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

Background 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.

External practices in distance courses

The problem of this research focuses on the communication between the organizing center and the external tutors at practicum centers. A non-experimental methodology is followed to explore the connections between the different variables. Six correlations between the following variables stand out. Positive correlation: gender with sports specialty, academic degree with distance training expertise, and age with collaboration with the organization. Negative correlation: sportive degree with needed training and received information; and, collaboration with the organization with received information. In addition, a dendrogram was constructed from the qualitative question with five large nodules. The results indicate that tutors do not receive information and that they are not related to the organization at any of the formative moments. It would be convenient to prepare a communication protocol where all participants could contribute from different points of view.

Brazilian health professionals’ perception about the Baby-Led Weaning (BLW) method for complementary feeding: an exploratory study

Objective: To describe Brazilian health professionals’ perception about the Baby-Led Weaning (BLW) method use for complementary feeding. Methods: Cross-sectional, descriptive study including 458 health professionals graduated in Nursing, Speech Therapy, Medicine, Nutrition or Dentistry and working in Pediatrics, being directly or indirectly involved with pediatric nutrition. We used a convenience non-probability sampling. The questionnaire applied to participants addressed demographic characteristics, academic degree, workplace, knowledge about clinical practice and perceptions about the possible advantages of the BLW method. Results: Participants had a mean age of 34.5±8.5 years, 64.6% of them working in Southeast Brazil and 65.3% being nutritionists. Most participants reported being acquainted with the BLW method (82.0%). Regarding clinical practice, 38.3% mentioned having recommended the BLW some times, 37.5% often and 20.5% always. Most participants fully agreed that the BLW method could have advantages for babies, for example, having them more likely to share family meals, facilitating adaptation to food flavors and consistencies, enhancing chewing and favoring the development of motor skills. On the other hand, important disagreements were also expressed regarding the BLW convenience and the possibility to create less concerns or anxiety in parents. Conclusions: The BLW method reported as advantageous, but disagreements were also raised, probably because scientific evidences on the suject are scarse. Further investigation is needed so we can better understand the risks and benefits and health care professionals can feel effectively assisted to offer support and advice to parents and caretakers.

"If you rake me over the coals…" – The Emotional Intelligence of Benjamin Netanyahu: The Prime Minister of Israel, as Perceived by Israeli Citizens

Benjamin Netanyahu, the Prime Minister of Israel, held the premiership for the longest period in the history of the Jewish nation. He considered as a very strong and influential leader. Leadership has manifestations of EI. The study aims to construct new knowledge about how Israeli citizens perceive the EI of Netanyahu. Questionnaire was sent to 414 Israeli participants who own first academic degree or above. Results show that the Israeli citizens perceived Bibi’s EI as high, with average of 5.08 out of 7. It was assumed that in order to achieve his goals, Netanyahu uses also dark side of EI. This study demonstrated that EI could be used with positive-oriented and can also use with negative-oriented. Keywords: emotional intelligence, Benjamin Netanyahu, leadership, dark EI

Catastrophic health expenditure: the case of households with adults over 60 years of age in Peru – 2019

Within the health sector, it is vitally important to analyze whether households incur catastrophic spending for using such services. In this sense, the study seeks to estimate catastrophic health spending for households with members over 60 years of age. To achieve the objective, the methodology of the World Health Organization was used to find the way in which the household incurs in catastrophic spending, using as an instrument the National Household Survey of Peru, for the year 2019. The main results found were: that families living in urban areas, who have health insurance, who have a higher academic degree, decrease the probability of incurring in catastrophic spending, while being over 60 years old, having a chronic disease, suffering some permanent limitation and not having hygienic services, help to incur in catastrophic spending, so it was concluded that the most vulnerable areas should be attended to achieve a better welfare for older adults. Keywords: catastrophic expense, out-of-pocket expense, health insurance. References [1]J. Alvis, c. Marruco, N. Alvis, F. Gomes, Á. Flores and D. Moreno, «Gasto de bolsillo y gasto catastrófico en salud en los hogares de Cartagena, Colombia,» Salud Publica, 10 2018. [2]E. Giménez, L. Flores, J. Rodriguez, G. Ocampos and N. Peralta, «Gastos catastróficos de salud en los hogares del Paraguay,» Instituto de Investigaciones en Ciencias de la Salud, vol. 16, nº 2, 2018. [3]E. Gonzáles and J. García, «Gastos catastróficos en salud, transferencias gubernamentales y remesas en México, » Papeles de población, vol. 23, nº 91, 2017.[4]A. Hernández, C. Rojas, M. Santero, J. Prado y D.Rosselli, «health-related out-of-pocket expenses in older peruvian adults: analysis of the national householdsurvey on living conditions and poverty 2017,» Rev Peru Med Exp Salud Publica, vol. 35, nº 3, 2017. [5]O. Lazo, J. Alcalde and O. Espinosa, «El sistema de salud en Perú,» Lima , 2016. [6]World Health Organization Geneva, «Distribución del gasto en salud y gastos catastróficos Metodología,» 2005. [7]Organización Mundial de la Salud, «Organización Mundial de la Salud,» 2014. [Online]. Available: https://www.who.int/topics/chronic_diseases/es/. [8]Organización Mundial de la Salud , «Organización Mundial de la Salud,» 2018. [Online]. Available: https://www.who.int/topics/disabilities/es/.

