Northwestern Health Sciences University

Background Structural Integration (SI) aims to improve whole-body alignment; however, quantitative evidence regarding global postural changes remains limited. Objective This study aimed to quantify pre-post changes in static posture following a 12-session SI series using photo-based posture indices. Methods A total of 73 adults (mean age 42.0 ± 8.3 years) participated in a study involving a 12-session SI protocol (Septum Work Structural Integration, SW-SI: a school-specific implementation of the Rolf paradigm, recognised by the International Association of Structural Integrators, in which the intermuscular septa and other deep fascial partitions are among the principal manual treatment targets and the session sequence is adapted to each participant's presenting pattern). Digital photographs (anterior, posterior, and lateral views) were analysed using the PostureScreen Mobile® application to extract eight postural outcomes (four translations and four angulations). Statistical analysis included repeated-measures MANOVA for the multivariate profile, paired t-tests for individual outcomes, and assessment of moderators (gender, age, height, weight and BMI). Clinical relevance was evaluated using Minimal Detectable Change (MDC95) and baseline–change correlations. Results The multivariate posture profile improved significantly following SI (Pillai's trace = 0.263, F(8,65) = 2.893, p = 0.008, partial η2 = 0.263). Significant composite improvements were observed in both translations (p = 0.009) and angulations (p = 0.001), particularly in anterior and left lateral views. Individually, significant reductions were found in anterior translation (p = 0.016), left lateral translation (p = 0.007), anterior angulation (p = 0.012) and left lateral angulation (p = 0.005); all four remained significant after Benjamini–Hochberg correction for multiple comparisons (q ≤ 0.032). While most demographic factors did not moderate outcomes, height showed a significant interaction (p = 0.030). Negative correlations (r = –0.35 to –0.77, p < 0.01) indicated that greater baseline misalignment was associated with larger improvements. At the individual level, 19–38% of participants exceeded the MDC95 threshold in the favourable direction, 42–74% changed within measurement error, and 7–25% exceeded it in the opposite direction, depending on the outcome. Conclusions The 12-session SI series was associated with significant multivariate improvements in global static posture, most notably in individuals with greater initial misalignment. The magnitude of change was strongly conditioned by the initial state, so that group-level improvement reflected a subset of responders rather than a uniform shift across participants. Although absolute changes varied, clinically meaningful improvements occurred in a subset of participants. Future controlled studies are needed to confirm causal effects and assess functional implications.

Noncommunicable diseases (NCDs) account for the majority of morbidity, mortality, and health expenditures, yet progress toward international reduction targets remains limited. Although evidence-based strategies for prevention and long-term management are well-established, health systems predominantly remain biomedical and fragmented across clinical, public health, and community sectors. This structural misalignment constrains the ability to scale prevention and deliver coordinated chronic disease management. This paper proposes "Operation Whole Health" as a framework for a paradigm shift in the health care system. Drawing on lessons from the coordinated mobilization observed in the United States during the COVID-19 response, the framework emphasizes the importance of mission clarity, cross-sector workforce integration, and sustained financing to achieve significant and scalable change. Whole health models-person-centered, interprofessional, and prevention-oriented-offer a mechanism for aligning clinical care with behavioral, social, and community determinants of health. Expanding prevention capacity includes systematic integration of traditional, complementary, and integrative medicine professionals, whose competencies align with chronic disease prevention but remain underutilized within publicly financed systems. Because effective whole health interventions for NCDs are known, a key constraint in widespread implementation may be policy prioritization rather than scientific uncertainty. A structural redesign of health care anchored in the whole health paradigm may be needed to alter NCD trajectories and stabilize long-term health expenditures.

ABSTRACT Objective The purpose of this study was to evaluate the alignment between chiropractic educational outcomes, the National Board of Chiropractic Examiners (NBCE) prelicensure exams, and the Council on Chiropractic Education (CCE) meta-competencies. Methods A qualitative thematic analysis was performed between January 2024 and December 2024. A detailed coding framework was used to systematically assess coherence among the content of NBCE prelicensure exams, the competencies from 4 sample chiropractic educational outcomes, and the CCE meta-competency framework. Data were analyzed to identify the presence and depth of key professional domains. Results The thematic analysis revealed a substantial degree of alignment between the NBCE exams and the CCE meta-competencies. The essential domains included assessment and diagnosis, patient case management, disease prevention, communication and documentation, professional ethics, jurisprudence, spinal adjustment and manipulation, interprofessional collaboration, clinical reasoning, and practical skills. Conclusion This study provides valuable insight into the degree of alignment among chiropractic educational outcomes, NBCE exams, and the CCE meta-competency framework. The analyses offer a detailed evaluation of the extent to which NBCE exam content reflects the knowledge, skills, and professional behaviors outlined in the CCE competencies. Collectively, the findings contribute to a deeper understanding of how exam standards support the preparation of competent, entry-level chiropractic practitioners.

ABSTRACT Objective This study explored chiropractic students’ self-reported understanding and attitudes regarding motivational interviewing (MI), and examined the relationship between students’ patient-centered communication (PCC)-related attitudes and beliefs and intent to use MI. Methods An explanatory sequential mixed methods study was conducted with full-time chiropractic students enrolled across 7 North American doctor of chiropractic degree programs. Eligible students completed an online survey; descriptive statistics and logistic regression were used to examine the relationship between PCC-related attitudes and beliefs and intent to use MI. Following the survey, students were invited to participate in virtual interviews; qualitative data were analyzed using thematic analysis. Results Of the 426 survey respondents (7% response rate), most reported completing PCC-related coursework (75.85%). While 69.73% reported understanding MI principles, only 13.51% felt proficient in its use. Over half (53.25%) intended to use MI, yet many endorsed beliefs misaligned with MI principles. The mean PCC-related attitudes and beliefs score was 143.39 (SD 18.42). Higher PCC-related attitudes and beliefs was significantly associated with greater odds of intent to use MI (odds ratio 1.03 [1.01–1.04], P < .001). Qualitative data responses reflected positivity toward MI, inconsistent exposure and training in MI, and student viewpoints that may be inconsistent with the spirit of MI. Conclusion This study contributes toward the understanding of North American chiropractic students’ understanding of MI and its relationship with PCC-related attitudes and beliefs. Further research is needed to investigate how MI is introduced, taught, and longitudinally supported within chiropractic education programs.

This review proposes that selected micronutrients may contribute to mitohormetic readiness, defined here as the pre-existing biochemical and regulatory capacity of a cell, tissue, or organism to sense, buffer, and transduce a bounded mitochondrial stressor, mount a proportionate adaptive response, and recover toward baseline, or a more capable post-challenge state, without persistent functional loss. This nutrient-centered construct extends the Energy Allocation System (EAS), in which resilience is shaped by how organisms allocate finite metabolic resources under stress and conservation-dominant phenotypes reflect coordinated energy-conserving responses rather than isolated dysfunction. The proposed relevance of micronutrients lies less in direct mitochondrial stimulation than in preserving the endocrine, redox, enzymatic, and one-carbon conditions required for beneficial adaptation. Thyroid physiology is used as the principal nutrient-centered exemplar, particularly through the roles of iodine, selenium, and iron, before the analysis is extended to methylfolate, cobalamin, riboflavin, magnesium, and niacin. The review does not present mitohormetic readiness as an established physiological principle or validated clinical construct, but as a hypothesis-generating extension of the EAS intended to refine how resilience, metabolic flexibility, and biochemical sufficiency are interpreted in clinical bioenergetics.