 It's time for Twitch this week in chiropractic. I'm Dr. Nathan Cashin. Here are the headlines for the week of February 12, 2021. In news, the World Federation of Chiropractic launched a new mobile app. The WFC chiropractic app is designed to keep users up to date with news, information, resources, and latest evidence from the world of chiropractic. The app is available on and searchable both on the Apple app store and on Google Play. Dr. Michelle Myers is elected the first female president of the American Chiropractic Association. The Board of Governors installed new leadership at the annual meeting for the ACA last week. Dr. Kathy Bollett of Maine was elected vice president. Dr. Myers is the executive director of research and innovation at Northwestern Health Sciences University and the vice president of the World Federation of Chiropractic. In events, the Chiroloquium convenes in three weeks. This virtual conference for the Chiropractic community will feature keynote talks and virtual poster sessions over two days, all in a virtual world called Verbella. Registration is $35 for each poster submitted and there are limited seats for observers who do not wish to present a poster. The virtual conference will be held March 2nd through 4th. In research, a new paper in chiropractic and manual therapies reveals chiropractic students cognitive dissonance statements about professional identity, role, setting, and future. Nearly 2,400 students from Europe, North America, and Australasia completed the surveys. Individual student responses frequently contradict in terms of professional ideology, but most students demonstrate concordant progressive and mainstream attitudes. Deed Harrison and Paul Oakley have a new paper addressing radiophobic fear mongering, misappropriation of medical references and dismissing relevant data forms, the false stance for advocating against the use of routine and repeat radiography in chiropractic and manual therapy. The article argues that there is considerable evidential support for routine use of radiological imaging in chiropractic and manual therapies, and that the long-held notion of carcinogenicity from X-rays is not a valid argument. The commentary was published in Dose Response, an international journal with an impact factor of 2.4. Those are the headlines for this week in chiropractic. For links to these stories and more, visit exploringchiropractic.com slash twitch. So let's talk about some of these stories, the WFC launching a new mobile app. You know, I'm seeing a few mobile apps coming out in the chiropractic world. Talk about another one for this actual week. And part of me feels like this is too little too late. I don't know what apps cost now, but certainly not too long ago, mobile apps were a huge investment. I mean, they were minimum $30,000 to develop an app. I'm sure that the cost has come down, but if you're actually building a full-featured app, it's no small feat. And I think there are, though, a lot of tools that allow you, especially when this is a cross-platform app available on the App Store and Google Play. But I always wonder, why don't you just make a website that is more mobile compatible? The WFC website isn't great. It certainly feels like older technology. Even these news releases open up in a PDF rather than an actual webpage. And that's not mobile friendly. But as their press release states that 86% of time that users spend is on mobile apps compared to just 14% on mobile websites. Now, this is skewed because most apps are social media apps. People are spending time on Facebook and Twitter and Instagram and maybe Clubhouse now. They're not spending it on websites because these social media apps are specifically built for mobile. Maybe news, I mean, I use the news, Apple news app, as well as a couple of, you know, kind of RSS readers. But I'm just not sure that I visit the WFC website enough to warrant having an app on my phone to get that information. Now, what they're trying to provide is news, events, information, social media, other resources, evidence and research, contacts, alerts and more. And so I've downloaded it. I've played with it a little bit. But again, I worry that organizations like the WFC are spending energy on this when that energy time finances could go to something a little bit more productive. So if I tap on social media in the app, it's fetching social media articles. And it looks to me like these are just, they're just pulling in Twitter posts. I follow the WFC on Twitter. I'd probably rather get their feed there. In fact, if I want to get more, it's going to take me to the Twitter post. And then I'm going to have to click the link anyway. So this just doesn't seem to me like the most efficient use of time. The calendar kind of nice. They have the WFC board of directors meeting. They've got Parker seminars on here. The World Health Organization launch of rehabilitation competency framework. I mean, that'll be interesting, actually. It was just talking on a meeting about that today. And it looks like that's happening next week. So okay, the calendar is kind of nice. And I want to, but I can't add it to my personal calendar or my Google calendar or anything like that. So again, just makes me wonder, is this really necessary? I'm hoping they did some focus group testing. They got some feedback before actually putting money into this. But it's an attempt. I appreciate the attempt going trying to focus on mobile. We do need to think of mobile first. I'm just not sure an app is a great way to do that. But it will remain to be seen. I'll be curious to hear whether it's highly downloaded, how many people install it and use it. Speaking of the World Federation, they also have recently launched a podcast. Rebecca Wilkes is a graduate of Western States, my alma mater. We're there at the same time, didn't know her personally terribly well, certainly crossed paths. And I believe is working in Veterans Administration Hospital, is my understanding, and is interviewing chiropractors from around the world. This is a really great idea. Very cool to see the first two episodes are out. The Pacific Region Australia with Matthew Fisher, PhD, and the Pacific Region Philippines with Martin Camara. And these are also available on YouTube. You can watch the interviews and then download it as a podcast, which I think is great. I love this idea. I