A united statement of the global chiropractic research community against the pseudoscientific claim that chiropractic care boosts immunity.

BACKGROUND: In the midst of the coronavirus pandemic, the International Chiropractors Association (ICA) posted reports claiming that chiropractic care can impact the immune system. These claims clash with recommendations from the World Health Organization and World Federation of Chiropractic. We discuss the scientific validity of the claims made in these ICA reports. MAIN BODY: We reviewed the two reports posted by the ICA on their website on March 20 and March 28, 2020. We explored the method used to develop the claim that chiropractic adjustments impact the immune system and discuss the scientific merit of that claim. We provide a response to the ICA reports and explain why this claim lacks scientific credibility and is dangerous to the public. More than 150 researchers from 11 countries reviewed and endorsed our response. CONCLUSION: In their reports, the ICA provided no valid clinical scientific evidence that chiropractic care can impact the immune system. We call on regulatory authorities and professional leaders to take robust political and regulatory action against those claiming that chiropractic adjustments have a clinical impact on the immune system

Work Ability and Return to Work Following a Traffic Injury

Background: Traffic injuries are a common source of work absenteeism. However, little is known about the factors associated with return to work following traffic injuries. One factor that may be a strong predictor of return to work is work ability. Objectives: 1) To determine whether modified work is a mediator of the association between work ability and return to work in a cohort of individuals injured in a traffic collision (Manuscript 3). 2) To identify factors associated with work ability by conducting a scoping review of the literature (Manuscript 1). 3) To develop a measurement model of work ability (Manuscript 2). Methods: The scoping review surveyed the literature for common measures of work ability and used the International Classification of Functioning, Disability and Heath framework to map factors associated with work ability. This informed the development of a reflective measurement model of work ability using confirmatory factor analysis. The measurement model was then used to examine the direct and indirect effect (through modified work) of work ability on return to work using a structural equation model. All analyses were conducted in a population-based incidence cohort of traffic injuries from Saskatchewan, Canada. Eligible participants for this thesis included those with acute soft tissue injuries. Work ability was measured at baseline and direct and indirect effects were studied longitudinally by examining modified work at six weeks and return to work at three months. Results: The second-order factor measurement model included four first-order factors (physical, psychological, cognitive functions, activities and participation) and 17 measured variables. The structural equation modeling suggests that work ability and modified work were positively and independently associated with return to work. However, work ability was not associated with modified work. Conclusion: This thesis supports the multidimensionality of work ability and recognizes its direct association with returning to work. This research also highlights the importance of modified work to the return to work process following a traffic injury.Ph.D.2019-07-11 00:00:0

Challenges with providing gender-sensitive care: exploring experiences within pediatric rehabilitation hospital

This is an Accepted Manuscript of an article published by Taylor & Francis in Disability and Rehabilitation June 24th 2020, available online: https://www.tandfonline.com/10.1080/09638288.2020.1781939Purpose The purpose of this study was to explore the perceived challenges with providing a gender-sensitive care approach among pediatric rehabilitation care providers. Methods Using a qualitative needs assessment design and a purposive sampling strategy, we recruited clinicians from a Canadian pediatric rehabilitation hospital. We conducted interviews with 23 pediatric rehabilitation healthcare providers (19 women, 3 men, 1 transgender man) from a range of disciplines. Three coders performed a thematic analysis of the transcripts. Results Our analysis revealed the following themes regarding the perceived challenges in providing a gender-sensitive care approach: (1) a lack of training and experience; (2) gender differences and stereotypes; (3) binary documentation and potential for misgendering; (4) the complexity of gender identity; and (5) the gender of the clinician. Conclusions Pediatric rehabilitation care providers face many challenges in offering a gender-sensitive care approach and need further training and systemic support.Funding for this study was provided by the Canadian Institutes of Health Research-Social Sciences and Humanities Research Council (CIHR-SSHRC) Partnership Grant (01561-000 and 895-2018-4002) and the Kimel Family Fund through the Holland Bloorview Kids Rehabilitation Hospital

