human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND AND PURPOSE Physiotherapists ' use of research evidence with clinical decision-making has interested research ers world-wide since 1980 ; however , little is known about such practice s in Australia . The present survey sought information on Australian physiotherapists ' perceptions of the importance of research , and barriers to uptake of evidence in clinical practice , when compared with an international cohort from 2001 . METHOD An Australian-relevant version of an English ( UK ) National Health Service ( NHS ) survey instrument was used to canvass 453 physiotherapists , r and omly selected from the South Australian Physiotherapy Registration Board 2004 - 2005 records . The first survey was mailed in August 2005 , a reminder was sent two weeks later to non-responders and a follow-up survey was sent in April 2006 to non-responders whose addresses had changed since 2005 . RESULTS There was a 51 % response rate . Of the non-responders , 12 % were not contactable at their listed address , highlighting the mobility of Australian physiotherapists . Most respondents had undertaken research as students ( 59.5 % ) or as students and clinicians ( 11.5 % ) . Of these , 37.1 % were encouraged to embark on more research , and 20.5 % were discouraged . The significant predictors of positive perceived importance of research were : previous research experience ; being positive about undertaking further research ; working in hospitals and holding a postgraduate degree . Clinicians working privately were significantly less likely than managers to be positive about research importance . The only significant predictor for not perceiving barriers to uptake of evidence was being positive about undertaking future research . CONCLUSIONS The study identified constraints on uptake of evidence into practice that were related to accessing , reading and interpreting published research , and implementing findings . Found consistently across employment categories were barriers relating to lack of time , uncertainty about what the research reported , scepticism about the value of research and being isolated from peer support and literature sources . The responses indicated a positive shift towards evidence uptake since the 2001 NHS survey , suggesting an influence of increased exposure to information on evidence -based practice . A greater focus on research whilst training , the application of educational strategies for empowerment , better knowledge transfer and upskilling within the workplace , and ensuring dedicated time and organizational support for research activities are indicated Background Many authors , as well as the American Physical Therapy Association , advocate that physical therapists adopt practice patterns based on research evidence , known as evidence -based practice ( EBP ) . At the same time , physical therapists should be capable of integrating EBP within the day-to-day practice of physical therapy . The purpose of this study was to determine the extent to which personal characteristics and the characteristics of the social system in the workplace influence the propensity of physical therapists to adopt EBP . Methods The study used a 69 item mailed self-completion question naire . The question naire had four major sections . The first three sections were each drawn from a different theoretical framework and from different authors ' work . The instrument was developed to capture the propensity of physical therapists to adopt EBP , characteristics of the social system in the workplace of physical therapists , personal characteristics of physical therapists , and selected demographic variables of physical therapists . The eligible population consisted of 3,897 physical therapists licensed by the state of Georgia in the United States of America . A r and om sample of 1320 potential participants was drawn . Results 939 question naires were returned for a response rate of 73 % . 831 of the participants ' question naires were useable and became the basis for the study . There was a moderate association between desire for learning ( r = .36 , r2 = .13 ) , highest degree held ( r = .29 , r2 = .08 ) , practicality ( r = .27 , r2 = .07 ) and nonconformity ( r = .24 , r2 = .06 ) and the propensity to adopt EBP .  A negative correlation was found between age , years licensed and percentage of time in direct patient care . The findings demonstrated that the best three variables for predicting the propensity to adopt EBP  in physical therapy were : desire for learning , highest degree held , and practicality . Conclusion The study confirms there is no single factor to facilitate research evidence into day-to-day practice . Multiple practice change strategies will be needed to facilitate change in practice Background Training in the five steps of evidence -based practice ( EBP ) has been recommended for inclusion in entry-level health professional training . The effectiveness of EBP education has been explored predominantly in the medical and nursing professions and more commonly in post-graduate than entry-level students . Few studies have investigated