INTRODUCTION: Evidence-based practice (EBP) is a critical framework for supporting clinical decision-making that has been increasingly promoted in occupational therapy over the last 20 years. Discipline-specific EBP frameworks and resources have emerged, primarily created by scholars from developed countries. However, EBP has received limited attention in literature published in developing and non-English speaking countries. This study aimed to explore Chilean occupational therapists' perceptions of EBP, factors influencing the adoption of EBP and sources of information used to inform clinical decision-making. METHODS: A cross-sectional online survey of Chilean occupational therapists included socio-demographic information, closed questions using a fivepoint Likert scale and open-ended questions. Numerical data were summarised using frequencies and percentages. Cross-tabulations explored relationships between variables. Narrative data from openended responses were analysed deductively using content analysis. RESULTS: Complete surveys were returned by 192 Chilean respondents. The majority of participants (68.3%) defined EBP as the use of research knowledge only and perceived EBP as useful and important. The most significant barriers to the application of research knowledge included: lack of time (68.2%), an emerging research culture (67.7%) and restricted access to scientific literature (56.8%). Additionally, Chilean occupational therapists did not feel confident finding, appraising and integrating research evidence. Of the four sources of knowledge used in EBP, participants predominantly relied on clinical observations of clients (99.5%), their clinical expertise (89.1%), and discussions with the multidisciplinary team (78.1%) and other occupational therapists (40.1%), to inform clinical decision-making. CONCLUSION: Language barriers, lack of time, scarcity of locally produced research, and an emergent research culture within Chile impede occupational therapists' ability to implement EBP. The adoption of EBP can facilitate access to contemporary occupational therapy knowledge powerfully guide clinical reasoning, and build local research capacity. Building research partnerships and collaborations with the international scientific community are crucial to the global achievement of EBP.
Occupational Therapy , Attitude of Health Personnel , Chile , Clinical Reasoning , Cross-Sectional Studies , Evidence-Based Practice , Health Knowledge, Attitudes, Practice , Humans , Surveys and Questionnaires
OBJECTIVE: Recent studies suggest that sensory phenotyping may provide critical information for the diagnosis and management of patients with chronic neuropathic pain (NP). However, many formal quantitative sensory testing (QST) paradigms require expensive equipment, a dedicated location, and substantial time commitments on the part of patient and examiner, highlighting the need for a convenient and portable "bedside" QST battery. We developed and tested a bedside QST battery in a sample of patients with chronic NP. METHODS: Participants (N = 51) attended two in-person visits over approximately two weeks, during which they underwent QST using both laboratory-based equipment and simple, easily accessible bedside tools. Participants also completed questionnaires about their daily pain and NP symptoms. RESULTS: Test-retest reliability estimates were highly statistically significant and did not differ between bedside (mean r = 0.60) and laboratory-based (mean r = 0.72) QST. Bedside QST variables and corresponding laboratory-based QST variables were highly correlated, suggesting adequate criterion validity for the bedside tests. CONCLUSIONS: Results from the present study may have important implications for the sensory phenotyping and subsequent management of patients with chronic NP. Implementation of a protocol that uses inexpensive, portable, and convenient tools may allow for the application of QST in variety of clinical settings and advance NP research.
Neuralgia , Pain Threshold , Boston , Humans , Neuralgia/diagnosis , Pain Measurement , Reproducibility of Results
The thermal behavior, phase stability, indicative stability and intrinsic dissolution rates of a series of cocrystals and cocrystal hydrates derived from the pharmaceutically active ingredient acetazolamide (ACZ) and 2-aminobenzamide (2ABAM), 2,3-dihydroxybenzoic acid (23DHBA), 2-hydroxybenzamide (2HBAM), 4-hydroxybenzoic acid (4HBA), nicotinamide (NAM) and picolinamide (PAM) as cocrystal formers have been evaluated. Upon heating in an inert atmosphere most of the cocrystals tested demonstrated first the elimination of the crystal former, followed by ACZ degradation. Only in cocrystals with NAM was melting observed. Under controlled temperature and relative humidity conditions all cocrystals tested were stable. However, phase stability tests in a medium simulating physiological conditions (HCl 0.01N, pH2.0) indicated that cocrystals ACZ-NAM-H2O and ACZ-PAM gradually transform into ACZ. All cocrystals examined gave enhanced intrinsic dissolution rates when compared to pure ACZ and the largest dissolution rate constants were measured for the cocrystals that transformed in the phase stability test (approximate two-fold increase of the dissolution rate constants). The series of cocrystals examined herein exhibits an inverse correlation between the intrinsic dissolution rates and the melting/decomposition temperatures as well as the dimension of the hydrogen-bonded ACZ aggregates found in the corresponding crystal structure, indicating that solid-state stability is the major influence on dissolution performance.
