depression

Exercise For Depression & Manipulation For Tendinopathy

CF 228: Exercise For Depression & Manipulation For Tendinopathy Today we’re going to talk about Exercise For Depression & Manipulation For Tendinopathy But first, here’s that sweet sweet bumper music

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OK, we are back anrd you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around.  We’re the fun kind of research. Not the stuffy, high-brow kind of research. We’re research talk over a couple of beers. I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.   If you haven’t yet I have a few things you should do. 

  • Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s a great resource for patient education and for YOU. It saves you time in putting talks together or just staying current on research. It’s categorized into sections and written in a way that is easy to understand for you and patients. Just search for it on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams. 
  • Then go Like our Facebook page, 
  • Join our private Facebook group, and then 
  • Review our podcast on whatever platform you’re listening to 
  • Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com

You have found yourself smack dab in the middle of Episode #228 Now if you missed last week’s episode , we talked about nerve flossing carpal tunnel and we talked about catastrophizing. Make sure you don’t miss that info. Keep up with the class. 

 

On the personal end of things….. I just got back from the MCM Mastermind that was started by Dr. Kevin Christie. This group is just outstanding y’all. I mean honestly, Dr. Mark King of the Motion Palpation Institute is a member. How do you beat that?? Dr. Jay Greenstein of Kaizenovate and Kaizo care clinics in Washington DC. Dr. Ben Fergus of the GRIP method. Seriously. THE Dr. Brett Winchester is joining us at the next one. You can’t make this stuff up. 

One theme we discussed a lot this weekend was The Front Stage and Back Stage Systems in your practice. Strategic Coach was kind enough to be our guest presenter and they rocked it.  Another theme I kept on bringing up was whatever you can have a vision on and take consistent action on, will happen for you.  BUT YOU MUST HAVE BOTH VISION AND ACTION. 

In our Mastermind Group we have: 

    • A Doc who takes one week off per month 
    • A Doc who lives in a different state than 
    • where is practice is located 
    • At least 5 practices clear well over 1M in revenue (and they are high quality of evidence informed care) 
    • One that is exiting patient care in the Fall
    • A Doc who is building a short term rental business – that’s me! 
    • All Docs who no matter their accomplishements and the size of their practices…..they are still pushing the envelope and humble enough to come to each meeting with a Beginner’s mind. Eager to learn and eager to share thier knowledge and experience. 

Remember, it’s not HOW….it’s WHO.

Who do you know that can help you get where you want to be? I know 14 others right now in this group.  What would you love to have in 5 years that is big? Our group has top chiros from North Carolina, Texas, Florida, Connecticut, Missouri, Montana, Ohio, Maryland, Minnesota, Alabama, and Illinois.  We meet four times a year to raise our games. World class care through a mastermind and collaboration of some of the best in the country. To be the best, it makes sense to learn from the best. It’s pretty exciting! 

Next meeting is in July in Sarasota.  I’m already making plans. I believe Dr. Christie is interested in growing the group by about 5 or so more seats. If you’re interested, let Dr. Christie know. Send him and email to [email protected] 

Before we get to the research, we all know that the number one type of case that we want is a personal injury case – they are gold because the clients are more compliant, and we get paid at rates far above insurance or Medicare or Medicaid. The patient’s attorney tells them to go for treatment as doing so enhances their legal case and gets them more money. The problem is, how do we get PI cases?  Attorneys don’t generally respond to your invitation for lunch. And let’s face it, they’re a tough bunch. I have the answer. An attorney I know has put together a system, that is both in written and video form, that shares how to approach attorneys and get them to send their PI clients to you. This is the real deal. Attorney Paul Samakow’s system costs $997 and he guarantees satisfaction or your money back. You have to check this out.  Even if you only get one case, you’ve made at least 4 or 5 times the investment.

Go to gettingpicases.com/cs

That’s gettingpicases.com/cs

One more time so you get it right:   gettingpicases.com/cs

Item #1

This first one is called, “Association Between Physical Activity and Risk of Depression A Systematic Review and Meta-analysis” by Pearce et. al. (Pearce M 2022) and published in Jama Psychiatry on April 13, 2022 – Dayumm that’s fresh and hot. 

