RESUMO
PURPOSE: To explore pediatric physical therapists' (PTs) perceptions about continuing telehealth services post-pandemic. METHODS: Two open-ended questions from a larger survey were analyzed using a pragmatic application of thematic analysis. RESULTS: Two hundred two pediatric PTs in the United States responded. Themes included Telehealth During COVID-19, Benefits, Drawbacks , and Recommendations . Telehealth During COVID-19 acknowledged adopting and providing telehealth during a global pandemic was likely different than at other times. Benefits described perceived positive aspects of telehealth for children, families, and PTs, which support continuation of telehealth post-pandemic. Drawbacks described perceived negative aspects of telehealth for children, families, and PTs, which may dissuade continuation. Recommendations described respondents' recommendations for the continuation of telehealth. Ultimately respondents recommended a hybrid model of telehealth and in-person services going forward. CONCLUSIONS: A hybrid model of telehealth and in-person services may have the benefits of increasing access, flexibility, efficiency, communication, and home programming across pediatric practice settings.
Assuntos
COVID-19 , Fisioterapeutas , Telemedicina , COVID-19/epidemiologia , Criança , Humanos , Pandemias , Inquéritos e Questionários , Estados UnidosRESUMO
PURPOSE: To describe the characteristics of pediatric physical therapy telehealth practice during COVID-19. METHODS: An anonymous, online survey was distributed to pediatric physical therapists (PTs) in the United States who transitioned to telehealth during COVID-19. RESULTS: Two hundred five respondents completed all quantitative questions. Ninety-six percent reported never providing telehealth previously and only 14.6% had formal training. More than 35% reported 76% to 100% of their caseload transitioned to telehealth. Most respondents perceived that telehealth was somewhat or very effective for caregivers (90.3%) and children (77.1%) and felt somewhat or very confident providing telehealth (73.2%). However, those practicing in school-based settings rated perceived effectiveness and confidence lower than PTs in other settings. Ultimately, 76.1% of respondents would consider providing telehealth in the future. CONCLUSION: The forced transition of pediatric PTs to the telehealth model during the COVID-19 pandemic resulted in positive experiences for many, supporting wider adoption in the future.
Assuntos
COVID-19 , Fisioterapeutas , Telemedicina , Criança , Humanos , Pandemias , SARS-CoV-2 , Inquéritos e Questionários , Estados UnidosRESUMO
PURPOSE: The purpose of this study was to identify the important factors, facilitators, and barriers for telehealth effectiveness as described by pediatric physical therapists, transitioning from in-person to telehealth during the COVID-19 pandemic. METHODS: Pediatric physical therapists' responses to 3 open-ended questions and 1 multipart Likert Scale question from an anonymous survey were collected and analyzed using thematic analysis and descriptive statistics. RESULTS: Three overarching themes (Caregiver Engagement, Technology, and Resilience) were identified and accompanied by 3 subthemes (Personal Attributes, Equity, and COVID-Specific Considerations). Themes were supported by the Likert Scale question with Child/Caregiver Interaction, Internet Connection, and Family Factors identified as the most important factors related to telehealth effectiveness. CONCLUSIONS: High caregiver engagement and access to stable technology were most important for telehealth effectiveness. The telehealth service model met a need during the pandemic; however, emerging evidence suggests that it could be considered as an effective service delivery mode postpandemic.
Assuntos
COVID-19/epidemiologia , Modalidades de Fisioterapia/tendências , Telemedicina/estatística & dados numéricos , Criança , Humanos , Pandemias , SARS-CoV-2 , Inquéritos e QuestionáriosRESUMO
The paper describes the SAR/SPR studies that led to the discovery of phenoxy cyclopropyl phenyl acetamide derivatives as potent and selective GPR119 agonists. Based on a cis cyclopropane scaffold discovered previously, phenyl acetamides such as compound 17 were found to have excellent GPR119 potency and improved physicochemical properties. Pharmacokinetic data of compound 17 in rat, dog and rhesus will be described. Compound 17 was suitable for QD dosing based on its predicted human half-life, and its projected human dose was much lower than that of the recently reported structurally-related benzyloxy compound 2. Compound 17 was selected as a tool compound candidate for NHP (Non-Human Primate) efficacy studies.
