Upscaling net ecosystem CO2 exchanges in croplands: The application of integrating object-based image analysis and machine learning approaches.

Accurately estimating the net ecosystem exchange of CO2 (NEE) in cropland ecosystems is essential for understanding the impacts of agricultural practices and climate conditions. However, significant uncertainties persist in the estimation of regional cropland NEE due to landscape heterogeneity and variations in the efficacy of upscaling models. Here, we applied an integrated approach that combined object-based image analysis (OBIA) techniques with advanced machine learning (ML) approaches to upscale regional cropland NEE. We conducted a thorough evaluation of the upscaling approach across four distinct cropland areas characterized by diverse climate conditions. Our study confirmed that OBIA techniques can efficiently segment cropland objects, thereby enhancing the representation and accuracy of characteristics relevant to cropland features. The sequential least squares programming algorithm, among the three methods used for ML model integration, demonstrated exceptional performance in predicting NEE, with an R2 value exceeding 0.80 across all study areas and peaking at 0.90 in the most successful area. On average, there was an 18 % improvement compared to the poorest-performing ML model and a 6 % enhancement compared to the best-performing ML model. The upscaled regional products exhibited superior performance in characterizing cropland NEE patterns compared to pixel-based products. Additionally, we utilized the SHapley Additive exPlanations (SHAP) to assess driver importance, revealing that phenology and radiation had the greatest influence on prediction accuracy, followed by temperature and soil moisture. This study highlights the potential of integrating OBIA techniques with machine learning approaches for upscaling regional cropland NEE, while concurrently reducing estimation uncertainties.

Predictors of salvage therapy for parasagittal meningiomas treated with primary surgery, radiosurgery, or surgery plus adjuvant radiotherapy.

OBJECTIVE: Parasagittal meningiomas (PM) are treated with primary microsurgery, radiosurgery (SRS), or surgery with adjuvant radiation. We investigated predictors of tumor progression requiring salvage surgery or radiation treatment. We sought to determine whether primary treatment modality, or radiologic, histologic, and clinical variables were associated with tumor progression requiring salvage treatment. METHODS: Retrospective study of 109 consecutive patients with PMs treated with primary surgery, radiation (RT), or surgery plus adjuvant RT (2000-2017) and minimum 5 years follow-up. Patient, radiologic, histologic, and treatment data were analyzed using standard statistical methods. RESULTS: Median follow up was 8.5 years. Primary treatment for PM was surgery in 76 patients, radiation in 16 patients, and surgery plus adjuvant radiation in 17 patients. Forty percent of parasagittal meningiomas in our cohort required some form of salvage treatment. On univariate analysis, brain invasion (OR: 6.93, p < 0.01), WHO grade 2/3 (OR: 4.54, p < 0.01), peritumoral edema (OR: 2.81, p = 0.01), sagittal sinus invasion (OR: 6.36, p < 0.01), sagittal sinus occlusion (OR: 4.86, p < 0.01), and non-spherical shape (OR: 3.89, p < 0.01) were significantly associated with receiving salvage treatment. On multivariate analysis, superior sagittal sinus invasion (OR: 8.22, p = 0.01) and WHO grade 2&3 (OR: 7.58, p < 0.01) were independently associated with receiving salvage treatment. There was no difference in time to salvage therapy (p = 0.11) or time to progression (p = 0.43) between patients receiving primary surgery alone, RT alone, or surgery plus adjuvant RT. Patients who had initial surgery were more likely to have peritumoral edema on preoperative imaging (p = 0.01). Median tumor volume was 19.0 cm3 in patients receiving primary surgery, 5.3 cm3 for RT, and 24.4 cm3 for surgery plus adjuvant RT (p < 0.01). CONCLUSION: Superior sagittal sinus invasion and WHO grade 2/3 are independently associated with PM progression requiring salvage therapy regardless of extent of resection or primary treatment modality. Parasagittal meningiomas have a high rate of recurrence with 80.0% of patients with WHO grade 2/3 tumors with sinus invasion requiring salvage treatment whereas only 13.6% of the WHO grade 1 tumors without sinus invasion required salvage treatment. This information is useful when counseling patients about disease management and setting expectations.