Why They Did It

To systematically review and meta-analyze the dose-response association between physical activity and incident depression from published prospective studies of adults.

How They Did It

PubMed, SCOPUS, Web of Science, PsycINFO, and the reference lists of systematic reviews retrieved by a systematic search up to December 11, 2020

What They Found

  • Fifteen studies comprising 191,130 participants and 2,110,588 person-years were included. 
  • Heterogeneity was large and significant. 
  • Those accumulating HALF the recommended volume of physical activity had 18% lower risk of depression. 
  • Adults accumulating the recommended volume of 8.8 marginal metabolic equivalent task hours per week had 25% lower risk with diminishing potential benefits and higher uncertainty observed beyond that exposure level. 

Wrap It Up

This systematic review and meta-analysis of associations between physical activity and depression suggest significant mental health benefits from being physically active, even at levels below the public health recommendations. Health practitioners should therefore encourage any increase in physical activity to improve mental health.

Before getting to the next one, I have to tell you, Dr. Chris Howson, the inventor of the Drop Release tool re-activated the code! It’s live again. Use the code HOTSTUFF upon purchase at droprelease.com to get $50 off your purchase. Y’all, it makes a world of difference. Would you like to spend 5-10 minutes doing pin and stretch and all of that? Or would you rather use a drop release to get the same or similar results in just a handful of seconds. My patients love it and I know yours will too. droprelease.com and the discount code is HOTSTUFF. Go do it. Hear me now and believe me later.

Item #2

The last one today is called, “”The analgesic effect of joint mobilization and manipulation in tendinopathy: a narrative review” by Savva et. al. (Savva C 2021) and was published in the Journal of Manual and Manipulative Therapy in 2021 – aye chi wa wa. Steamy. 

Why They Did It

To summarize the available literature with regards to the potential analgesic effect and mechanism of joint mobilization and manipulation in tendinopathy. 

What They Found

  • The effect of these techniques in rotator cuff tendinopathy and lateral elbow tendinopathy, applied alone, compared to a placebo intervention or along with other interventions has been reported in some randomized controlled trials which have been scrutinized in systematic reviews. 
  • Literature in other tendinopathies such as medial elbow tendinopathy, de Quervain’s disease and Achilles tendinopathy is limited since the analgesic effect of these techniques has been identified in few case series and reports. 
  • Therefore, the low methodological quality renders caution in the generalization of findings in clinical practice. 
  • Studies on the analgesic mechanism of these techniques highlight the activation of the descending inhibitory pain mechanism and sympathoexcitation although this area needs further investigation.

Wrap It Up

Study suggests that joint mobilization and manipulation may be a potential contributor in the management of tendinopathy as a pre-conditioning process prior to formal exercise loading rehabilitation or other proven effective treatment approaches. Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week. 

Store

Remember the evidence-informed brochures and posters at chiropracticforward.com.   

Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!

Chiropractic evidence-based products

Integrating Chiropractors

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The Message

I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health!

Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic!

Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference. 

Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward.

Website https://www.chiropracticforward.com

Social Media Links https://www.facebook.com/chiropracticforward/

Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/

Twitter https://twitter.com/Chiro_Forward

YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q

iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2

Player FM Link https://player.fm/series/2291021

Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through

TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/

About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger  

Bibliography

Pearce M, G. L., Abbas A, (2022). “Association Between Physical Activity and Risk of Depression: A Systematic Review and Meta-analysis.” JAMA Psychiatry.  

Savva C, K. C., Korakakis V, Efstathiou M, (2021). “The analgesic effect of joint mobilization and manipulation in tendinopathy: a narrative review.” J Man Manip Ther 29(5): 276-287.    

Sleep, Energy, and Pain & Depression and Rehab

Today we’re going to talk about Sleep, Energy, and Pain & Depression and Rehab

... continue reading.

Nonoperative Disc Treatment, D3 for Depression, & The Biopsychosocial Part Of Chronic Pain

CF 142: Nonoperative Disc Treatment, D3 for Depression, & The Biopsychosocial Part Of Chronic Pain

Today we’re going to talk about Nonoperative Disc Treatment, D3 for Depression, & The Biopsychosocial Part Of Chronic Pain

But first, here’s that sweet sweet bumper music

Subscribe button

OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way aro

und. 

