the same time within months of each other, they decrease access for the same nonpharmacological care. It’s hard to understand,” Stewart noted. Last November, the federal government issued a “Joint Statement of Action to Address the Opioid Crisis.” In it are commitments from the various provincial governments – including Manitoba – as well as other organizations to help address the opioid crisis. The medical community also recently issued new guidelines for the treatment and management of lowback pain, citing non-pharmacological interventions as the first line of treatment for acute and chronic low back pain. New opioid prescribing guidelines were also recently issued by the Canadian Medical Association, urging doctors to avoid prescribing opioids as first line of treatment for patients with chronic, non-cancer pain. “If you want to deal with the opioid crisis, you want to decrease or remove access barriers not increase them,” Stewart pointed out. “Last year, 19 million prescriptions were written in Canada for opioids. Things are going in the wrong direction and unless we improve access for non-pharmacological interventions, this opioid crisis has no end in sight.” Stewart expects the board of the MCA to continue to develop strategies to improve communications with the provincial government to look at issues of “mutual concern” including the opioid crisis. “Hopefully the disconnect between (resolving the opioid problem and increasing barriers to nonpharmacological care) can be evaluated... If they are serious about the opioid crisis there’s going to have to be a systemic change at the budgetary level for interventions that substitutes for drugs in this province,” Stewart said. Mari-Len De Guzman PUBLIC HEALTH PM calls for lasting solution to opioid epidemic ottawa – Prime Minister Justin Trudeau says governments won’t rest until they turn the tide on a rising opioid epidemic. Health officials and political leaders have been sounding the alarm about a dramatic spike in opioid deaths across Canada – the focus of a national summit in Ottawa last fall that pulled together experts from across the country. Municipal leaders are lobbying the federal government in Ottawa for more help to respond to what they describe as an epidemic spreading through their communities. Trudeau says the government is listening to municipal concerns and plans to work with local officials on longterm solutions. The prime minister made the comments during a keynote address to the annual meeting of the Federation of Canadian Municipalities. As part of that meeting, mayors are pushing federal officials and cabinet ministers on a number of files, including opioids, affordable housing and infrastructure spending. – The Canadian Press

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