Acetazolamide/chemistry , Acetazolamide/metabolism , Crystallization , Solubility , X-Ray Diffraction/methods
Objectives Infant developmental outcomes may be influenced by a range of prenatal maternal characteristics. While there is some evidence to suggest that maternal-foetal attachment may be associated with infant developmental outcomes, there is a need to systematically review this evidence to guide future research and clinical practice. Methods Five electronic databases were systematically scanned. Key journals and reference lists were hand-searched. Papers were included if: (1) pregnant women were assessed for maternal-foetal attachment; (2) the infants were later assessed, under 2 years old, for any developmental outcome (e.g., social-emotional, cognition, motor, language, adaptive behaviour); and (3) they were published in English. Two independent reviewers used the STROBE checklist to appraise the quality of each paper. Results Of the 968 papers identified, eight were included in the review, and four of these were of low quality (<60 %) based on the STROBE. The developmental domains that were examined included: infant temperament (n = 5), adaptive behaviour (e.g., colic, sleep) (n = 2), and milestone attainment (n = 1). There is some evidence to suggest that lower maternal-foetal attachment is related to suboptimal developmental outcomes. However, these results should be interpreted with caution due to the limited and low quality studies available. Conclusions Although maternal-foetal attachment may be associated with infant developmental outcomes, future research is required which: (1) considers a range of developmental outcomes, (2) has increased scientific rigour, (3) assesses mother-infant dyads at different prenatal and postnatal time points, and (4) examines different target populations.
Child Development/physiology , Fetus , Mother-Child Relations , Adult , Female , Humans , Infant, Newborn , Pregnancy
Objetivo. Comparar viabilidad, crecimiento en cultivo, fenotipo y diferenciación a linaje osteogénico de ADAS (Adipose-Derived Adult Stem Cells) pre y post congelamiento. Método. Se obtuvieron muestras de TA de individuos sanos que fueron sometidos a liposucción, con posterior digestión enzimática con Colagenasa I. La fracción vascular estromal (FVE) obtenida fue dividida equitativamente en dos fracciones una de las cuales fue criopreservada y almacenada a -196°C y la otra cultivada hasta pase uno antes de ser criopreservada. Ambas fracciones fueron criopreservadas en cámara de congelamiento automatizada utilizando dos soluciones de congelamiento: (A) Dimetilsulfóxido (DMSO)/Dextrano40/albúmina sérica humana (HSA) y (B) DMSO/HESSICO/HSA, mantenidas 3 meses a -196°C y descongeladas con buffer fosfato salino (PBS)/HSA/HESSICO. Posterior a su descongelamiento fueron sometidas a cultivo, recuento, viabilidad celular, fenotipificación y potencial osteogénico. Resultados. Las células congeladas con la solución crioprotectora DMSO/Dextrano40/HSA y con un cultivo previo al congelamiento, presentaban porcentajes de viabilidad más altos y alcanzaban confluencia del 80% en cultivo en menos tiempo. Las muestras expandidas no presentaron diferencias en el fenotipo por citometría de flujo y mostraron diferenciación a linaje osteogénico.
Objective. Comparing viability, growth in culture, phenotype and osteogenic lineage differentiation of Adipose-Derived Adult Stem Cells (ADAS) pre and post freezing. Methods. Samples were obtained from adipose tissue of healthy individuals who underwent liposuction, to which underwent enzymatic digestion with collagenase I. The stromal vascular fraction (SVF) obtained was divided equally into two fractions one of which was cryopreserved and stored at -196 °C and another cultivated to passage 1 (P1) before being cryopreserved. Both fractions were cryopreserved by chamber automated freezing using two solutions: (A) DMSO/Dextran40/HSA and (B) DMSO/HESSICO/HSA kept 3 months at -196°C and thawed in PBS/HSA/HESSICO. After its thawing were also subjected to cultivation, count, cell viability, phenotyping and osteogenic potential. Results. Found that frozen cells with cryoprotectant solution DMSO/Dextran40/HSA and a pre-freezing culture, viability percentages exhibited higher and reached 80% confluence in less time. Expanded samples showed no differences in the phenotype by flow cytometry and shown to osteogenic lineage differentiation.
Humans , Stem Cells , Bone Marrow , Cryopreservation , Regenerative Medicine