Cranial Nerve Palsies in the Setting of Arachnoid Cysts: A Case Series and Literature Review.

BACKGROUND: Arachnoid cysts (ACs) are benign lesions typically believed to not cause neurologic defects in the adult population and are most often found incidentally on imaging. We describe 2 patients with ACs potentially leading to isolated cranial nerve (CN) dysfunction. METHODS: We describe 2 patients, 1 with a fourth nerve palsy and the other with a sixth nerve palsy found to have ACs on MRI brain imaging in locations that potentially caused a compressive CN palsy. We review previous literature of ACs presenting with CN III, IV, or VI palsy. RESULTS: Patient 1 was a 62-year-old man who presented with a 22-year history of diplopia with strabismus examination consistent with a congenital CN IV palsy. Despite multiple surgeries, his CN IV palsy insidiously worsened. An AC in the posterior fossa with mass effect on the quadrigeminal plate and asymmetric atrophy of the right superior oblique was identified on imaging. Patient 2 was an 80-year-old man who presented with an 18-year history of diplopia and was found to have a left esotropia and abduction deficit consistent with complete CN VI palsy. An AC in the left cavernous sinus was identified on imaging. He underwent strabismus surgery with satisfactory resolution of diplopia. We identified a total of 18 previously published cases: 8 reports of CN III palsy, 4 reports of CN IV palsy, and 6 reports of CN VI palsy. Patient ages ranged from 1 to 67 with a median of 34.5. In 16/18 (89%) cases, the diagnosis of ACs was made within 1 year of symptom onset. Surgical removal of the AC was successful in resolving diplopia in 7/12 (58%) cases. In no case was strabismus surgery performed as primary treatment. CONCLUSIONS: Although ACs are typically congenital asymptomatic lesions, we present a case series of 2 patients with ACs in anatomic locations that potentially caused chronic, progressive, isolated CN palsies leading to strabismus. Our literature review revealed that most published cases detailing this clinical scenario resulted in neurosurgical fenestration of ACs with mixed results. Our cases represent 2 patients with AC-associated CN palsy treated with strabismus surgery.

State-Specific Medicaid/CHIP Eligibility Criteria and Their Impact on Health Care Access for Foreign-born Children Living in the United States.

INTRODUCTION: Foreign-born children are subject to discrepant state policies in determining eligibility for Medicaid/Children's Health Insurance Program (CHIP) coverage. The objective of this study was to determine the effect of these policies on health care access. METHODS: Data from the National Survey of Children's Health (NSCH) were used to assess associations between health care access outcomes and three categories of state health insurance eligibility: restrictive (only U.S. citizens plus immigrants who "qualified" after five-year waiting period), semi-restrictive (same as restrictive except no waiting period), and inclusive (all children). RESULTS: When compared with restrictive states, foreign-born children in inclusive states were significantly more likely to have current insurance, consistent coverage, recent preventive exams, and fewer problems paying medical bills. DISCUSSION: Extending health care eligibility to all children, regardless of immigration status, improves health care coverage and access for foreign-born children. Expansion of eligibility criteria in all states is necessary to reduce health disparities in the immigrant population.

Spanish-Speaking Caregivers' Perception of Emergency Physicians' Interpersonal and Communication Skills in a Pediatric Emergency Department.

