Measuring evidence-based practice in physical therapy: a mix-methods study

Evidence-based practice (EBP) is considered the “holy grail” to manage patients by health practitioners (such as physical therapists). However, sometimes, patients are not treated with the best interventions for their condition. Although studies already explored the facilitators and barriers for this issue, they increase in the level of importance if the information gathered are context appropriated. As the profession is relatively new in Portugal, currently little is known about the implementation of EBP in Portuguese physical therapists context. So, the aim of this study is to know if the Portuguese physical therapists use an EBP, and collect and deeper understand the factors, barriers and facilitators associated with EBP. Methods: This study incorporated a mixed-methods design (quantitative and qualitative). In an attempt to ensure the correct population sample, a national professional association e-mail database and the e-mails of past students from national schools were requested. For the quantitative data it was choose an e-survey, adapted from the EBP: Beliefs, Attitudes, Knowledge, and Behaviors of Physical Therapists Portuguese version questionnaire, consisted of 55 close-ended questions. It was analyzed response frequencies and associations between variables with logistic regression analyses. For the qualitative data, it was choose to perform semi-structured interviews in purposefully selected physical therapists to include different sociodemographic factors (especially those found to be statistically significant in the logistic regression) and survey responses regarding the physical therapists’ beliefs, attitudes, knowledge, and behaviors. The interviews were performed in an online software, where only audio contact was performed. The audios were anonymized and verbatim transcribed, and the texts explored by the thematic approach. Results: From the 277 physical therapists that shown interest in participating in the study, 193 fully completed the questionnaire and, from those, 10 participated in the interviews. The Portuguese physical therapists reported positive beliefs, attitudes, knowledge, and behaviors regarding EBP. Among the physical therapists characteristics it seems that age (younger therapists), education (participating in continuing education courses; belonging to practice-orientated organizations; having a doctorate degree; pursuing a higher academic degree; and being a clinical instructor), and workplace (working for someone else account; and academic sector) are the main factors in the Portuguese EBP implementation. The Portuguese physical therapists, beyond the physical therapists individual characteristics and workplace, also stated that evidence, patients, clinical experience, schools, country and physical therapy characteristics, may behave as facilitators or barriers when performing an EBP.info:eu-repo/semantics/publishedVersio

Physical therapists’ choices, views and agreements regarding non-pharmacological and non-surgical interventions for knee osteoarthritis patients: a mixed-methods study

The aims of this study are to collect the most common non-pharmacological and non-surgical interventions used by the Portuguese physical therapists in their knee osteoarthritis patients, and to deeper understand the factors associated to their intervention choices. Methods: This study incorporated a mixed-methods design. For the quantitative data it was choose an e-survey (with 25 close-end questions, plus general information of the study and a clinical vignette), retrieving sociodemographic and self-reported practice on knee osteoarthritis information. It was analysed response frequencies and associations between variables with logistic regression analyses. For the qualitative data, it was chosen to perform semi-structured interviews in purposefully selected physical therapists to include different sociodemographic factors and survey responses regarding the physical therapists’ interventions chosen. After the interviews, the audios were collected, anonymised, transcribed verbatim, and the texts explored by the thematic approach. Results: From the 277 PTs that shown interest in participating in the study, 120 fully completed the questionnaire and, from those, 10 participated in the interviews. The most chosen interventions included Resistance Exercise, Manual Therapy, Nutrition/Weight Loss, Self-care/Education, Stretching and Aquatic Exercise. Furthermore, it seems that PTs’ individual characteristics (age, experience, and clinical reasoning), patient’s characteristics (clinical findings and preferences), and work-related factors (facility type, work environment and available resources) are the main actors responsible for an intervention chosen. Conclusions: In the Portuguese PTs context the most important interventions are Exercise, Manual Therapy, Nutrition/Weight Loss, and Self-care/Education; these interventions chosen may be influenced by PT, patient and work-related factors.info:eu-repo/semantics/publishedVersio

Bringing Dicynodonts Back to Life: Paleobiology and Anatomy of a New Emydopoid Genus from the Upper Permian of Mozambique

Dicynodontia represent the most diverse tetrapod group during the Late Permian. They survived the Permo-Triassic extinction and are central to understanding Permo-Triassic terrestrial ecosystems. Although extensively studied, several aspects of dicynodont paleobiology such as, neuroanatomy, inner ear morphology and internal cranial anatomy remain obscure. Here we describe a new dicynodont (Therapsida, Anomodontia) from northern Mozambique: Niassodon mfumukasi gen. et sp. nov. The holotype ML1620 was collected from the Late Permian K5 formation, Metangula Graben, Niassa Province northern Mozambique, an almost completely unexplored basin and country for vertebrate paleontology. Synchrotron radiation based micro-computed tomography (SRµCT), combined with a phylogenetic analysis, demonstrates a set of characters shared with Emydopoidea. All individual bones were digitally segmented allowing a 3D visualization of each element. In addition, we reconstructed the osseous labyrinth, endocast, cranial nerves and vasculature. The brain is narrow and the cerebellum is broader than the forebrain, resembling the conservative, "reptilian-grade" morphology of other non-mammalian therapsids, but the enlarged paraflocculi occupy the same relative volume as in birds. The orientation of the horizontal semicircular canals indicates a slightly more dorsally tilted head posture than previously assumed in other dicynodonts. In addition, synchrotron data shows a secondary center of ossification in the femur. Thus ML1620 represents, to our knowledge, the oldest fossil evidence of a secondary center of ossification, pushing back the evolutionary origins of this feature. The fact that the specimen represents a new species indicates that the Late Permian tetrapod fauna of east Africa is still incompletely known.Mozambique (Ministério dos Recursos Minerais), National Geographic Society, TAP airlines and other anonymous patrons, financial support from DESY through the I-20110184 EC project