Scientific Publishing Differences between Sexes in Cardiology, Cardiac, and General Surgery

Background Research and scientific publications are important for the advancement of science but also for the individual career development. While women have become the majority of students in medicine we do not know about female presence and scientific activity in cardiac surgery. We thus aimed to compare scientific output of women and men in German University departments of cardiac surgery with cardiology departments focusing on the same organ and surgical departments not addressing the heart (general surgery) of 34 universities in Germany. Methods Personnel working at University departments was identified on the institutions internet homepage in 2014. Publications in 2011 to 2013 on PubMed were identified. Author and manuscript characteristics were determined. Results A lower proportion of women were working in cardiac surgery (25%) compared with cardiology (35%) and general (32%) surgery independent of executive function or academic degree. Scientifically active women published fewer manuscripts per capita than men both, in total and as first author. Additionally, the mean and the cumulated journal impact factor of the journals chosen was lower for women compared with men in cardiology but not in cardiac and general surgery. Conclusion We conclude that the differences in scientific activity between women and men are more pronounced in cardiology compared with general and cardiac surgery, indicating that a higher proportion of women in a field does not result in reduced differences between sexes. The low number of women together with the lower number of manuscripts in cardiac surgery may render the appointment of women as directors challenging.

Digital Content Creation Tools: American University Teachers’ Perception

This paper studies the perception of Latin American university teachers about the effectiveness of digital content creation (DCC) tools for the creation of e-learning training actions. For this purpose, the opinions of a group of 564 teachers from different universities in 16 Latin American countries have been collected and their answers have been analyzed according to different sociological and academic characteristics (gender, age, teaching experience, area of knowledge, and academic degree). The results indicate that Latin American university teachers express high levels of digital training and highly value the didactic effectiveness of DCC tools to develop e-learning training actions. This valuation is significantly higher among females than males. Gender is also revealed as the most influential characteristic in the perception of teachers about the use of digital resources in the classroom, above any other aspect.

Factors in university teaching staff perfectionism

Introduction. The attention to the study of perfectionism in universities in Ukraine can be explained with modernization and development of Ukrainian higher education, as an access to the European educational research environment. The interest to the perfectionism in teaching staff of university can be explained by new requirements for professional activity and these factors demand from a teacher of higher school can be an achievement of new standards, obtaining successfully by focusing on avoiding failures. The study is conducted within the pedagogy field. Aim. In this article, the author identifies and analyzes the impact of social-demographic factors (such as age, gender, place of residence), organizational and professional factors (such as job experience, academic degree, post, direction of teaching activity, number of students, university status, level of social-psychological climate etc.) on the manifestations of perfectionism. Results. The four manifestations of perfectionism, which are: Absence of perfectionism (where normal and pathological perfectionism are represented at a low level); Perfectionism with negative orientation (consists of the respondents with pathological type of perfectionism); Ambivalent perfectionism (included the respondents in which the pathological and normal types of perfectionism are equally highly represented); Perfectionism with positive orientation (consists of the respondents with manifestations of normal type of perfectionism). Conclusions. The findings of this investigation show the impact of social-demographic, organizational and professional factors on the manifestations of perfectionism.