OBJECTIVES: Medical communication is more than just the delivery of information; language differences between physicians and patients/caregivers create a challenge to providing effective care in the pediatric emergency department (ED). Overcoming this barrier is vital to providing high-quality care. We evaluated Spanish- versus English-speaking caregivers' perception of their pediatric ED physicians' interpersonal and communication skills. We also compared perceptions of Spanish- versus English-speaking caregivers who self-identified as Hispanic. METHODS: This study is a retrospective analysis of data from surveys administered in an urban, free-standing children's hospital ED. Surveys were administered in English and Spanish to pediatric patient caregivers. In person, video, and telephonic interpretations were available during patient encounters. RESULTS: There were 2542 (82.4%) surveys completed in English and 543 (17.6%) in Spanish. There were significant differences in demographic data of English versus Spanish survey respondents, including level of education, insurance status, and rates of nonpublic insurance. Spanish survey respondents rated their physicians' interpersonal skills lower than English survey respondents. There were 1455 (47%) surveys completed by the respondents who self-identified as Hispanic. Within this group, 928 (63.8%) respondents completed the survey in English and 527 (36.2%) in Spanish. Among this Hispanic population, the Spanish survey respondents rated their physicians' interpersonal and communication skills lower than English survey respondents. After adjusting for education level and insurance type, these differences persisted. CONCLUSIONS: Language barriers have a meaningful impact on physician ability to communicate effectively in the pediatric ED. Improving physicians' ability to overcome this barrier is essential toward enriching patient outcomes and experience in the ED.

Monkeypox-Associated Central Nervous System Disease: A Case Series and Review.

OBJECTIVE: Monkeypox virus (MPXV) disease has been declared a public health emergency by the World Health Organization, creating an urgent need for neurologists to be able to recognize, diagnosis, and treat MPXV-associated neurologic disease. METHODS: Three cases of MPXV-associated central nervous system (CNS) disease occurring during the 2022 outbreak, and their associated imaging findings are presented, with 2 cases previously published in a limited capacity in a public health bulletin. RESULTS: Three previously healthy immunocompetent gay men in their 30s developed a febrile illness followed by progressive neurologic symptoms with presence of a vesiculopustular rash. MPXV nucleic acid was detected by polymerase chain reaction (PCR) from skin lesions of 2 patients, with the third patient having indeterminate testing but an epidemiologic link to a confirmed MPXV disease case. Cerebrospinal fluid demonstrated a lymphocytic pleocytosis, elevated protein, and negative MPXV-specific PCR. In 2 patients, magnetic resonance imaging of the brain and spine demonstrated partially enhancing, longitudinally extensive central spinal cord lesions with multifocal subcortical, basal ganglia, thalamic, cerebellar, and/or brainstem lesions. The third patient had thalamic and basal ganglia lesions. All patients received 14 days of tecovirimat, and 2 patients also received multiple forms of immunotherapy, including intravenous immunoglobulin, pulsed high-dose steroids, plasmapheresis, and/or rituximab. Good neurologic recovery was observed in all cases. INTERPRETATION: MPXV can be associated with CNS disease. It is unclear whether this is from a parainfectious immune-mediated injury or direct CNS viral invasion. ANN NEUROL 2023;93:893-905.

Housing inadequacy in rural Saskatchewan First Nation communities.

Housing and house conditions on First Nation communities in Canada are important determinants of health for community members. Little is known about rural First Nation housing in the Canadian Prairies. The aim was to survey houses in two rural First Nation communities in Saskatchewan, Canada to understand housing conditions, prevalence of mold/mildew and dampness, and sources, locations and frequency of mold and dampness. Surveys were conducted with an adult member of each household in 144 houses. Surveys assessed: size, age, and number of rooms in the house; number of individuals residing in the house; presence of mold/mildew and dampness, and sources, locations and frequency of mold and dampness. Houses were mostly two-bedrooms (25.7%) or more (67.4%). Thirty-one percent of houses had six or more people living in the house with crowding present in 68.8% of houses. Almost half of the houses (44.5%) were in need of major repairs. More than half of the houses had water or dampness in the past 12 months in which dripping/puddles and standing water were most commonly identified and were from surface water and plumbing. More than half of the houses indicated that this dampness caused damage. A smell of mold or mildew was present in over half of the houses (52.1%) and 73.3% of these houses indicated that this smell was always present. Housing adequacy including crowding, dampness, and mold are significant issues for houses in these two rural Saskatchewan First Nation communities. Housing inadequacy is more common in these rural communities as compared to Canadian statistics. Housing inadequacy is modifiable and is important to address for multiple reasons, but notably, as a social determinant of health. Federal government strategy to address and redress housing in First Nation communities in Canada is a fiduciary responsibility and critical to reconciliation.