We’re the fun kind of research. Not the stuffy, high-brow kind of research. We’re research talk over a couple of beers.

I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  

If you haven’t yet I have a few things you should do. 

  • Like our Facebook page, 
  • Join our private Facebook group and interact, and then 
  • go review our podcast on iTunes and other podcast platforms. 
  • We also have an evidence-based brochure and poster store at chiropracticforward.com
  • While you’re there, join our weekly email newsletter. No spam, just a reminder when the newest episodes go live. Nothing special so don’t worry about signing up. Just one a week friends. Check your JUNK folder!!

Do it do it do it. 

You have found yourself smack dab in the middle of Episode #142

Now if you missed last week’s episode , we talked about the update from the authors on The Lancet low back series and we talked about movement disorders and whether or not they translate into pain. Make sure you don’t miss that info. Keep up with the class. 

While we’re on the topic of being smart, did you know that you can use our website as a resource? Quick and easy, you can go to chiropracticforward.com, click on Episodes, and use the search function to find whatever you want quickly and easily. With over 100 episodes in the tank and an average of 2-3 papers covered per episode, we have somewhere between 250 and 300 papers that can be quickly referenced along with their talking points. 

Just so you know, all of the research we talk about in each episode is cited in the show notes for each episode if you’re looking to dive in a little deeper. 

On the personal end of things…..

Kids still in school. I called it early. I’m giving most of the schools about 4-6 weeks before they decide the numbers are too high. I do not want to be a pessimist. I just don’t see how they’ll keep it under control. I drove by my daughter’s junior high at lunch and they had 100-200 kids out on the playground playing basketball. Right up on each other. Lol. 

I know they’re outside. I know. We’ll see. I know the University of Alabama just reported 1200 positives at the campus. Notre Dame, University of North Carolina. I just see it as a start. 

My son told me a kid in his math class turned up positive so that got him all up in a wrinkle. I told him he’s got a better chance of getting it riding in a car with someone to eat or gathering up in dorm rooms than getting it in a big huge classroom. It’ll hold 300 kids but there’s around 50 or 60 in there all wearing masks and distanced. Minimal risk. 

Then I had a patient in here just last week, I treated her on a Tuesday. No temp, no symptoms at all….she goes home. The next day she feels a little funky. Her husband had the Rona a couple of weeks ago if I remember right. Anyway, she’s on high alert because of her husband so she goes and gets tested and she’s positive. The day after we had her in the clinic. 

Now, she was masked the whole time and my time with her was less than 3-5 minutes, she had no symptoms at the time so the risk, to my knowledge, while certainly not ideal, in the long run is probably minimal. 

Had that happened 3-4 weeks ago, I’d probably have been down at the place getting the tests and all that good stuff. Had Jake had a positive kid in his big ol math class a month ago, they’d probably be doing something more than just saying, hey this happened. Y’all wear a mask. 

Things ahve changed slightly in the past month I believe. I think more and more, we’re seeing we can live with this and it’s not the end of the world like some thought it’d be back in March and April. We still see cases going down but they’re still higher than they were in the first wave. Yet deaths aren’t. They’ve leveled and dropped as well. Which is all great news. 

I’m a nerd so I watch interviews with experts on vaccines and epidemilology and all that stuff done through the Journal of the American Medical Association. One of the experts said that’s it’s just not in the virus’s best interest to kill us off. It’s in its best interest to become more transmissible but less deadly so it can spread easier but not kill us…..so it can survive. Basically. 

That’s an interesting way to look at it. Then, yesterday, the CDC comes out and says that only 6% of deaths are due strictly to COVID. Well now hell. Doesn’t that give fuel to the fire for the science hating conspiracy nut cases? More ammo to confuse other dummies into their way of thinking but the truth is, it changed nothing. It just meant that 94% of COVID deaths have an average of 2.6 co-morbidities. 

Well, no durr Sherlock. That’s one of the few things we’ve all actually known this whole time. The CDC just was finally able to quantify it. That’s all. I’m still overweight. I’m still more at risk than John Workout over there drinking his fruit smoothie after his 6 mile run. No change whatsoever but day-um if the nut cases didn’t jump all over that one. 

