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Daniel KY Zheng,1 Gregory N Kawchuk,2 André E Bussières,3,4 Fadi M Al Zoubi,1 Jan Hartvigsen,5 Siu Ngor Fu,1 Katie de Luca,6 Debra K Weiner,7,8 Jaro Karppinen,9,10 Dino Samartzis,11 Manuela L Ferreira,12 Jinlong Wu,13 Liz Dennett,2 Arnold YL Wong1 1Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, People’s Republic of China; 2University of Alberta, Edmonton, Canada; 3Université McGill, Montreal, Canada; 4Université du Québec à Trois-Rivières, Trois‑Rivières, Canada; 5University of Southern Denmark, Odense, Denmark; 6Central Queensland University, Brisbane, Australia; 7University of Pittsburgh, Pittsburgh, PA, USA; 8VA Pittsburgh Healthcare System, Pittsburgh, PA, USA; 9Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland; 10Rehabilitation Services of South Karelia Social and Health Care District, Lappeenranta, Finland; 11Rush University Medical Center, Chicago, IL, USA; 12The University of Sydney, Sydney, Australia; 13Southwest University, Chongqing, People’s Republic of ChinaCorrespondence: Arnold YL Wong, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, People’s Republic of China, Tel +852 2766 6741, Email arnold.wong@polyu.edu.hkAbstract: Although the number of publications focusing on low back pain in older adults (LBP-O) and working-age adults (LBP-W) has been growing for decades, comparative research trends in these two populations, which may help to guide future investigation, have not been rigorously explored. This analysis aimed to describe publication patterns and trends of research targeting LBP-O and LBP-W over the last three decades. Peer-reviewed LBP-O and LBP-W articles published between 1993 and 2023 were retrieved from the Web of Science, which provided the details of annual publication volume, and prominent journals/countries/institutions. The relationship between the annual publication volumes and years was analyzed by Spearman correlation analysis. The hot topics and emerging trends were analyzed by VOSviewer and CiteSpace, respectively. A total of 4217 LBP-O-related and 50,559 LBP-W-related documents were included. The annual publication volumes of LBP-O and LBP-W articles increased over the years (r=0.995 to 0.998, p< 0.001). The United States had the highest number of prominent institutions publishing relevant articles. The most prolific journal for LBP-O (5.4%) and LBP-W-related (6.1%) papers is the journal “Spine”. Cognitive behavioral therapy, intervertebral disc (IVD) degeneration, physiotherapy, physical activity, and walking were the recent hot topics and physical activity was an emerging trend in LBP-O, while surgery and IVD degeneration (also a hot topic) were emerging trends in LBP-W. This study highlights the paucity of LBP-O-related research in the past. The United States and the journal Spine stand out in LBP research. The research trend of physical activity in LBP-O is consistent with the recognized importance of physical activity for older adults in general, and for managing LBP-O in particular. Conversely, the emerging trends of surgery and intervertebral disc degeneration in LBP-W research highlight a focus on the biomedical model of LBP despite LBP being a biopsychosocial condition.Keywords: low back pain, older adults, working-age adults, bibliometrics, intervertebral disc degeneration, physical activity, surgery

Health professions educators often use social media to share knowledge; however, it is unclear what specific dissemination and knowledge translation (KT) processes are occurring and the implications of this sharing for health professions education (HPE). This study explored how educators have used social media as a mechanism of dissemination and KT in the literature. A critical scoping review methodology, informed by Engeström's Activity Theory, was employed. Twelve databases were searched and studies that: (a) addressed health professions educators; (b) described the use of social media for dissemination or KT; (c) focused on a regulated health profession; (d) focused on undergraduate or graduate education; and (e) were published in English or French between 2011 and 2021 were included. Data were analyzed using numerical and qualitative content analyses. Of the 4859 articles screened, 37 were eligible for inclusion. Social media may facilitate knowledge sharing in HPE, but there is a lack of conceptual clarity on what is meant by 'dissemination' and 'KT'. Who is responsible for sharing knowledge, what knowledge is being shared, and the target audiences are not always clear. Multiple factors (e.g., affordances, opportunity costs) influence how social media is used as a mechanism of dissemination, and it remains unclear whether and how it is used as a mechanism of KT. Concepts like KT and dissemination, which are often borrowed from other disciplines, must be critically evaluated for their relevance and suitability if they are to be appropriately applied to HPE and in particular to social media. Educators looking to use social media to teach students about KT should consider whether this use of technology truly aligns with their stated learning outcomes.