longitudinal changes in EBP attitudes and behaviours . This study aim ed to assess the changes in EBP knowledge , attitudes and behaviours in entry-level physiotherapy students transitioning into the workforce . Methods A prospect i ve , observational , longitudinal design was used , with two cohorts . From 2008 , 29 participants were tested in their final year in a physiotherapy program , and after the first and second workforce years . From 2009 , 76 participants were tested in their final entry-level and first workforce years . Participants completed an Evidence -Based Practice Profile question naire ( EBP2 ) , which includes self-report EBP domains [ Relevance , Terminology ( knowledge of EBP concepts ) , Confidence , Practice ( EBP implementation ) , Sympathy ( disposition towards EBP ) ] . Mixed model analysis with sequential Bonferroni adjustment was used to analyse the matched data . Effect sizes ( ES ) ( 95 % CI ) were calculated for all changes . Results Effect sizes of the changes in EBP domains were small ( ES range 0.02 to 0.42 ) . While most changes were not significant there was a consistent pattern of decline in scores for Relevance in the first workforce year ( ES -0.42 to -0.29 ) followed by an improvement in the second year ( ES + 0.27 ) . Scores in Terminology improved ( ES + 0.19 to + 0.26 ) in each of the first two workforce years , while Practice scores declined ( ES -0.23 to -0.19 ) in the first year and improved minimally in the second year ( ES + 0.04 ) . Confidence scores improved during the second workforce year ( ES + 0.27 ) . Scores for Sympathy showed little change . Conclusions During the first two years in the workforce , there was a transitory decline in the self-reported practice and sense of relevance of EBP , despite increases in confidence and knowledge . The pattern of progression of EBP skills beyond these early professional working years is unknown RATIONALE The concept of evidence -based practice ( EBP ) encourages health care professionals to provide the most effective health care , and to be accountable for the interventions they provide . Little work has been undertaken to examine how practically allied health professionals ' encompass EBP and how they perceptive and underst and the concept of EBP . The use of opinion leaders to disseminate new evidence into practice , and thereby encourage the behaviour of health care professionals has been proposed . AIMS The aims of this study were to investigate physiotherapists ' attitudes towards EBP and to examine change in their attitudes following an education package , which utilized local opinion leaders . METHOD Thirty musculoskeletal physiotherapists from a Community Trust in North Staffordshire were cluster r and omized by location of work to two groups . The intervention group received an evidence -based programme on aspects of EBP including literature search ing and critical appraisal . The attention control group received a st and ard in-service training package on the management of common knee pathologies . The physiotherapists ' attitudes towards EBP were measured at baseline ( before r and omization ) and at 3 and 6 months follow-up . RESULTS Physiotherapists reported that they primarily relied on ' courses ' and ' in-service training ' for informing their clinical practice . Most agreed that clinical practice should be based on the best available evidence and that they would change their clinical practice if evidence suggested they should do so . However , many of the physiotherapists reported difficulty in reading journals and could not identify opinion leaders in key areas . In terms of clinical practice , literature , journals and research were ascribed low priority throughout . Differences in attitudes between the intervention and control groups were observed in relation to management support for EBP at 3 and 6 months follow-up . CONCLUSIONS In this study , physiotherapists appeared to be in favour of the idea of EBP , yet they remained reluctant to change their practice . Opinion leaders were not easily identifiable by physiotherapists , suggesting that this method alone may not be an effective method of changing attitudes in clinical practice . The process of changing attitudes in the clinical environment is a complex issue worthy of further research The emphasis of UK Government policy on primary -care-based services has led to more physiotherapists working in the community . The aims of the present study were to identify the perceived professional , educational and personal needs of community physiotherapists , and to determine good practice in meeting these needs . A survey of physiotherapists working in 15 National Health Service community trusts in the West Midl and s was carried out in September 2000 . The survey question naire was developed through focus groups and mailed to a r and om sample of 200 community physiotherapists . The response rate was 67 % , and the median age group of the respondents was 21 - 30 years . The participants worked mainly in ' urban but not inner city ' areas , most commonly in domiciliary ( 31 % , n = 38 ) and general practitioner surgery/health