Watching science haters just explode and reveal themselves on Facebook over the last 6 months has been such a disappointment. Especially the ones that you respected as doctorate level caregivers. 

Now look, I’ll admit something, in the very beginning, when nobody knew what the hell, how many would die and this and that, I got caught up in some of it. A whole bunch of us did. As more information comes to light, as we learn more about it, as we experience life with it, the danger is still there but, education has lessened any fear that might have been there in the beginning. 

Now, it’s just life and we have to keep living. We have to try to send kids to school. Let’s see what happens. We have to go to work. I’ve been working full time for basically 6 months following guidelines and so far so good. Can you imagine what business would look like if I just took off for months? Nope. Can’t do it. 

And isn’t there something to be said about government over reach on some of this stuff? How can they shut down bars yet allow people to gather up in a church? How can some bars stay open with music and bands but they’re able to stay open because you can buy a hamburger. Yet other bars are closed because they don’t sell a hamburger? How does any of it make sense? It’s a stack of hooey balls. 

I’m a Christian, I want people to want to go to church. So don’t get the wrong idea there. It’s a valid comparison. You can group up in church but not in a bar. It’s silly. 

We’ll know more about the back to school thing in jsut a few weeks. 

Alright, I’m rambling, let’s get to it. 

Item #1

The first article here is called “Effect of Long-term Vitamin D3 Supplementation vs Placebo on Risk of Depression or Clinically Relevant Depressive Symptoms and on Change in Mood Scores. A Randomized Clinical Trial” by Okereke et. al(Okereke O 2020). and published in JAMA on August 4, 2020. Hot tamale, hot tamale….

Why They Did It

The authors wanted to know if long-term supplementation with vitamin D3 prevent depression in the general adult population? What’s your guess? D3 is a bit of a wonder kid, right?

How They Did It

  • 18353 men and women aged 50 years or older 
  • Randomized clinical trial 
  • Randomized testing happened from November 2011 through March 2014
  • Randomized treatment ended on December 31, 2017
  • Randomization was D3 or placebo

Wrap It Up

“Among adults aged 50 years or older without clinically relevant depressive symptoms at baseline, treatment with vitamin D3 compared with placebo did not result in a statistically significant difference in the incidence and recurrence of depression or clinically relevant depressive symptoms or for change in mood scores over a median follow-up of 5.3 years. These findings do not support the use of vitamin D3 in adults to prevent depression.”

Before we get to the next paper, I want to tell you a little about this new tool on the market called Drop Release. I love new toys! If you’re into soft tissue work, then it’s your new best friend. Heck if you’re just into getting more range of motion in your patients, then it’s your new best friend.

Drop Release uses fast stretch to stimulate the Golgi Tendon Organ reflex.  Which causes instant and dramatic muscle relaxation and can restore full ROM to restricted joints like shoulders and hips in seconds.  

Picture a T bar with a built-in drop piece.  This greatly reduces time needed for soft tissue treatment, leaving more time for other treatments per visit, or more patients per day.  Drop Release is like nothing else out there, and you almost gotta see it to understand, so check out the videos on the website.

It’s inventor, Dr. Chris Howson, from the great state of North Dakota, is a listener and friend. He offered our listeners a great discount on his product. When you order, if you put in the code ‘HOTSTUFF’ all one word….as in hot stuff….coming up!! If you enter HOTSTUFF in the coupon code area, Dr. Howson will give you $50 off of your purchase.

Go check Drop Release at droprelease.com and tell Dr. Howson I sent you.

Item #2

This second one here is called “An Assessment of Nonoperative Management Strategies in a Herniated Lumbar Disc Population: Successes Versus Failures” by Lilly et. al(Lilly D 2020). published in Global Spine Journal in July of 2020. Is it hot in here? I need some air!

Why They Did It

To compare the utilization of conservative treatments in patients with lumbar intervertebral disc herniations who were successfully managed nonoperatively versus patients who failed conservative therapies and elected to undergo surgery (microdiscectomy).

How They Did It

  • Clinical records from adult patients with an initial herniated lumbar disc between 2007 and 2017 were selected from a large insurance database.
  • Patients were divided into 2 cohorts: patients treated successfully with nonoperative therapies and patients that failed conservative management and opted for microdiscectomy surgery.
  • Nonoperative treatments utilized by the 2 groups were collected over a 2-year surveillance window.
  • “Utilization” was defined by cost billed to patients, prescriptions written, and number of units disbursed.