Scholarly practitioners are broadly defined as healthcare professionals that address critical practice problems using theory, scientific evidence, and practice-based knowledge. Though scholarly practice is included in most competency frameworks, it is unclear what scholarly practice "is," how it "develops" and how it is "operationalized" in clinical practice. The aim of this review was to determine what is known about scholarly practice in healthcare professionals. We conducted a scoping review and searched MEDLINE, EMBASE, CINAHL from inception to May 2020. We included papers that explored, described, or defined scholarly practice, scholar or scholarly practitioner, and/or related concepts in healthcare professionals. We included a total of 90 papers. Thirty percent of papers contained an explicit definition of scholarly practice. Conceptualizations of scholarly practice were organized into three themes: the interdependent relationship between scholarship and practice; advancing the profession's field; and core to being a healthcare practitioner. Attributes of scholarly practitioners clustered around five themes: commitment to excellence in practice; collaborative nature; presence of virtuous characteristics; effective communication skills; and adaptive change ethos. No single unified definition of scholarly practice exists within the literature. The variability in terms used to describe scholarly practice suggests that it is an overarching concept rather than a definable entity. There are similarities between scholarly practitioners and knowledge brokers regarding attributes and how scholarly practice is operationalized. Individuals engaged in the teaching, research and/or assessment of scholarly practice should make explicit their definitions and expectations for healthcare professionals.

Objective: Recommendations discouraging high levels of physical activity and sports following unicompartmental (UKA) and total knee arthroplasty (TKA) have been questioned in recent years. This scoping review aimed to summarize the literature examining the impact of physical activity level and sports participation on implant integrity and failure in patients following UKA and TKA. Methods: Five databases (Medline, Embase, SCOPUS, CINAHL, ProQuest) were searched up to April 17, 2024. Retrospective, prospective and cross-sectional studies were included if they assessed the impact of physical activity level and/or sports participation (exposure variables) on implant integrity and/or failure (outcome variables) at ≥1 year following UKA or TKA. Two authors independently conducted abstract/full text reviews and data charting. Extracted data were summarized using descriptive analysis. Results: Of 2014 potential records, 20 studies (UKA: n ​= ​6 studies, 2387 patients/TKA: n ​= ​14 studies, 7114 patients) met inclusion criteria. Following both UKA & TKA, most patients regularly participated in light to moderate physical activities and lower impact sports (e.g. walking, cycling, golf). No studies reported a deleterious effect of physical activity level or sports participation on implant integrity or failure post UKA (mean follow-up: 3.3–10.3 years). Three studies reported an association between greater levels of physical activity with increased risk of implant failure post TKA (mean follow-up: 1–11.4 years). Conclusions: No studies demonstrated an association between greater levels of physical activity and sports participation with increased implant wear or failure post UKA, whereas results were mixed following TKA. There is a need for large, prospective cohort studies with long-term follow-up.