A disability disclosure simulation as an educational tool

'This author accepted manuscript is deposited under a Creative Commons Attribution Non-commercial 4.0 International (CC BYNC) licence. This means that anyone may distribute, adapt, and build upon the work for non-commercial purposes, subject to full attribution. If you wish to use this manuscript for commercial purposes, please contact [email protected] Many employers struggle with how to have a disability disclosure discussion with their employees and job candidates. The primary purpose of this study was to identify issues relevant to disability disclosure discussions. In addition, we explored how simulations, as an educational tool, may help employers and managers. Design/methodology/approach Seven participants (four employers and three human resource professionals) took part in this study. We used a qualitative design that involved two focus group discussions to understand participants' experiences of building a simulation training scenario that focused on how to have a disability disclosure discussion. The simulation sessions were audio-recorded and analyzed using an open-coding thematic approach. Findings Four main themes emerged from our analysis. Three themes focused on issues that participants identified as relevant to the disability disclosure process, including: (1) creating a comfortable and safe space for employees to disclose, (2) how to ask employees or job candidates about disability and (3) how to respond to employees disability disclosure. A fourth theme focused on how simulations could be relevant as an educational tool. Originality/value Developing a simulation on disability disclosure discussions is a novel approach to educating employers and managers that has the potential to help enhance diversity and inclusion in the workplace. Further, the process that we followed can be used as a model for other researchers seeking to develop educational training scenarios on sensitive diversity and inclusion topics.Funding for this study was provided by the Canadian Institutes of Health Research-Social Sciences and Humanities Research Council (CIHR-SSHRC) Partnership Grant (01561-000 and 895-2018-4002) and the Kimel Family Fund through the Holland Bloorview Kids Rehabilitation Hospital. The authors would like to thank the participants and the staff who contributed to this study

Disclosure and workplace accommodations for people with autism: a systematic review

This is an Accepted Manuscript of an article published by Taylor & Francis in Disability and Rehabilitation July 7th 2019, available online: http://www.tandfonline.com/10.1080/09638288.2019.1635658Purpose: The objective of this systematic review was to describe the prevalence and processes of disability disclosure for persons with autism spectrum disorder. Methods: Systematic searches of seven international databases revealed 26 studies meeting our inclusion criteria. We analyzed these studies with respect to participant demographics, methodology, results and quality of the evidence. Results: Among the 26 studies, 7006 participants (aged 13-75, mean 28.1 years) were represented across seven countries. Our findings showed that rates of disclosure and receiving workplace accommodations varied considerably. Benefits of disclosing in the workplace included greater acceptance and inclusion, receiving accommodations, and increasing awareness about autism. Limitations of disclosing to employers involved experiencing stigma and discrimination. Factors affecting decisions to disclose included age at diagnosis, social demands of the job, and workplace policies. Types of accommodations that were received or desired included adjustments to the job interview process, schedules (i.e., flexibility, working from home), job content or working conditions, environment (i.e., lighting, quiet space); support with communication and social skills; and disability awareness training for their workplace colleagues. Conclusions: Our findings highlight that disclosing a condition of autism in the workplace and requesting accommodations is complex. More research is needed to explore processes of disclosing and accommodation and how these processes vary by autism sub-type, gender, and industry type. Implications for rehabilitation Clinicians and vocational Counselors should support people with autism to advocate for their needs in the workplace, including the potential benefits of disclosing their conditions so they can access accommodations that allow them to keep healthy and productive in workplace.Clinicians should recognize that people with autism spectrum disorder may have different workplace accommodation needs than those with other types of disabilities, in particular support with social and communication skills.Clinicians should aid people with autism to access resources and supports that are available to them to access workplace accommodations.This research was funded by a CIHR-SSHRC partnership grant and the Kimmel Family Fund

Outcomes of gender-sensitivity educational interventions for healthcare providers: A systematic review

