How does a practice-based research network facilitate evidence-informed practice within the chiropractic profession in Australia? A commentary

This commentary summarises the background, rationale, structure and context of Practice-Based Research Networks (PBRNs) with an emphasis on chiropractic within the Australian health care setting. Following an overview of the importance and value of research based within practice-based settings and a summary of international developments in chiropractic PBRN’s there is a brief description of the genesis, construction and implementation of the Australian Chiropractic Research Network (ACORN) project. The role of the ACORN PBRN is to help facilitate the development and promotion of a research agenda; improve the uptake of best clinical practice; address issues relevant to chiropractors and their patients; and build research capacity and output for the Australian chiropractic profession. The commentary identifies how the chiropractic profession in Australia is already starting to see the tangible results from the establishment of the ACORN PBRN

Spinal pain: Current understanding, trends, and the future of care

© 2015 Trainor et al. This commissioned review paper offers a summary of our current understanding of nonmalignant spinal pain, particularly persistent pain. Spinal pain can be a complex problem, requiring management that addresses both the physical and psychosocial components of the pain experience. We propose a model of care that includes the necessary components of care services that would address the multidimensional nature of spinal pain. Emerging care services that tailor care to the individual person with pain seems to achieve better outcomes and greater consumer satisfaction with care, while most likely containing costs. However, we recommend that any model of care and care framework should be developed on the basis of a multidisciplinary approach to care, with the scaffold being the principles of evidence-based practice. Importantly, we propose that any care services recommended in new models or frameworks be matched with available resources and services-this matching we promote as the fourth principle of evidence-based practice. Ongoing research will be necessary to offer insight into clinical outcomes of complex interventions, while practice-based research would uncover consumer needs and workforce capacity. This kind of research data is essential to inform health care policy and practice

A workforce survey of Australian chiropractic: The profile and practice features of a nationally representative sample of 2,005 chiropractors

© 2017 The Author(s). Background: This paper reports the profile of the Australian chiropractic workforce and characteristics of chiropractic care from a large nationally-representative sample of practitioners. Methods: A 21-item questionnaire examining practitioner, practice and clinical management characteristics was distributed to all registered chiropractors (n=4,684) in Australia in 2015 via both online and hard copy mail out. Results: The survey attracted a response rate of 43% (n=2,005), and the sample is largely representative of the national chiropractic workforce on a number of key indicators. The average age of the chiropractors was 42.1 years, nearly two-thirds are male, and the vast majority hold a bachelor degree or higher qualification. Australian chiropractors are focused upon treating people across a wide age range who mainly present with musculoskeletal conditions. Australian chiropractors have referral relationships with a range of conventional, allied health and complementary medicine (CAM) providers. Conclusion: The chiropractic profession represents a substantial component of the contemporary Australian health care system with chiropractors managing an estimated 21.3 million patient visits per year. While the Australian chiropractic workforce is well educated, research engagement and research capacity remains sub-optimal and there is much room for further capacity building to help chiropractic reach full potential as a key integrated profession within an evidence-based health care system. Further rich, in-depth research is warranted to improve our understanding of the role of chiropractic within the Australian health care system

Lawson criterion for ignition exceeded in an inertial fusion experiment

For more than half a century, researchers around the world have been engaged in attempts to achieve fusion ignition as a proof of principle of various fusion concepts. Following the Lawson criterion, an ignited plasma is one where the fusion heating power is high enough to overcome all the physical processes that cool the fusion plasma, creating a positive thermodynamic feedback loop with rapidly increasing temperature. In inertially confined fusion, ignition is a state where the fusion plasma can begin "burn propagation" into surrounding cold fuel, enabling the possibility of high energy gain. While "scientific breakeven" (i.e., unity target gain) has not yet been achieved (here target gain is 0.72, 1.37 MJ of fusion for 1.92 MJ of laser energy), this Letter reports the first controlled fusion experiment, using laser indirect drive, on the National Ignition Facility to produce capsule gain (here 5.8) and reach ignition by nine different formulations of the Lawson criterion

The Chiropractic Research Priorities in Australia (ChiRPA) project: A study protocol