mean, this is kind of what I started doing with exploring chiropractic interviewing students around the world. And now this is a great way to hear from the professionals from practicing chiropractors, as well as people involved probably at more of a regional or global scale. Very pleased, very pleased to hear that Michelle Myers was elected first woman to serve as ACA President, along with Vice President Kathy Boulet, not sure how to pronounce her name. And I think this is a great step forward. Michelle Myers is just imminently impressive. One of my favorite podcast guests. I ask all of my guests, what did you want to be when you grew up as a little child? If you think back to five, 10 years old, what did you want to be? And her answer had me just kind of chuckling to myself for days. And I still go back and listen to that. I'm not going to tell you what her answer was because I want you to go listen to that episode, which I'll include in the show notes. But a really great interview. She is a proponent of the younger generation, very involved with the millennial ACA, which became the next gen ACA. She actually has a paper that she published on millennials in chiropractic. And so I think this is great. I worry how much she's doing. She is the Director of the Research Program at Northwestern, I believe. She is Vice President of the WFC and now President of ACA. I'm sure these aren't all full-time jobs, but altogether they probably make up at least 1.5, not two full-time equivalents. So excited to see where she takes the organization by being at the leadership and really looking forward to that. Speaking of ACA, AC engage was February 4th through 6th, so two weeks ago now, but last week as of the recording of this podcast, I'm recording late because of power outages and internet outages over the past four days. I am recording via my phone, using my phone as a hotspot. So anyway, AC engage was February 4th through 6th. I was not able to participate in many of the meetings, but did join the next gen ACA call. The little bit that I did participate in, I liked the format. I liked the Zoom calls. I liked having recorded sessions that are still available, by the way, to get your CEs completed and then having follow-up Q&As. So the lectures or courses were recorded, but then to have some interaction, that presenter then had a live Zoom call, where you could ask questions. And I thought that was a great way to approach it. Better, I think, than what is planned for Carl Okewem coming up into three weeks, March 2nd through 4th. This is the Carl Research Fellows are putting on this Carl Okewem, a virtual poster presentation and conference, but they're doing it within a platform called Virbella, which is basically Second Life for academic nerds and researchers like, I'm not a researcher, but a nerd, certainly. And it'll be interesting to see how this comes off. So there will be some keynote speakers. There will be poster sessions. And then you can just walk around this virtual world. You create an avatar. And in the private forward thinking chiropractic Facebook group, Dr. Kachuk and some others gave a preview of this. And I have to just reconnect here to the internet, but they kind of walk people through. And I'm trying to see if I can skip forward, but I don't have the controls that I need here. So gave a tour of what this looks like. And you really are just walking around this Second Life world and you make the avatar look like you or not. I think this is an interesting concept, but it will remain to be seen how well it comes off. The things I've been learning about virtual conferences are that you need to, much like mobile, you need to think virtual first. You need to think, you know, how do we connect people, good quality audio and video so that people feel like they're involved without necessarily making it complicated. And I worry that this makes it complicated. I'm going to go. This is going to be fun. I'm going to participate as much as I can. And I'm just going to be curious to see, especially how the poster presentations come across. You're going to have to redesign your poster for this world. I'm sure you can just import a PDF and put it, you know, on some wall that you come to. But, you know, the point of a poster presentation is to give it a quick overview and you might have come across better posters. This is a new format that a lot of people are in academics are jumping on and allow people to ask some questions and kind of just to walk by and spend two to three minutes looking at the poster, getting the key ideas. Well, that can be done with Zoom breakout sessions or with recording a video. And so I'm just curious how this is going to go. I'm not terribly optimistic about it, but I think it's going to be a great attempt. And these guys know technology. I mean, I'm no one to talk about about the team that involves someone like Greg Katzak, who's, you know, doing actual AI machine learning research into chiropractic. So that's, you know, way above my head. So I'm hoping that this comes off well. Speaking of research, a couple of papers to point out. This one was very interesting on chiropractic students cognitive dissonance to statements about professional identity, role, setting and future. I haven't fully read the paper yet, but the gist is they interviewed or provided a survey to a number of students from 2013 to 2018 all around the world and asked them a number of questions about professional identity and the philosophy. You know, I'm sure it touched on things like vitalism. And it was interesting to see that there was some cognitive dissonance. And this is something I've certainly experienced through my personal life as well as professional life. Cognitive dissonance actually is a good thing to have, but it can be very unsettling and very disconcerting. I'll be interested to read through a lot of the questions that were asked. I'm curious how I would respond to them and, but it does sound like that, you know, there was some cognitive dissonance that there were some inconsistencies and their replies and that, you know, for instance, they may claim to be evidence base, but then adhere to some philosophy that is not supported in the evidence. But in general, it sounds like the majority were of a more progressive mindset. And I think that is a good thing for the profession, in my personal