Numerical tools to estimate the flux of a gas across the air-water interface and assess the heterogeneity of its forcing functions

A numerical tool was developed for the estimation of gas fluxes across the air-water interface. The primary objective is to use it to estimate CO2 fluxes. Nevertheless application to other gases is easily accomplished by changing the values of the parameters related to the physical properties of the gases. A user-friendly software was developed allowing to build upon a standard kernel a custom-made gas flux model with the preferred parameterizations. These include single or double layer models; several numerical schemes for the effects of wind in the air-side and water-side transfer velocities; the effects of atmospheric stability, surface roughness and turbulence from current drag with the bottom; and the effects on solubility of water temperature, salinity, air temperature and pressure. An analysis was also developed which decomposes the difference between the fluxes in a reference situation and in alternative situations into its several forcing functions. This analysis relies on the Taylor expansion of the gas flux model, requiring the numerical estimation of partial derivatives by a multivariate version of the collocation polynomial. Both the flux model and the difference decomposition analysis were tested with data taken from surveys done in the lagoon system of Ria Formosa, south Portugal, in which the CO2 fluxes were estimated using the infrared gas analyzer (IRGA) and floating chamber method, whereas the CO2 concentrations were estimated using the IRGA and degasification chamber. Observations and estimations show a remarkable fit

Recent highlights in sustainable bio-based edible films and coatings for fruit and vegetable applications

The present review paper focuses on recent developments in edible films and coatings made of base compounds from biological sources, namely plants, animals, algae, and microorganisms. These sources include by-products, residues, and wastes from agro-food industries and sea products that contribute to sustainability concerns. Chitosan, derived from animal biological sources, such as crustacean exoskeletons, has been the most studied base compound over the past three years. Polysaccharides typically constitute no more than 3–5% of the film/coating base solution, with some exceptions, like Arabic gum. Proteins and lipids may be present in higher concentrations, such as zein and beeswax. This review also discusses the enrichment of these bio-based films and coatings with various functional and/or bioactive compounds to confer or enhance their functionalities, such as antimicrobial, antioxidant, and anti-enzymatic properties, as well as physical properties. Whenever possible, a comparative analysis among different formulations was performed. The results of the applications of these edible films and coatings to fruit and vegetable products are also described, including shelf life extension, inhibition of microbial growth, and prevention of oxidation. This review also explores novel types of packaging, such as active and intelligent packaging. The potential health benefits of edible films and coatings, as well as the biodegradability of films, are also discussed. Finally, this review addresses recent innovations in the edible films and coatings industry, including the use of nanotechnologies, aerogels, and probiotics, and provides future perspectives and the challenges that the sector is facing.info:eu-repo/semantics/publishedVersio

Chitosan scaffolds incorporating lysozyme into CaP coatings produced by a biomimetic route : a novel concept for tissue engineering combining a self-regulated degradation system with in situ pore formation

This study describes an innovative self-regulated degrading material with gradual in situ pore formation ability for bone tissue engineering applications. This approach is based on the incorporation of the lysozyme enzyme into calcium phosphate (CaP) coatings, prepared on the surface of chitosan scaffolds by means of a biomimetic coating technique with the aim of controlling their degradation rate and subsequent formation of pores. However, because lysozyme has antibacterial properties, these coatings may act as a carrier for its sustained release, preventing infection upon implantation. In order to prove the concept of in situ pore formation, the coated scaffolds (with and without lysozyme) were incubated in two different solutions at different pH to simulate normal physiological conditions (pH 7.4) and inflammatory response (pH 5). The weight loss and morphology of the scaffolds was monitored over time. At pH 7.4, the scaffolds remained more stable than at pH 5. The scaffolds incubated at pH 5 showed a rapid decrease in their initial weight, and scanning electron microscopy imaging revealed the formation of a highly porous structure. Furthermore, evaluation of the activity of the incorporated lysozyme revealed that the enzyme was able to hydrolyse the peptidoglycan of the bacteria cell walls (as detected by the decrease in optical density with time), indicating that the enzyme remained active after being incorporated into the CaP coating.This work was supported by the European NoE EXPERTISSUES (NMP3-CT-2004-500283), the European STREP HIPPOCRATES (NMP3-CT-2003-505758), the Portuguese Foundation for Science and Technology (FCT) through POCTI and/or FEDER programmes

A comparative study of drying technologies for apple and ginger pomace: kinetic modeling and antioxidant properties