Knowledge of and willingness to take pre-exposure prophylaxis among men who have sex with men in Israel

Background Oral pre-exposure prophylaxis (PrEP) with tenofovir disoproxil fumarate and emtricitabine (TDF/FTC) has been found to reduce viral acquisition among HIV-negative MSM. This cross-sectional study was conducted before pre-exposure prophylaxis (PrEP) licensure in Israel, and aimed to compare men who have sex with men (MSM) who had heard of PrEP with those who had not, as well as MSM willing to take PrEP with those who were hesitant or not willing to take PrEP. Methods HIV-negative MSM responded anonymously to questionnaires in 2017 regarding their knowledge of and willingness to take PrEP, prior use of PrEP and post-exposure prophylaxis (PEP), and their sexual behaviors. Results Among 1705 participants, 1431 (83.9%) had heard about PrEP. They were older and more often reported being Jewish, having an academic degree, self-identifying as gay/bisexual, being tested for HIV in the last year, participating in group sex, using alcohol or drugs before or during sex, and having prior use of PrEP/PEP compared with MSM who had not heard about PrEP. A total of 760 (44.8%) participants indicated that they would consider taking PrEP, 567 (33.5%) maybe would consider taking PrEP, and 367 (21.7%) would not take PrEP. Those who were willing to take PrEP had a lower level of education, were involved in high-risk sexual behaviors, used alcohol or drugs before or during sex, and had previously used PrEP/PEP compared with participants who maybe would consider taking or would not take PrEP. When participants were asked to indicate if they were willing to take PrEP at different potential efficacies and costs, the willingness to using PrEP increased with the potential efficacy of the drug and adversely related to its cost. Conclusions PrEP awareness was high, and 44.8% indicated willingness to take PrEP, especially those who reported high-risk sexual behaviors. This supports the current policy in Israel to allow PrEP to MSM who are at high-risk. In order to maintain a high level of PrEP-adherence, physicians should consider structural barriers, such as negative stigma of being promiscuous, lack of perceived HIV-risk, difficulties in accessing clinics or paying for PrEP, inability to follow-up or low tolerability of the medication.

Self-rated familiarity with autism spectrum disorders among practicing nurses: a cross-sectional study in the palestinian nursing practice

Background Autism spectrum disorders (ASDs) are one of the most prevalent neurodevelopmental disabilities of early childhood. Practicing nurses are in a key position to help patients with ASDs and/or their caregivers/families. This study was conducted to assess self-rated familiarity with ASDs among practicing nurses in Palestine. The study also aimed to identify the sociodemographic and practice variables that could predict high self-rated familiarity scores. Methods This was a cross-sectional study using a questionnaire. The study was conducted in the period between January 2019 and May 2019. The questionnaire collected: 1) the sociodemographic, pedagogic, and practice variables of the nurses, 2) their self-rated familiarity with signs and symptoms, treatment options, and community resources of ASDs, 3) their self-rated confidence in their abilities to provide counseling for parents/family/caregivers on the drugs prescribed for children/patients with ASDs and their potential adverse effects, and 4) their willingness to receive education/training on issues in ASDs. Results The questionnaire was completed by 357 practicing nurses. The practicing nurses self-reported inadequate familiarity with symptoms, treatment, and community resources of ASDs. The mean familiarity score was 35.8% (SD: 18.9%). The nurses also expressed low confidence in their ability to provide counseling services to caregivers/families of children with ASDs. About 75% of the nurses agreed that they could benefit from taking a continuing educational/training program in the area of ASDs and about 82% of the nurses agreed that the nursing school curriculum should include courses in the area of ASDs. The multiple linear regression model showed that higher familiarity scores were predicted by having longer practical experience, having a higher academic degree in nursing, and having a continuing educational course/program on ASDs. Conclusion Findings of this study highlighted inadequate familiarity with issues of ASDs among practicing nurses. Higher familiarity was predicted by the length of practical experience, higher academic degree in nursing, and having continuing educational course/program on ASDs. Specifically designed pedagogic interventions might be helpful in increasing familiarity of practicing nurses on ASDs. More investigations are still needed to evaluate if these interventions can improve familiarity and services provided to patients with ASDs.