Background: Although gender plays an important role in health, most healthcare providers lack knowledge in providing gender-sensitive care. Offering gender-sensitivity training for healthcare providers can help to address gender-based health inequalities. Method: A mixed-methods systematic review of gender-sensitivity training programmes or interventions for healthcare providers was undertaken to assess their outcomes and to document areas for future research. Comprehensive searches of seven international databases were conducted for peer-reviewed literature published between 1998 and 2018. Eligible studies included at least one outcome related to gender-sensitivity training for healthcare providers. Results: Twenty-nine studies met the inclusion criteria. Fourteen studies focused on gender-sensitivity in reducing gender bias towards men and women, and 15 studies focused on addressing the needs of lesbian, gay, bisexual and transgender (LGBT) patients. Thirty-seven percent of studies showed a significant improvement in gender-related knowledge, attitudes or practice after the training. Multiple training methods were used to teach gender-sensitive care. Common content of the training included learning sex/gender terminology, understanding gender issues and inequalities in health, stigma and discrimination and communication skills. The duration and frequency of interventions ranged considerably. Sex differences in training outcomes also occurred among the learners. Conclusion: Review findings highlight that although gender-sensitivity training for healthcare providers is increasing, there is insufficient evidence to determine its effectiveness. Additional, more rigorously designed studies are needed to assess the long-term implications on learner behaviours and practices, especially across a wide variety of healthcare providers.The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was funded through a Canadian Institutes of Health Research and Social Sciences and Humanities Research Council (CIHR-SSHRC) partnership grant and also the Kimmel Family Fund

The chiropractic workforce: a global review

Abstract Background The world is faced with a chronic shortage of health workers, and the World Health Organization (WHO) has estimated a global shortage of 7.2 million health workers resulting in large gaps in service provision for people with disability. The magnitude of the unmet needs, especially within musculoskeletal conditions, is not well established as global data on health work resources are scarce. Methods We conducted an international, cross-sectional survey of all 193 United Nation member countries and seven dependencies to describe the global chiropractic workforce in terms of the availability (numbers and where they are practising), quality (education and licensing), accessibility (entry and reimbursement), and acceptability (scope of practice and legal rights). An electronic survey was issued to contact persons of constituent member associations of the World Federation of Chiropractic (WFC). In addition, data were collected from government websites, personal communication and internet searches. Data were analysed using descriptive statistics. Worldwide density maps of the distribution of numbers of chiropractors and providers of chiropractic education were graphically presented. Results Information was available from 90 countries in which at least one chiropractor was present. The total number of chiropractors worldwide was 103,469. The number of chiropractors per country ranged from 1 to 77,000 (median = 10; IQR = [4–113]). Chiropractic education was offered in 48 institutions in 19 countries. Direct access to chiropractic services was available in 81 (90%) countries, and services were partially or fully covered by government and/or private health schemes in 46 (51.1%) countries. The practice of chiropractic was legally recognized in 68 (75.6%) of the 90 countries. It was explicitly illegal in 12 (13.3%) countries. Conclusion We have provided information about the global chiropractic workforce. The profession is represented in 90 countries, but the distribution of chiropractors and chiropractic educational institutions, and governing legislations and regulations largely favour high-income countries. There is a large under-representation in low- and middle-income countries in terms of provision of services, education and legislative and regulatory frameworks, and the available data from these countries are limited

Response to Lawrence DJ: the global summit on the efficacy and effectiveness of spinal manipulative therapy for the prevention and treatment of non-musculoskeletal disorders: a systematic review of the literature

In summary, the statements made by Lawrence about our methodology are incorrect and ill informed. While we thank Lawrence for his interest in our work, his statements about our methodology are in our opinion misconstrued and hence not appropriate.Medicine, Faculty ofNon UBCPopulation and Public Health (SPPH), School ofReviewedFacultyResearche

Correction to: The global summit on the efficacy and effectiveness of spinal manipulative therapy for the prevention and treatment of non-musculoskeletal disorders: a systematic review of the literature

An amendment to this paper has been published and can be accessed via the original article.Medicine, Faculty ofNon UBCPopulation and Public Health (SPPH), School ofReviewedFacult