centre ( 26 % , n = 32 ) locations . Fifty-one per cent ( n = 66 ) of respondents had no specific learning objectives for continuing professional development ( CPD ) ; those with such objectives were more positive as to their helpfulness than those without them ( Mann-Whitney U-test z = 2.519 , P = 0.012 ) . Fifty-three per cent ( n = 68 ) also often/very often found it problematic getting cover for their caseloads so that they could take part in CPD activities . Access to library re sources and use of computers were problems , as were confidence in appraising literature and opportunities to discuss research evidence with colleagues . Fifty-nine per cent ( n = 77 ) of respondents indicated that they often/very often felt stressed by the size of their caseloads . Colleague support included mentorship , peer review , journal clubs , clinical interest groups and multidisciplinary in-service training ; respondents with experience of these re sources expressed more positive attitudes to them than those without ( Mann-Whitney U-test z = 2.871 , P < 0.0005 for each ) . Forty-two per cent ( n = 54 ) indicated that there were problems with safety issues . This study has identified needs that will have an impact on the ability of community physiotherapists to meet the dem and s of clinical governance . National Health Service management at all levels has a responsibility to facilitate the education , training and support of community physiotherapists BACKGROUND AND PURPOSE Little research has been done regarding the attitudes and behaviors of physical therapists relative to the use of evidence in practice . The purpose s of this study were to describe the beliefs , attitudes , knowledge , and behaviors of physical therapist members of the American Physical Therapy Association ( APTA ) as they relate to evidence -based practice ( EBP ) and to generate hypotheses about the relationship between these attributes and personal and practice characteristics of the respondents . METHODS A survey of a r and om sample of physical therapist members of APTA result ed in a 48.8 % return rate and a sample of 488 that was fairly representative of the national membership . Participants completed a question naire design ed to determine beliefs , attitudes , knowledge , and behaviors regarding EBP , as well as demographic information about themselves and their practice setting s. Responses were summarized for each item , and logistic regression analyses were used to examine relationships among variables . RESULTS Respondents agreed that the use of evidence in practice was necessary , that the literature was helpful in their practice s , and that quality of patient care was better when evidence was used . Training , familiarity with and confidence in search strategies , use of data bases , and critical appraisal tended to be associated with younger therapists with fewer years since they were licensed . Seventeen percent of the respondents stated they read fewer than 2 articles in a typical month , and one quarter of the respondents stated they used literature in their clinical decision making less than twice per month . The majority of the respondents had access to online information , although more had access at home than at work . According to the respondents , the primary barrier to implementing EBP was lack of time . DISCUSSION AND CONCLUSION Physical therapists stated they had a positive attitude about EBP and were interested in learning or improving the skills necessary to implement EBP . They noted that they needed to increase the use of evidence in their daily practice OBJECTIVE To measure the impact of a state health department policy to provide allied health professional staff with access to a point-of-care , 24h , online evidence system in terms of awareness , use and clinical impact of the system on clinical practice ; to identify perceived barriers to use , and differences in measures between seven professional groups ( physiotherapists , occupational therapists , speech pathologists , dieticians , clinical psychologists , pharmacists and social workers ) . METHOD A convenience sample of 790 allied health professionals from 65 r and omly selected hospitals in New South Wales , Australia . A self-administered question naire was distributed . Rates of use , frequency and types of re sources accessed were calculated . Comparisons between professional groups were undertaken using Chi-square analyses and t-tests . RESULTS The results showed that 82 % of allied health professionals had heard of the online evidence system  , and of those 76 % had used it . Pharmacists had the highest rates of use and social workers the lowest . Of users , 90 % agreed that use of the system had the potential to improve patient care and 45 % reported direct experience of this . Computer skills and easy access were significantly associated with use and frequency of use . Among non-users , lack of specific training in the use of the online evidence system and 
    Output:
    
agent
RESULTS Many physiotherapists hold positive attitudes towards EBP .
However , this does not necessarily translate into consistent , high- quality EBP .