Case Report: Anterior Spinal Cord Ischemia Following Embolization of Cerebellar Arteriovenous Malformation: An Illustrative Case and Review of Spinal Cord Vascular Anatomy.

Spinal cord ischemia (SCI) is a rare entity with high mortality and morbidity which can arise from causes such as atherosclerosis, aortic dissection or aneurysm, thromboembolic events or systemic hypotension, and is a potential complication of spinal surgery. Published literature contains very few reports of SCI as a complication of intracranial interventions, highlighting the uncommon nature of SCI in these circumstances. We report the occurrence of anterior SCI in a 69-year-old patient following successful embolization of a cerebellar arteriovenous malformation (AVM), marked by upper extremity weakness, lower extremity paraplegia, loss of bladder and bowel control, and hypercapnic respiratory failure requiring mechanical ventilation. Magnetic resonance imaging (MRI) demonstrated upper cervical diffusion restriction and T2/STIR hyperintensity. Unusually, SCI occurred in this case without intraprocedural catheter wedging or obvious flow limitation, prolonged procedure time, hypercoagulable state, or general hypotension. We review previous cases in the literature as well as spinal cord vascular anatomy, and discuss the possible etiologies of this complication. Spinal cord ischemia could be a very rare complication of neuroendovascular procedures even in the absence of warning signs and should be carefully evaluated in patients with suspected neurologic symptoms after such procedures.

Associations between Housing Factors and Respiratory Symptoms in Two Saskatchewan First Nations Communities.

Inadequate housing is commonplace in First Nations in Canada, often leading to environmental impacts on housing such as dampness and mold. First Nations communities suffer from a higher prevalence of respiratory-related health conditions than the general Canadian population. There is limited Canadian literature evaluating the relationship between housing factors and the respiratory health of adults within First Nations communities. This study was undertaken with two Saskatchewan First Nations communities. The study population consisted of 293 individuals within 131 households. The individuals completed questionnaires on their general and respiratory health, and one member of each household completed a household questionnaire. The collection of environmental samples from within the house was undertaken. The respiratory outcomes of interest focused on the individuals with ever wheeze, reported by 77.8% of the individuals, and shortness of breath, reported by 52.6% of the individuals. Body mass index, the nontraditional use of tobacco (i.e., current and ex-smoking), the nontraditional use of tobacco in the house (i.e., smoking in the house), dampness in the house in the last 12 months, and always having a smell of mold in the house were significantly associated with respiratory symptoms. The results reveal that respiratory symptom rates were high in the population and housing factors were significantly associated with respiratory symptoms. Addressing and redressing housing inadequacies in First Nations communities are important in preventing additional burdens to health.

A Traumatic Quinceañera: Acute Superior Mesenteric Artery Syndrome in an Adolescent Girl.

ABSTRACT: A 15-year-old girl presented with 3 days of progressive abdominal distention, pain, and bilious hematemesis. Her symptoms began after her quinceañera, during which she wore a tight corset. On examination, she was thin and had significant abdominal distention and pain. A computed tomography revealed a massively dilated stomach and proximal duodenum to the region of the superior mesenteric artery (SMA) with distal decompression. An upper gastrointestinal fluoroscopy demonstrated marked dilation of the stomach through the mid third portion of the duodenum with distal decompression and an associated linear compression on her duodenal wall. We believe that she developed acute SMA syndrome. Superior mesenteric artery syndrome is a partial bowel obstruction caused when the third portion of the duodenum is compressed as it passes between the SMA and the aorta. Although the SMA syndrome is most commonly described as a condition associated with chronic, severe weight loss resulting in a narrowing of the SMA to aorta angle and subsequent duodenal compression, it can present acutely from causes such as a postoperative complication, blunt trauma, or external compression. Previously described acute SMA syndrome from external compression has been the result of medically necessary causes, such as body casting. In this case, the tight gown was likely the inciting factor for her development of SMA syndrome; however, she was placed at high risk for the condition by being underweight at baseline and experiencing food restriction for several days preceding her quinceañera. She was treated conservatively with nasogastric decompression and parenteral nutrition, and has since completely recovered.