What They Found

  • 277 941 patients with lumbar intervertebral disc herniations were included.
  • Of these, 269 713 (97.0%) were successfully managed with nonoperative treatments,
  • 8228 (3.0%) failed maximal nonoperative therapy (MNT) and underwent a lumbar microdiscectomy.
  • failures occurred more frequently in males (3.7%), and patients with a history of lumbar epidural steroid injections (4.5%) or preoperative opioid use (3.6%).
  • A cost analysis indicated that patients who failed nonoperative treatments billed for nearly double ($1718/patient) compared to patients who were successfully treated ($906/patient).

Wrap It Up

“Our results suggest that the majority of patients are successfully managed nonoperatively. However, in the subset of patients that fail conservative management, male sex and prior opioid use appear to be independent predictors of treatment failure.”

Item #3

The last one is called “Biopsychosocial baseline values of 15 000 patients suffering from chronic pain: Dutch DataPain study” by Brouwer et. al (Brouwer B 2020) . and published in Regional Anesthesia and Pain Medicine in August of 2020….only the freshest for you fresh people. 

Why They Did It

They did this one in an effort to understand multidisciplinary approaches to solving chronic pain. 

How They Did It

  • 11,214 patients suffering from chronic pain
  • The pain was analyzed using relevant Initiative on Methods, Measurement, and Pain assessment in Clinical Trials Instruments. 
  • Most patients were female

What They Found

  • The mean age was 55.6 years old
  • Severe pain was reported by 71.9%
  • Psychological and quality of life values deteriorated when pain severity increased
  • About 36% of them showed severe signs of depression or anxiety
  • 39% had high pain catastrophizing
  • Of all patients, 17.8% reported high values for pain severity, catastrophizing and anxiety or depression 

Wrap It Up

“Based on baseline biopsychosocial values, this study shows the complexity of patients referred to pain centers. Pain management with a biopsychosocial approach in an integrated multidisciplinary setting is indispensable. Above all, adjusted education on chronic pain and attention to its biopsychosocial aspects are deemed necessary.”

It becomes more and more clear that if all you’re doing is adjusting and sending them on their way, you’re wrong. 

If you’re adjusting and doing some exericises and sending chronic pain on its way, you’re partly wrong. 

If you’re adjusting when appropriate, if you’re prescribing patients exercises and teaching them how to self manage at home, addressing yellow flags and building confidence while you encourage addressing the cognitive aspect of chronic pain…..well….now you’re starting to get it. You’re becoming someone that can make a realy difference in your patients’ lives. 

Alright, that’s it. Y’all be safe. Keep changing the world and our profession from your little corner of the world. Continue taking care of yourselves and taking care of your neighbors. Tough times are upon us but, the sun will shine again. Trust it, believe it, count on it.

Let’s get to the message. Same as it is every week. 

Key Takeaways

Store

Remember the evidence-informed brochures and posters at chiropracticforward.com. 

Subscribe Button

The Message

I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots.

When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few.

It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient.

And, if the patient treats preventativly after initial recovery, we can usually keep it that way while raising the overall level of health!

Key Point:

At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints….

That’s Chiropractic!

Contact

Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes. 

Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms. 

We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference. 

Connect

We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward.

Website

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TuneIn

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About the Author & Host

Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & VloggerBibliography

Brouwer B, W. S., Jacobs C, Overdijk M, (2020). “Biopsychosocial baseline values of 15 000 patients suffering from chronic pain: Dutch DataPain study.” Reg Anesth Pain Med.

Lilly D, D. M., Eldridge C, (2020). “An Assessment of Nonoperative Management Strategies in a Herniated Lumbar Disc Population: Successes Versus Failures.” Global Spine J.

Okereke O, R. C., Mschoulon D, (2020). “Effect of Long-term Vitamin D3 Supplementation vs Placebo on Risk of Depression or Clinically Relevant Depressive Symptoms and on Change in Mood Scores A Randomized Clinical Trial.” JAMA 324(5): 471-480.