Many barriers to EBP implementation are apparent , including : lack of time and skills , and misperceptions of EBP .
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND AND PURPOSE Physiotherapists ' use of research evidence with clinical decision-making has interested research ers world-wide since 1980 ; however , little is known about such practice s in Australia . The present survey sought information on Australian physiotherapists ' perceptions of the importance of research , and barriers to uptake of evidence in clinical practice , when compared with an international cohort from 2001 . METHOD An Australian-relevant version of an English ( UK ) National Health Service ( NHS ) survey instrument was used to canvass 453 physiotherapists , r and omly selected from the South Australian Physiotherapy Registration Board 2004 - 2005 records . The first survey was mailed in August 2005 , a reminder was sent two weeks later to non-responders and a follow-up survey was sent in April 2006 to non-responders whose addresses had changed since 2005 . RESULTS There was a 51 % response rate . Of the non-responders , 12 % were not contactable at their listed address , highlighting the mobility of Australian physiotherapists . Most respondents had undertaken research as students ( 59.5 % ) or as students and clinicians ( 11.5 % ) . Of these , 37.1 % were encouraged to embark on more research , and 20.5 % were discouraged . The significant predictors of positive perceived importance of research were : previous research experience ; being positive about undertaking further research ; working in hospitals and holding a postgraduate degree . Clinicians working privately were significantly less likely than managers to be positive about research importance . The only significant predictor for not perceiving barriers to uptake of evidence was being positive about undertaking future research . CONCLUSIONS The study identified constraints on uptake of evidence into practice that were related to accessing , reading and interpreting published research , and implementing findings . Found consistently across employment categories were barriers relating to lack of time , uncertainty about what the research reported , scepticism about the value of research and being isolated from peer support and literature sources . The responses indicated a positive shift towards evidence uptake since the 2001 NHS survey , suggesting an influence of increased exposure to information on evidence -based practice . A greater focus on research whilst training , the application of educational strategies for empowerment , better knowledge transfer and upskilling within the workplace , and ensuring dedicated time and organizational support for research activities are indicated Background Many authors , as well as the American Physical Therapy Association , advocate that physical therapists adopt practice patterns based on research evidence , known as evidence -based practice ( EBP ) . At the same time , physical therapists should be capable of integrating EBP within the day-to-day practice of physical therapy . The purpose of this study was to determine the extent to which personal characteristics and the characteristics of the social system in the workplace influence the propensity of physical therapists to adopt EBP . Methods The study used a 69 item mailed self-completion question naire . The question naire had four major sections . The first three sections were each drawn from a different theoretical framework and from different authors ' work . The instrument was developed to capture the propensity of physical therapists to adopt EBP , characteristics of the social system in the workplace of physical therapists , personal characteristics of physical therapists , and selected demographic variables of physical therapists . The eligible population consisted of 3,897 physical therapists licensed by the state of Georgia in the United States of America . A r and om sample of 1320 potential participants was drawn . Results 939 question naires were returned for a response rate of 73 % . 831 of the participants ' question naires were useable and became the basis for the study . There was a moderate association between desire for learning ( r = .36 , r2 = .13 ) , highest degree held ( r = .29 , r2 = .08 ) , practicality ( r = .27 , r2 = .07 ) and nonconformity ( r = .24 , r2 = .06 ) and the propensity to adopt EBP .  