Are general practitioners referring patients with low back pain for CTs appropriately according to the guidelines: a retrospective review of 3609 medical records in Newfoundland using routinely collected data.

BACKGROUND: CT Imaging is often requested for patients with low back pain (LBP) by their general practitioners. It is currently unknown what reasons are common for these referrals and if CT images are ordered according to guidelines in one province in Canada, which has high rates of CT imaging. The objective of this study is to categorise lumbar spine CT referrals into serious spinal pathology, radicular syndrome, and non-specific LBP and evaluate the appropriateness of CT imaging referrals from general practitioners for patients with LBP. METHODS: A retrospective medical record review of electronic health records was performed in one health region in Newfoundland and Labrador, Canada. Inclusion criteria were lumbar spine CT referrals ordered by general practitioners for adults ≥18 years, and performed between January 1st-December 31st, 2016. Each CT referral was identified from linked databases (Meditech and PACS). To the study authors' knowledge, guidelines regarding when to refer patients with low back pain for CT imaging had not been actively disseminated to general practitioners or implemented at clinics/hospitals during this time period. Data were manually extracted and categorised into three groups: red flag conditions (judged to be an appropriate referral), radicular syndrome (judged be unclear appropriateness), or nonspecific LBP (determined to be inappropriate). RESULTS: Three thousand six hundred nine lumbar spine CTs were included from 2016. The mean age of participants was 54.7 (SD 14 years), with females comprising 54.6% of referrals. 1.9% of lumbar CT referrals were missing/unclear, 6.5% of CTs were ordered on a red-flag suspicion, 75.6% for radicular syndromes, and 16.0% for non-specific LBP; only 6.5% of referrals were clearly appropriate. Key information including patient history and clinical exams performed at appointment were often missing from referrals. CONCLUSION: This audit found high proportions of inappropriate or questionable referrals for lumbar spine CT and many were missing information needed to categorise. Further research to understand the drivers of inappropriate imaging and cost to the healthcare system would be beneficial.

Children in Immigrant Families: Advocacy Within and Beyond the Pediatric Emergency Department.

In the United States, 1 in 4 children lives in an immigrant family. State and national policies have historically precluded equitable access to health care among children in immigrant families. More recently, increasingly restrictive policies, political rhetoric, and xenophobic stances have made immigrant families less able to access health care and less comfortable in attempting to do so, thus increasing the likelihood that patients will present to the emergency department. Once in the emergency department, language, cultural, and health literacy barriers make providing high-quality care potentially challenging for some families. Emergency care professionals can therefore glean critical insight regarding inequities from clinical work to inform advocacy and policy changes at institutional, community, regional, and national levels.

Low socioeconomic status and eating in the absence of hunger in children aged 3-14.

A growing body of research indicates that one's early life experiences may play an important role in regulating patterns of energy intake in adulthood. In particular, adults who grew up under conditions characterized by low socioeconomic status (SES) tend to eat in the absence of hunger (EAH), a pattern that is not generally observed among higher-SES individuals. In the current study, we sought to examine (a) the environmental correlates of low SES that drive the association between low childhood SES and EAH and (b) whether the relationship between these variables is already manifest in children ages 3-14. Results of our study revealed that growing up in low-SES environments predicted less food security, diminished ability to meet financial needs, and less environmental predictability/safety. Further, the results indicated that reduced environmental predictability/safety in the children's environment interacted with children's current energy need to predict eating behavior. Consistent with patterns observed in adults, children from more predictable/safe environments ate food commensurate with their energy need, whereas those from less predictable/safe environments ate comparably high amounts of food across levels of energy need. These results offer needed insights into the development of environmentally-contingent energy-regulation strategies.

