The Level of Knowledge of Evidenced Based Practice (EBP) by OT Managers

Introduction: Occupational therapy (OT) managers are stakeholders in the expectations of occupational therapists, and hold great influence over evidence-based practice (EBP) implementation (Clark, Park & Burke, 2013). There are no research articles pertaining to the knowledge, attitudes or practices related to EBP among OT managers. The purpose of this research was to determine the knowledge, attitudes, practices and perceived barriers to EBP implementation held by OT managers. Managers who oversee occupational therapists will be referred to as OT managers in this study no matter their professional background. Methodology: This study was approved by the Institutional Review Board at the University of North Dakota (UND) in Grand Forks, North Dakota. A descriptive design was used to conduct this study. Convenience sampling was utilized to obtain participants for this study using the University of North Dakota Fieldwork Contact Database. Participants were emailed a survey. Quantitative data was analyzed using Qualtrics and the Statistical Package for Social Sciences, version 25. Quantitative data was analyzed using an open coding process. Results: A total of 40 surveys were returned out of 258 deliverable messages, yielding a response rate of 15.5%. Most of the respondents were female (85%, n= 34) and held Master’s degrees (72.5%, n=29).The respondents reported an overall “high” knowledge score (x= 25.36). The respondents had “moderate” attitudes towards EBP (x= 12.13, sd= 3.4). Scores related to EBP practice, indicated that practices were “moderate” (x=14.4). The mean score on the barriers subscale was 12.45, which indicated that a moderate level of barriers was perceived. Conclusion: OT managers hold positive attitudes towards EBP, which positively influences their intentions to implement EBP. They also have moderate levels of EBP practices, which positively influences their intentions to implement EBP. Lastly, they have high knowledge of EBP, but perceive moderate levels of barriers to implementation, which decreases their perceived control over EBP implementation. Based on the results of this study, a potential factor inhibiting the intention to implement EBP, is OT managers’ perceived barriers to implementation. Understanding OT managers’ perceived KAPB of EBP and the relationships between those factors helps to guide the next level of research, which is knowledge translation. Future research at the level of knowledge translation needs to explore the most effective interventions for increasing EBP implementation and active involvement in EBP by OT practitioners, students, and managers alike

Challenges in developing a cross-serotype rhinovirus vaccine

A great burden of disease is attributable to human rhinovirus (HRV) infections which are the major cause of the common cold, exacerbations of both asthma and chronic obstructive pulmonary disease (COPD), and are associated with asthma development. Despite this there is currently no vaccine for HRV. The first vaccine studies showed some promise in terms of serotype-specific protection against cold symptoms, but antigenic heterogeneity amongst the >150 HRVs has been regarded as a major barrier to effective vaccine development and has resulted in little progress over 50 years. Here we review those vaccine studies conducted to date, discuss the difficulties posed by antigenic heterogeneity and describe some recent advances in generating cross-reactive antibodies and T cell responses using peptide immunogens

Novel insights into the aetiology and pathophysiology of increased airway inflammation during COPD exacerbations

Airway inflammation increases during acute exacerbations of COPD. Extrinsic factors, such as airway infections, increased air pollution, and intrinsic factors, such as increased oxidative stress and altered immunity may contribute to this increase. The evidence for this and the potential mechanisms by which various aetiological agents increase inflammation during COPD exacerbations is reviewed. The pathophysiologic consequences of increased airway inflammation during COPD exacerbations are also discussed. This review aims to establish a cause and effect relationship between etiological factors of increased airway inflammation and COPD exacerbations based on recently published data. Although it can be speculated that reducing inflammation may prevent and/or treat COPD exacerbations, the existing anti-inflammatory treatments are modestly effective

Viruses exacerbating chronic pulmonary disease: the role of immune modulation

Chronic pulmonary diseases are a major cause of morbidity and mortality and their impact is expected to increase in the future. Respiratory viruses are the most common cause of acute respiratory infections and it is increasingly recognized that respiratory viruses are a major cause of acute exacerbations of chronic pulmonary diseases such as asthma, chronic obstructive pulmonary disease and cystic fibrosis. There is now increasing evidence that the host response to virus infection is dysregulated in these diseases and a better understanding of the mechanisms of abnormal immune responses has the potential to lead to the development of new therapies for virus-induced exacerbations. The aim of this article is to review the current knowledge regarding the role of viruses and immune modulation in chronic pulmonary diseases and discuss avenues for future research and therapeutic implications

Non-Invasive Evaluation of Retinal Vascular Alterations in a Mouse Model of Optic Neuritis Using Laser Speckle Flowgraphy and Optical Coherence Tomography Angiography

Optic neuritis, a characteristic feature of multiple sclerosis (MS), involves the inflammation of the optic nerve and the degeneration of retinal ganglion cells (RGCs). Although previous studies suggest that retinal blood flow alterations occur during optic neuritis, the precise location, the degree of impairment, and the underlying mechanisms remain unclear. In this study, we utilized two emerging non-invasive imaging techniques, laser speckle flowgraphy (LSFG) and optical coherence tomography angiography (OCTA), to investigate retinal vascular changes in a mouse model of MS, known as experimental autoimmune encephalomyelitis (EAE). We associated these changes with leukostasis, RGC injury, and the overall progression of EAE. LSFG imaging revealed a progressive reduction in retinal blood flow velocity and increased vascular resistance near the optic nerve head in the EAE model, indicating impaired ocular blood flow. OCTA imaging demonstrated significant decreases in vessel density, number of junctions, and total vessel length in the intermediate and deep capillary plexus of the EAE mice. Furthermore, our analysis of leukostasis revealed a significant increase in adherent leukocytes in the retinal vasculature of the EAE mice, suggesting the occurrence of vascular inflammation in the early development of EAE pathology. The abovechanges preceded or were accompanied by the characteristic hallmarks of optic neuritis, such as RGC loss and reduced visual acuity. Overall, our study sheds light on the intricate relationship between retinal vascular alterations and the progression of optic neuritis as well as MS clinical score. It also highlights the potential for the development of image-based biomarkers for the diagnosis and monitoring of optic neuritis as well as MS, particularly in response to emerging treatments