A negative correlation was found between age , years licensed and percentage of time in direct patient care . The findings demonstrated that the best three variables for predicting the propensity to adopt EBP  in physical therapy were : desire for learning , highest degree held , and practicality . Conclusion The study confirms there is no single factor to facilitate research evidence into day-to-day practice . Multiple practice change strategies will be needed to facilitate change in practice Background Training in the five steps of evidence -based practice ( EBP ) has been recommended for inclusion in entry-level health professional training . The effectiveness of EBP education has been explored predominantly in the medical and nursing professions and more commonly in post-graduate than entry-level students . Few studies have investigated longitudinal changes in EBP attitudes and behaviours . This study aim ed to assess the changes in EBP knowledge , attitudes and behaviours in entry-level physiotherapy students transitioning into the workforce . Methods A prospect i ve , observational , longitudinal design was used , with two cohorts . From 2008 , 29 participants were tested in their final year in a physiotherapy program , and after the first and second workforce years . From 2009 , 76 participants were tested in their final entry-level and first workforce years . Participants completed an Evidence -Based Practice Profile question naire ( EBP2 ) , which includes self-report EBP domains [ Relevance , Terminology ( knowledge of EBP concepts ) , Confidence , Practice ( EBP implementation ) , Sympathy ( disposition towards EBP ) ] . Mixed model analysis with sequential Bonferroni adjustment was used to analyse the matched data . Effect sizes ( ES ) ( 95 % CI ) were calculated for all changes . Results Effect sizes of the changes in EBP domains were small ( ES range 0.02 to 0.42 ) . While most changes were not significant there was a consistent pattern of decline in scores for Relevance in the first workforce year ( ES -0.42 to -0.29 ) followed by an improvement in the second year ( ES + 0.27 ) . Scores in Terminology improved ( ES + 0.19 to + 0.26 ) in each of the first two workforce years , while Practice scores declined ( ES -0.23 to -0.19 ) in the first year and improved minimally in the second year ( ES + 0.04 ) . Confidence scores improved during the second workforce year ( ES + 0.27 ) . Scores for Sympathy showed little change . Conclusions During the first two years in the workforce , there was a transitory decline in the self-reported practice and sense of relevance of EBP , despite increases in confidence and knowledge . The pattern of progression of EBP skills beyond these early professional working years is unknown RATIONALE The concept of evidence -based practice ( EBP ) encourages health care professionals to provide the most effective health care , and to be accountable for the interventions they provide . Little work has been undertaken to examine how practically allied health professionals ' encompass EBP and how they perceptive and underst and the concept of EBP . The use of opinion leaders to disseminate new evidence into practice , and thereby encourage the behaviour of health care professionals has been proposed . AIMS The aims of this study were to investigate physiotherapists ' attitudes towards EBP and to examine change in their attitudes following an education package , which utilized local opinion leaders . METHOD Thirty musculoskeletal physiotherapists from a Community Trust in North Staffordshire were cluster r and omized by location of work to two groups . The intervention group received an evidence -based programme on aspects of EBP including literature search ing and critical appraisal . The attention control group received a st and ard in-service training package on the management of common knee pathologies . The physiotherapists ' attitudes towards EBP were measured at baseline ( before r and omization ) and at 3 and 6 months follow-up . RESULTS Physiotherapists reported that they primarily relied on ' courses ' and ' in-service training ' for informing their clinical practice . Most agreed that clinical practice should be based on the best available evidence and that they would change their clinical practice if evidence suggested they should do so . However , many of the physiotherapists reported difficulty in reading journals and could not identify opinion leaders in key areas . In terms of clinical practice , literature , journals and research were ascribed low priority throughout . Differences in attitudes between the intervention and control groups were observed in relation to management support for EBP at 3 and 6 months follow-up . CONCLUSIONS In this study , physiotherapists appeared to be in favour of the idea of EBP , yet they remained reluctant to change their practice . Opinion leaders were not easily identifiable by physiotherapists , suggesting that this method alone may not be an effective method of changing attitudes in clinical practice . The process of changing attitudes in the clinical environment is a complex issue worthy of further research The emphasis of UK Government policy on primary -care-based services has led to more physiotherapists working in the community . The aims of the present study were to identify the perceived professional , educational and personal needs of community physiotherapists , and to determine good practice in meeting these needs . A survey of physiotherapists working in 15 National Health Service community trusts in the West Midl and s was carried out in September 2000 . The survey question naire was developed through focus groups and mailed to a r and om sample of 200 community physiotherapists . The response rate was 67 % , and the median age group of the respondents was 21 - 30 years . The participants