An international stakeholder survey of the role of chiropractic qualifying examinations: A qualitative analysis.

OBJECTIVE: Many countries require examinations as a gateway to chiropractic licensure; however, the relevance of these exams to the profession has not been explored. The purposes of this study were to analyze perceptions of international stakeholders about chiropractic qualifying examinations (CQEs), observe if their beliefs were in alignment with those that society expects of professions, and suggest how this information may be used when making future decisions about CQEs. METHODS: We designed an electronic survey that included open-ended questions related to CQEs. In August 2019, the survey was distributed to 234 international stakeholders representing academic institutions, qualifying boards, students, practitioners, association officers, and others. Written comments were extracted, and concepts were categorized and collapsed into 4 categories (benefits, myths, concerns, solutions). Qualitative analysis was used to identify themes. RESULTS: The response rate was 56.4% representing 43 countries and yielding 775 comments. Perceived benefits included that CQEs certify a minimum standard of knowledge and competency and are part of the professionalization of chiropractic. Myths included that CQEs are able to screen for future quality of care or ethical practices. Concerns included a lack of standardization between jurisdictions and uncertainty about the cost/value of CQEs and what they measure. Solutions included suggestions to standardize exams across jurisdictions and focus on competencies. CONCLUSION: International stakeholders identified concepts about CQEs that may facilitate or hinder collaboration and efforts toward portability. Stakeholder beliefs were aligned with those expected of learned professions. This qualitative analysis identified 9 major themes that may be used when making future decisions about CQEs.

Childhood malnutrition within the indigenous Wayuú children of northern Colombia.

Malnutrition contributes to nearly half of all preventable deaths in children under the age of five. While the burden of disease is heaviest in Sub-Saharan Africa, South, and Southeast Asia, malnutrition in Latin America remains high, especially within indigenous communities. This study evaluates the prevalence of malnutrition and its relationship with access to healthcare resources within 172 indigenous Wayuú communities in La Guajira, Colombia. Healthcare workers administered a health questionnaire and collected anthropometric measurements on all children 6 months to 5 years of age within the Wayuú households. These data were utilised to calculate the prevalence of acute malnutrition, stunting, and underweight. Of all surveyed Wayuú children, 22.9% and 18.3% met criteria for moderate and severe malnutrition, 33.4% and 28.1% met criteria for moderate and severe stunting, and 28.1% and 16.6% were moderately and severely underweight. Across all categories, malnourished children were older, less likely to have had a medical professional present at birth, less likely to have received medical care after birth, and more likely to have been born in a non-medical, community setting. The prevalence of malnutrition is much higher than national levels in Colombia. This population requires urgent assistance to address their disproportionately high rates of malnutrition.

N2O Emissions From Two Agroecosystems: High Spatial Variability and Long Pulses Observed Using Static Chambers and the Flux-Gradient Technique.

With the addition of nitrogen (N), agricultural soils are the main anthropogenic source of N2O, but high spatial and temporal variabilities make N2O emissions difficult to characterize at the field scale. This study used flux-gradient measurements to continuously monitor N2O emissions at two agricultural fields under different management regimes in the inland Pacific Northwest of Washington State, USA. Automated 16-chamber arrays were also deployed at each site; chamber monitoring results aided the interpretation of the flux gradient results. The cumulative emissions over the six-month (1 April-30 September) monitoring period were 2.4 ± 0.7 and 2.1 ± 2 kg N2O-N/ha at the no-till and conventional till sites, respectively. At both sites, maximum N2O emissions occurred following the first rainfall event after N fertilization, and both sites had monthlong emission pulses. The no-till site had a larger N2O emission factor than the Intergovernmental Panel on Climate Change Tier 1 emission factor of 1% of the N input, while the conventional-till site's emission factor was close to 1% of the N input. However, these emission factors are likely conservative. We estimate that the global warming potential of the N2O emissions at these sites is larger than that of the no-till conversion carbon uptake. We recommend the use of chambers to investigate spatiotemporal controls as a complementary method to micrometeorological monitoring, especially in systems with high variability. Continued monitoring coupled with the use of models is necessary to investigate how changing management and environmental conditions will affect N2O emissions.