# Introduction Respiratory therapists (RTs) are expected to provide high-quality care for patients with chronic and acute cardiopulmonary conditions across the lifespan by staying abreast of emerging scientific evidence and effectively integrating it into clinical practice. This integration of evidence is encompassed within the competency of scholarly practice. However, there is currently a limited understanding of RTs' scholarly practice. Furthermore, despite RTs' widespread presence in the Canadian healthcare system, comprehensive studies describing the profiles of RTs are lacking. This study aimed to describe the demographic characteristics, scholarly and practice profiles of the respiratory therapy profession in Canada. # Methods A cross-sectional survey was distributed via the national professional association and regulatory bodies. The survey contained seven sections with 52 items. We calculated means and standard deviations, or medians and interquartile ranges for continuous variables and frequencies and proportions for categorical variables. Open-ended questions were analyzed using summative content analysis. # Results We analyzed data from 832 participants (6.8% response rate) from Ontario (17.8%), Québec (15.7%), and Alberta (13.3%), and across other provinces. Nearly 40% had completed an undergraduate degree beyond their respiratory therapy diploma. Few participants had authored or co-authored peer-reviewed publications. RTs reported reading approximately 2.2 peer-reviewed publications monthly. Most participants agreed on the importance of critical reflection in practice (93.1%) and that having a supportive work environment was vital. Almost three-quarters of participants (73.4%) reported that they believe that RTs are valued members of interprofessional teams, and 78% agreed that understanding research enables them to engage in patient advocacy. # Conclusion This survey provides a portrait of the practice and scholarly profile of the respiratory therapy profession in Canada. While the profession shows potential for growth, concerns persist regarding limited engagement in activities related to scholarly practice. Addressing these challenges and nurturing a culture of scholarly practice are likely necessary to support the development of scholarly practice in the profession. Creating supportive environments, providing access to resources, and encouraging professional development activities may advance the scholarly practice of RTs. Future national surveys could employ random sampling strategies to achieve a more representative sample of the profession.

BackgroundNational strategies from North America call for substantive improvements in entry-level pain management education to help reduce the burden of chronic pain. Past work has generated a valuable set of interprofessional pain management competencies to guide the education of future health professionals. However, there has been very limited work that has explored the development of such competencies for individual professions in different regions. Developing profession-specific competencies tailored to the local context is a necessary first step to integrate them within local regulatory systems. Our group is working toward this goal within the context of entry-level physiotherapy (PT) programs across Canada.AimsThis study aimed to create a consensus-based competency profile for pain management, specific to the Canadian PT context.MethodsA modified Delphi design was used to achieve consensus across Canadian university-based and clinical pain educators.ResultsRepresentatives from 14 entry-level PT programs (93% of Canadian programs) and six clinical educators were recruited. After two rounds, a total of 15 competencies reached the predetermined endorsement threshold (75%). Most participants (85%) reported being "very satisfied" with the process.ConclusionsThis process achieved consensus on a novel pain management competency profile specific to the Canadian PT context. The resulting profile delineates the necessary abilities required by physiotherapists to manage pain upon entry to practice. Participants were very satisfied with the process. This study also contributes to the emerging literature on integrated research in pain management by profiling research methodology that can be used to inform related work in other health professions and regions.

Abstract Background The Theoretical Domains Framework (TDF) was developed to investigate determinants of specific clinical behaviors and inform the design of interventions to change professional behavior. This framework was used to explore the beliefs of chiropractors in an American Provider Network and two Canadian provinces about their adherence to evidence-based recommendations for spine radiography for uncomplicated back pain. The primary objective of the study was to identify chiropractors’ beliefs about managing uncomplicated back pain without x-rays and to explore barriers and facilitators to implementing evidence-based recommendations on lumbar spine x-rays. A secondary objective was to compare chiropractors in the United States and Canada on their beliefs regarding the use of spine x-rays. Methods Six focus groups exploring beliefs about managing back pain without x-rays were conducted with a purposive sample. The interview guide was based upon the TDF. Focus groups were digitally recorded, transcribed verbatim, and analyzed by two independent assessors using thematic content analysis based on the TDF. Results Five domains were identified as likely relevant. Key beliefs within these domains included the following: conflicting comments about the potential consequences of not ordering x-rays (risk of missing a pathology, avoiding adverse treatment effects, risks of litigation, determining the treatment plan, and using x-ray-driven techniques contrasted with perceived benefits of minimizing patient radiation exposure and reducing costs; beliefs about consequences); beliefs regarding professional autonomy, professional credibility, lack of standardization, and agreement with guidelines widely varied ( social/professional role & identity); the influence of formal training, colleagues, and patients also appeared to be important factors ( social influences); conflicting comments regarding levels of confidence and comfort in managing patients without x-rays ( belief about capabilities); and guideline awareness and agreements ( knowledge). Conclusions Chiropractors’ use of diagnostic imaging appears to be influenced by a number of factors. Five key domains may be important considering the presence of conflicting beliefs, evidence of strong beliefs likely to impact the behavior of interest, and high frequency of beliefs. The results will inform the development of a theory-based survey to help identify potential targets for behavioral-change strategies.