Assuntos
Acetamidas/farmacologia , Receptores Acoplados a Proteínas G/agonistas , Acetamidas/farmacocinética , Animais , Meia-Vida , Humanos , Pontos Quânticos , Ratos , Relação Estrutura-AtividadeRESUMO
The design and synthesis of two conformationally restricted oxazabicyclo octane derivatives as GRP119 agonists is described. Derivatives of scaffold C, with syn configuration, have the best overall profiles with respect to solubility and in vivo efficacy. Compound 25a was found to have extremely potent agonistic activity and was orally active in lowering blood glucose levels in a mouse oral glucose tolerance test at a dose of 0.1 mg/kg.
Assuntos
Compostos Azabicíclicos/síntese química , Hipoglicemiantes/síntese química , Pirimidinas/síntese química , Receptores Acoplados a Proteínas G/agonistas , Animais , Compostos Azabicíclicos/farmacologia , Teste de Tolerância a Glucose , Células HEK293 , Humanos , Hipoglicemiantes/farmacologia , Camundongos , Pirimidinas/farmacologia , SolubilidadeRESUMO
The lead optimization studies of a series of GPR119 agonists incorporating a nortropanol scaffold are described. Extensive structure-activity relationship (SAR) studies of the lead compound 20f led to the identification of compound 36j as a potent, single digit nanomolar GPR119 agonist with high agonist activity. Compound 36j was orally active in lowering blood glucose levels in a mouse oral glucose tolerance test and increased plasma insulin levels in a rat hyperglycemic model. It showed good to excellent pharmacokinetic properties in rats and monkeys and no untoward activities in counter-screen assays. Compound 36j demonstrated an attractive in vitro and in vivo profile for further development.
Assuntos
Diabetes Mellitus Tipo 2/tratamento farmacológico , Descoberta de Drogas , Hiperglicemia/tratamento farmacológico , Nortropanos/síntese química , Receptores Acoplados a Proteínas G/agonistas , Administração Oral , Animais , Modelos Animais de Doenças , Teste de Tolerância a Glucose , Concentração Inibidora 50 , Camundongos , Nortropanos/química , Nortropanos/uso terapêutico , RatosRESUMO
A novel series of benzopyran derivatives were synthesized and evaluated as K(ATP) channel openers. Structure-activity relationships were investigated around 4-position of the benzopyran nucleus. Optimization of 4-substituent with some heterocyclic rings led to compound 13b bearing a benzo[d]isoxazol-3-one moiety as a potent and selective K(ATP) channel opener in vitro. In two anesthetized rat models of myogenic bladder overactivity, compound 13b was found to inhibit spontaneous bladder contractions.
Assuntos
Benzopiranos/farmacologia , Canais de Potássio Corretores do Fluxo de Internalização/agonistas , Incontinência Urinária de Urgência/tratamento farmacológico , Animais , Modelos Animais de Doenças , Ratos , Relação Estrutura-Atividade , Bexiga Urinária/efeitos dos fármacos , Bexiga Urinária/fisiopatologiaRESUMO
We report herein the design and synthesis of a series of potent and selective GPR119 agonists. Our objective was to develop a GPR119 agonist with properties that were suitable for fixed-dose combination with a DPP4 inhibitor. Starting from a phenoxy analogue (1), medicinal chemistry efforts directed toward reducing half-life and increasing solubility led to the synthesis of a series of benzyloxy analogues. Compound 28 was chosen for further profiling because of its favorable physicochemical properties and excellent GPR119 potency across species. This compound exhibited a clean off-target profile in counterscreens and good in vivo efficacy in mouse oGTT.