Comparison of chiropractic student lexicon at two educational institutions: a cross-sectional survey.

OBJECTIVE: To evaluate student perceptions of chiropractic cultural authority, role in healthcare and use of terms at two chiropractic institutions, the Canadian Memorial Chiropractic College (CMCC) and Parker University (Parker). METHODS: A unique survey was developed and administered electronically to Year 2-3 students (n=387) at CMCC and as a paper-based surveys to trimester 4-5 (comparison with Year 2) and 6-7 (comparison with Year 3) (n=277) students at Parker. Responses were anonymous. The survey assessed the likelihood that students at both chiropractic programs would use eight different chiropractic terms. The survey also assessed their preference toward different options with respect to chiropractic's cultural authority. RESULTS: Response rates were 36.2% and 78.1% at CMCC and Parker, respectively. Students at both institutions reported that chiropractic cultural authority was 'neuromusculoskeletal' (NMSK); however, CMCC students was more favorable toward 'musculoskeletal' (MSK) care compared to Parker students, whereas students at Parker favored 'wellness' (59.7%) compared to CMCC students (46.4%). Students at CMCC were more likely to use 'impingement' and 'joint dysfunction' whereas Parker students were more likely to use 'innate intelligence' and 'vertebral subluxation'. Both institutions were equally likely to use 'spinal lesion'. CONCLUSION: This survey found significant cultural authority differences between institutions. While this adds to the emerging need in the literature to evaluate the impact of curriculum and co-curriculum within chiropractic training programs on professional identity, explanations were not evaluated.

OBJECTIF: Évaluer la perception des étudiants sur l'autorité culturelle de la chiropratique, le rôle dans les soins de santé et l'utilisation des termes dans deux établissements chiropratiques, le Canadian Memorial Chiropractic College (CMCC) et l'Université de Parker (Parker). MÉTHODOLOGIE: Un sondage unique a été élaboré et envoyé par courriel aux étudiants de 2e et 3e année (387 étudiants) du CMCC et en format papier aux étudiants du trimestre 4­5 (en comparaison avec la 2e année) et 6­7 (en comparaison avec la 3e année) (277 étudiants) de l'Université de Parker. Les réponses étaient anonymes. Le sondage a évalué la probabilité que les étudiants des deux programmes de chiropratique utilisent huit termes chiropratiques différents. Le sondage a également évalué leur préférence pour différentes options en ce qui concerne l'autorité culturelle de la chiropratique. RÉSULTATS: Les taux de réponses étaient de 36,2 % au CMCC et de 78,1 % à l'Université de Parker. Les étudiants des deux établissements ont déclaré que l'autorité culturelle en chiropratique était les soins « neuro-musculo-squelettiques ¼. Cependant, les étudiants du CMCC étaient plus favorables aux soins « musculo-squelettiques ¼ contrairement aux étudiants de l'Université de Parker, qui eux étaient plus favorables aux soins « bien-être ¼ (59,7 %) contrairement aux étudiants du CMCC (46,4 %). Les étudiants du CMCC étaient plus susceptibles d'utiliser les termes « impact ¼ et « dysfonctionnement articulaire ¼, tandis que les étudiants de l'Université de Parker étaient plus susceptibles d'utiliser « intelligence innée ¼ et « subluxation vertébrale ¼. Les deux établissements étaient également susceptibles d'utiliser « lésion épinière ¼. CONCLUSION: Ce sondage a révélé d'importantes différences d'autorité culturelle entre les établissements. Bien que, dans la documentation, cela s'ajoute au besoin émergent d'évaluer les répercussions du programme et du coprogramme d'études des programmes de formation en chiropratique sur l'identité professionnelle, les explications n'ont pas été évaluées.