© 2020 Elsevier Ltd Introduction: Building and implementing a robust evidence-base which is informed by high quality research is the challenge facing contemporary healthcare professions. In doing so, it can be valuable for healthcare professions to establish a strategic research agenda in order to enhance the professions public health priorities within healthcare and assist in the allocation of limited research resources. Whilst formal chiropractic research agendas have been established in North America and Europe, no comprehensive, inter-organisational chiropractic research agenda has been formulated within the Australian context. A critical precursor to inform the development of any such Australian chiropractic research agenda, is the identification of the priorities held by practising chiropractors, chiropractic academics, educators, researchers, and postgraduate HDR students, along with an appraisal of the current research capacity and output of the Australian chiropractic profession. Objectives: Design a questionnaire to; a) identify and rank the research priorities of a national sample of practising chiropractors, chiropractic academics, educators, researchers, and postgraduate HDR students, and; b) examine the current research capacity and output of the Australian chiropractic profession. Methods: A survey instrument design was developed via an iterative process that initially built upon an extensive search of the chiropractic research priority literature from which items were aggregated and distilled. Senior and experienced members of the profession were then consulted to identify other items that should be considered for inclusion. Results: The finalised cross-sectional questionnaire is a self-administered, multi-dimensional instrument comprising 5 main research categories. In addition, the questionnaire also includes items such as research funding, support for existing research agendas, and suggestions for future research. The questionnaire also explores research output, research barriers, research time allocation, perspectives on engagement, interdisciplinary collaboration and secured research funding. Analysis: Quantitative data will be descriptively analysed whilst qualitative data will be analysed and reported along standard qualitative study protocols. Conclusion: The Australian chiropractic profession needs to maximise ambitious, collaborative, creative research performed at best practice standards and then accelerate the implementation of useful findings that emerge. By ensuring the voices of all sectors of the profession are heard in the formulation of an Australian Chiropractic Research Agenda, the findings from our study will provide important insights into future research directions for the Australian chiropractic profession

Research Priorities of the Australian Chiropractic Profession: A Cross-Sectional Survey of Academics and Practitioners.

OBJECTIVE: The purpose of this study was to explore the research priorities of Australian practicing chiropractors and academics across a set of research domains to determine the agreement or disagreement based on these domains. METHODS: We conducted a pilot-tested online survey focusing on the following 5 principal research domains: basic science, conditions (disorders chiropractors may encounter), patient subgroups, clinical interventions, and practice and public health/health services. Responses were sought regarding support for funding research scholarships, practice-based research networks, scientific conferences/symposia, journals, and existing research agendas. Data were collected (February 19 to May 24, 2019) from a sample of chiropractic academics (n1 = 33) representing 4 Australian programs and practicing chiropractors (n2 = 340). Collected data were ranked and analyzed to determine agreement across domains and items. RESULTS: There was agreement between the 2 groups across the majority (>90%) of domain items. The closest agreement and highest rankings were achieved for the "clinical interventions and practice" and "conditions" domains. Disagreement was observed within specific domain items, such as patient subgroups (infants), and for 1 intervention (chiropractic-specific techniques). Disagreement also occurred outside of the main domains, including research agenda support and funding. CONCLUSIONS: There was overall agreement between practicing chiropractors and academics across most research area domain items, which should help facilitate consensus-led development of any potential Australian Chiropractic research agenda. Disagreements across specific domain items, such as population subgroups, interventions, and funding require further investigation

Spinal pain: current understanding, trends, and the future of care

Gregory F Parkin-Smith,1 Lyndon G Amorin-Woods,2–4 Stephanie J Davies,5–7 Barrett E Losco,8 Jon Adams9,10 1General Practice, Surgery 82, Busselton, WA, Australia; 2School of Health Professions, Murdoch University, Murdoch, WA, Australia; 3Chiropractors’ Association of Australia, Nedlands, WA, Australia; 4ACORN Project, 5WA Specialist Pain Services, WA, Australia; 6School of Physiotherapy, Curtin University, Bentley, WA, Australia; 7School of Medicine and Pharmacology, University of Western Australia, Crawley, WA, Australia; 8Murdoch University, Murdoch, WA, Australia; 9Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia; 10Australian Research Centre in Complementary and Integrative Medicine, University of Technology Sydney, Ultimo, NSW, Australia Abstract: This commissioned review paper offers a summary of our current understanding of nonmalignant spinal pain, particularly persistent pain. Spinal pain can be a complex problem, requiring management that addresses both the physical and psychosocial components of the pain experience. We propose a model of care that includes the necessary components of care services that would address the multidimensional nature of spinal pain. Emerging care services that tailor care to the individual person with pain seems to achieve better outcomes and greater consumer satisfaction with care, while most likely containing costs. However, we recommend that any model of care and care framework should be developed on the basis of a multidisciplinary approach to care, with the scaffold being the principles of evidence-based practice. Importantly, we propose that any care services recommended in new models or frameworks be matched with available resources and services – this matching we promote as the fourth principle of evidence-based practice. Ongoing research will be necessary to offer insight into clinical outcomes of complex interventions, while practice-based research would uncover consumer needs and workforce capacity. This kind of research data is essential to inform health care policy and practice. Keywords: back pain, pain management, combined modality therapy, patient care tea