Abstract The high prevalence of neck and low back pain in the rapidly aging population is associated with significant increases in health care expenditure. While spinal imaging can be useful to identify less common causes of neck and back pain, overuse and misuse of imaging services has been widely reported. This narrative review aims to provide primary care providers with an overview of available imaging studies with associated potential benefits, adverse effects, and costs for the evaluation of neck and back pain disorders in the elderly population. While the prevalence of arthritis and degenerative disc disease increase with age, fracture, infection, and tumor remain uncommon. Prevalence of other conditions such as spinal stenosis and abdominal aortic aneurysm (AAA) also increase with age and demand special considerations. Radiography of the lumbar spine is not recommended for the early management of non-specific low back pain in adults under the age of 65. Aside from conventional radiography for suspected fracture or arthritis, magnetic resonance imaging (MRI) and computed tomography (CT) offer better characterization of most musculoskeletal diseases. If available, MRI is usually preferred over CT because it involves less radiation exposure and has better soft-tissue visualization. Use of subspecialty radiologists to interpret diagnostic imaging studies is recommended.

IntroductionBack and neck pain are the leading causes of disability worldwide. Doctors of chiropractic (DCs) are trained to manage these common conditions and can provide non-pharmacological treatment aligned with international clinical practice guidelines. Although DCs practice in over 90 countries, chiropractic care is rarely available within integrated healthcare delivery systems. A lack of DCs in private practice, particularly in low-income communities, may also limit access to chiropractic care. Improving collaboration between medical providers and community-based DCs, or embedding DCs in medical settings such as hospitals or community health centres, will improve access to evidence-based care for musculoskeletal conditions.Methods and analysesThis scoping review will map studies of DCs working with or within integrated healthcare delivery systems. We will use the recommended six-step approach for scoping reviews. We will search three electronic data bases including Medline, Embase and Web of Science. Two investigators will independently review all titles and abstracts to identify relevant records, screen the full-text articles of potentially admissible records, and systematically extract data from selected articles. We will include studies published in English from 1998 to 2020 describing medical settings that have established formal relationships with community-based DCs (eg, shared medical record) or where DCs practice in medical settings. Data extraction and reporting will be guided by the Proctor Conceptual Model for Implementation Research, which has three domains: clinical intervention, implementation strategies and outcome measurement. Stakeholders from diverse clinical fields will offer feedback on the implications of our findings via a web-based survey.Ethics and disseminationEthics approval will not be obtained for this review of published and publicly accessible data, but will be obtained for the web-based survey. Our results will be disseminated through conference presentations and a peer-reviewed publication. Our findings will inform implementation strategies that support the adoption of chiropractic care within integrated healthcare delivery systems.

The association between maternal sensitivity and attachment security has long been established among normative samples. However, less is known about how this association operates among children with Autism Spectrum Disorder (ASD). This meta-analytic review is the first to address the association between maternal sensitivity/availability and attachment security in a population of children with ASD (aged 1 to 7 years) and to explore if this association is moderated by child chronological age, mental age, ASD-related symptoms severity. The objective was also to assess the role of methodological moderators, including the informant of the attachment measure, country and publication year. A systematic search was performed on relevant databases. Seven studies were retained. Meta-analytic results showed a significant medium effect size between maternal sensitivity/availability and attachment security in children with ASD (r = .47; 95% CI: 0.32-.60; p < .001), which is a stronger association than in the general population (r = .24). Moderation analyses did not show any significant effect of child chronological age and publication year on effect sizes. The categorical moderators (e.g., informant, country) could not be tested due to the limited number of studies. More research is needed to better understand the way mothers adapt to their children with autism and identify the nuances regarding how maternal sensitivity/availability relates to child attachment in the context of ASD., Author(s): F. Cossette-Côté [sup.1] , E. L. Bussières [sup.2] , K. Dubois-Comtois [sup.2] Author Affiliations: (1) grid.14848.31, 0000 0001 2292 3357, Psychology Department, Université de Montréal, , 2900 boul Edouard-Montpetit, [...]