worked mainly in ' urban but not inner city ' areas , most commonly in domiciliary ( 31 % , n = 38 ) and general practitioner surgery/health centre ( 26 % , n = 32 ) locations . Fifty-one per cent ( n = 66 ) of respondents had no specific learning objectives for continuing professional development ( CPD ) ; those with such objectives were more positive as to their helpfulness than those without them ( Mann-Whitney U-test z = 2.519 , P = 0.012 ) . Fifty-three per cent ( n = 68 ) also often/very often found it problematic getting cover for their caseloads so that they could take part in CPD activities . Access to library re sources and use of computers were problems , as were confidence in appraising literature and opportunities to discuss research evidence with colleagues . Fifty-nine per cent ( n = 77 ) of respondents indicated that they often/very often felt stressed by the size of their caseloads . Colleague support included mentorship , peer review , journal clubs , clinical interest groups and multidisciplinary in-service training ; respondents with experience of these re sources expressed more positive attitudes to them than those without ( Mann-Whitney U-test z = 2.871 , P < 0.0005 for each ) . Forty-two per cent ( n = 54 ) indicated that there were problems with safety issues . This study has identified needs that will have an impact on the ability of community physiotherapists to meet the dem and s of clinical governance . National Health Service management at all levels has a responsibility to facilitate the education , training and support of community physiotherapists BACKGROUND AND PURPOSE Little research has been done regarding the attitudes and behaviors of physical therapists relative to the use of evidence in practice . The purpose s of this study were to describe the beliefs , attitudes , knowledge , and behaviors of physical therapist members of the American Physical Therapy Association ( APTA ) as they relate to evidence -based practice ( EBP ) and to generate hypotheses about the relationship between these attributes and personal and practice characteristics of the respondents . METHODS A survey of a r and om sample of physical therapist members of APTA result ed in a 48.8 % return rate and a sample of 488 that was fairly representative of the national membership . Participants completed a question naire design ed to determine beliefs , attitudes , knowledge , and behaviors regarding EBP , as well as demographic information about themselves and their practice setting s. Responses were summarized for each item , and logistic regression analyses were used to examine relationships among variables . RESULTS Respondents agreed that the use of evidence in practice was necessary , that the literature was helpful in their practice s , and that quality of patient care was better when evidence was used . Training , familiarity with and confidence in search strategies , use of data bases , and critical appraisal tended to be associated with younger therapists with fewer years since they were licensed . Seventeen percent of the respondents stated they read fewer than 2 articles in a typical month , and one quarter of the respondents stated they used literature in their clinical decision making less than twice per month . The majority of the respondents had access to online information , although more had access at home than at work . According to the respondents , the primary barrier to implementing EBP was lack of time . DISCUSSION AND CONCLUSION Physical therapists stated they had a positive attitude about EBP and were interested in learning or improving the skills necessary to implement EBP . They noted that they needed to increase the use of evidence in their daily practice OBJECTIVE To measure the impact of a state health department policy to provide allied health professional staff with access to a point-of-care , 24h , online evidence system in terms of awareness , use and clinical impact of the system on clinical practice ; to identify perceived barriers to use , and differences in measures between seven professional groups ( physiotherapists , occupational therapists , speech pathologists , dieticians , clinical psychologists , pharmacists and social workers ) . METHOD A convenience sample of 790 allied health professionals from 65 r and omly selected hospitals in New South Wales , Australia . A self-administered question naire was distributed . Rates of use , frequency and types of re sources accessed were calculated . Comparisons between professional groups were undertaken using Chi-square analyses and t-tests . RESULTS The results showed that 82 % of allied health professionals had heard of the online evidence system  , and of those 76 % had used it . Pharmacists had the highest rates of use and social workers the lowest . Of users , 90 % agreed that use of the system had the potential to improve patient care and 45 % reported direct experience of this . Computer skills and easy access were significantly associated with use and frequency of use . Among non-users , lack of specific training in the use of the online evidence system and 
    Output:
    