opinion. On the other hand, this paper by Indeed Harrison and Paul Oakley came out the day that I was planning on recording this. And it's quite funny. I actually was thinking to myself, okay, I'm trying to do this week in chiropractic talking about news stories, current stuff that comes up. And before I saw this, I thought to myself, gosh, what do I do if something controversial comes out? What if there's an important story that comes out of a group of chiropractors who maybe I don't align myself with? And, and then sure enough, this, and I did think of Indeed Harrison as an example of that, you know, I've seen him speak. I'm curious about chiropractic biophysics. A lot of people have had great results with it, both patients and the chiropractors providing this type of treatment. And so my curiosity is piqued. But I've also, when I've seen him speak, seen him be quite divisive as well as making some statements that just don't seem to hold up to reality as I know it. And this paper follows that same pattern. So I read the paper. And he, he and Paul Oakley claim that there is considerable evidential support for routine use of radiological imaging and chiropractic and manual therapies. So this is basically a rebuttal to what he calls a faction within the chiropractic profession that is advocating against the routine use of x-rays. I don't know that guidelines and the, the bulk of evidence is considered a faction, but take that for what it is. Speaking of which, they, they, they refute these arguments that there are no guidelines supporting routine imaging, that there is no evidence for biomechanical spine assessment by x-ray. And what they say finally, and most importantly, they summarize why the long held notion of carcinogenicity from x-rays is not a valid argument. And this is the linear, no threshold argument, which I actually agree with. This is kind of funny that I think based on the research that I've read, and if you go to my YouTube channel, I briefly did a review of a book called Strange Glow, the history of radiation and some of its application in healthcare. And I talk about this idea, the linear, no threshold idea of radiation exposure basically states that there is no amount of radiation to be, that we can be exposed to that does not have some type of negative effect. It comes out of research with fruit flies in which they gradually reduce the dose and found a linear pattern, but they did not go to very, very, very low doses, which would be equivalent to what is produced in an x-ray, even a CT. And once that type of research was done, they showed that, no, it's not linear, that actually there is somewhat even of a bell curve. And so you're probably familiar with the concept of hormesis where just a little bit of exposure to a negative stimulus actually has a positive response in the body. And this is seen in Japan with the bombs in Hiroshima and Nagasaki where those right at the side of the bombing were killed. Those within a certain radius had a lot of problems, whether it was burns and cancers and mutations in their cells, but at a certain distance where they were exposed to some of the radiation from the bombs, they actually had positive effects. And this is discussed in Strange Glow. And even the American radiological body, I'm trying to think of the correct name. I think the American College of Radiologists has come out with guidelines removing the need for gonadal shielding because these types of interventions actually lead to poor image quality, missing diagnoses, and in the end lead to more harm. So I actually agree with Harrison and Oakley on this final point. However, all of the other points they make really lack strong evidence. I mean, they talk about using X-rays to screen for severe pathologies and anomalies. And they talk about how that can happen. They just don't give good evidence that it makes a clinical difference. And so they say that, you know, in certain studies, up to 90% of people were found to have anomalies in these X-rays, but they don't say what that means. Okay, were these deadly, did people, did these conditions get completely missed to the detriment of the patients? They don't make any arguments. So this commentary felt kind of light to me, and felt like it missed an opportunity to make some really strong arguments. But I think it's worth reading. I think, you know, I remain open to the possibility that the technique is effective. D. Harrison certainly claims that they've done a large, large study looking at the angle of, I think they call it the thoracic outlet or inlet, and showing a change and not just a change that can be measured, but also that it's correlated with improvements in pain, dysfunction, that type of thing. And so if that study comes out and those findings are, you know, found to be accurate, then great. I think it's still important to keep reading and understanding, but I was not impressed by this paper. So spending way too much time on that one topic, I think. But that is this week in chiropractic for last week. Again, recording this almost a week late due to power outages in the Portland area, spent three days without electricity and still I'm without internet, but fortunately have a good data plan on my cell phone that's working. And so in a couple days we'll be recording another episode of this week in chiropractic. You can find all the links to these stories, these papers, these events on exploringchiropractic.com slash twitch T W I C H this week in chiropractic, or just go to the page and look at the blog feed. It's available there as well. You can follow exploring chiropractic on all the social media channels, Twitter, Facebook, Instagram, even Tik Tok at exploring chiro. And you can find me, Nathan cash in at Nathan cash in on most of those platforms as well as going to exploring chiropractic and leaving me a message. Let me know if you have any articles, research articles, news articles, stories, events coming up in the chiropractic world that I should discuss. And you can also listen to just the headlines on Amazon Alexa or in your podcast catcher, your favorite podcast app. If you just want to get the headlines in about a three to five minute snippet, and that should be available on Amazon Alexa as well in the very near future. Thanks for watching. Thanks for joining me on this week in chiropractic and I'll see you again next week.