A clinician with a working knowledge of these minimum detectable change values can be up to 95% confident that a true change or not a true change in a patients' functional balance has occurred and can therefore alter their interventions accordingly to ensure quality, focused rehabilitation.

This study investigated the dissolution-based toxicity mechanism for silver nanoparticles to Escherichia coli K12. The silver nanoparticles, synthesised in the vapour phase, are effective anti-bacterial agents against the Gram-negative bacterium, E. coli K12. The nanoparticles associate with the bacterial cell wall, appearing to interact with the outer and inner membranes, and then dissolve to release Ag(+) into the cell and affect a transcriptional response. The dissolution of these nanoparticles in a modified LB medium was measured by inductively coupled plasma mass spectrometry (ICP-MS) and has been shown to follow a simple first-order dissolution process proportional to the decreasing surface area of the nanoparticles. However, the resulting solution phase concentration of Ag(+), demonstrated by the ICP-MS data, is not sufficient to cause the observed effects, including inhibition of bacterial growth and the differential expression of Cu(+) stress response genes. These data indicate that dissolution at the cell membrane is the primary mechanism of action of silver nanoparticles, and the Ag(+) concentration released into the bulk solution phase has only limited anti-bacterial efficacy.

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Aim:The implementation of evidence-based practice (EBP) is extremely important and plays a vital role in healthcare practice. There have been few studies concerning the level of healthcare provided to patients in Saudi Arabia, using EBP as an indicator. This study is aimed at investigating physiotherapists’ behaviour, attitudes, awareness and knowledge about EBP, along with barriers that curb the implementation of EBP.Methods:A sample of convenience was used and an online survey consisting of 14 closed-ended questions was given to both clinical and academic physiotherapists in Saudi Arabia from May to October 2016. Data regarding demographics, behaviour, attitudes, awareness, knowledge, previous formal training and barriers to implementation of EBP were recorded. The data were analysed using IBM SPSS version 19.Results:A total of 604 physiotherapists participated in the survey, out of which 385 respondents provided complete data. Nine participants were undergraduate physiotherapy students or not physiotherapists and their responses were excluded. The final number of participants included in data analysis was 376. The majority of the participants were men (60.4%) and most of them had completed their bachelor degree (66.2%). Although most physiotherapists reported a positive attitude towards the use of research in practice, there were many who were unfamiliar with the terms and implementation of EBP. The majority of physiotherapists had no formal EBP training (70.2%) in universities or any authorized training centres. According to the responses collected, the most important barrier to the implementation of EBP was insufficient teaching in previous education (43.1%), followed by lack of research knowledge and skills (36.4%). The study revealed that there was a significant association between physiotherapists’ attitude and their education level, while no significant associations were identified based on other demographic data. In addition, there were significant associations between physiotherapists’ awareness and knowledge and demographics such as education level, work setting, job title and previous training in EBP.Conclusion:There is a prominent gap in terms of understanding and applying the concept of EBP among physiotherapists in Saudi Arabia. Given that the majority of practicing physiotherapists reported no formal training in EBP, there is a need to integrate concepts related to EBP into the undergraduate and graduate curriculum. In addition, strategies must be developed and implemented to encourage practicing physiotherapists for gaining knowledge and proficiency in EBP.

This research serves to increase our understanding of the role of family members in the rehabilitation process after stroke, particularly in relation to exercise delivery, from the perspective of the individuals with stroke and their family members.