Apple and ginger mixed pomace is a by-product that can be valorized by drying. In this study, mixed pomace was subjected to hot-air drying (HAD) at 45, 62, and 70 °C and stepwise at 45 °C followed by at 62 °C or the reverse, at 62 °C followed by at 45 °C (2.5 mm layer), and microwave drying (MWD) at 100, 180, and 300 W (2.5 mm and 1.5 mm layers) and stepwise at 100 W followed by at 3000 W (2.5 mm layer). The results show that the Crank model well fitted the HAD kinetics, with a water effective diffusivity (Deff) of 2.28 ± 0.06 × 10−10–4.83 ± 0.16 × 10−10 m2/s and energy of activation of 23.9 kJ/mol. The step approach of drying at 45 °C followed by at 62 °C resulted in a higher Deff than the reverse approach (drying at 62 °C followed by at 45 °C). The Midilli et al. model presented a good fit for the MWD kinetics. The drying time was calculated using these models to achieve 12% moisture content in the pomace and found to be 125.0 ± 9.2–439.5 ± 118.2 min for HAD, and 11.1 ± 0.2–61.5 ± 6.0 min for MWD. The specific energy required was 410.78 ± 6.30–763.79 ± 205.4 kWh/kg and 1.32 ± 0.01–2.26 ± 0.05 kWh/kg, respectively. MWD at 180 W preserved the total phenolic content and the antioxidant activity (ABTS, DPPH) better than HAD at 62 °C. The former technology also preserved the pomace color well, with a low color difference, ΔE, of 7.39 ± 1.1. Therefore, MWD is more promising than HAD to dry apple and ginger pomace, reducing the environmental impact of the drying process due to its lower energy consumption, shorter drying time, and better quality. The dried product could be converted into apple and ginger pomace flour to be used as a novel food ingredient.info:eu-repo/semantics/publishedVersio

Vanadium distribution, lipid peroxidation and oxidative stress markers upon decavanadate in vivo administration

The contribution of decameric vanadate species to vanadate toxic effects in cardiac muscle was studied following an intravenous administration of a decavanadate solution (1 mM total vanadium) in Sparus aurata. Although decameric vanadate is unstable in the assay medium, it decomposes with a half-life time of 16 allowing studying its effects not only in vitro but also in vivo. After 1, 6 and 12 h upon decavanadate administration the increase of vanadium in blood plasma, red blood cells and in cardiac mitochondria and cytosol is not affected in comparison to the administration of a metavanadate solution containing labile oxovanadates. Cardiac tissue lipid peroxidation increases up to 20%, 1, 6 and 12 h after metavanadate administration, whilst for decavanadate no effects were observed except 1 h after treatment (+20%). Metavanadate administration clearly differs from decavanadate by enhancing, 12 h after exposure, mitochondrial superoxide dismutase (SOD) activity (+115%) and not affecting catalase (CAT) activity whereas decavanadate increases SOD activity by 20% and decreases ( 55%) mitochondrial CAT activity. At early times of exposure, 1 and 6 h, the only effect observed upon decavanadate administration was the increase by 20% of SOD activity. In conclusion, decavanadate has a different response pattern of lipid peroxidation and oxidative stress markers, in spite of the same vanadium distribution in cardiac cells observed after decavanadate and metavanadate administration. It is suggested that once formed decameric vanadate species has a different reactivity than vanadate, thus, pointing out that the differential contribution of vanadium oligomers should be taken into account to rationalize in vivo vanadate toxicity

Comparison among different green extraction methods of polyphenolic compounds from exhausted olive oil pomace and the bioactivity of the extracts

The use of by-products as a source of bioactive compounds with economic added value is one of the objectives of a circular economy. The olive oil industry is a source of olive pomace as a by-product. The olive pomace used in the present study was the exhausted olive pomace, which is the by-product generated from the air drying and subsequent hexane extraction of residual oil from the olive pomace. The objective was to extract bioactive compounds remaining in this by-product. Various types of green extraction were used in the present study: solvent extraction (water and hydroalcoholic); ultrasound-assisted extraction; Ultra-Turrax-assisted extraction; and enzyme-assisted extraction (cellulase; viscoenzyme). The phenolic profile of each extract was determined using HPLC-DAD and the total phenolic content (TPC) and antioxidant activity (ABTS, DPPH, and ORAC) were determined as well. The results showed significant differences in the yield of extraction among the different methods used, with the enzyme-assisted, with or without ultrasound, extraction presenting the highest values. The ultrasound-assisted hydroethanolic extraction (USAHE) was the method that resulted in the highest content of the identified phenolic compounds: 2.021 ± 0.29 mg hydroxytyrosol/100 mg extract, 0.987 ± 0.09 mg tyrosol/100 mg extract, and 0.121 ± 0.005 mg catechol/100 mg extract. The conventional extraction with water at 50 °C produced the best results for TPC and antioxidant activity of the extracts. The extracts from the USAHE were able to inhibit Gram-positive bacteria, especially Bacillus cereus, showing 67.2% inhibition at 3% extract concentration.info:eu-repo/semantics/publishedVersio