Editors’ note The idea that for every effect there is a cause can be traced back to the first natural scientists, and received its classical formulation in the philosophy of Aristotle. This idea of cause and effect is reflected in the Newton’s third law of action that for every action (cause) there is an equal and opposite reaction (effect).1 Unfortunately, this can sometimes be erroneously simplified to the idea that for any given effect, there is only one cause. The history of medicine is replete with failed theories about health that, at root, were the application of this idea that there was one cause that needed to be sought out. After Louis Pasteur’s investigations and lectures in the mid- to late-19th century helped establish the germ theory of disease,2 many Western medical practitioners adopted the idea that all disease was caused by germs, despite earlier evidence that some diseases were caused by deficiencies,3 which impeded the search for curative therapies for diseases like beriberi. It has become increasingly clear, however, that promoting optimum health in people can only happen when the many causes, or determinants, of health are taken into account. In a sense, we have to return to the Aristotelian idea that there are multiple types of causes, and all of them have to be considered in evaluating an effect.4 The Healthy People 2020 initiative of the US Department of Health and Human Services recognized five principle determinants of health outcomes: biology & genetics, individual behavior, social environment, physical environment, and health services.5 For those involved in the care of people with spinal cord injury (SCI), this recognition of the many factors that contribute to health comes as no surprise. This issue of The Journal of Spinal Cord Medicine showcases the range of issues and therapies that need to be addressed in assisting people with SCI to better health, from addressing the hormonal and physical changes that accompany SCI to the impact on health of the strategies that are used to deal with the effects of SCI on function and mobility. One of the best ways to continue exploring the multiple factors that influence the health of the people with SCI we work with is to attend the annual conference of the

© The Academy of Spinal Cord Injury Professionals, Inc. 2016 DOI 10.1080/10790268.2016.1180758

Academy of Spinal Cord Injury Professionals (ASCIP). Often enough, our time at work is spent in silos, working only with colleagues in our own profession; but the ASCIP annual conference is the opportunity to listen to and reflect on our work with others from all the many professions that are engaged with research, treatment and therapy dealing with SCI. This year’s conference will be held in Nashville, Tennessee from September 4th through the 7th, and conference registration will be available beginning in late April or May at http://www.acade myscipro.org/Public/Conference2016.aspx. We hope to see many of our readers there. Have a comment? A suggestion? We are always interested in input from our readers.

ORCID Stephen Cavanaugh 4314


References 1 Newton I. The Mathematical Principles of Natural Philosophy. Motte A, translator. Daniel Adde, New York, NY. 1846. p. 83. Available at https://archive.org/details/newtonspmathema00new trich. Accessed 15 April 2016. 2 Pasteur L. On the extension of the germ theory to the etiology of certain common diseases. Ernst HC, translator. Available at https ://ebooks.adelaide.edu.au/p/pasteur/louis/exgerm/complete .html. University of Adelaide, Adelaide, Australia. Accessed 15 April 2016. 3 Carter KC. The germ theory, beriberi, and the deficiency theory of disease. Med Hist 1977;21:119–36. 4 Aristotle. Physics, Book II, part 3. Available at http://classics.mit .edu/Aristotle/physics.2.ii.html. Accessed 15 April 2016. 5 US Department of Health and Human Services. Healthy People 2020 framework. Available at https://www.healthypeople.gov/ sites/default/files/HP2020Framework.pdf. Accessed 15 April 2016.

Florian Thomas, MD, MA, PhD, MS Editor-in-Chief Carolann Murphy, PA Assistant Editor Stephen Cavanaugh Managing Editor

The Journal of Spinal Cord Medicine







Editors' note.

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